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Background: Intraoperative adverse events (iAEs) are surgical and anesthesiologic complications. Despite the availability of grading criteria, iAEs are infrequently reported in the surgical literature and in cases for which iAEs are reported, these events are described with significant heterogeneity., Objective: To develop Intraoperative Complications Assessment and Reporting with Universal Standards (ICARUS) Global Surgical Collaboration criteria to standardize the assessment, reporting, and grading of iAEs. The ultimate aim is to improve our understanding of the nature and frequency of iAEs and our ability to counsel patients regarding surgical procedures., Design, Setting, and Participants: The present study involved the following steps: (1) collecting criteria for assessing, reporting, and grading of iAEs via a comprehensive umbrella review; (2) collecting additional criteria via a survey of a panel of experienced surgeons (first round of a modified Delphi survey); (3) creating a comprehensive list of reporting criteria; (4) combining criteria acquired in the first two steps; and (5) establishing a consensus on clinical and quality assessment utility as determined in the second round of the Delphi survey., Outcome Measurements and Statistical Analysis: Panel inter-rater agreement and consistency were assessed as the overall percentage agreement and Cronbach's α., Results and Limitations: The umbrella review led to nine common criteria for assessing, grading, and reporting iAEs, and review of iAE grading systems led to two additional criteria. In the first Delphi round, 35 surgeons responded and two criteria were added. In the second Delphi round, 13 common criteria met the threshold for final guideline inclusion. All 13 criteria achieved the consensus minimum of 70%, with agreement on the usefulness of the criteria for clinical and quality improvement ranging from 74% to 100%. The mean inter-rater agreement was 89.0% for clinical improvement and 88.6% for quality improvement., Conclusions: The ICARUS Global Collaboration criteria might aid in identifying important criteria when reporting iAEs, which will support all those involved in patient care and scientific publishing., Patient Summary: We consulted a panel of experienced surgeons to develop a set of guidelines for academic surgeons to follow when publishing surgical studies. The surgeon panel proposed a list of 13 criteria that may improve global understanding of complications during specific procedures and thus improve the ability to counsel patients on surgical risk., (Copyright © 2022 European Association of Urology. Published by Elsevier B.V. All rights reserved.)

Multi-wall carbon nanotubes (MWCNTs) exhibit exceptional mechanical and electrical properties and can be used to improve the mechanical and piezoelectric properties of cement-based materials. In the present study, the effect of different MWCNT concentrations as well as different types of surfactants and a superplasticizer were examined to reinforce, at the nanoscale, a white cement mortar typically used for the restoration of monuments of cultural heritage. It was shown that sodium dodecylbenzenesulfonate (SDBS) and Triton X-100 surfactants slightly decreased the white cement mortars' electrical resistivity (by an average of 10%), however, the mechanical properties were essentially decreased by an average of 60%. The most suitable dispersion agent for the MWCNTs proved to be the superplasticizer Ceresit CC198, and its optimal concentration was investigated for different MWCNT concentrations. Carboxylation of the MWCNT surface with nitric acid did not improve the mechanical performance of the white cement nanocomposites. The parametric experimental study showed that the optimum combination of 0.8 wt% of cement superplasticizer and 0.2 wt% of cement MWCNTs resulted in a 60% decrease in the electrical resistivity; additionally, the flexural and compressive strengths were both increased by approximately 25% and 10%, respectively.

Citrus fruits are rich sources of bioactive compounds and their consumption is associated to health-promoting effects. Citrus processing wastes contain bioflavonoids and other high added value compounds. The aim of this study was to evaluate the antiallergic properties of a new phytoextract obtained by citrus wastes and peels. Blood orange and lemon processing wastes were used to produce a Red orange and Lemon Extract (RLE). Blood samples from 30 allergic donors were collected and used to evaluate the basophil activation (CD203c) and degranulation (CD63) by stimulation trough allergen with and without the RLE. Reduced basophil expression of CD203c and CD63 were observed in RLE + Allergen treated samples, with -20.21% of CD203c expression ( p  < 0.0001) and -54.11% of CD63 expression ( p  < 0.0001), compared to Allergen treated samples. The RLE evidenced a good antiallergic activity, mainly acting on basophils degranulation, and therefore reducing the key event of pro-inflammatory mediators release after allergic stimuli.

