Search

Natural pollination of species belonging to the pantropical orchid genus Vanilla remains poorly understood. Based on sporadic records, euglossine bees have been observed visiting flowers of Neotropical Vanilla species. Our research aimed at better understanding the pollinator attraction mechanism of the Neotropical species Vanilla pompona, a crop wild relative with valuable traits for vanilla crop improvement programs. Using video footage, we identified floral visitors and examined their behavior. The flowers of V. pompona attracted Eulaema cingulata males, which distinctively displayed two behaviors: floral scent collection and nectar search; with the latter leading to pollen removal. Morphological measurements of floral and visitor traits showed that other Eulaema species may also act as potential pollinators. Additionally, we recorded natural fruit set in three populations and over a period of two years, tested for nectar presence and analyzed floral fragrances through gas chromatography - mass spectrometry. We observed a low natural fruit set (2.42%) and did not detect nectar. Twenty floral volatile compounds were identified, with the dominant compound trans-carvone oxide previously found to attract Eulaema cingulata males. We hypothesize a dual attraction of Eulaema cingulata males to V. pompona flowers, based on floral fragrance reward as the primary long-distance attraction, and food deception for successful pollen removal. Further research confirming this hypothesis is recommended to develop appropriate conservation policies for Vanilla crop wild relatives, which are the primary reserves of this crops genetic variation.

Background: Cancer patients experience multiple symptoms throughout the course of the disease. We aimed to provide a comprehensive analysis of the symptom burden in patients with advanced cancer at admission to specialist palliative care (PC) services and seven days later to estimate the immediate impact of PC intervention. Patient and methods: The analysis was based on an observational, prospective, multicenter study (named DEMETRA) conducted in Italy on new patients accessing network specialist PC centers during the period May 2017&ndash, November 2017. The prevalence and intensity of symptoms were assessed at baseline and after seven days using three tools including the Edmonton Symptom Assessment System (ESAS). Results: Five PC centers recruited 865 cancer patients. Thirty-three different symptoms were observed at the baseline, the most frequent being asthenia (84.9%) and poor well-being (71%). The intensity of the most frequent symptoms according to ESAS ranged from 5.5 for asthenia to 3.9 for nausea. The presence and intensity of physical symptoms increased with increasing levels of anxiety and depression. After seven days, prevalence of nausea and breathlessness as well as intensity of almost all symptoms significantly decreased. Conclusions: The study confirmed the considerable symptom burden of patients with advanced cancer. PC intervention has significantly reduced the severity of symptoms, despite the patients&rsquo, advanced disease and short survival.

The possibility of coming to a “good death” is a challenging issue that crosses ethical and religious beliefs, cultural assumptions, as well as medical expertise. The provision of palliative care for relieving patients’ pain is a practice that reshapes the path to the event of death and gives form to a particular context of awareness, recalling the notion proposed by Glaser and Strauss. This decision redesigns the relationships between patients, practitioners and caregivers and introduces a new pattern of collaboration between them. Our study focuses on the implications of the collaboration between practitioners and caregivers, starting from the assumption that the latter may provide support to their loved ones and to the practitioners, but need to be supported too. We provide a qualitative analysis of this collaboration based on an empirical research that took place in four different settings of provision of palliative care, reporting the contrast between the affective engagement of caregivers and the professional approach of practitioners. We claim that this ambivalent collaboration, while embedded in contingent and incommensurable experiences, brings to the fore the broader understanding of the path to a “good death,” outlining its societal representation as a collective challenge.

The sudden worldwide outbreak of Coronavirus Disease 2019 (COVID-19) has certainly provided new challenges in the management of acute ischaemic stroke, and the risk-benefit ratio of intravenous thrombolysis in COVID-19 positive patients is not well known. We describe four COVID-19 patients treated with intravenous thrombolysis for acute ischaemic stroke. Although rt-PA administration is the main therapeutic strategy, our patients experienced unpredictable complications and showed atypical features: the overall mortality was very high. In conclusion, in this article, we provide information about these cases and discuss the possible explanation behind this trend.

Substrate engineering for steering cell growth is a wide and well-established area of research in the field of modern biotechnology. Here we introduce a micromachining technique to pattern an inert, transparent polymer matrix blended with a photoactive polymer. We demonstrate that the obtained scaffold combines the capability to align with that to photostimulate living cells. This technology can open up new and promising applications, especially where cell alignment is required to trigger specific biological functions, e.g. generate powerful and efficient muscle contractions following an external stimulus., Comment: 30 pages, 7 images in main text, 5 images in supporting

Background Pediatric palliative care (PPC) addresses the physical and psychological needs of children suffering from life-limiting diseases. To define prevention and educational plans and to properly allocate resources, a precise estimation of the PPC burden is required. Objectives To estimate the current number of children requiring PPC in Italy, useful to assist policy-makers and healthcare bodies in the organization and allocation of PPC resources. Methods Literature data, The Global Atlas of Palliative Care at the End of Life and Italian national databases have been consulted. Results According to our estimation, at present, a total of 20,540–32,864 children in Italy require PPC (34–54 children/100,000 inhabitants) of whom 18 children/100,000 inhabitants require specialized PPC. Conclusions The present work is a fundamental tool to be used by the institutions, the local networks of PPC and the health programmers when formulating organizational models and care plans consistent with the actual need for PPC.

