16 results on '"Barone ME"'
Search Results
2. Comparative genomics of emerging MDR Enterococcus raffinosus causing hospital outbreaks in European countries
- Author
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Leon-Sampedro, Rl, Barone, Me, Tedim, A, Ayala, J, Freitas, A, Novais, C., Peixe, L, Loens, K, Cattoir, V, Goossens, H, Sadowy, E., Top, J, Willems, Rj, Campanile, F, Stefani, S, Cantón, R, Baquero, F, and Coque, Tm.
- Published
- 2018
3. Le certificazioni ambientali
- Author
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Barone, ME, Benedetti, A, Blasi, E, Braido, E, Cafagno, MM, Caruso, GM, Civitarese, S, Comporti, GD, Conio, A, Corso, G, De Leonardis, F, Dinelli, F, Fari, A, Fonderico, F, Fracchia, F, Pappano, D, Pioggia, A, Portaluri, P, Pozzo, B, Renna, M, Rossi, G, BENEDETTI, AURETTA, Barone, ME, Benedetti, A, Blasi, E, Braido, E, Cafagno, MM, Caruso, GM, Civitarese, S, Comporti, GD, Conio, A, Corso, G, De Leonardis, F, Dinelli, F, Fari, A, Fonderico, F, Fracchia, F, Pappano, D, Pioggia, A, Portaluri, P, Pozzo, B, Renna, M, Rossi, G, and BENEDETTI, AURETTA
- Published
- 2011
4. Le certificazioni ambientali
- Author
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BENEDETTI, AURETTA, Barone, ME, Benedetti, A, Blasi, E, Braido, E, Cafagno, MM, Caruso, GM, Civitarese, S, Comporti, GD, Conio, A, Corso, G, De Leonardis, F, Dinelli, F, Fari, A, Fonderico, F, Fracchia, F, Pappano, D, Pioggia, A, Portaluri, P, Pozzo, B, Renna, M, and Rossi, G
- Subjects
certificati verdi ,certificazioni volontarie ,ambiente ,mercato ,certificazioni EMAS Ecolabel ,certificati bianchi - Published
- 2011
5. Bioactivity of Amphidinol-Containing Extracts of Amphidinium carterae Grown Under Varying Cultivation Conditions.
- Author
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Barone ME, Murphy E, Fierli D, Campanile F, Fleming GTA, Thomas OP, and Touzet N
- Subjects
- Anti-Bacterial Agents pharmacology, Anti-Bacterial Agents chemistry, Enterococcus faecalis drug effects, Enterococcus faecalis growth & development, Staphylococcus aureus drug effects, Staphylococcus aureus growth & development, Chromatography, Liquid, Antifungal Agents pharmacology, Antifungal Agents chemistry, Anti-Infective Agents pharmacology, Anti-Infective Agents chemistry, Amphidinols, Dinoflagellida chemistry, Dinoflagellida growth & development, Dinoflagellida drug effects, Candida albicans drug effects, Candida albicans growth & development, Microbial Sensitivity Tests
- Abstract
Microalgae are of great interest due to their ability to produce valuable compounds, such as pigments, omega-3 fatty acids, antioxidants, and antimicrobials. The dinoflagellate genus Amphidinium is particularly notable for its amphidinol-like compounds, which exhibit antibacterial and antifungal properties. This study utilized a two-stage cultivation method to grow Amphidinium carterae CCAP 1102/8 under varying conditions, such as blue LED light, increased salinity, and the addition of sodium carbonate or hydrogen peroxide. After cultivation, the biomass was extracted and fractionated using solid-phase extraction, yielding six fractions per treatment. These fractions were analyzed using Liquid Chromatography-High-Resolution Mass Spectrometry (LC-HRMS/MS) to identify their chemical components. Key amphidinol compounds (AM-B, AM-C, AM-22, and AM-A) were identified, with AM-B being the most abundant in Fraction 4, followed by AM-C. Fraction 5 also contained a significant amount of AM-C along with an unknown compound. Fraction 4 returned the highest antimicrobial activity against the pathogens Staphylococcus aureus, Enterococcus faecalis, and Candida albicans, with Minimal Biocidal Concentrations (MBCs) ranging from 1 to 512 µg/mL. Results indicate that the modulation of both amphidinol profile and fraction bioactivity can be induced by adjusting the cultivation parameters used to grow two-stage batch cultures of A. carterae., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)
- Published
- 2024
- Full Text
- View/download PDF
6. Modulation of the metabolite content of the unicellular rhodophyte Porphyridium purpureum using a 2-stage cultivation approach and chemical stressors.
