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Background. Overweight and obesity have reached epidemic proportions and safe treatments are needed to heal these diseases. Objective. The objective of this study is to examine the activity of a medical device based on polyglucosamine polymers (PG) on body weight (BW) reduction, insulin resistance, and the serum levels of fat-soluble vitamins and glucosamine. Methods. A double-blind placebo-controlled interventional study comparing PG and a placebo (PL) was conducted. One hundred and fifty overweight or obese cases were treated, divided into two groups for a period of 90 days at the dosage of 3 g/day. Results. One hundred and nineteen cases (58 with PG and 61 with PL, respectively) concluded the treatment. PG was more effective than the PL on the reduction of BW and insulin resistance. No modification of fat-soluble vitamins (Vit A, E, D3, K1) and glucosamine levels was shown. Total cholesterol levels were significantly more reduced in the PG group compared to the PL group as it was for subjects with a BW decrease of >5%. Conclusions. PG acts as a safe medical device, is not absorbed, and binds lipids in the upper gastrointestinal tract, reducing their availability, with a significant activity on the reduction of BW, insulin resistance, and cholesterol levels without the modification of fat-soluble vitamins.

The use of dietary supplements for weight loss has gained significant momentum. Polyglucosamine, a chitosan derivative, is a dietary supplement increasingly used for weight loss. In this meta-analysis, we systematically summarized and quantified the key findings of four randomized, placebo-controlled clinical trials examining the effects of polyglucosamine supplementation and caloric restriction, and physical activity on body weight, body mass index (BMI), and waist circumference in subjects with overweight and obesity. The control group was set with a physical activity from 6–7 MET-h/week activity and up to 21 MET-h/week activity with caloric restriction. Compliance in the latter trials was reported via a follow-up questionnaire with the individual participants. The analysis included 399 subjects followed for a period ranging from 12 weeks to one year. Subjects’ age ranged from 21–75 years, BMI from 26–45 kg/m2, and all were white European or Caucasian in ethnicity. The meta-analyzed mean differences for random effects showed that polyglucosamine supplementation improves weight loss by −1.78 kg [−2.78, −0.79], BMI by −1.52 kg/m2 [−3.58, 0.54], and improves waist circumference reduction by −1.45 cm [−2.77, −0.12]. In conclusion, the use of polyglucosamine supplementation in conjunction with lifestyle behavioral therapies can be effective for weight reduction. Further studies are needed to examine the long-term effects of polyglucosamine supplementation on weight loss and other metabolic parameters

N-3 eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) seem to prevent endothelial dysfunction, a crucial step in atherogenesis, by modulating the levels of vasoactive molecules and by influencing Na,K-ATPase activity of vascular myocytes. The activity of endothelial Na,K-ATPase controls the ionic homeostasis of the neighboring cells, as well as cell function. However, controversy exists with respect to the vascular protective effect of EPA and DHA. We argue that this dispute might be due to the use of different concentrations of EPA and DHA in different studies. Therefore, this study was designed to define an optimal concentration of EPA and DHA to investigate endothelial function. For this purpose, human endothelial cells were exposed for 24 h to different concentrations of DHA or EPA (0−20 μM) to study membrane fluidity, peroxidation potential and Na,K-ATPase activity. EPA and DHA were linearly incorporated and this incorporation was mirrored by the linear increase of unsaturation index, membrane fluidity, and peroxidation potential. Na,K-ATPase activity peaked at 3.75 μM of EPA and DHA and then gradually decreased. It is noteworthy that DHA effects were always more pronounced than EPA. Concluding, low concentrations of EPA and DHA minimize peroxidation sensitivity and optimize Na,K-ATPase activity.