ObjectivesThe aim of this work is to describe the multidisciplinary model of intervention applied and the characteristics of some COVID-19 patients assisted by the hospital palliative care unit (UCP-H) of an Italian hospital in Lombardy, the Italian region most affected by the COVID-19 pandemic.MethodsA retrospective study was conducted on patients admitted to the A. Manzoni Hospital (Lecco, Lombardy Region, Italy) and referred to the UCP-H between 11 March 2020 and 18 April 2020, the period of maximum spread of COVID-19 in this area. Data were collected on the type of hospitalisation, triage process, modality of palliative care and psychological support provided.Results146 COVID-10 patients were referred to the UCP-H. Of these, 120 died during the observation time (82%) while 15 (10.2%) improved and were discharged from the UCP-H care. 93 had less favourable characteristics (rapid deterioration of respiratory function, old age, multiple comorbidities) and an intensive clinical approach was considered contraindicated, while 48 patients had more favourable presentations. Mean follow-up was 4.8 days. A mean of 4.3 assessments per patient were performed. As to respiratory support, 94 patients were treated with oxygen only (at different volumes) and 45 with Continuous Positive Airway Pressure (CPAP).ConclusionThe ongoing pandemic highlighted the need for dedicated palliative care teams and units for dying patients. This work highlights how palliative medicine specialist can make a fundamental contribution thanks to their ability and work experience in an organised multiprofessional context.

Background: Dependency in older ages is increasing. Many older persons receive care while living in the community. We aimed to identify the predictive value of four clinical measurements to predict home care intensity in older patients following discharge from hospital to home care over 90days. Methods: We included 425 inpatients from the “Frailty Department–Local Palliative Care Network” of the local social health authority (ASST) Lecco, Italy (mean age 75.4years, SD 14.5; female 75.5%). Changes in Health, End-stage disease, and Signs and Symptoms, light version (CHESS-Lite), activities of daily living (ADL), frailty, and the Service Urgency Algorithm. Receiver operative curves were used to calculate thearea under the curve (AUC) for predicting Home Care Intensity coefficient (ratio of the number of days when any home care was provided 90days post-discharge). The interRAI Contact Assessment Instrument was used to calculate these measures. Results: Analysis was stratified using six different home care intensity score cut-offs. CHESS-Lite had a higher AUC for predicting home care intensity at all cut-off levels but was best for predicting the highest level of home care intensity (≥ 0.8) where the AUC was 0.71 (0.64–0.79). The frailty index also had an acceptable AUC. ADL had the lowest AUC. Conclusions: Health instability measured with CHESS-Lite has a high predictive value for identifying home care intensity in geriatric patients after discharge from hospital to home, especially in persons with higher home care intensity scores. Geriatric patients with high health instability should be focused on at discharge to prioritize assessment and initiate timely services for home care support.

Natural pollination of species belonging to the pantropical orchid genusVanillaremains poorly understood. Based on sporadic records, euglossine bees have been observed visiting flowers of NeotropicalVanillaspecies. Our research aimed at better understanding the pollinator attraction mechanism of the Neotropical speciesVanilla pompona, a crop wild relative with valuable traits for vanilla crop improvement programs. Using video footage, we identified floral visitors and examined their behavior. The flowers ofV. pomponaattractedEulaema cingulatamales, which distinctively displayed two behaviors: floral scent collection and nectar search; with the latter leading to pollen removal. Morphological measurements of floral and visitor traits showed that otherEulaemaspecies may also act as potential pollinators. Additionally, we recorded natural fruit set in three populations and over a period of two years, tested for nectar presence and analyzed floral fragrances through gas chromatography - mass spectrometry. We observed a low natural fruit set (2.42%) and did not detect nectar. Twenty floral volatile compounds were identified, with the dominant compound trans-carvone oxide previously found to attractEulaema cingulatamales. We hypothesize a dual attraction ofEulaema cingulatamales toV. pomponaflowers, based on floral fragrance reward as the primary long-distance attraction, and food deception for successful pollen removal. Further research confirming this hypothesis is recommended to develop appropriate conservation policies forVanillacrop wild relatives, which are the primary reserves of this crop’s genetic variation.