Several natural products have been reported to be involved in the suppression of adipogenesis. In this study, we reveal that a bergamot extract (BE) decreased the accumulation of intracellular lipids in murine pre-adipocytes 3T3-L1 cells during adipogenic differentiation. Both the inhibition of HMG-CoA reductase activity and the differentiation and proliferation of adipocytes could be used as a strategy for the treatment and prevention of obesity. The results of this study show a reduction of HMG-CoA activity and of lipid droplet accumulation in the presence of the BE, suggesting the potential of BE as an anti-adipogenic agent to lower the content of cholesterol and body fat and prevent a gain in body weight. Moreover, BE as the result of high percentages of flavonoid compounds such as neoriocitrin, naringin and neohesperidin, the main flavonoids contained in BE, led to significant inhibition of DPPH free radical, demonstrating a strong radical scavenging activity.

Lemon fruit is a source of bioactive compounds, which has many beneficial effects on health. Obesity is characterized by over-accumulation of adipose tissue as a result of increased adipocyte size and number. Adipogenesis is mediated and assisted by various transcription factors that induce lipid-metabolizing enzymes followed by an increase of perilipin expression and lipid droplets generation. Here, we evaluate the effect of lemon extract (LE) as radical scavenger and the consequent regulation of adipocyte differentiation and lipid accumulation. 3T3-L1 murine pre-adipocytes were differentiated and treated with different LE concentrations. The high percentages of flavonoid contained in LE led to a significant inhibition of DPPH radical and reactive oxygen species, demonstrating a strong radical scavenger activity. Treatment of 3T3-cells with LE showed a significant decrease of perilipin expression, subsequently confirmed by the reduction of lipid droplet accumulation, resulting from Oil Red O Staining and by the downregulation of PPARγ and DGAT-1mRNA.

The consumption of plant-based food is important for health promotion, especially regarding the prevention and management of chronic diseases such as diabetes. We investigated the effects of a lemon extract (LE), containing ≥20.0% total flavanones and ≥1.0% total hydroxycinnamic acids, on insulin signaling in murine 3T3-L1 adipocytes treated with TNF-α, which was used to mimic in vitro the insulin resistance condition that characterizes diabetes mellitus. Our results showed LE increased PPARγ, GLUT4 and DGAT-1 levels, demonstrating the potential of this lemon extract in the management of insulin resistance conditions associated with TNF-α pathway activation. LE treatment further decreased the release of interleukin 6 (IL-6) and restored triglyceride synthesis, which is the main feature of a healthy adipocyte.

Citrus fruits are a rich source of high-value bioactive compounds and their consumption has been associated with beneficial effects on human health. Red (blood) oranges ( Citrus sinensis L. Osbeck) are particularly rich in anthocyanins (95% of which are represented by cyanidin-3-glucoside and cyanidin-3-6″-malonyl-glucoside), flavanones (hesperidin, narirutin, and didymin), and hydroxycinnamic acids (caffeic acid, coumaric acid, sinapic, and ferulic acid). Lemon fruit ( Citrus limon ) is also rich in flavanones (eriocitrin, hesperidin, and diosmin) and other polyphenols. All of these compounds are believed to play a very important role as dietary antioxidants due to their ability to scavenge free radicals. A standardized powder extract, red orange and lemon extract (RLE), was obtained by properly mixing anthocyanins and other polyphenols recovered from red orange processing waste with eriocitrin and other flavanones recovered from lemon peel by a patented extraction process. RLE was used for in vivo assays aimed at testing a potential beneficial effect on glucose and lipid metabolism. In vivo experiments performed on male CD1 mice fed with a high-fat diet showed that an 8-week treatment with RLE was able to induce a significant reduction in glucose, cholesterol and triglycerides levels in the blood, with positive effects on regulation of hyperglycemia and lipid metabolism, thus suggesting a potential use of this new phytoextract for nutraceutical purposes.

