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Background: Factors influencing the outcome of structured treatment interruptions (STIs) in HIV chronic infection are not fully elucidated. Methods: In ISS-PART, 273 subjects were randomly assigned to arm A (137 assigned to continuous highly active antiretroviral therapy [HAART]) and arm B (136 assigned to 5 STIs of 1, 1, 2, 2, and 3 months'duration, each followed by 3 months of therapy). Main outcome measures were the proportion of subjects with a CD4 count >500 cells/mm 3 , the rate of virologic failure, and the emergence of resistance at 24 months. Results: The proportion of subjects with a CD4 count >500 cells/mm 3 was higher in arm A than in arm B (86.5% vs. 69.1%; P = 0.0075). Pre-HAART CD4 cell count and male gender were independent predictors of a CD4 count >500 cells/mm 3 in arm B. The overall risk of virologic failure was not increased in arm B; however, it was higher in the 38 subjects who had resistance mutations in the rebounding virus. Archived mutations at baseline and the use of a regimen that included an unboosted protease inhibitor (PI), compared with nonnucleoside reverse transcriptase inhibitor-based HAART, independently predicted the emergence of plasma mutations during STI (P = 0.002 for DNA mutations and P = 0.048 for PI-based HAART). Conclusions: Our results suggest that patients with preexisting mutations and treated with unboosted PI-based HAART should not be enrolled in studies of time-fixed treatment interruptions, being at higher risk of developing plasma mutations during STI and virologic failure at therapy reinstitution.

In Italy, malaria continues to be one of the most common imported parasitoses; therefore, continuous surveillance of epidemiological data and clinical management is needed. In 2016, the National Institute for Infectious Diseases 'Lazzaro Spallanzani' in Rome promoted a retrospective questionnaire-based survey to assess the clinical management of imported malaria cases in Italy in 2015. The questionnaire was sent to 104 Tropical and/or Infectious Diseases Units in the country, and 37 of them filled out and returned the questionnaires. A total of 399 malaria cases were reported in 2015, mostly caused by Plasmodium falciparum and imported from Africa. Malaria chemoprophylaxis was correctly used by a minority of patients. Most patients presented with uncomplicated malaria and were treated orally. In severe cases, intravenous artesunate or quinine alone or in combination were administered, although one third of these severe cases received oral treatment. This retrospective survey reveals a lack of homogeneity in management of malaria-imported cases in Italy. Improvement of malaria chemoprophylaxis, standardization of clinical management of malaria cases and harmonization of oral and intravenous drug availability are needed throughout the country.

A new procedure is proposed for the voltammetric determination of ultra-trace cadmium(II), copper(II), lead(II), platinum(II), palladium(II), rhodium(III) and zinc(II) by a single run of square wave adsorptive catalytic stripping voltammetry. The voltammetric cell was based on a typical three-electrodes set-up: working electrode (stationary hanging mercury drop), reference electrode (Ag|AgCl|KClsat) and auxiliary electrode (platinum). The supporting electrolyte contained the formazone complex together with dimethylglyoxime and the disodium salt of ethylenediaminetetraacetic acid. Validation of the analytical procedure was obtained by the analysis of standard reference materials (Mussel Tissue BCR-CRM 278, Oyster Tissue NIST-SRM 1566a). Comparison with spectroscopic measurements was performed. Good accuracy was achieved. The analytical procedure was finally applied to mussels and clams sampled on the mouth of Po river, employed as bio-monitors.

A new application of voltammetric techniques in stripping mode to the quantitative determination of metals belonging to the platinum group (PGM) in herbal medicines, at the ultra-trace level, is reported. Pd (II), Pt (II) and Rh (III) are determined by means of square-wave adsorption voltammetry (SWAdSV); Os (VIII) and Ru (III) are determined through square-wave voltammetry in catalytic mode (SWCV); Ir (III) is determined through the application of square-wave catalytic voltammetry in adsorption mode (SWAdCSV). In all the applied methods, the voltammetric cell has the conventional setting with three-electrodes, which sees the presence of a suspended mercury-drop electrode (HMDE) or a glassy carbon electrode (GCE) as working electrodes for the determination of Ir (III). The auxiliary electrode was a platinum electrode, and an Ag∣AgCl∣KClsatd. electrode was employed as reference electrode. Validation of the analytical procedure here proposed has been achieved using reference standards: NIST-SRM 1570a (Spinach Leaves) and NIST-SRM 1573a (Tomato Leaves), both added with pure metal standards, obtaining satisfying precision values, better than the limits set for the validation of quantitative methods. Following the verification of the validity of the here presented procedure, commercially available herbal medicines, based on Eucalyptus globulus, Harpagophytum procumbens DC and Taraxacun officinale weber, were analyzed. Standard samples were also analyzed by atomic absorption spectroscopy, in order to have a reference technique for validating the entire procedure.