The increased generation of reactive oxygen species that occurs in the condition of obesity may be responsible for oxidative injury to erythrocyte membranes, which could lead to a decrease in tissue oxygenation. Therefore, we have looked into the effects of obesity on both indexes of oxidative damage and physical-chemical properties of erythrocyte membranes in 50 overweight or obese [25 < body mass index (BMI) < 33], normotensive, nondiabetic women and 50 age-matched lean healthy women (BMI < 25). In the obese group compared with the lean group, we found that a) the onset of free radical-induced erythrocyte hemolysis and the ratio between reduced and oxidized glutathione were reduced, whereas the rate of free radical-induced damage increased; b) the n-3 fatty acid and the phospholipid contents decreased; c) the ratio between cholesterol and phospholipids increased; and d) the membrane fluidity decreased.These findings suggest an impairment of erythrocyte membrane physical-chemical properties in overweight and obese people as a consequence of oxidative injury that might be part of a pathogenetic mechanism responsible for obesity-related pathologies such as atherosclerosis and hypertension.

El síndrome de ovario poliquístico (SOP) afecta entre un 5-10% de las mujeres en edad reproductiva y constituye la endocrinopatía más frecuente de la población adolescente de nuestro país. Su diversa sintomatología puede provocar un impacto en la calidad de vida de las mujeres, lo que amenaza la identidad femenina en ellas. Esta revisión bibliográfica tiene como objetivo conocer de qué manera el SOP afecta la calidad de vida de las mujeres. La literatura señala que al comparar la calidad de vida entre mujeres sanas y con SOP, éstas últimas presentan un deterioro en diversos dominios estudiados con instrumentos generales. Al ser evaluada la calidad de vida de mujeres con SOP, por medio de un instrumento específico para dicha patología, los dominios más afectados fueron: el área de problemas menstruales, emociones y vello corporal. Investigaciones que evalúan el efecto de la sintomatología del SOP por separado en la calidad de vida de las mujeres señalan igualmente un impacto negativo. Se concluye en base a esta revisión que el SOP afecta la calidad de vida en sus diferentes dimensiones, por lo que se postula la importancia de evaluar este parámetro en las mujeres afectadas y la necesidad de que los profesionales de la salud lo consideren al momento de evaluar la intervención realizadaPolycystic ovary syndrome (PCOS) has a prevalence of 5-10% in women of reproductive age, and constitutes the most frequent endocrine disease among teenagers in our country. Its very diverse clinical manifestations can impact women's quality of life, which can also be responsible of jeopardizing their female identity. The objective of this study is to know how polycystic ovary syndrome affects quality of life among women. In comparison to normal women, literature suggests that the ones suffering from PQOS appear to have a degree of deterioration in different domains studied with general instruments. The quality of life of women having PQOS was evaluated, using a specific instrument for this pathology. The domains found to be most affected were: menstrual problems, emotional aspects and body hair. Other investigations which separately evaluate clinical manifestations of PQOS from quality of life equally suggest a negative impact. Based on this study, it is concluded that PCOS affects women's quality of life in a multidimensional way, therefore its importance of evaluating this parameter in affected women. It also outlines the need of health professionals to consider this at the time of evaluating a given intervention

Competing Interests: Declaration of competing interest Dr. Leone received speaking honoraria from St. Jude Medical/Abbott, Medtronic, Abiomed, and from Bracco Imaging; Dr. Biscaglia received unrestricted research grants and speaker's fees from SMT, Medis, Abbott, and Insight Lifetech; Dr. Campaniello received institutional research grants from Medis, GE Healthcare (Little Chalfont, United Kingdom), Siemens Healthcare, Abbott Vascular, Sahajanand Medical Technologies, and Insight Lifetech; Dr. Vergallo received consulting or lecturing fees from Abbott Vascular, Daiichi Sankyo, Amgen, Medtronic and Terumo; Dr. Porto reports consultant or speaker fees from Biotronik, ABIOMED, Terumo, Philips, Sanofi, Amgen, Daiichi-Sankyo, AstraZeneca, Bayer, and PIAM; Drs. Trani and Burzotta received speaker's fees from Abbott, Medtronic, and Abiomed. The remaining authors have no competing interests to declare.