Background and Aims Colour pattern is a key cue of bee attraction selectively driving the appeal of pollinators. It comprises the main colour of the flower with extra fine patterns, indicating a reward focal point such as nectar, nectaries, pollen, stamens and floral guides. Such advertising of floral traits guides visitation by the insects, ensuring precision in pollen gathering and deposition. The study, focused in the Southwest Australian Floristic Region, aimed to spot bee colour patterns that are usual and unusual, missing, accomplished by mimicry of pollen and anthers, and overlapping between mimic-model species in floral mimicry cases. Methods Floral colour patterns were examined by false colour photography in 55 flower species of multiple highly diverse natural plant communities in south-west Australia. False colour photography is a method to transform a UV photograph and a colour photograph into a false colour photograph based on the trichromatic vision of bees. This method is particularly effective for rapid screening of large numbers of flowers for the presence of fine-scale bee-sensitive structures and surface roughness that are not detectable using standard spectrophotometry. Key Results Bee- and bird-pollinated flowers showed the expected but also some remarkable and unusual previously undetected floral colour pattern syndromes. Typical colour patterns include cases of pollen and flower mimicry and UV-absorbing targets. Among the atypical floral colour patterns are unusual white and UV-reflecting flowers of bee-pollinated plants, bicoloured floral guides, consistently occurring in Fabaceae spp., and flowers displaying a selective attractiveness to birds only. In the orchid genera (Diuris and Thelymitra) that employ floral mimicry of model species, we revealed a surprising mimicry phenomenon of anthers mimicked in turn by model species. Conclusion The study demonstrates the applicability of ‘bee view’ colour imaging for deciphering pollinator cues in a biodiverse flora with potential to be applied to other eco regions. The technique provides an exciting opportunity for indexing floral traits on a biome scale to establish pollination drivers of ecological and evolutionary relevance.

Many workers are exposed to foot-transmitted vibration, which can lead to the development of vibration-induced white foot: a debilitating condition with neurological, vascular and osteoarticular symptoms. To design effective prevention mechanisms (i.e., boots and insoles) for isolating workers from vibration exposure, continued model development of the foot’s biodynamic response in different positions is necessary. This study uses a previously developed model of the foot–ankle system (FAS) to investigates how altering the center of pressure (COP) location can change the biodynamic response of the FAS to standing vibration exposure. Formerly published experimental responses for apparent mass and transmissibility at five anatomical locations in three COP positions were used to optimize the model. Differences occurred with the Kelvin–Voigt elements used to represent the soft tissues of the foot sole: at the heel, the distal head of the metatarsals and distal phalanges. The stiffness increased wherever the COP was concentrated (i.e., forward over the toes or backward over the heel). The variability of the model parameters was always greatest when the COP was concentrated in the heel. This suggests future FAS models need to more clearly address how the soft tissue of the plantar fat pad is modelled.

In order to plan the right palliative care for patients and their families, it is essential to have detailed information about patients&rsquo, needs. To gain insight into these needs, we analyzed five Italian local palliative care networks and assessed the clinical care conditions of patients facing the complexities of advanced and chronic disease. A longitudinal, observational, noninterventional study was carried out in five Italian regions from May 2017 to November 2018. Patients who accessed the palliative care networks were monitored for 12 months. Sociodemographic, clinical, and symptom information was collected with several tools, including the Necesidades Paliativas CCOMS-ICO (NECPAL) tool, the Edmonton Symptom Assessment System (ESAS), and interRAI Palliative Care (interRAI-PC). There were 1013 patients in the study. The majority (51.7%) were recruited at home palliative care units. Cancer was the most frequent diagnosis (85.4%), and most patients had at least one comorbidity (58.8%). Cancer patients reported emotional stress with severe symptoms (38.7% vs. 24.3% in noncancer patients, p = 0.001) and were less likely to have clinical frailty (13.3% vs. 43.9%, p &lt, 0.001). Our study confirms that many patients face the last few months of life with comorbidities or extreme frailty. This study contributes to increasing the general knowledge on palliative care needs in a high-income country.

Objective: The aim of this study was to illustrate the characteristics of patients with palliative care (PC) needs, early identified by general practitioners (GPS), and to analyze their care process in home PC services. Background: Early identification and service integration are key components to providing quality palliative care (PC) services ensuring the best possible service for patients and their families. However, in Italy, PC is often provided only in the last phase of life and for oncological patients, with a fragmented service. Methods: Multicenter prospective observational study, lasting in total 18 months, implemented in a sample of Italian Home Palliative Care Units (HPCUs), enrolling and monitoring patients with limited life expectancy, early identified by 94 GPS. The study began on March 1, 2014 and ended on August 31, 2015. Results: Nine hundred thirty-seven patients, out of a total pool of 139,071, were identified by GPS as having a low life expectancy and PC needs. Of these, 556 (59.3%) were nononcological patients. The GPS sent 433 patients to the HPCUs for multidimensional assessment, and 328 (75.8%) were placed in the care of both settings (basic or specialist). For all patients included in the study, both oncological and nononcological patients, there was a high rate of death at home, around 70%. Discussion: This study highlights how a model based on early identification, multidimensional evaluation, and integration of services can promote adequate PC, also for noncancer patients, with a population-based approach.