Previous researches have demonstrated the bioenergetic potential of agri-food Mediterranean wastes showing that anaerobic co-digestion is a valuable solution for Mediterranean areas. This implies a great interest for anaerobic digestates use in agriculture to replace fertilizers. The present study aimed at: i) producing knowledge on continuous anaerobic co-digestion of feedstock mixture composed by different Mediterranean agri-food wastes in terms of multielemental characterization and ii) assessing the agronomic value of industrial anaerobic digestate (AD) based on the potential as fertiliser in nursery condition for the citrus seedlings. Results have demonstrated that agro-industrial biomasses have great potentiality to be converted by anaerobic digestion in biofertilizer to be used in citrus nurseries as sustainable alternative to mineral fertilisers. Multielemental traits of the tested AD were valuable in terms of nutritional supply for the growth and development of the plant. AD was useful to replace the mineral fertilizers in terms of total N content (10.81 ± 0.32 %TS) and organic matter (43.32 ± 0.80 %TS). The seedlings nutritive status showed that no need for supplemental of nutrients was requested. Volkamer lemon highly benefited from the administration of liquid digestate, increasing the total chlorophyll level (2.97 ± 0.31 mg g -1 FW) presumably due to the higher ammonium content of the AD (59 ± 0.08 %TKN). Besides providing useful tools for citrus nurseries for conceiving new sustainable fertilization strategies, this study is a starting point for further in-depth works on physiological status and traits of citrus plants fertilized by using agro-industrial anaerobic digestate., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Self-healing concrete has the potential to optimise traditional design approaches; however, commercial uptake requires the ability to harmonize against standardized frameworks. Within EU SARCOS COST Action, different interlaboratory tests were executed on different self-healing techniques. This paper reports on the evaluation of the effectiveness of proposed experimental methodologies suited for self-healing concrete with expansive mineral additions. Concrete prisms and discs with MgO-based healing agents were produced and precracked. Water absorption and water flow tests were executed over a healing period spanning 6 months to assess the sealing efficiency, and the crack width reduction with time was monitored. High variability was reported for both reference (REF) and healing-addition (ADD) series affecting the reproducibility of cracking. However, within each lab, the crack width creation was repeatable. ADD reported larger crack widths. The latter influenced the observed healing making direct comparisons across labs prone to errors. Water absorption tests highlighted were susceptible to application errors. Concurrently, the potential of water flow tests as a facile method for assessment of healing performance was shown across all labs. Overall, the importance of repeatability and reproducibility of testing methods is highlighted in providing a sound basis for incorporation of self-healing concepts in practical applications.

Objective: To describe the trend in surgical volume in urology in Italy during the coronavirus disease 2019 (COVID-19) outbreak, as a result of the abrupt reorganisation of the Italian national health system to augment care provision to symptomatic patients with COVID-19., Methods: A total of 33 urological units with physicians affiliated to the AGILE consortium (Italian Group for Advanced Laparo-Endoscopic Surgery; www.agilegroup.it) were surveyed. Urologists were asked to report the amount of surgical elective procedures week-by-week, from the beginning of the emergency to the following month., Results: The 33 hospitals involved in the study account overall for 22 945 beds and are distributed in 13/20 Italian regions. Before the outbreak, the involved urology units performed overall 1213 procedures/week, half of which were oncological. A month later, the number of surgeries had declined by 78%. Lombardy, the first region with positive COVID-19 cases, experienced a 94% reduction. The decrease in oncological and non-oncological surgical activity was 35.9% and 89%, respectively. The trend of the decline showed a delay of roughly 2 weeks for the other regions., Conclusion: Italy, a country with a high fatality rate from COVID-19, experienced a sudden decline in surgical activity. This decline was inversely related to the increase in COVID-19 care, with potential harm particularly in the oncological field. The Italian experience may be helpful for future surgical pre-planning in other countries not so drastically affected by the disease to date., (© 2020 The Authors BJU International © 2020 BJU International Published by John Wiley & Sons Ltd.)

Azospirillum brasilense Az19 is a plant-beneficial bacterium capable of protecting plants from the negative effects of drought. The objective of this study was to determine and analyze the genomic sequence of strain Az19 as a means of identifying putative stress-adaptation mechanisms. A high-quality draft genome of ca. 7 Mb with a predicted coding potential of 6710 genes was obtained. Phylogenomic analyses confirmed that Az19 belongs to the brasilense clade and is closely related to strains Az39 and REC3. Functional genomics revealed that the denitrification pathway of Az19 is incomplete, which was in agreement with a reduced growth on nitrate under low O 2 concentrations. Putative genes of the general stress response and oxidative stress-tolerance, as well as synthesis of exopolysaccharides, carotenoids, polyamines and several osmolytes, were detected. An additional poly-beta-hydroxybutyrate (PHB) synthase coding gene was found in Az19 genome, but the accumulation of PHB did not increase under salinity. The detection of exclusive genes related to DNA repair led to discover that strain Az19 also has improved UV-tolerance, both in vitro and in planta. Finally, the analysis revealed the presence of multiple kaiC-like genes, which could be involved in stress-tolerance and, possibly, light responsiveness. Although A. brasilense has been a model for the study of beneficial plant-associated rhizobacteria, the evidence collected in this current study suggests, for the first time in this bacterial group, an unexpected possibility of adaptation to the phyllosphere., Competing Interests: Declaration of Competing Interest The authors report no declarations of interest., (Copyright © 2020 Elsevier GmbH. All rights reserved.)