- Author
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Barone ME, Herbert H, Mc Donnell A, Fierli D, Fleming GTA, and Touzet N
- Subjects
- Antioxidants, Hydrogen Peroxide, Plant Extracts pharmacology, Porphyridium
- Abstract
There have been growing interests in microalgal biotechnology for the biorefining of bioactive compounds such as carotenoid pigments, ω-3 fatty acids, antioxidants or antimicrobials for sectoral applications in the pharmacology, nutraceutical and cosmetic fields. This study focused on the unicellular marine rhodophyte Porphyridium purpureum CCAP 1380/1 A, which was cultivated via a two-stage batch growth mode for 10 days using hydrogen peroxide (H
2 O2 ), the phytohormone methyl jasmonate (MJ) and three plant extracts (Passiflora incarnata, Panax ginseng and Valeriana officinalis). The microalgal biomass was then analysed for its protein, phycoerythtin, carbohydrate and pigment composition together with its pigment content and antioxidant activity. Of note, MJ increased the protein and phycoerythtin content (up to 225 µg BSA eq./mg DW and 15 mg/ml, respectively) while both the MJ and H2 O2 treatments increased carotenoid pigment yields (β-carotene and zeaxanthin, up to 5 and 4 mg/g, respectively). Carbohydrates were enhanced ∼10 fold by the Valeriana officinalis treatment (up 192 μg starch eq./mg). Overall, neutral lipids and antioxidants were mostly negatively affected by the plant extracts. The greatest antioxidant activity registered was obtained with the H2 O2 treatment (15 μmol Trolox eq./g DW with TEAC assay). P. purpureum contains multiple valuable compounds of commercial interest. These results indicate that they can be favorably modulated using specific cultivation regimes and chemical enhancers, thereby facilitating the exploitation of the biomass by applying a suitable co-refinery pipeline., 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 © 2022 Elsevier B.V. All rights reserved.)- Published
- 2022
- Full Text
- View/download PDF
7. Cold stress combined with salt or abscisic acid supplementation enhances lipogenesis and carotenogenesis in Phaeodactylum tricornutum (Bacillariophyceae).
- Author
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Fierli D, Barone ME, Graceffa V, and Touzet N
- Subjects
- Abscisic Acid pharmacology, Abscisic Acid metabolism, Lipogenesis, Sodium Chloride, Cold-Shock Response, Plant Growth Regulators metabolism, Dietary Supplements, Diatoms, Microalgae metabolism
- Abstract
Compounds from microalgae such as ω3-fatty acids or carotenoid are commercially exploited within the pharmacology, nutraceutical, or cosmetic sectors. The co-stimulation of several compounds of interest may improve the cost-effectiveness of microalgal biorefinery pipelines. This study focussed on Phaeodactylum tricornutum to investigate the effects on lipogenesis and carotenogenesis of combined stressors, here cold temperature and addition of NaCl salt or the phytohormone abscisic acid, using a two-stage cultivation strategy. Cold stress with NaCl or phytohormone addition increased the neutral lipid content of the biomass (20 to 35%). These treatments also enhanced the proportions of EPA (22% greater than control) in the fatty acid profile. Also, these treatments had a stimulatory effect on carotenogenesis, especially the combination of cold stress with NaCl addition, which returned the highest production of fucoxanthin (33% increase). The gene expression of diacylglycerol acyltransferase (DGAT) and the ω-3 desaturase precursor (PTD15) were enhanced 4- and 16-fold relative to the control, respectively. In addition, zeaxanthin epoxidase 3 (ZEP3), was downregulated at low temperature when combined with abscisic acid. These results highlight the benefits of applying a combination of low temperature and salinity stress, to simultaneously enhance the yields of the valuable metabolites EPA and fucoxanthin in Phaeodactylum tricornutum., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2022
- Full Text
- View/download PDF
8. Antioxidant Activity and Carotenoid Content Responses of Three Haematococcus sp. (Chlorophyta) Strains Exposed to Multiple Stressors.