Background: In Italy, there currently is a lack of reliable and consistent data on home palliative care provided to people near death. Objectives: Monitoring the activities of the Italian Home Palliative Care Services, according to the 2014 national data collection program entitled &ldquo, Observatory of Best Practices in Palliative Care&rdquo, and providing process/outcome measures on a subsample (Best Practice Panel), on regulatory standards and on complete/reliable activity data. Design: A data collection web portal using two voluntary internet-based questionnaires in order to retrospectively identify the main care activity data provided within the year 2013 by Home care units. In the Best Practice Panel and International best practices, eligibility and quality measures refer to the national standards of the NL 38/2010. Setting/Subject: Home Palliative Care Services (HPCSs) that provided care from January to December 2013. Results: 118 Home care units were monitored, globally accounting for 40,955 assisted patients within the year 2013 (38,384 cancer patients), 56 (47.5% of 118) were admitted in the Best Practice Panel. Non-cancer (5%) and pediatric (0.4%) patients represented negligible percentages of frail care patients, and a majority of patients died at home (respectively nearly 75% and 80% of cancer and non-cancer patients). Conclusion: The study demonstrated the feasibility of the collection of certified data from Home care services through a web-based system. Only 80% of the facilities met the requirements provided by the Italian NL 38/2010. Moreover, the extension of the palliative care services provided to frail non-cancer and pediatric patients, affected by complex and advanced chronic conditions, is still inadequate in Italy.

Organic mixed conductors find use in batteries, bioelectronics technologies, neuromorphic computing, and sensing. While great progress has been achieved, polymer-based mixed conductors frequently experience significant volumetric changes during ion uptake/rejection, i.e., during doping/de-doping and charging/discharging. Although ion dynamics may be enhanced in expanded networks, these volumetric changes can have undesirable consequences, e.g., negatively affecting hole/electron conduction and severely shortening device lifetime. Here, the authors present a new material poly[3-(6-hydroxy)hexylthiophene] (P3HHT) that is able to transport ions and electrons/holes, as tested in electrochemical absorption spectroscopy and organic electrochemical transistors, and that exhibits low swelling, attributed to the hydroxylated alkyl side-chain functionalization. P3HHT displays a thickness change upon passive swelling of only +2.5%, compared to +90% observed for the ubiquitous poly(3,4-ethylenedioxythiophene):polystyrene sulfonate, and +10 to +15% for polymers such as poly(2-(3,3'-bis(2-(2-(2-methoxyethoxy)ethoxy)ethoxy)-[2,2'-bithiophen]-5-yl)thieno[3,2-b]thiophene) (p[g2T-TT]). Applying a bias pulse during swelling, this discrepancy becomes even more pronounced, with the thickness of P3HHT films changing by10% while that of p(g2T-TT) structures increases by +75 to +80%. Importantly, the initial P3HHT film thickness is essentially restored after de-doping while p(g2T-TT) remains substantially swollen. The authors, thus, expand the materials-design toolbox for the creation of low-swelling soft mixed conductors with tailored properties and applications in bioelectronics and beyond.

Background: Cancer patients experience a number of symptoms throughout the course of the disease. We aimed to provide a comprehensive analysis of the symptom burden in patients with advanced cancer at admission to specialist palliative care (PC) services and seven days later, to estimate the immediate impact of PC intervention.Patient and methods: The analysis was based on an observational, prospective, multicenter study (named DEMETRA) conducted in Italy to outline the profile of patients, families and PC services in different care settings (hospital, hospice and home care). The prevalence and intensity of symptoms were assessed using three tools, including the Edmonton Symptom Assessment System (ESAS).Results: Five PC centers recruited 865 cancer patients. Thirty-three different symptoms were observed at baseline, the most frequent being asthenia (85%) and lack of appetite (71%). Two-thirds of patients experienced six to twelve simultaneous symptoms. The intensity of the most frequent symptoms according to ESAS varied from 5.5 for asthenia to 3.9 for nausea. The presence and intensity of physical symptoms increased with increasing levels of anxiety and depression. After seven days, prevalence decreased significantly only for nausea and breathlessness, while intensity diminished significantly for almost all symptoms. At admission we noted a correlation between patients' symptoms and the care setting. After one week, the symptom intensity was uniformly reduced in all settings.Conclusions: The study confirmed the considerable symptom burden of patients with advanced cancer. PC intervention significantly lessened the severity of symptoms, despite the patients’ advanced disease and short survival.

OBJECTIVES We evaluated a prospective cohort of 150 patients under observation in our centre for lacunar strokes. The purpose of this study was to evaluate the outcome at time of discharge and 6 months after lacunar stroke, as well as the correlation with cardiovascular risk factors and selected biochemical parameters already evaluated on admission. Focus was to identify possible prognostic factors, which might be targeted through appropriate intervention concentrating on reduction in the incidence and impact of early clinical deterioration. METHODS 150 patients with a lacunar stroke were included in the present study. A clinical 6-month follow-up was available for 98.7% of the patients. Infarcts were classified by size, shape and location. RESULTS The most important predictors of high NIHSS score at time of discharge resulted NIHSS on admission (P