In this work, we investigated the effects of red orange and lemon extract (RLE) on ochratoxin A (OTA)-induced nephrotoxicity. In particular, we analyzed the change in renal function and oxidative stress in Sprague-Dawley rats treated with OTA (0.5 mg/kg body weight, b.w.) and with RLE (90 mg/kg b.w.) by oral administration. After OTA treatment, we found alterations of biochemical and oxidative stress parameters in the kidney, related to a severe decrease of glomerular filtration rate. The RLE treatment normalized the activity of antioxidant enzymes and prevented the glomerular hyperfiltration. Histopathological examinations revealed glomerular damages and kidney cortex fibrosis in OTA-rats, while we observed less severe fibrosis in OTA plus RLE group. Then, we demonstrated that oxidative stress could be the cause of OTA renal injury and that RLE reduces this effect., (© 2020 Wiley Periodicals, Inc.)

Cold storage may cause changes in the volatile and non-volatile components of orange fruit, in association with the decrement of the characteristic fruit flavour and sensory acceptability. The aim of this work was to evaluate the changes of some non-volatile taste-altering components (total and individual sugars, acids, anthocyanins, putrescine and limonin) that may affect the organoleptic perception of cold-stored orange fruit. Three blood orange varieties ('Tarocco TDV', 'Tarocco Gallo', and 'Moro') and a common variety ('Washington navel') were stored at 6 ± 1 °C and 90-95% Relative Humidity (RH) for 60 d. Chemical and sensory assessments were performed during fruit storage at 15 d intervals. During storage, no dramatic change of the physicochemical parameters was recorded and the ascorbic acid content remained almost unchanged in all varieties. As expected, total anthocyanins significantly increased during storage. Limonin significantly decreased in all varieties. A consistent and significant increase in putrescine occurred during storage in the fruit of the pigmented varieties, not recorded in the common orange variety. Putrescine behaviour showed direct correlation with the accumulation of off-flavour in cold-stored 'Moro' and 'T. TDV' fruit, showing a clear influence of its relative concentration on the sensory perception of fruit. Finally, principal component analysis showed that the complete quality profile of the four investigated varieties represented clear differentiation without overlapping clusters. Our results suggest that the arise of a negative sensory perception in cold stored blood orange fruit might be linked to their accumulation of putrescine., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Purpose: The coronavirus disease 2019 (COVID-19) pandemic has put a substantial burden on the Italian healthcare system, resulting in the restructuring of hospitals to care for COVID-19 patients. However, this has likely impacted access to care for patients experiencing other conditions. We aimed to quantify the impact of COVID-19 on access to care for patients with urgent/emergent urological conditions throughout Italy., Materials and Methods: A questionnaire was sent to 33 urological units in the AGILE consortium, asking clinicians to report on the number of urgent/emergent urological patients seen and/or undergoing surgery over a 3-week period during the peak of the COVID-19 outbreak and a reference week prior to the outbreak. ANOVA and linear regression models were used to quantify these changes., Results: Data from 27 urological centres in Italy showed a decrease from 956 patients/week seen just prior to the outbreak to 291 patients/week seen by the end of the study period. There was a difference in the number of patients with urgent/emergent urological disease seen within/during the different weeks (all p values < 0.05). A significant decrease in the number of patients presenting with haematuria, urinary retention, urinary tract infection, scrotal pain, renal colic, or trauma and urgent/emergent cases that required surgery was reported (all p values < 0.05)., Conclusion: In Italy, during the COVID-19 outbreak there has been a decrease in patients seeking help for urgent/emergent urological conditions. Restructuring of hospitals and clinics is mandatory to cope with the COVID-19 pandemic; however, the healthcare system should continue to provide adequate levels of care also to patients with other conditions., (© 2020 S. Karger AG, Basel.)

The major cause of end-stage renal disease is the diabetic nephropathy. Oxidative stress contributes to the development of type II diabetes mellitus (T2DM). In this study we have evaluated the effect of a diet with a new standardized of red orange and lemon extract (RLE) rich in anthocyanins (ANT) in the progression of the kidney disease on Zucker diabetic fatty rats. Oxidative stress and renal function were analyzed. In diabetic rats, the RLE restored the blood glucose levels, body weight, and normalized the reactive oxygen species (ROS) total pathways. The kidney inflammation, in diabetic rats, has not shown significant change, showing that the oxidative stress rather than to inflammatory processes is a triggering factor in the renal complication associated with T2DM. Therefore, the administration of the RLE prevents this complication and this effect could be related to the inhibition of ROS production., (© 2019 Wiley Periodicals, Inc.)