Constrictive pericarditis is a rare, but fatal disease, leading to heart failure due to diastolic dysfunction resulting from the fibrotic and non-elastic pericardium. Clinical presentation is sneaky, with initial symptoms of splanchnic and peripheral venous congestion, then with hepatomegaly and ascites: this kind of presentation is not often recognized, delaying diagnosis. We report the case of a young male adult with no previous cardiovascular history, but with a diagnosis of hepatic cirrhosis: investigations in our Centre led to the diagnosis of constrictive pericarditis, successfully treated with pericardiectomy; however, despite the effective venous decongestion, it was not possible to spare the patient from liver transplant.

Traditionally, dominant breeders have been considered to be able to control the reproduction of other individuals in multimember groups that have high variance in reproductive success/reproductive skew (e.g., forced sterility/coercion of conspecifics in eusocial animals; sex-change suppression in sequential hermaphrodites). These actions are typically presented as active impositions by reproductively dominant individuals. However, how can individuals regulate the reproductive physiology of others? Alternatively, all contestants make reproductive decisions, and less successful individuals self-downregulate reproduction in the presence of dominant breeders. Shifting perspective from a top-down manipulation to a broader view, which includes all contenders, and using a multitaxon approach, we propose a unifying framework for the resolution of reproductive skew conflicts based on signalling rather than control, along a continuum of levels of strategic regulation of reproduction., Competing Interests: Declaration of interests The authors declare no conflicts of interest., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Large vessel vasculitis, such as Takayasu's arteritis (TA), is a rare inflammatory disease affecting multiple vascular districts including the coronary arteries, producing either stenosis and/or aneurysms: these lesions can be found in the same patient and also in the same vessel, with potentially devastating effects. Moreover, TA often affects young people, in the midst of their work and social activity. Ischemic heart disease is the leading cause of cardiovascular mortality in Western countries and is mainly due to coronary atherosclerosis, whose etiopathogenesis is multifactorial and is closely related to the concomitant presence of classic cardiovascular risk factors and inflammation of the vessel wall. We report the case of a young, physically active adult with multivessel coronary artery disease developed in the context of a TA bursted 7 years before and currently in clinical remission. This complex case required a careful literature review and a multidisciplinary approach, since the best treatment option for coronary lesions induced by TA has not been established: a "watchful waiting" strategy was eventually adopted, considering the poor outcome of both percutaneous and surgical revascularization in this group of patients.

Sexual systems are highly diverse and have profound consequences for population dynamics and resilience. Yet, little is known about how they evolved. Using phylogenetic Bayesian modelling and a sample of 4614 species, we show that gonochorism is the likely ancestral condition in teleost fish. While all hermaphroditic forms revert quickly to gonochorism, protogyny and simultaneous hermaphroditism are evolutionarily more stable than protandry. In line with theoretical expectations, simultaneous hermaphroditism does not evolve directly from gonochorism but can evolve slowly from sequential hermaphroditism, particularly protandry. We find support for the predictions from life history theory that protogynous, but not protandrous, species live longer than gonochoristic species and invest the least in male gonad mass. The distribution of teleosts' sexual systems on the tree of life does not seem to reflect just adaptive predictions, suggesting that adaptations alone may not fully explain why some sexual forms evolve in some taxa but not others (Williams' paradox). We propose that future studies should incorporate mating systems, spawning behaviours, and the diversity of sex determining mechanisms. Some of the latter might constrain the evolution of hermaphroditism, while the non-duality of the embryological origin of teleost gonads might explain why protogyny predominates over protandry in teleosts., (© 2022. The Author(s).)

Interactions between hosts and their resident microbial communities are a fundamental component of fitness for both agents. Though recent research has highlighted the importance of interactions between animals and their bacterial communities, comparative evidence for fungi is lacking, especially in natural populations. Using data from 49 species, we present novel evidence of strong covariation between fungal and bacterial communities across the host phylogeny, indicative of recruitment by hosts for specific suites of microbes. Using co-occurrence networks, we demonstrate marked variation across host taxonomy in patterns of covariation between bacterial and fungal abundances. Host phylogeny drives differences in the overall richness of bacterial and fungal communities, but the effect of diet on richness was only evident in the mammalian gut microbiome. Sample type, tissue storage and DNA extraction method also affected bacterial and fungal community composition, and future studies would benefit from standardized approaches to sample processing. Collectively these data indicate fungal microbiomes may play a key role in host fitness and suggest an urgent need to study multiple agents of the animal microbiome to accurately determine the strength and ecological significance of host-microbe interactions.