Plants growing on heavy metal (HM)-polluted soils show toxicity symptoms, such as chlorosis and growth reduction, and undergo oxidative stress due to the formation of reactive oxygen species (ROS). Plants overcome oxidative stress by producing a wide range of antioxidant molecules, such as polyphenols and flavonoids. The aim of the present work was to study the accumulation of these molecules in response to increasing concentrations of Cd, Cr, Cu, Ni, Pb and Zn and to assess whether they can be used as a tool in assessing metal-related stress in Polygonum aviculare and Senecio vulgaris. On average, P. aviculare shoots accumulated lower amounts of metals than S. vulgaris shoots. The uptake of all six elements was correlated and proportional to their concentration in the nutrient solution (&rho, &gt, 0.9), with the bioaccumulation factor (BAF) being &gt, 1 for most of them. The present research demonstrated that 82% of the samples showed a good correlation (|&rho, 0.5) between the level of polyphenols, flavonoids and antioxidant activity and the metal concentration in plant shoots, confirming that the metal stress level and production of phenolic compounds having antioxidant activity were strictly connected. Nonetheless, the mere quantification of these molecules cannot identify the type of metal that caused the oxidative stress, neither determine the concentration of the stressors. The five tested populations of each species did not show any specific adaptation to the environment of origin.

In recent years, heavy metals (HMs) levels in soil and vegetation have increased considerably due to traffic pollution. These pollutants can be taken up from the soil through the root system. The ability of plants to accumulate HMs into their tissues can therefore be used to monitor soil pollution. The aim of this study was to test the ruderal species Senecio vulgaris L., Polygonum aviculare L., and Poa annua L., as possible candidates for biomonitoring Cu, Zn, Cd, Cr, Ni and Pb in multiple environments. The soils analyzed in this work came from three different environments (urban, woodland, and ultramafic), and therefore deeply differed for their metal content, texture, pH, and organic matter (OM) content. All urban soils were characterized by high OM content and presence of anthropogenic metals like Pb, Zn, Cd, and Cu. Woodland soils were sandy and characterized by low metal content and low OM content, and ultramafic soils had high Ni and Cr content. This soil variability affected the bioindication properties of the three studied species, leading to the exclusion of most metals (Zn, Cu, Cr, Cd, and Pb) and one species (P. aviculare) due to the lack of linear relations between metal in soil and metal in plants. Senecio vulgaris and Poa annua, conversely, appeared to be good indicators of Ni in all the soils tested. A high linear correlation between total Ni in soil and Ni concentration in P. annua shoots (R2 = 0.78) was found and similar results were achieved for S. vulgaris (R2 = 0.88).

3D cylindrical layered scaffolds with anisotropic mechanical properties were prepared according to a new and simple method, which involves gelatin foaming, deposition of foamed strips, in situ crosslinking, strip rolling and lyophilization. Different genipin concentrations were tested in order to obtain strips with different crosslinking degrees and a tunable stability in biological environment. Before lyophilization, the strips were curled in a concentric structure to generate anisotropic spiral-cylindrical scaffolds. The scaffolds displayed significantly higher values of stress at break and of the Young modulus in compression along the longitudinal than the transverse direction. Further improvement of the mechanical properties was achieved by adding strontium-substituted hydroxyapatite (Sr-HA) to the scaffold composition and by increasing genipin concentration. Moreover, composition modulated also water uptake ability and degradation behavior. The scaffolds showed a sustained strontium release, suggesting possible applications for the local treatment of abnormally high bone resorption. This study demonstrates that assembly of layers of different composition can be used as a tool to obtain scaffolds with modulated properties, which can be loaded with drugs or biologically active molecules providing properties tailored upon the needs.

Strontium has a beneficial role on bone remodeling and is proposed for the treatment of pathologies associated to excessive bone resorption, such as osteoporosis. Herein, the possibility to utilize a biomimetic scaffold as strontium delivery system is explored. Porous 3D gelatin scaffolds containing about 30% of strontium substituted hydroxyapatite (SrHA) or pure hydroxyapatite (HA) are prepared by freeze-drying. The scaffolds display a very high open porosity, with an interconnectivity of 100%. Reinforcement with further amount of gelatin provokes a modest decrease of the average pore size, without reducing interconnectivity. Moreover, reinforced scaffolds display reduced water uptake ability and increased values of mechanical parameters when compared to as-prepared scaffolds. Strontium displays a sustained release in phosphate buffered saline: the quantities released after 14 d from as-prepared and reinforced scaffolds are just 14 and 18% of the initial content, respectively. Coculture of osteoblasts and osteoclasts shows that SrHA-containing scaffolds promote osteoblast viability and activity when compared to HA-containing scaffolds. On the other hand, osteoclastogenesis and osteoclast differentiation are significantly inhibited on SrHA-containing scaffolds, suggesting that these systems could be usefully applied for local delivery of strontium in loci characterized by excessive bone resorption.