In this Letter, a detailed analysis of 30 4-aminoquinoline-based compounds with regard to their potential as antileishmanial drugs has been carried out. Ten compounds demonstrated IC50 lt 1 mu M against promastigote stages of L. infantum and L. tropica, and five compounds showed IC50 lt 1 mu M against intramacrophage L. infantum amastigotes. Two compounds showed dose-dependent enhancement of NO and ROS production by bone marrow-derived macrophages and remarkable reduction of parasite load in vivo, with advantage of being short-term and orally active. To the best of our knowledge, this is the first example of 4-amino-7-chloroquinoline derivatives active in Leishmania infantum infected mice. This is the peer-reviewed version of the following article: Konstantinović, J.; Videnović, M.; Orsini, S.; Bogojević, K.; D’Alessandro, S.; Scaccabarozzi, D.; Terzić Jovanović, N.; Gradoni, L.; Basilico, N.; Šolaja, B. A. Novel Aminoquinoline Derivatives Significantly Reduce Parasite Load in Leishmania Infantum Infected Mice. ACS Medicinal Chemistry Letters 2018, 9 (7), 629–634. [https://doi.org/10.1021/acsmedchemlett.8b00053] Sipplementary material: [http://cherry.chem.bg.ac.rs/handle/123456789/2949]

Background: Over one quarter of the health care expenditures is estimated to be spent for patients in the last year of life (LYL). For these patients, palliative care (PC) has been suggested as a response for improving the standards of care and reducing health costs. The aim of this study was to analyze a cohort of LYL people, in terms of comparing hospitalised patients who had been referred for PC to patients receiving usual care (UC). Methods: Retrospective study carried out on patients resident in Lecco (Italy) who died between 2012 and 2013. Records of patients were obtained from the Death certificate registry and cross-linked with Regional Healthcare Information System, Hospital Discharge Records and Palliative Care Registry . A total of 5830 patients were analyzed. Results: At least one hospitalization was reported by 2586 (44.3%) patients in the last month of life and 3957 (67.9%) patients in the last year of life. A total of 1114 (19.1%) patients were referred to palliative care with median duration of enrollment of 31 days (IQR = 11–69). PC was found to decrease the risk of hospital admission (adj-OR = 0.21; 95% CI = 0.18–0.26) and dying in hospital (adj-OR = 0.03; 95% CI = 0.02–0.04). Conclusions: Patients in the last year of life show a high risk of hospitalization, which represents a substantial component of health-care costs. Our study suggests that home PC consultation could represent an important public health strategy in order to lower hospital costs for LYL patients and reduce the probability of dying in hospital.

Background Pathogenesis of Ebola virus disease remains poorly understood. We used concomitant determination of routine laboratory biomarkers and Ebola viremia to explore the potential role of viral replication in specific organ damage. Methods We recruited patients with detectable Ebola viremia admitted to the EMERGENCY Organizzazione Non Governativa Organizzazione Non Lucrativa di Utilita Sociale (ONG ONLUS) Ebola Treatment Center in Sierra Leone. Repeated measure of Ebola viremia, alanine aminotransferase (ALT), aspartate aminotransferase (AST), bilirubin, creatine phosphokinase (CPK), lactate dehydrogenase (LDH), activated prothrombin time (aPTT), international normalized ratio (INR), creatinine, and blood urea nitrogen (BUN) were recorded. Patients were followed up from admission until death or discharge. Results One hundred patients (49 survivors and 51 nonsurvivors) were included in the analysis. Unadjusted analysis to compare survivors and nonsurvivors provided evidence that all biomarkers were significantly above the normal range and that the extent of these abnormalities was generally higher in nonsurvivors than in survivors. Multivariable mixed-effects models provided strong evidence for a biological gradient (suggestive of a direct role in organ damage) between the viremia levels and either ALT, AST, CPK LDH, aPTT, and INR. In contrast, no direct linear association was found between viremia and either creatinine, BUN, or bilirubin. Conclusions This study provides evidence to support that Ebola virus may have a direct role in muscular damage and imbalance of the coagulation system. We did not find strong evidence suggestive of a direct role of Ebola virus in kidney damage. The role of the virus in liver damage remains unclear, but our evidence suggests that acute severe liver injury is not a typical feature of Ebola virus disease.

We evaluated a prospective cohort of 150 patients under observation in our centre for lacunar strokes. The purpose of this study was to investigate if lacunar stroke of varying size, shape and locations had different risk factors between them and possibly different mechanisms and causes.150 patients with a lacunar stroke were included in the present study. Infarcts were classified by size, shape and location. We evaluated the correlation between several risk factors of stroke and the radiological characteristics of the infarcts.Older age was associated with the presence of a basal ganglia lesion (p0.001) and with the presence of a smaller lesion (trend to statistical significance, p = 0.07). Patients with infarcts15 mm had higher NIHSS score at admission (p 0.01).The different subtypes of lacunar infarcts have distinct pathogenesis. Further studies, with a larger numbers of patients, are necessary to confirm our data.

Among neglected tropical diseases, leishmaniasis is one of the most relevant with an estimated 30,000 deaths annually. Existing therapies have serious drawbacks in safety, drug resistance, field-adapted application and cost; therefore, new safer and shorter treatments are needed for this disease. Here we report on the synthesis of novel 4-amino-7-chloroquinoline-based compounds with leishmanicidal activity, together with deeper insight into the mechanism of action of our previously published hit compound 1. New derivatives showed comparable activity to 1 against both promastigote and intracellular amastigote forms of Leishmania infantum, with IC < 1 μM. Furthermore, we have determined that compound 1 induced a decrease of intracellular ATP levels, as well as a mitochondrial depolarization, together with an alteration of plasma membrane permeability and a significant ROS production. The inhibition of the energy metabolism of Leishmania plays an important role in the leishmanicidal mechanism of this compound. In all, these results support the consideration of compound 1 for the future development of new leishmanicidal drugs., This work was supported by the Ministry of Education, Science and Technological Development of Serbia Grant #172008 (JK, BS), Grant #173048 (AP), Serbian Academy of Sciences and Arts (BS, Grant #F80), Ministero dell’Istruzione, dell’Università e della Ricerca [PRIN 2015.4JRJPP_004] and University of Milan “Piano sostegno alla Ricerca, Linea 2 2018”, (NB) and the Spanish Ministerio de Ciencia, Innovación y Universidades Grant (RTI2018-097210-B-I00 to FG).