The morphological characteristics and health-promoting components (anthocyanins, phenolic compounds, carotenoids, and ascorbic acid) together with the in-vitro antioxidant capacity of hips collected from four rose species (Rosa canina, R. corymbifera, R. micrantha, and R. sempervirens) growing in Sicily (South Italy) were evaluated. The results revealed significant variability among the rose species as the hips collected from R. canina and R. sempervirens exhibited the highest total polyphenol contents (6784.5 and 6241.2 mg GAE/100 g DW, respectively) and highest antioxidant activities, whereas R. canina and R. micrantha hips had the highest total anthocyanin contents (2.94 and 3.86 mg CGE/100 g DW, respectively). The data showed that the analysed Sicilian rose hips have good nutritional quality, making them suitable as functional foods according to their biochemical composition and as promising sources of natural antioxidants. Also, these findings confirm that rose pseudo-fruits contain significant amounts of secondary metabolites that may positively affect human health., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Prostate Imaging Reporting and Data System version 2 (PI-RADS v2) provides clinical guidelines for multiparametric magnetic resonance imaging (mpMRI) [T2-weighted imaging (T2WI), diffusion-weighted imaging (DWI) and dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI)] of prostate. However, DCE-MRI seems to show a limited contribution in prostate cancer (PCa) detection and management. In our experience, DCE-MRI, did not show significant change in diagnostic performance in addition to DWI and T2WI [biparametric MRI (bpMRI)] which represent the predominant sequences to detect suspected lesions in peripheral and transitional zone (TZ). In this article we reviewed the role of DCE-MRI also indicating the potential contribute of bpMRI approach (T2WI and DWI) and lesion volume evaluation in the diagnosis and management of suspected PCa., Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.

Background: The phytotherapic treatment of overweight and/or moderate obesity is growing widely, thus there is a great interest towards the phenolic compounds of fruits and vegetables which may inhibit pancreatic lipase enzyme. In this study, we report the chemical composition and in vitro pancreatic lipase inhibitory activity of 13 freeze-dried anthocyanin-containing extracts of different Mediterranean plants: fruits (blood orange, pomegranate, blackberry, mulberry and sumac), citrus by-products (blood orange peel), citrus vegetative tissues (young lemon shoots); vegetables (red cabbage and violet cauliflower), legume seeds (black bean), cereals (black rice), and cereal processing by-products (black rice hull). Total phenols and anthocyanins were determined. Individual anthocyanins were identified by UHPLC-PDA-ESI/MS n ., Results: Results revealed a wide variation in the distribution of anthocyanin compounds. Blood orange and pomegranate juice extracts had the highest total anthocyanin content and exhibited the strongest inhibition of pancreatic lipase in vitro., Conclusion: Inhibitory activity was positively correlated with anthocyanin content. In appropriate formulations, anthocyanin-containing extracts could find a use as anti-obesity agents. © 2016 Society of Chemical Industry., (© 2016 Society of Chemical Industry.)

Background: Anthocyanins are water-soluble pigments belonging to the flavonoid family. They are typically present in the flesh and peel in the blood orange cultivars. Although blood orange young shoots and flowers are not anthocyanin-colored, lemon, citron, rangpur lime, and Meyer lemon young shoots and flowers exhibit marked pigmentation as a result of anthocyanins, demonstrating that anthocyanin biosynthesis in the Citrus genus is both tissue- and genotype-dependent. The present study aimed to examine the qualitative and quantitative anthocyanin profile of fruit and other tissues from different Citrus species., Results: The presence of anthocyanin-pigmented stigmas in the young flowers of a blood orange tree (cv. 'Moro') was characterized and reported for the first time. The dominant pigments in blood orange fruits were cyanidin 3-glucoside and cyanidin 3-(6''-malonyl-glucoside), whereas different patterns were observed in the young shoots, flowers and peel tissues of different Citrus species., Conclusion: The present study is the first to report differentially expressed anthocyanin pigmentation patterns in different organs from several species of the genus Citrus. The results obtained could also represent a starting point for further investigations that aim to better understand which regulatory genes are involved in anthocyanin biosynthesis in the fruits, shoots and floral tissues of different Citrus species. © 2016 Society of Chemical Industry., (© 2016 Society of Chemical Industry.)