The “Point-Of-Care Testing" (POCT) approach is based on the development of portable analytical platforms suitable to perform analysis directly in any required place. To meet analytical and diagnostic requirements, a POCT device should combine portability, minimum sample pre-treatment, and the possibility to perform highly sensitive simultaneous detection of several biomarkers (multiplexing) in a short assay time. POCT devices should also comprise an integrated module for on-line sample pre-analytical treatment and/or clean-up to achieve high sensitivity and specificity even in complex matrices. With this respect, field-flow fractionation (FFF) techniques, a family of flow-assisted separation techniques which can separate analytes based on their morphologic characteristics (size, shape and superficial properties) can be exploited. Thanks to its “soft” separation mechanism, FFF has been successfully applied to a wide range of bioanalytes, from relatively small biomolecules to living cells in complex biological samples, which after separation keep their native characteristics such as the enzymatic activity, cell vitality, or quaternary protein structure [1]. In FFF, separation is achieved within a capillary empty channel in which a laminar flow of mobile phase sweeps sample components down the channel. A field is applied perpendicularly to the parabolic flow to make the analytes be driven into different laminar flows due to their differences in physical properties. As a consequence, the different analytes will elute from the separation device with a characteristic velocity. Gravitational FFF (GrFFF), exploiting the Earth gravitational field to structure the separation, is the humblest FFF technique which appears to be particularly suited for its implementation in POCT devices, thanks to the simplicity of its separative device, amenable to miniaturization, and the potential easy integration with specific analytical modules [2]. In this work, we propose the implementation of GrFFF as a pre-analytical module of a POCT device, thus providing a selectively enriched fraction for the analysis with an increase of overall analytical output. We present the use of GrFFF to prepare whole blood samples for the automatic on-line analysis of alkaline phosphatase activity in serum, as a biomarker of obstructive liver diseases and bone disorders. Serum alkaline phosphatase is commonly assayed after a preliminary blood sample centrifugation to obtain serum, by employing spectrophotometric techniques. In this work, the GrFFF device is employed to separate plasma from cells components which elute with different retention times. After the injection of heparin-treated whole blood in the GrFFF device, plasma is separated from cells and then directly addressed by means of a microfluidic system and valves to the analytical module, where a chemiluminescent substrate is added and the enzyme activity is measured by means of an on-line flow-through luminometer. The diagnostic test gave quantitative results with low sample (50 uL) and reagents consumption, short analysis time (10 minutes) and high reproducibility. In addition, the use of an array of FFF devices will be considered to increase enrichment productivity and to allow the development of multiplexed systems based on the same separative principle.

Supporting Web-based services through geographical distributed clusters of servers is a common solution to the increasing volume and variability of modern traffic. These architectures pose interesting challenges to request management strategies where the most important goal is not to achieve maximum performance, but to guarantee stable and robust results. In this paper, we propose novel request management algorithms that are based on autonomic principles that is, on loose collaboration among the closest nodes and no knowledge about the global system state. Experimental evaluation shows that our autonomic-enhanced algorithms can guarantee robust performance in a variety of settings and reduce standard deviations of the response times with respect to existing request management algorithms.

Membraneless hyperlayer flow field-flow fractionation (Hyp FIFFF) has shown improved performance with respect to Hyp FIFFF with membrane. The conditions for high recovery and recovery independent of sample loading in membraneless Hyp FIFFF have been previously determined. The effect of sample loading should be also investigated in order to optimize the form of the peaks for real samples. The effect of sample loading on peak retention parameters is of prime importance in applications such as the conversion of peaks into particle size distributions. In this paper, a systematic experimental work is performed in order to study the effect of sample loading on retention parameters. A procedure to regenerate the frit operating as accumulation wall is described. High reproducibility is obtained with low system conditioning time.

Field-flow fractionation is a separation technique characterized by a retention mechanism which makes it suitable for sorting cells over a short analysis time, with low sample carry-over and preserving cell viability. Thanks to its high sensitivity, chemiluminescence detection is suitable for the quantification of just a few cells expressing chemiluminescence or bioluminescence. In this work, different formats for coupling gravitational field-flow fractionation and chemiluminescence detection are explored to achieve ultra-sensitive cell detection in the framework of cell sorting. The study is carried out using human red blood cells as model sample. The best performance is obtained with the on-line coupling format, performed in post-column flow-injection mode. Red cells are isolated from diluted whole human blood in just a few minutes and detected using the liquid phase chemiluminescent reaction of luminol catalysed by the red blood cell heme. The limit of detection is a few hundred injected cells. This is lower than the limit of detection usually achieved by means of conventional colorimetric/turbidimetric methods, and it corresponds to a red blood cell concentration in the injected sample of five orders of magnitude lower than in whole blood.

Methotrexate may rarely provoke serositis, even with low doses and after just a few weeks of therapy. We report here a rare case of pleuropericarditis due to methotrexate. The effusion resolved after the withdrawal of the drug and the beginning of anti-inflammatory therapy; there was no relapse during a 10-month follow-up.