WOS: 000456314600046, An Italian certified Neemseed oil was characterized through the color analysis, the HPLC phenolic fingerprint and the preliminary evaluation of the cytotoxicity profile against the human macrophage (THP-1) cell line. Moreover, a wide screening of its enzyme inhibitory profile, antimicrobial activity towards Helicobacter pylori, several Candida spp. and Malassezia furfur strains and antiprotozoal activity against Plasmodium falciparum, Leishmania infantum and Leishmania tropica were performed. Neemseed oil demonstrated low toxicity and a great inhibitory efficacy against tyrosinase and lipase enzymes. Antimalarial and anti-leishmanial activities were also demonstrated, but weak or no activity was evidenced against Helicobacter pylori, Candida and Malassezia strains. Overall, these findings encourage the potential use of this natural product in some disease treatments and justify its use in traditional medicine. (c) 2018 SAAB. Published by Elsevier B.V. All rights reserved., G. d'Annunzio University of Chieti-Pescara (FAR 2017), This work was supported by local grants from "G. d'Annunzio" University of Chieti-Pescara (FAR 2017).

Background Systemic Lupus Erythematous is a systemic autoimmune disease with multiorgan inflammation. Clinical manifestations are variable and may involve the Central Nervous System. Acute transverse myelitis is a rare complication. Recent studies have shown an association between SLE, transverse myelitis and presence of anti-aquaporin 4 antibodies. Case presentation We describe the case of an 80-year-old woman with a subacute onset of right hemiplegia followed by left-sided ataxia. Cervical MRI revealed longitudinally extensive transverse myelitis. Blood examinations showed positivity for anti-nuclear antibodies, anti-double-stranded DNA antibodies, anti-phospholipid antibodies and anti-aquaporin 4 antibodies. Conclusions Anti-aquaporin 4 antibody testing is of paramount importance in order to reach a correct diagnosis and to treat patients with the best therapeutic approach.

The aims of this study were (i) to evaluate the clinical features of a consecutive series of young patients with ischemic stroke and (ii) to assess the changes in the clinical management of these patients over the study period. All consecutive cases of young adults aged 16 to 44 years, with ischemic stroke, that were admitted between 2000 and 2005 in 10 Italian hospitals were included. We retrospectively identified 324 patients. One or more vascular risk factors were present in 71.5% of the patients. With respect to the diagnostic process, an increase in the frequency of cerebral noninvasive angiographic studies and a decrease in the use of digital subtraction angiography were observed (P<0.001andP=0.03, resp.). Undetermined causes decreased over 5-year period of study (P<0.001). The diagnosis of cardioembolism increased. Thrombolysis was performed for 7.7% of the patients. PFO closure (8%) was the most frequently employed surgical procedure. In conclusion, the clinical care that is given to young patients with ischemic stroke changed over the study period. In particular, we detected an evolution in the diagnostic process and a reduction in the number of undetermined cases.

Background: Extracorporeal carbon dioxide removal has been proposed to achieve protective ventilation in patients at risk for ventilator-induced lung injury. In an acute study, the authors previously described an extracorporeal carbon dioxide removal technique enhanced by regional extracorporeal blood acidification. The current study evaluates efficacy and feasibility of such technology applied for 48 h. Methods: Ten pigs were connected to a low-flow veno-venous extracorporeal circuit (blood flow rate, 0.25 l/min) including a membrane lung. Blood acidification was achieved in eight pigs by continuous infusion of 2.5 mEq/min of lactic acid at the membrane lung inlet. The acid infusion was interrupted for 1 h at the 24 and 48 h. Two control pigs did not receive acidification. At baseline and every 8 h thereafter, the authors measured blood lactate, gases, chemistry, and the amount of carbon dioxide removed by the membrane lung (VCO2ML). The authors also measured erythrocyte metabolites and selected cytokines. Histological and metalloproteinases analyses were performed on selected organs. Results: Blood acidification consistently increased VCO2ML by 62 to 78%, from 79 ± 13 to 128 ± 22 ml/min at baseline, from 60 ± 8 to 101 ± 16 ml/min at 24 h, and from 54 ± 6 to 96 ± 16 ml/min at 48 h. During regional acidification, arterial pH decreased slightly (average reduction, 0.04), whereas arterial lactate remained lower than 4 mEq/l. No sign of organ and erythrocyte damage was recorded. Conclusion: Infusion of lactic acid at the membrane lung inlet consistently increased VCO2ML providing a safe removal of carbon dioxide from only 250 ml/min extracorporeal blood flow in amounts equivalent to 50% production of an adult man.