In this paper, four different olive cultivars from Southern Italy, Carolea, Cassanese, Nocellara del Belice, Nocellara Messinese table olives, produced according to traditional fermentation processes, were evaluated with the aim of assessing the effect of selected starter cultures on growth of bacterial population and on olive phenols during fermentation. Only Cassanese and Nocellara del Belice inoculated samples reached a safe pH value under 4.6 after 90 days while maintaining it until the end of storage. The most representative phenols in brine samples analysed by HPLC-MS/MS were hydroxytyrosol and verbascoside. Among the analysed phenols, only hydroxytyrosol, caffeic acid and ferulic acid always increased during fermentation, while the others increased up to 90-120 days and then decreased. The Principal Component Analysis (PCA) performed on pH and phenol values highlighted three clusters of olive cultivars. Throughout the brining period, lactic acid bacteria were always present while staphylococci and coliform bacteria disappeared after 30 and 90 days, respectively., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The cultivation of lemon (Citrus limon (L.) Burm f.) has occurred for centuries at the mountainsides of the Mount Etna the largest active volcano in Europe (Sicily, Italy). The peculiar geographical, soil and climatic conditions that characterize this area have recently prompted citrus growers to launch the brand name 'Limone dell'Etna' for the lemon fruits produced in that area. The present research focused on evaluating the quality and nutraceutical properties of the 'Limone dell'Etna' fruit juice ('Primofiore', 'Bianchetto', and 'Verdello' blooming) to enhance the value of a product that, due to its peculiar qualities, could be awarded with one of the European certified labels protecting the lemon geographical origin. Qualitative parameters, health-promoting components (such as ascorbic acid, flavonoids, and hydroxycinnamic acids) and the in-vitro total antioxidant capacity (ORAC, FCR) of fruit juice of two different varieties ('Femminello zagara bianca' and 'Monachello') were determined at fruit maturity. The results showed that the Bianchetto and Verdello lemon fruit exhibited higher levels of ascorbic acid than those recorded for the Primofiore production. The amount of flavonoids in Verdello fruits of both cultivars was the highest, as was reflected in the highest antioxidant activity. Thus, the 'Limone dell'Etna' production, with particular reference to the Verdello fruit, must be considered as a new, valuable and original source of natural antioxidants to be valorized and even exploited in the processing industry., (Copyright © 2015 Elsevier Ltd. All rights reserved.)

The fruit quality characteristics, phenolic compounds and antioxidant capacities of 24 sweet cherry (Prunus avium L.) cultivars grown on the mountainsides of the Etna volcano (Sicily, Italy) were evaluated. High-performance liquid chromatographic methods were used to identify and quantify sugars, organic acids and phenolics. A total of seven phenolic compounds were characterised as hydroxycinnamic acid derivatives (neochlorogenic acid, p-coumaroylquinic acid and chlorogenic acid) and anthocyanins (cyanidin 3-glucoside, cyanidin 3-rutinoside, pelargonidin 3-rutinoside and peonidin 3-rutinoside). The total anthocyanin content ranged from 6.21 to 94.20mg cyanidin 3-glucoside equivalents/100g fresh weight (FW), while the total phenol content ranged from 84.96 to 162.21mg gallic acid equivalents/100g FW. The oxygen radical absorbance capacity (ORAC) assay indicated that fruit of all genotypes possessed considerable antioxidant activity. The high level of phenolic compounds and antioxidant capacity of some sweet cherry fruits implied that they might be sources of bioactive compounds that are relevant to human health., (Copyright © 2012 Elsevier Ltd. All rights reserved.)

The link between ultraviolet (UV)-B, nitric oxide (NO) and phenylpropanoid biosynthetic pathway (PPBP) was studied in maize and Arabidopsis. The transcription factor (TF) ZmP regulates PPBP in maize. A genetic approach using P-rr (ZmP+) and P-ww (ZmP⁻) maize lines demonstrate that: (1) NO protects P-rr leaves but not P-ww from UV-B-induced reactive oxygen species (ROS) and cell damage; (2) NO increases flavonoid and anthocyanin content and prevents chlorophyll loss in P-rr but not in P-ww and (3) the NO scavenger 2-(4-carboxyphenyl)-4,4,5,5-tetramethylimidazoline-1-oxyl-3-oxide (cPTIO) blocks the UV-B-induced expression of ZmP and their targets CHS and CHI suggesting that NO plays a key role in the UV-B-regulated PPBP. Involvement of endogenous NO was studied in Arabidopsis nitric oxide dioxygenase (NOD) plants that express a NO dioxygenase gene under the control of a dexamethasone (DEX)-inducible promoter. Expression of HY5 and MYB12, TFs involved in PPBP regulation, was induced by UV-B, reduced by DEX in NOD plants and recovered by subsequent NO treatment. C4H regulates synapate esters synthesis and is UV-B-induced in a NO-independent pathway. Data indicate that UV-B perception increases NO concentration, which protects plant against UV-B by two ways: (1) scavenging ROS; and (2) up-regulating the expression of HY5, MYB12 and ZmP, resulting in the PPBP activation., (© 2011 Blackwell Publishing Ltd.)

