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In this article, we describe our Métis-guided community-based participatory research exploring health protective factors for mental health and addiction within the Métis Nation of Alberta (MNA)—Region 3. There is much research regarding the detrimental effects of colonialism but a lack of Métis-guided research contributing to understanding of individual, family, and community well-being. The primary aim of our study was to explore health protective factors for mental health and addiction challenges. Our study was informed by Indigenous ways of knowing, focusing on the connectedness of all things, and participatory action research, a philosophy and method focused on inclusion and community incorporation of local knowledge. Participants described the need to foster respect, trust, courage, wisdom, humility, truth, humor, esteem, honesty, acceptance, identity, and love, emphasizing well-being through connection with Creator. All authors but the first are members of the MNA—Region 3.

Background: There is a lack of Métis-guided participatory research on factors that contribute to individual, family and community well-being, such as developing social support and engaging in cultural, social and historical processes for healing and health. The purpose of this study was to explore links among health, spirituality and well-being within the Métis Nation of Alberta (MNA) – Region 3. Methods: In the largest of 12 MNA – Region 3 communities, together with a working group of 9 community members, informal and elected leaders, and an Elder, we codeveloped a qualitative structured survey exploring health, spirituality and well-being. Following face-to-face distribution of the paper survey to community members (February to March 2019), we engaged with 7 working group members in coding and theme development. Results were shared with the community. Results: Thirty-one community members requested surveys, with 29 participants aged 28–80 years (mean 54.77 yr, standard deviation 15.31 yr) completing the surveys (94% completion rate). Six participants were in the working group that codeveloped the survey. An overarching theme of connection and 4 corresponding subthemes were identified; central to well-being was maintaining connection and balance in mental, emotional, spiritual and physical aspects of health. Connection to Métis ancestry required understanding identity; connection to community involved feeling at home; connection to land included belonging; and connection to tradition encompassed blending of cultures. Interpretation: Connection among ancestry, land, community and tradition contributed to well-being in our sample. Under the direction of each MNA region, exploration of health, spirituality and well-being with the use of our survey could be considered in community-specific Métis-guided ways across the remaining 5 MNA regions; the survey may also be of use to other provincial bodies in the Métis Nation.

In forest ecosystems, a variety of abiotic and biotic soil forming factors drives soil organic matter (SOM) and nutrients cycling with a profitable outcome on climate change mitigation. As a consequence, type and intensity of forest management, through its impact on carbon (C) and nutrient soil stocks, can be considered as an additional soil forming force. In this study, we investigated the influence of the coppice conversion into high forest on pedogenesis and on soil C and nutrient (N, P, Ca, Mg, and K) stocks, fifty years later the beginning of the conversion-cycle. The trial was established in a Turkey oak forest historically managed under the coppice system in central Italy. Specifically, we considered tree population density (natural evolution - control, moderate thinning, heavy thinning) where soil samples were collected according to genetic horizon to estimate C, N, and P stocks both in the forest floor and at fixed depth intervals (0-30, 30-50 and 50-75 cm). Further, the stocks of exchangeable Ca, Mg, and K were also assessed for the mineral layers. The results showed that litter and the upper layer of mineral soil (0-30 cm) contained a similar quantity of C (about 74-83 Mg ha

Fine needle aspiration (FNA) is a marginally invasive, fast and cost-effective technique to diagnose malignancy as well as other pathologies in different anatomical sites. In the last few years, there has been a significant increase in the demands on sensitivity and specificity of cytodiagnosis as well as in the requirement to produce further biological data to better determine treatment and prognosis.1 Unfortunately, cytology specimens often are not suitable for ancillary studies both for the quality and the amount of the material. Furthermore, carrying out more aspirations may not be doable. Another point to be underlined is the fact that many times pathologists adapt ancillary techniques learnt in histology to cytology specimens without bearing in mind main differences in the specimen preparation that could alter the final interpretation of the data and ultimately the diagnosis for patient care.2 This is particularly true in the case of immunohistochemistry, where the great majority of the commercially available antibodies have been selected for their reliability when used in tissues fixed in formalin and paraffin-embedded.3 4 In this article, we propose a novel approach for the immunohistochemical characterisation of tumour fine needle aspirates by taking advantage of Cytomatrix, a recently defined synthetic matrix that counts among its various characteristics the property to capture and store inside its three-dimensional structure, the biological material (micro-macro cells …

We report a brief discussion on a clinical case of a female patient, 85 years old, affected by severe cognitive impairment and chronic obstructive pulmonary disease (COPD). The patient was not taking drugs at home (apart from promazine: 10 drops when necessary to control her behavioral diseases). A previous neuropsychological evaluation had shown a severe cognitive impairment MMSE = 16/30; ADL = 3/6; IADL = 0/8) due to multiple brain ischemic areas (confirmed in 2003 by MRI neuroimaging). When the patient was admitted to our center she was able to perform some basic activities of daily living such as eating and walking and was not too confused. She was included in cognitive rehabilitation groups. Since she showed signs of Parkinsonism, a therapy based on omeprazol 20 mg, acetylsalicylic acid, donepezil 10 mg, pramipexol 0.18 mg, nimodipine 10 drops, levodopa + carbidopa 100/25 mg was started. A few days later she became sleepy during daytime and, once, she lost her balance and fell. She was not self-sufficient any more. At first this was attributed to a lung infection that the patient had, but her state continue after the infection was completely cured with appropriate antibiotics therapy. At that point an adverse drug reaction was suspected and therapy with pramipexol 0.18 mg was interrupted. In a few days the patient regained her previous level of consciousness and self-sufficiency. We consider this a typical case of complex management in a patient with dementia and comorbidity in which adverse drug reactions can play an important role in lowering the level of cognitive functions. In this case the relationship with the family of the patient was made difficult by the attitude of the patient's daughter who decided, after the onset of the adverse drug reaction, to interrupt her mother's stay in our center even at risk of the worst consequences.