- Author
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Parkes R, Barone ME, Herbert H, Gillespie E, and Touzet N
- Subjects
- Antioxidants metabolism, Antioxidants pharmacology, Carotenoids metabolism, Hydrogen Peroxide, Oxidants metabolism, Plant Extracts metabolism, Plant Growth Regulators metabolism, Sodium Chloride, Xanthophylls metabolism, beta Carotene metabolism, Chlorophyceae metabolism, Chlorophyta, Herbicides, Microalgae metabolism
- Abstract
There has been increasing demands worldwide for bioactive compounds of natural origins, especially for the nutraceutical and food-supplement sectors. In this context, microalgae are viewed as sustainable sources of molecules with an array of health benefits. For instance, astaxanthin is a xanthophyll pigment with powerful antioxidant capacity produced by microalgae such as the chlorophyte Haematococcus sp., which is regarded as the most suitable organism for the mass production of this pigment. In this study, three Haematococcus sp. strains were cultivated using a batch mode under favourable conditions to promote vegetative growth. Their environment was altered in a second phase using a higher and constant illumination regime combined with either exposure to blue LED light, an osmotic shock (with NaCl addition) or supplementation with a phytohormone (gibberellic acid, GA3), a plant extract (ginger), an herbicide (molinate) or an oxidant reagent (hydrogen peroxide). The effects of these stressors were evaluated in terms of antioxidant response and astaxanthin and β-carotene accumulation. Overall, strain CCAP 34/7 returned the highest Trolox Equivalent Antioxidant Capacity (TEAC) response (14.1-49.1 µmoL Trolox eq. g
- 1 of DW), while the highest antioxidant response with the Folin-Ciocalteu (FC) was obtained for strain RPFW01 (62.5-155 µmoL Trolox eq. g- 1 of DW). The highest β-β-carotene content was found in strain LAFW15 when supplemented with the ginger extract (4.8 mg. g- 1 ). Strain RPFW01 exposed to blue light returned the highest astaxanthin yield (2.8 mg. g- 1 ), 5-fold that of strain CCAP 34/7 on average. This study documents the importance of screening several strains when prospecting for species with potential to produce high-value metabolites. It highlights that strain-specific responses can ensue from exposure of cells to a variety of stressors, which is important for the adequate tailoring of a biorefinery pipeline., (© 2022. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)- Published
- 2022
- Full Text
- View/download PDF
9. Influence of exogenous phytohormone supplementation on the pigment and fatty acid content of three marine diatoms.
- Author
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Fierli D, Aranyos A, Barone ME, Parkes R, and Touzet N
- Subjects
- Dietary Supplements, Eicosapentaenoic Acid, Fatty Acids, Humans, Plant Growth Regulators, Diatoms, Microalgae
- Abstract
Diatoms are ubiquitous photosynthetic microorganisms with great potential for biotechnological applications. However, their commercialisation is hampered by production costs, requiring hence optimisation of cultivation methods. Phytohormones are plant growth regulators which may be used to influence physiological processes in microalgae, including diatoms. In this study, the model species Phaeodactylum tricornutum (Phaeodactylaceae) and two Irish isolates of Stauroneis sp. (Stauroneidaceae) and Nitzschia sp. (Bacillariaceae) were grown with varying amounts of the phytohormones indoleacetic acid (IAA), gibberellic acid (GA3), methyl jasmonate (MJ), abscisic acid (ABA) or salicylic acid (SA), and their influence on pigment and fatty acid profiles was monitored. The application of GA3 (200 mg/l) stimulated the growth of P. tricornutum which accumulated 52% more dry biomass compared to the control and concomitantly returned the highest eicosapentaenoic acid (EPA) yield (0.6 mg/l). The highest fucoxanthin yield (0.18 mg/l) was obtained for P. tricornutum cultivated with GA3 (2 mg/l) supplementation. In Stauroneis sp., SA (1 mg/l) had the most positive effect on EPA, the content of which was enhanced up to 45.7 μg/mg (4.6% of total dry weight). The SA (1 mg/l) treatment also boosted carotenogenesis in Nitzschia sp., leading to 1.7- and 14-fold increases in fucoxanthin and β-carotene compared to the control, respectively. Of note, MJ (0.5 mg/l) increased the EPA content of all diatom species compared to their controls. These results indicate that phytohormone-based treatments can be used to alter the pigment and lipid content of microalgae, which tend to respond in dose- and species-specific manners to individual compounds.Key points• Response to phytohormones was investigated in diatoms from distinct families.• MJ (0.5 mg/l) caused an increase in EPA cellular content in all three diatoms.• Phytohormones mostly caused dose-dependent and species-specific responses., (© 2022. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)