Background and Aim: Constipation is one of the most common disorders in Western countries and it is known that dietary factors such as a low fiber diet and low caloric intake are associated with this condition. Weight loss can disrupt the intestinal ecosystem resulting in intestinal dysbiosis that worsens constipation. The aim of this study was to evaluate the effects of treatment with symbiotic zir fos (Bifidobacterium longum W11 + FOS Actilight) on chronic constipation in patients undergoing a weight loss diet., Methods: Our evaluation included the recording of age, gender, weight, height, BMI, physical activity, constipation, diet, therapy compliance and laxative supplies. A hypocaloric diet (1,200/1,400 cal.) was prescribed to all patients, and they were submitted to a physical activity program and received 1 bag of symbiotic zir fos per day for the entire duration of the study. Patients' follow-up was available for up to 60 days., Results: Two hundred and ninety seven patients (79.4% women and 18.2% men, mean age 32.2) were included in the study. The mean baseline BMI was 33.4 +/- 5.6 (range 22.8-56.3 Kg). The improvement of constipation turned out to be associated to age (p < 0.01). Patients with a mean age of 35 +/- 12 showed an improvement of constipation. BMI values were not significantly different among the groups of patients with improved, worsened or unchanged constipation. No significative difference was observed among groups due to physical activity. At the follow-up, after 20 days from the beginning of the study, patients that assumed at least 17/20 of the zir fos bags showed a greater improvement of constipation (p < 0.01) than the remaining patients who assumed less than 17/20 of the zir fos bags or that didn't assumed any at all. Patients that assumed laxatives (at least once a week) showedn to be more frequently associated with a worsening of constipation (p < 0.001). Diet compliance does not seem to influence the course of constipation., Conclusion: Our data demonstrate the utility of symbiotics in improving constipation during hypocaloric diet in the treatment of obesity.

The objective of this paper is to analyze the effectiveness of group therapy to produce psychic change in patients with schizophrenia and other related psychosis. The experience took place in a Public Psychiatric Hospital. It involved 96 patients with this condition who entered different groups from 1998 up to the present. During the year 2000, 66 of them were asked to answer a questionnaire especially designed to investigate the changes that they thought they had gone through during this treatment. On one hand, the results show the high valorization of the group appliance, while on the other hand the most valued operational categories were the facilitation of interpersonal links, the valorization of listening and being listened, the recognition of improvement and the recognition of one's own characteristics in the other person. On account of these discoveries, the mechanisms of these group appliances to produce such changes are postulated. In conclusion, group treatment for schizophrenic patients and related psychosis turns out to be useful for producing psychic changes different from those achieved with psychopharmacological agents.

In HIV-1 infected patients severe enteritis and chronic diarrhea are often documented as a consequence of multiple opportunistic infections. We analyzed 48 HIV-1 positive patients for the presence of intestinal pathogenic protozoa. Patients with CD4 > or = 200/mm3 showed a higher prevalence of a single pathogenic protozoa than patients with CD4 < or =200/mm3, who showed the presence of multiple protozoal infections. Patients who proved positive for only a single protozoa, Cryptosporidium or Blastocystis, were also positive, by stool culture, for the presence of Proteus mirabilis (3 samples), Citrobacter freundii (3 samples), Escherichia coli (one sample) or Enterobacter cloacae (one sample). Treatment with rifaximin (600 mg, 3 times a day, for 14 days) was efficacious in resolving the clinical symptoms and clearing protozoan infections in HIV-1 infected patients with CD4 > or = 200/mm3, who presented enteric and systemic symptoms due to Criptosporidium or Blastocystis associated with enteropathogenic bacteria.

The purpose of this study was to identify factors that predict nurses' spiritual care perspectives and practices and compare these perspectives and practices between nurses in two subspecialties. The sample included 181 oncology nurses and 638 hospice nurses who completed the Spiritual Care Perspectives Survey and a demographic form by mail. The hospice nurses surveyed used traditional spiritual care interventions more frequently and held more positive perspectives regarding spiritual caregiving than oncology nurses. However, what determined spiritual care practices and perspectives most was the spirituality of the nurse. Nurses must continue to explore how their personal spirituality contributes to their caregiving.

Purpose/objectives: To determine what spiritual care practices oncology nurses use., Design: Descriptive, cross-sectional survey., Setting: Variety of oncology clinical settings from all regions of the United States., Sample: Stratified, random sampling of Oncology Nursing Society members who identified themselves as clinicians; 181 out of 700 completed the questionnaires; respondents typically were Christian, caucasian, female, adult inpatient oncology staff nurses., Methods: Oncology Nurse Spiritual Care Perspectives Survey and a demographic form were delivered and returned through mailing; questionnaires required up to two hours for completion; respondents were given one month to complete the questionnaires., Main Research Variables: Spiritual care practices/interventions (types and frequency) and indicators of spiritual need., Findings: Frequent practices included praying with patients, referring them to chaplains or clergy, providing them with religious materials, serving as a therapeutic presence, and listening and talking to them. Frequency of traditional spiritual care practices differed by variables such as self-reported spirituality, religious service attendance, ethnicity, and education. Identified indicators of spiritual need included anxiety, depression, patient requests, death issues, hopelessness, and withdrawal., Conclusions: Oncology nurses provide spiritual care in a variety of ways that often are personal and private, yet they do so infrequently and with some discomfort. Research examining relationships between spiritual care practices and demographic variables is needed., Implications for Nursing Practice: Spiritual care education and resources for clinicians are needed. Data provide examples of interventions for and indicators of spiritual need.