The Sparids are an ideal group of fishes in which to study the evolution of sexual systems since they exhibit a great sexual diversity, from gonochorism (separate sexes) to protandrous (male-first) and protogynous (female-first) sequential hermaphroditism (sex change). According to the size-advantage model (SAM), selection should favour sex change when the second sex achieves greater reproductive success at a larger body size than the first sex. Using phylogenetic comparative methods and a sample of 68 sparid species, we show that protogyny and protandry evolve from gonochorism but evolutionary transitions between these two forms of sequential hermaphroditism are unlikely to happen. Using male gonadosomatic index (GSI) as a measure of investment in gametes and proxy for sperm competition, we find that, while gonochoristic and protogynous species support the predictions of SAM, protandrous species do not, as they exhibit higher GSI values than expected even after considering mating systems and spawning modes. We suggest that small males of protandrous species have to invest disproportionally more in sperm production than predicted not only when spawning in aggregations, with high levels of sperm competition, but also when spawning in pairs due to the need to fertilize highly fecund females, much larger than themselves. We propose that this compensatory mechanism, together with Bateman's principles in sequential hermaphrodites, should be formally incorporated in the SAM.

We focus on a case study along an English canal comparing environmental DNA (eDNA) metabarcoding with two types of electrofishing techniques (wade-and-reach and boom-boat). In addition to corroborating data obtained by electrofishing, eDNA provided a wider snapshot of fish assemblages. Given the semi-lotic nature of canals, we encourage the use of eDNA as a fast and cost-effective tool to detect and monitor whole fish communities., (© 2019 The Fisheries Society of the British Isles.)

Given their positioning and biological productivity, estuaries have long represented key providers of ecosystem services and consequently remain under remarkable pressure from numerous forms of anthropogenic impact. The monitoring of fish communities in space and time is one of the most widespread and established approaches to assess the ecological status of estuaries and other coastal habitats, but traditional fish surveys are invasive, costly, labour intensive and highly selective. Recently, the application of metabarcoding techniques, on either sediment or aqueous environmental DNA, has rapidly gained popularity. Here, we evaluate the application of a novel, high-throughput DNA-based monitoring tool to assess fish diversity, based on the analysis of the gut contents of a generalist predator/scavenger, the European brown shrimp, Crangon crangon. Sediment and shrimp samples were collected from eight European estuaries, and DNA metabarcoding (using both 12S and COI markers) was carried out to infer fish assemblage composition. We detected 32 teleost species (16 and 20, for 12S and COI, respectively). Twice as many species were recovered using metabarcoding than by traditional net surveys. By comparing and interweaving trophic, environmental DNA and traditional survey-based techniques, we show that the DNA-assisted gut content analysis of a ubiquitous, easily accessible, generalist species may serve as a powerful, rapid and cost-effective tool for large-scale, routine estuarine biodiversity monitoring., (© 2018 The Authors. Molecular Ecology Resources Published by John Wiley & Sons Ltd.)