- Published
- 2022
- Full Text
- View/download PDF
10. Psychological distress during the COVID-19 pandemic in the population of Argentina.
- Author
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Lucuix MB, Gómez-Salgado J, Barone ME, Domínguez-Salas S, Luque LE, Rodríguez-Domínguez C, and Ruiz-Frutos C
- Subjects
- Adult, Argentina epidemiology, Communicable Disease Control, Cross-Sectional Studies, Female, Humans, Male, Stress, Psychological epidemiology, COVID-19 psychology, Pandemics, Psychological Distress
- Abstract
Abstract: In addition to the implications that this pandemic has had on physical health, there are other circumstances that threaten the mental health of the population, such as lockdown measures to prevent the spread of the virus, uncertainty, and the increase in infections and deaths. For this reason, this study explored indicators of psychological distress in the Argentine population, as well as its relationship with sociodemographic and health variables.Cross-sectional observational study, with data collection from May to August 2020. A total of 1112 people over the age of 18 who responded to various measurement instruments through an online questionnaire participated. A bivariate analysis and logistic regression were carried out in order to determine predictive factors of psychological distress.The data revealed that 60.9% of the sample presented psychological distress. A greater number with this condition was observed in women, apart from younger people, with a greater number of symptoms associated with the disease and with worse self-perceived health. There was no evidence of association between psychological distress and contact with people infected with coronavirus disease 2019 or with material suspicious of being infected.This research provided an overview of the mental health status of a significant population sample in Argentina, months after the onset of the coronavirus disease 2019 pandemic. These findings complement those found in other national and international studies, allowing the accumulation of evidence that states the need to demand to draw attention to the mental health of the population, especially the most vulnerable groups, on behalf of the public authorities., Competing Interests: The authors have no conflicts of interest to disclose., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
- Published
- 2021
- Full Text
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11. Comparative Response of Marine Microalgae to H 2 O 2 -Induced Oxidative Stress.
- Author
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Barone ME, Parkes R, Herbert H, McDonnell A, Conlon T, Aranyos A, Fierli D, Fleming GTA, and Touzet N
- Subjects
- Hydrogen Peroxide pharmacology, Microalgae metabolism, Oxidative Stress drug effects
- Abstract
There have been growing interests in the biorefining of bioactive compounds from marine microalgae, including pigments, omega-3 fatty acids or antioxidants for use in the nutraceutical and cosmetic sectors. This study focused on the comparative responses of five marine microalgal species from different lineages, including the dinoflagellate Amphidinium carterae, chlorophyte Brachiomonas submarina, diatom Stauroneis sp., haptophyte Diacronema sp. and rhodophyte Rhodella violacea, to exposure during their batch growth to hydrogen peroxide (H
2 O2 ). A. carterae returned an enhanced signal with the DPPH assay (8.8 µmol Trolox eq/g DW) when exposed to H2 O2 , which was associated with reduced pigment yields and increased proportions in saturated C16 and C18 fatty acids. B. submarina showed enhanced antioxidant response upon exposure to H2 O2 with the DPPH assay (10 µmol Trolox eq/g DW), a threefold decrease in lutein (from 2.3 to 0.8 mg/g) but a twofold increase in chlorophyll b (up to 30.0 mg/g). Stauroneis sp. showed a downward response for the antioxidant assays, but its pigment yields did not vary significantly from the control. Diacronema sp. showed reduced antioxidant response and fucoxanthin content (from 4.0 to 0.2 mg/g) when exposed to 0.5 mM H2 O2 . R. violacea exposed to H2 O2 returned enhanced antioxidant activity and proportions of EPA but was not significantly impacted in terms of pigment content. Results indicate that H2 O2 can be used to induce stress and initiate metabolic changes in microalgae. The responses were however species-specific, which would require further dosage optimisation to modulate the yields of specific metabolites in individual species., (© 2021. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)- Published
- 2021
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12. Antibacterial Activity and Amphidinol Profiling of the Marine Dinoflagellate Amphidinium carterae (Subclade III).