Because attitudes and beliefs about spiritual care have been linked with spiritual caregiving practices in previous research among non-hospice nurses, and because little is known about hospice nurses' attitudes and beliefs about spiritual care, this study explored such attitudes and beliefs among hospice nurses. Data were obtained from 641 Hospice Nurses Association members who completed the Spiritual Care Perspectives Survey and a demographic form. While respondents rather uniformly agreed that patients had spiritual needs and that it was appropriate for nurses to attend to such needs, attitudes about how a nurse should relate to patients' spirituality were variable. Education and indicators reflecting personal religiosity were associated with these hospice nurses' attitudes and beliefs about spiritual care.

Explores nurses' perspectives regarding collaboration with chaplains and clergy in the provision of spiritual care to persons with cancer. Reports results of a survey via questionnaire of a random sample of Oncology Nursing Society members. Concludes that although a majority of the respondents report referring patients in spiritual need to clergy and chaplains, a significant minority did not do so. Notes that results secured from these respondents bring to surface several aspects of the collaborative relationship between nurses and chaplains and clergy.

The objective of this study was to determine the effects of very high cost patients on hospice financial status. Ten Pennsylvania hospices dually certified by Medicare were randomly selected and agreed to participate. Patient age, sex, diagnosis, length of stay and payer were fairly uniform across hospices. Payments varied by diagnosis and payer. High cost patients were irregularly found in hospices; low cost patients were commonly and regularly distributed. Every hospice had at least one high cost patient. In one, the uncompensated payment for the 6.6 percent of patients defined as high cost ($7,300 and above) would have been 14.7 percent of total annual revenues. In another, uncompensated payments for high cost patients (9.8 percent) would have accounted for 17.2 percent of revenue. In 96.3 percent of the instances patients utilized less than the Medicare Hospice Benefit maximum allowable cost ($7,300); and, 98.8 percent of the time patients stayed less than the maximum allowable length of time of 210 days. A logistic regression model found long length of stay (p < 0.0001), Medicare hospice benefit as primary payer (p < 0.0001), any hospitalization during hospice stay (p < 0.003) and cerebrovascular disease diagnosis (p < 0.02) to be significantly related to high cost. Between the time the study was planned and completed, Medicare instituted a reinsurance program allowing unused funds below the maximum allowable limit from one patient to be used for patients who exhausted their benefits. Thus, no study hospice was adversely affected by high cost patients. However, it should serve as an object lesson to Medicare in using prospective payment.(ABSTRACT TRUNCATED AT 250 WORDS)

An assessment of need survey questionnaire sent to the hospice nursing community yielded a substantial return (1,550). The respondents overwhelmingly endorsed a certification process. They also emphasized the value of hospice experience and caring personal attitudes over formal educational preparation both for hospice work and for certification purposes. The preferences of these nurses for various elements of a certification process are compared to those revealed in a Delphi study of 16 hospice nursing leaders. Certain of their experimental and demographic characteristics are related to other research findings about the characteristics of hospice nurses.

In this study the McCubbin stress and coping model was used as a theoretical framework to compare the differences in family adaptation to AIDS and to other terminal illnesses. The non-probability convenience sample consisted of 26 families of AIDS patients and 26 of hospice patients with other terminal illnesses. The Family Inventory of Life Events and Changes was used to measure the number of stressful events experienced by the family since diagnosis and the Family Adaptation to Medical Stressors Questionnaire measured role flexibility. Families of AIDS patients had significantly more stress, more rules prohibiting emotional expression, lower trust levels, and more illness anxiety than the other families.

Compared 36 hospice nurses with 35 nurses who were working in traditional settings. Data from a battery of five tests ( Templer Death Anxiety Scale, Purpose in Life, Shneidman "You and Death" Questionnaire, Myers- Briggs , Cattell 16PF) revealed the hospice nurses to be significantly more assertive, imaginative, forthright , free-thinking and independent than their colleagues, who scored lower than the norms. The nurses in traditional settings exhibited a stronger preference than both hospice nurses and norms for the practical and no-nonsense in their approach to life. They were also more conventional and comfortable with structure. These data suggest a useful basis for hospice staff selection procedures as well as further study of the hospice as a setting evocative of autonomous professional nursing practice.