A thorough understanding of ecological networks relies on comprehensive information on trophic relationships among species. Since unpicking the diet of many organisms is unattainable using traditional morphology-based approaches, the application of high-throughput sequencing methods represents a rapid and powerful way forward. Here, we assessed the application of DNA metabarcoding with nearly universal primers for the mitochondrial marker cytochrome c oxidase I in defining the trophic ecology of adult brown shrimp, Crangon crangon, in six European estuaries. The exact trophic role of this abundant and widespread coastal benthic species is somewhat controversial, while information on geographical variation remains scant. Results revealed a highly opportunistic behaviour. Shrimp stomach contents contained hundreds of taxa (>1,000 molecular operational taxonomic units), of which 291 were identified as distinct species, belonging to 35 phyla. Only twenty ascertained species had a mean relative abundance of more than 0.5%. Predominant species included other abundant coastal and estuarine taxa, including the shore crab Carcinus maenas and the amphipod Corophium volutator. Jacobs' selectivity index estimates based on DNA extracted from both shrimp stomachs and sediment samples were used to assess the shrimp's trophic niche indicating a generalist diet, dominated by crustaceans, polychaetes and fish. Spatial variation in diet composition, at regional and local scales, confirmed the highly flexible nature of this trophic opportunist. Furthermore, the detection of a prevalent, possibly endoparasitic fungus (Purpureocillium lilacinum) in the shrimp's stomach demonstrates the wide range of questions that can be addressed using metabarcoding, towards a more robust reconstruction of ecological networks., (© 2018 The Authors. Molecular Ecology published by John Wiley & Sons Ltd.)

Sequential hermaphroditism, where males change to females (protandry) or the reverse (protogyny), is widespread in animals and plants, and can be an evolutionarily stable strategy (ESS) if fecundity rises faster with age in the second sex. Sequential hermaphrodites also generally have sex ratios skewed towards the initial sex, and standard theory based on fixed sexes indicates that this should reduce effective population size ( N e ) and increase the deleterious effects of genetic drift. We show that despite having skewed sex ratios, populations that change sex at the ESS age do not have reduced N e compared with fixed-sex populations with an even sex ratio. This implies that the ability of individuals to operate as both male and female allows the population to avoid some evolutionary constraints imposed by fixed sexes. Furthermore, N e would be maximized if sex change occurred at a different (generally earlier) age than is selected for at the individual level, which suggests a potential conflict between individual and group selection. We also develop a novel method to quantify the strength of selection for sex reversal.

A combination of burrowing behaviour and very efficient background matching makes the brown shrimp Crangon crangon almost invisible to potential predators and prey. This raises questions on how shrimp succeed in concealing themselves in the heterogeneous and dynamic estuarine habitats they inhabit and what type of environmental variables and behavioural factors affect their colour change abilities. Using a series of behavioural experiments, we show that the brown shrimp is capable of repeated fast colour adaptations (20% change in dark pigment cover within one hour) and that its background matching ability is mainly influenced by illumination and sediment colour. Novel insights are provided on the occurrence of non-adaptive (possibly stress) responses to background changes after long-time exposure to a constant background colour or during unfavourable conditions for burying. Shrimp showed high levels of intra- and inter-individual variation, demonstrating a complex balance between behavioural-plasticity and environmental adaptation. As such, the study of crustacean colour changes represents a valuable opportunity to investigate colour adaptations in dynamic habitats and can help us to identify the mayor environmental and behavioural factors influencing the evolution of animal background matching.

The study of animal colouration addresses fundamental and applied aspects relevant to a wide range of fields, including behavioural ecology, environmental adaptation and visual ecology. Although a variety of methods are available to measure animal colours, only few focus on chromatophores (specialized cells containing pigments) and pigment migration. Here, we illustrate a freely available and user-friendly method to quantify pigment cover (PiC) with high precision and low effort using digital images, where the foreground (i.e. pigments in chromatophores) can be detected and separated from the background. Images of the brown shrimp, Crangon crangon , were used to compare PiC with the traditional Chromatophore Index (CI). Results indicate that PiC outcompetes CI for pigment detection and transparency measures in terms of speed, accuracy and precision. The proposed methodology provides researchers with a useful tool to answer essential physiological, behavioural and evolutionary questions on animal colouration in a wide range of species., (© The Author 2017. Published by Oxford University Press.)