Following the identification of a case of severe clinical mastitis in a Saanen dairy goat (goat A), an average of 26 lactating goats in the herd was monitored over a period of 11 months. Milk microbiological analysis revealed the presence of Pseudomonas aeruginosa in 7 of the goats. Among these 7 does, only goat A showed clinical signs of mastitis. The 7 P. aeruginosa isolates from the goat milk and 26 P. aeruginosa isolates from environmental samples were clustered by RAPD-PCR and PFGE analyses in 3 genotypes (G1, G2, G3) and 4 clusters (A, B, C, D), respectively. PFGE clusters A and B correlated with the G1 genotype and included the 7 milk isolates. Although it was not possible to identify the infection source, these results strongly suggest a spreading of the infection from goat A. Clusters C and D overlapped with genotypes G2 and G3, respectively, and included only environmental isolates. The outcome of the antimicrobial susceptibility test performed on the isolates revealed 2 main patterns of multiple resistance to beta-lactam antibiotics and macrolides. Virulence related phenotypes were analyzed, such as swarming and swimming motility, production of biofilm and production of secreted virulence factors. The isolates had distinct phenotypic profiles, corresponding to genotypes G1, G2 and G3. Overall, correlation analysis showed a strong correlation between sampling source, RAPD genotype, PFGE clusters, and phenotypic clusters. The comparison of the levels of virulence related phenotypes did not indicate a higher pathogenic potential in the milk isolates as compared to the environmental isolates.

Context General practitioners (GPs) play a key role in the end-of-life care of patients; however, currently in Italy, there are no national population-based studies available of the knowledge and activities of GPs in palliative care. Objectives This survey aimed to investigate the knowledge, opinions, and activities of Italian GPs regarding palliative care. Methods A telephone survey of 1690 GPs was performed. Information was gathered through an ad hoc questionnaire. Results Valid interviews were obtained for 88% of the sampled GPs (n=1489). Regarding knowledge, 25% of GPs recognized a correct definition of palliative care, 41% the objectives of palliative care, 66% that palliative care should be provided by a multiprofessional team including GPs, and 60% that in-home care for patients at the end of life requires an individual plan care. Furthermore, 92% of them reported that "there is no maximum daily morphine dose for the management of pain." Regarding opinions, most of the GPs strongly agreed that for patients at the end of life, the GPs' duties included availability during working hours to break bad news to patients and families and to collaborate with the multiprofessional team in establishing an individual care plan. Finally, regarding activities, most GPs reported that, in their daily practice with patients at the end of life, they discontinue the drugs that are not beneficial to symptom management and seek advice from palliative care physicians when symptom management is ineffective. Conclusion This survey reveals the uncertainty of GPs regarding many theoretical issues but a strong willingness to integrate with the multiprofessional palliative care team. To further enhance the skills of GPs and facilitate the collaboration with palliative care services, it might be useful to realize ad hoc training schemes tailored to the different organizational procedures of in-home palliative care services.

Xenopus laevisoocytes are an interesting model for the study of many developmental mechanisms because of their dimensions and the ease with which they can be manipulated. In addition, they are widely employed systems for the expression and functional study of heterologous proteins, which can be expressed with high efficiency on their plasma membrane. Here we applied atomic force microscopy (AFM) to the study of the plasma membrane ofX. laevisoocytes. In particular, we developed and optimized a new sample preparation protocol, based on the purification of plasma membranes by ultracentrifugation on a sucrose gradient, to perform a high-resolution AFM imaging ofX. laevisoocyte plasma membrane in physiological-like conditions. Reproducible AFM topographs allowed visualization and dimensional characterization of membrane patches, whose height corresponds to a single lipid bilayer, as well as the presence of nanometer structures embedded in the plasma membrane and identified as native membrane proteins. The described method appears to be an applicable tool for performing high-resolution AFM imaging ofX. laevisoocyte plasma membrane in a physiological-like environment, thus opening promising perspectives for studyingin situcloned membrane proteins of relevant biomedical/pharmacological interest expressed in this biological system.

Puerperal metritis is a common disease in the first 3 weeks after calving in dairy cattle. Complicated par-turitions and retained placenta are factors facilitating contamination of the uterine lumen by environmental and opportunistic pathogens. Post-partum uterine in-fections are considered factors able to reduce animal welfare and fertility, causing economic losses and ear -ly animal elimination from the herd (Williams et al., 2007). The most common pathogens associated with metritis are