- Author
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Barone ME, Murphy E, Parkes R, Fleming GTA, Campanile F, Thomas OP, and Touzet N
- Subjects
- Anti-Bacterial Agents chemistry, Aquatic Organisms growth & development, Bridged Bicyclo Compounds, Heterocyclic chemistry, Dinoflagellida growth & development, Macrolides chemistry, Anti-Bacterial Agents pharmacology, Aquatic Organisms chemistry, Bacteria growth & development, Bridged Bicyclo Compounds, Heterocyclic pharmacology, Dinoflagellida chemistry, Macrolides pharmacology
- Abstract
Microalgae have received growing interest for their capacity to produce bioactive metabolites. This study aimed at characterising the antimicrobial potential of the marine dinoflagellate Amphidinium carterae strain LACW11, isolated from the west of Ireland. Amphidinolides have been identified as cytotoxic polyoxygenated polyketides produced by several Amphidinium species. Phylogenetic inference assigned our strain to Amphidinium carterae subclade III, along with isolates interspersed in different geographic regions. A two-stage extraction and fractionation process of the biomass was carried out. Extracts obtained after stage-1 were tested for bioactivity against bacterial ATCC strains of Staphylococcus aureus , Enterococcus faecalis , Escherichia coli and Pseudomonas aeruginosa . The stage-2 solid phase extraction provided 16 fractions, which were tested against S. aureus and E. faecalis. Fractions I, J and K yielded minimum inhibitory concentrations between 16 μg/mL and 256 μg/mL for both Gram-positive. A targeted metabolomic approach using UHPLC-HRMS/MS analysis applied on fractions G to J evidenced the presence of amphidinol type compounds AM-A, AM-B, AM-22 and a new derivative dehydroAM-A, with characteristic masses of m/z 1361, 1463, 1667 and 1343, respectively. Combining the results of the biological assays with the targeted metabolomic approach, we could conclude that AM-A and the new derivative dehydroAM-A are responsible for the detected antimicrobial bioactivity.
- Published
- 2021
- Full Text
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13. Isolation of extracellular vesicles from microalgae: towards the production of sustainable and natural nanocarriers of bioactive compounds.