Behavioural observations in the field of male Mediterranean damselfish Chromis chromis were combined with molecular analyses, using bi-parentally and maternally inherited markers, to investigate reproductive success patterns of alternative reproductive tactics (ARTs) in terms of number of eggs sired and number of females contributing to each nest. Cuckoldry was observed in every nest sampled, with at least two and up to seven sneaker males per nest. The nesting male, however, always significantly fertilized the greater number of eggs (on average 49%) in each clutch, whereas each sneaker fertilized around 7% of the clutch. The average number of females whose eggs were fertilized by nesting males was 6·76 (range 2-13), while each sneaker on average fertilized the eggs of 1·74 (range 1-8) females. Using this sibship reconstruction, some of the factors involved in the regulation of the dynamic equilibrium of reproductive success were investigated between the two ARTs shown by C. chromis males. Results show that the sneakers' reproductive success was positively linked to egg clutch size; the density of individuals in the nesting area negatively affected the size of egg clutches; the rate of defence behaviours performed by nesting males negatively influenced the number of females contributing to each nest., (© 2016 The Fisheries Society of the British Isles.)

Aim: Cholecystectomy is among surgical procedures with the longest waiting list and a significant amount of patients waiting for surgery suffer from symptoms related to complications of cholelithiasis. The aim of this study is to evaluate the economic impact caused by waiting lists., Material and Methods: A retrospective study was performed on patients undergoing intervention of cholecystectomy. 86 patients were included in the study. A comparative analysis was carried out among patients without complications (group A) and patients who faced complications while waiting for surgery, therefore requiring unplanned hospital admissions (group B), and patients who were operated in emergency for complications (group C)., Results: The overall cost of health care amounted to 1.849,4 € for each patient of group A, 3.513,2 € for each patient of group B and 2.584,6 € for each patient of group C. Each patient of group B was about 1.9 times more expensive than an asymptomatic one (group A) and about 1.36 times more expensive than one operated in emergency (group C). The conversion rate of the groups was not statistically significant, whereas the length of hospital stays was: patients in group B had longer hospital stays compared to patients in groups A and C., Conclusion: Early laparoscopic cholecystectomy for complicated cholelithiasis is the cheapest treatment considering the costs of health care, causing lower social costs related to absence from work and an improved perception of the quality of life.

Aim: Cholecystectomy is among surgical procedures with the longest waiting list and a significant amount of patients waiting for surgery suffer from symptoms related to complications of cholelithiasis. The aim of this study is to evaluate the economic impact caused by waiting lists., Material and Methods: A retrospective study was performed on patients undergoing intervention of cholecystectomy. 86 patients were included in the study. A comparative analysis was carried out among patients without complications (group A) and patients who faced complications while waiting for surgery, therefore requiring unplanned hospital admissions (group B), and patients who were operated in emergency for complications (group C)., Results: The overall cost of health care amounted to 1.849,4 € for each patient of group A, 3.513,2 € for each patient of group B and 2.584,6 € for each patient of group C. Each patient of group B was about 1.9 times more expensive than an asymptomatic one (group A) and about 1.36 times more expensive than one operated in emergency (group C). The conversion rate of the groups was not statistically significant, whereas the length of hospital stays was: patients in group B had longer hospital stays compared to patients in groups A and C., Conclusion: Early laparoscopic cholecystectomy for complicated cholelithiasis is the cheapest treatment considering the costs of health care, causing lower social costs related to absence from work and an improved perception of the quality of life., Key Words: Cholecystectomy, Complications, Medical care costs, Waiting list.

In the framework of biological control, the selection of effective natural enemies determines the final pest control. Thus, the genetic improvement of biocontrol agents could enhance the efficiency of biocontrol programs. Although promising, this approach has rarely been applied in this field. At the intraspecific level, hybridization between divergent populations of biocontrol agents is expected to promote hybrid vigor (heterosis), but it is not clear to what extent. An even more difficult task is the ability to predict the fitness of hybrids from the biological characteristics of their parents. We investigated these general questions by crossing seven populations of the parasitoid wasp Trichogramma chilonis (Hymenoptera: Trichogrammatidae). Our results show different levels of mating compatibilities among populations, including asymmetric or almost complete reproductive isolation. Hybrids' performance (fitness of the F(1) generation) ranges from inbreeding depression to heterosis. It was possible, to some extent, to predict hybrid fitness from pairwise genetic and phenotypic distances among parents, in accordance with the 'dominance' hypothesis. This may provide general guidelines for the genetic improvement of biological control agents.