In the present study, we investigated DNA barcoding effectiveness to characterize honeybee pollen pellets, a food supplement largely used for human nutrition due to its therapeutic properties. We collected pollen pellets using modified beehives placed in three zones within an alpine protected area (Grigna Settentrionale Regional Park, Italy). A DNA barcoding reference database, including rbcL and trnH-psbA sequences from 693 plant species (104 sequenced in this study) was assembled. The database was used to identify pollen collected from the hives. Fifty-two plant species were identified at the molecular level. Results suggested rbcL alone could not distinguish among congeneric plants; however, psbA-trnH identified most of the pollen samples at the species level. Substantial variability in pollen composition was observed between the highest elevation locality (Alpe Moconodeno), characterized by arid grasslands and a rocky substrate, and the other two sites (Cornisella and Ortanella) at lower altitudes. Pollen from Ortanella and Cornisella showed the presence of typical deciduous forest species; however in samples collected at Ortanella, pollen of the invasive Lonicera japonica, and the ornamental Pelargonium x hortorum were observed. Our results indicated pollen composition was largely influenced by floristic local biodiversity, plant phenology, and the presence of alien flowering species. Therefore, pollen molecular characterization based on DNA barcoding might serve useful to beekeepers in obtaining honeybee products with specific nutritional or therapeutic characteristics desired by food market demands. Copyright

This work deals with measurement of the force and pressure distribution during walking of a patient with both feet not fully formed. Patient' legs are completely formed down to the heels and the beginning of one midfoot. Since the forefoot is missing, the subject has a difficult propulsion during the boost phase and an excessive rotation at the ankle due to an absent malleolar stability. Design of a customized prosthesis, conceived to ease the subject movement, required the measurement of the forces and pressure distributions during movement. In fact, existing trans-tibial and trans-femoral prostheses studies cannot be applied given that the patient has a limited ankle mobility that shall be preserved during the movement. The force and pressure distributions, measured by means of a commercial measurement system based on capacitive sensors, have been used as input for the finite elements based design. Models of the prostheses have been developed and the performed finite element analyses validated the preliminary design, allowing the manufacturing of prosthetic prototypes.

Falls have always been a frequent and complex problem that might cause fatality, morbidity, loss or damage of body functions and undesired health care needs. The problem is relevant especially for senior citizens and different studies focused on systems for fall detections. This work analyzes the fall kinematics by means of accelerometers placed on head and torso of a crush test dummy used for fall simulations. This configuration reflects the situation in which the subject does not have any voluntary reaction to possible injuries, which is similar to what occurs during elder people fall. Accelerations were measured upon varying the dummy posture; data obtained from accelerometers were compared with those measured with a vision system. The comparison was based on both the peak velocity and on the fall duration. Results showed the compatibility between the data measured with the two methods, outlining the possibility of identifying the peak velocity from videos available on the internet captured, for instance by video surveillance cameras.

We report a 63-year-old female patient with Guillain-Barré syndrome revealed after posterior reversible encephalopathy syndrome. The onset was characterized by hypertension, headache, and cortical blindness, followed a few days later by progressive limb and facial paresis, dysautonomia, and respiratory failure. Treatment with plasmapheresis led to a rapid improvement of the clinical picture and the disappearance of magnetic resonance abnormalities. This report reviews the literature on this unusual association and discusses possible pathophysiological mechanisms.

To study gene expression within the mammary glands of dairy goats with mastitis, mRNA was collected from milk somatic cells (MSCs) of left udder halves challenged with Staphylococcus aureus and right udder halves infused with PBS, as control, at different time points (0, 12, 24 and 48 h post-infection). Transcriptional profiles were investigated using bovine cDNA microarrays; of the total 288 differentially expressed genes identified with ANOVA analysis (False Discovery Rate = 0.05, 1.5-fold change), 26, 36 and 16 genes were down-regulated at 12, 24 and 48 h post-infection, respectively, while 60, 141 and 9 genes were up-regulated at the same corresponding time points. The expression profiles clearly changed at 24 h post-infection with 177 genes significantly altered, corresponding to a 10-fold increase of S. aureus bacterial count in milk from infected udders. Differential expression of selected genes (CD2BP2, BCAP31, MHCII, FOSL2, MAPK13, ILT5 and JUNB) was also confirmed by real-time PCR at the different time points considered, showing high correlation with the microarray measurements and high reliability of the microarray analyses. The most readily inducible classes of genes in caprine MSCs infected with S. aureus were pro-inflammatory cytokines, chemokines and their receptors; IL-1α, lymphotoxin alpha, granulocyte chemotactic protein (CXCL6), and IL-2 receptor gamma were all up-regulated in infected udders versus healthy controls. This study identified a number of differentially expressed genes induced by S. aureus intramammary infection and demonstrates the intricacy of the patterns of gene expression that influence host response to a complex pathogen of significant relevance to both human and veterinary medicine.

This study investigates the whole-body vibration exposure in kite surfing, alpine skiing, snowboarding and cycling. The vibration exposure was experimentally evaluated following the ISO 2631 guidelines. Results evidenced that the most critical axis is the vertical one. The weighted vibration levels are always larger than 2.5 m/s(2) and the vibration dose values are larger than 25 m/s(1.75). The exposure limit values of the EU directive are reached after 8-37 min depending on the sport. The vibration magnitude is influenced by the athletes' speed, by their skill level and sometimes by the equipment. The large vibration values suggest that the practice of sport activities may be a confounding factor in the aetiology of vibration-related diseases.The vibration exposure in some sports is expected to be large, but has never been quantified in the literature. Results of experiments performed in cycling, alpine and water sports outlined vibration levels exceeding the EU standard limit values.