- Author
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Picciotto S, Barone ME, Fierli D, Aranyos A, Adamo G, BoŽič D, Romancino DP, Stanly C, Parkes R, Morsbach S, Raccosta S, Paganini C, Cusimano A, Martorana V, Noto R, Carrotta R, Librizzi F, Capasso Palmiero U, Santonicola P, Iglič A, Gai M, Corcuera L, Kisslinger A, Di Schiavi E, Landfester K, Liguori GL, Kralj-Iglič V, Arosio P, Pocsfalvi G, Manno M, Touzet N, and Bongiovanni A
- Subjects
- Biomarkers, Biotechnology, Dynamic Light Scattering, Extracellular Vesicles, Microalgae
- Abstract
Safe, efficient and specific nano-delivery systems are essential for current and emerging therapeutics, precision medicine and other biotechnology sectors. Novel bio-based nanotechnologies have recently arisen, which are based on the exploitation of extracellular vesicles (EVs). In this context, it has become essential to identify suitable organisms or cellular types to act as reliable sources of EVs and to develop their pilot- to large-scale production. The discovery of new biosources and the optimisation of related bioprocesses for the isolation and functionalisation of nano-delivery vehicles are fundamental to further develop therapeutic and biotechnological applications. Microalgae constitute sustainable sources of bioactive compounds with a range of sectorial applications including for example the formulation of health supplements, cosmetic products or food ingredients. In this study, we demonstrate that microalgae are promising producers of EVs. By analysing the nanosized extracellular nano-objects produced by eighteen microalgal species, we identified seven promising EV-producing strains belonging to distinct lineages, suggesting that the production of EVs in microalgae is an evolutionary conserved trait. Here we report the selection process and focus on one of this seven species, the glaucophyte Cyanophora paradoxa, which returned a protein yield in the small EV fraction of 1 μg of EV proteins per mg of dry weight of microalgal biomass (corresponding to 10
9 particles per mg of dried biomass) and EVs with a diameter of 130 nm (mode), as determined by the micro bicinchoninic acid assay, nanoparticle tracking and dynamic light scattering analyses. Moreover, the extracellular nanostructures isolated from the conditioned media of microalgae species returned positive immunoblot signals for some commonly used EV-biomarkers such as Alix, Enolase, HSP70, and β-actin. Overall, this work establishes a platform for the efficient production of EVs from a sustainable bioresource and highlights the potential of microalgal EVs as novel biogenic nanovehicles.- Published
- 2021
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14. Nanoalgosomes: Introducing extracellular vesicles produced by microalgae.
- Author
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Adamo G, Fierli D, Romancino DP, Picciotto S, Barone ME, Aranyos A, Božič D, Morsbach S, Raccosta S, Stanly C, Paganini C, Gai M, Cusimano A, Martorana V, Noto R, Carrotta R, Librizzi F, Randazzo L, Parkes R, Capasso Palmiero U, Rao E, Paterna A, Santonicola P, Iglič A, Corcuera L, Kisslinger A, Di Schiavi E, Liguori GL, Landfester K, Kralj-Iglič V, Arosio P, Pocsfalvi G, Touzet N, Manno M, and Bongiovanni A
- Subjects
- Extracellular Vesicles metabolism, Extracellular Vesicles physiology, Microalgae genetics, Ultracentrifugation methods, Drug Delivery Systems methods, Extracellular Vesicles chemistry, Microalgae metabolism
- Abstract
Cellular, inter-organismal and cross kingdom communication via extracellular vesicles (EVs) is intensively studied in basic science with high expectation for a large variety of bio-technological applications. EVs intrinsically possess many attributes of a drug delivery vehicle. Beyond the implications for basic cell biology, academic and industrial interests in EVs have increased in the last few years. Microalgae constitute sustainable and renewable sources of bioactive compounds with a range of sectoral applications, including the formulation of health supplements, cosmetic products and food ingredients. Here we describe a newly discovered subtype of EVs derived from microalgae, which we named nanoalgosomes. We isolated these extracellular nano-objects from cultures of microalgal strains, including the marine photosynthetic chlorophyte Tetraselmis chuii , using differential ultracentrifugation or tangential flow fractionation and focusing on the nanosized small EVs (sEVs). We explore different biochemical and physical properties and we show that nanoalgosomes are efficiently taken up by mammalian cell lines, confirming the cross kingdom communication potential of EVs. This is the first detailed description of such membranous nanovesicles from microalgae. With respect to EVs isolated from other organisms, nanoalgosomes present several advantages in that microalgae are a renewable and sustainable natural source, which could easily be scalable in terms of nanoalgosome production., Competing Interests: The authors report no conflict of interest., (© 2021 The Authors. Journal of Extracellular Vesicles published by Wiley Periodicals, LLC on behalf of the International Society for Extracellular Vesicles.)
- Published
- 2021
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15. [Withdrawal of life support in the permanent vegetative state, and a dignified death].