IFN-alpha has recently been shown to prolong the remission phase in MM patients with low tumor mass. So far, it is not known whether IFN-alpha exerts its effect directly on the myeloma cells or is mediated by modulation of the host response.The immune status of 12 multiple myeloma patients with low tumor mass (10 in remission phase, 2 with stage IA disease) was investigated by phenotypic and functional analyses before, after 3, and after 6 months of recombinant interferon-alpha 2b (IFN-alpha) therapy.Phenotyping of peripheral blood lymphocytes (PBL) revealed a significant decrease of HLA-DR+ (P = 0.01) and CD20+ (P = 0.04) cells after 6 months of therapy. Two-color phenotyping of purified T cell populations (PBT) showed a significant increase of CD4+ CD11b+ cells (P = 0.01) after 6 months of therapy. Functional analyses were carried out on PBL (NK cell-mediated cytotoxicity) and PBT (alloreactive cytotoxicity, CTL; IL2-induced cytotoxicity, LAK activity). NK and CTL activities were poorly influenced by IFN-alpha treatment, whereas LAK activity showed a significant increase (P = 0.007). Any significant association between these immunological changes and the disease status was questioned by the lack of differences between MM in relapse and MM with stable disease at the sixth month of IFN-alpha therapy.i) IFN-alpha in MM with low tumor mass may exert its therapeutic activity by directly acting on the tumor cells; ii) the parameters which have been used in this study are not appropriate to monitor the immunological effects (if any) of IFN-alpha therapy.

Subset distribution, ecto-5'nucleotidase (5'NT) activity, and the generation of allospecific cytotoxic T lymphocytes (CTL) were investigated in peripheral blood T lymphocytes from 39 hemophilia A patients divided into three groups: group A and group B (HIV-patients with CD4:CD8 ratio less than 1 and greater than 1 respectively), and group C (HIV + patients). 5'NT activity was significantly decreased compared with healthy controls in groups B and C. In group B, this deficiency was attributable to expansion of CD8 + CD11 + suppressor cells. In group C, activated (HLA-DR+) CD8+ cells were also present and contributed to 5'NT deficiency. The suppressor cell expansion seemed to be mainly related to AHF infusions, whereas HLA-DR expression was related to HIV infection. CD11+ and HLA-DR+ cells were also expanded in the CD4+ subpopulation of all three groups, whereas CD4+ CD28+ lymphocytes were significantly decreased in group C only. Lastly, alloreactive cytotoxicity was decreased in group B and was normal in groups A and C.

The generation of cytotoxic T lymphocytes (CTL) towards allogeneic cells was investigated in 19 patients with monoclonal gammopathy of undetermined significance (MGUS) and 31 patients with multiple myeloma (MM). This function was significantly decreased in all patients. The cytotoxic deficiency was more pronounced in MM with poor prognosis than MM with good prognosis and MGUS patients. A phenotypic analysis of PBT lymphocytes showed that poor prognosis MM also had the highest proportions of activated cells (HLA-DR+) in CD8+ subpopulations. CTL were generated after depletion of CD11+ lymphocytes (including suppressor cells) or after inhibition of suppressor function with deoxyguanosine. No increase of cytotoxicity was detected under these conditions. Exogenous supplementation of recombinant interleukin 2 (rIL-2) was also ineffective. These data indicate that MG PBT lymphocytes are unable to fully differentiate into CTL following allogeneic stimulation. This deficiency is most evident in MM patients already showing the poorest prognosis and the most altered T cell phenotype.

SUMMARY The recombinant interleukin-2 (rIL-2) generation of lymphokine-activated killer (LAK) cells wasinvestigated in peripheral blood T lymphocytes (PBT) of 16 patients with monoclonal gammopathyof undetermined significance (MGUS) and 32 patients with multiple myeloma (MM). LAK activitywas significantly decreased in MM. but not in MGUS patients, and was partially recovered in MM inthe remission phase. This finding was unexpected, because CD8+ CD11b+ cells, which contain LAKprecursors, are significantly increased in MM. LAK activity was investigated in purifiedCD8+ CD11b+ lymphocytes to discriminate between an intrinsic defect or a defective regulation byother T cell subsets. These cells were intrinsically unable to generate LAK activity fully followingrIL-2 stimulation. MM showed the more pronounced LAK deficiency, while MGUS patients showedintermediate values. Phenotyping revealed significantly increased proportions of Leu7+ and HLA-DR+ cells in MM patients. These data reveal another dysregulation of T cell effector functions inpatients with monoclonal gammopathies and offer further evidence of the impairment of their cell-mediated immunity.

The phenotypic pattern of peripheral blood T (PBT) lymphocytes was correlated with diagnosis and clinical status in 63 patients with monoclonal gammopathies (MGs). The numbers of lymphocytes expressing activation and CD11 determinants were significantly increased in suppressor/cytotoxic and helper/inducer subpopulations of patients with multiple myeloma (MM) and MG of undetermined significance (MGUS). The number of activated suppressor/cytotoxic cells was closely correlated with diagnosis and disease status. These cells were significantly higher in MM at diagnosis (160 +/- 88) than MGUS patients (61 +/- 79; P less than .01). Their number decreased to MGUS levels in MM in stable remission (58 +/- 53), but not in MM with tumor progression (172 +/- 102; P less than .001). In individual patients, part of these cells specifically adhered to dishes precoated with the related M-protein. No monoclonal T-beta gene rearrangement was detected in PBT and cytotoxic/suppressor subpopulations from two patients with a large proportion of activated cells.