- Author
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Fustinoni O, Barone ME, Elli JR, Gonorazky SE, Martínez Perea MDC, and Rotta Escalante R
- Subjects
- Argentina, Humans, Life Support Care legislation & jurisprudence, Persistent Vegetative State, Right to Die legislation & jurisprudence, Withholding Treatment legislation & jurisprudence
- Abstract
Patient relatives often request withdrawal of life support, especially artificial nutrition and hydration, in cases of permanent vegetative or minimally conscious state, and resort to court in case of disagreement. Two recent cases of withdrawal authorized by the courts concerned, one from abroad and one from Argentina, have been controversial. Although it may appear inhuman to stop feeding and hydrating such patients, to continue it only prolongs a state of irreversible biological subsistence. Families tend to increasingly accept withdrawal if the patient status remains unchanged. However, concern persists regarding the suffering that patients may undergo from onset of withdrawal till death, even though such suffering is little conceivable in the absence of cortical function and conscience content. While doctors and the layman consider ethical to withdraw life support, a nonnegligible proportion of doctors consider that vegetative state patients, even more minimally conscious state patients, do experience hunger, thirst and pain. In some countries, like the United Kingdom, strict withdrawal criteria were proposed, together with pharmacological treatment schemes for the distress arising during the withdrawal period, even though its benefit is controversial. In Argentina, two scientific societies have publicly advocated withdrawal, but not issued formal guidelines. In any case, both "dignified death" Law 26.742 and the Civil Code consent withdrawal of life support, if accompanied by appropriate relief of clinical symptoms indicating suffering.
- Published
- 2020
16. Neurocritical Patient Characteristics Related to Brain Death.
- Author
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Bacqué MC, Barone ME, Yankowski A, Antik A, Trunzo L, Fioretti S, and Penone P
- Subjects
- Adult, Aged, Argentina, Cerebral Hemorrhage pathology, Disease Progression, Female, Humans, Male, Middle Aged, Multivariate Analysis, Retrospective Studies, Stroke pathology, Subarachnoid Hemorrhage pathology, Brain Death pathology, Brain Diseases pathology, Glasgow Outcome Scale statistics & numerical data
- Abstract
Background: The lack of viable organs for transplantation led to the creation in Argentina of the Glasgow 7 Program based on the detection and follow-up of acute neurologic patients admitted with Glasgow scores ≤7 in selected hospitals. The objective of this study was to determine the likelihood of hospitalized acute neurologic patients progressing to brain death (BD) based on several variables, including age, sex, and admission diagnosis., Methods: This study was a retrospective cohort analysis of data obtained from the SINTRA (Procurement and Transplantation National Information System) database between 2006 and 2015. Independent variables included the following: age, sex, and diagnosis at admission; ischemic stroke; spontaneous intracerebral hematoma (SIH); subarachnoid hemorrhage (SH); anoxia, meningitis; penetrating head injury (PHI); closed head injury; and tumors. A multivariate analysis was performed adjusting the diagnosis at admission according to age and sex., Results: A total of 31,877 patients were included: 19,308 (61%) patients died and 9736 (30%) evolved to BD. Overall, 36% of women and 28% of men evolved to BD (relative risk, 0.87 [95% confidence interval (CI), 0.86-0.89]; P < .001). In the multivariate analysis adjusted for age and sex, we observed the following: SIH OR, 1.79 (95% CI, 1.69-1.9; P < .001); ischemic stroke OR, 0.82 (95% CI, 0.73-0.92; P < .001); SH OR, 2.33 (95% CI, 2.16-2.52; P < .001); anoxia OR, 0.71 (95% CI, 0.64-0.79; P < .001); closed head injury OR, 0.41 (95% CI, 0.38-0.43; P < .001); PHI OR, 2.64 (95% CI, 2.38-2.94; P < .001); and tumors OR, 1.07 (95% CI, 0.93-1.24; P = .31)., Conclusions: Thirty percent of the patients who entered the Glasgow 7 Program evolved with BD. The characteristics most likely to result in BD were age, female sex, PHI, SH, and SIH., (Copyright © 2017 Elsevier Inc. All rights reserved.)
- Published
- 2018
- Full Text
- View/download PDF
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