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Introduction and Aim The purpose of replacement therapy in adrenal insufficiency (AI) is mimicking endogenous cortisol levels as closely as possible: dual release hydrocortisone (DR-HC) has been introduced to replicate the circadian cortisol rhythm. Multiple daily saliva collections could be used to assess the cortisol rhythm during real life: our aim was to study the salivary cortisol profile in AI. Materials and Methods We prospectively evaluated, in an observational study, 18 adult outpatients with AI (11 primary and 7 secondary AI), switched from conventional treatment (conv-HC, 25 mg/day) to the same dose of DR-HC. We collected six samples of saliva in a day, measuring cortisol (F) and cortisone (E) with LC-MS/MS. Forty-three matched healthy subjects served as controls. Results F levels were similar in the morning (and higher than controls) in patients treated with conv-HC or DR-HC; otherwise F levels and exposure were lower in the afternoon and evening in patients with DR-HC, achieving a cortisol profile closer to healthy controls. Daily cortisol exposure, measured with area under the curve, was lower with DR-HC. Morning F and E presented sensitivity and specificity >90% to diagnose AI (respectively threshold of 3 and 9.45 nmol/L). Total cholesterol and HbA1c levels reduced with DR-HC. Conclusions Salivary cortisol daily curve could be used as a new tool to assess the cortisol profiles in patients treated with conv-HC and DR-HC. A lower daily cortisol exposure was achieved with DR-HC (despite the same HC dose), especially in the afternoon-evening.

Agriculture can be either a source or sink of atmospheric CO2 depending on soil management. The application of swine slurry in conventional tilled soils could enhance soil CO2 emission depleting soil organic C stocks. However, the use of recalcitrant C-rich organic fertilizers in no-till soils can offset soil CO2 emission promoting soil C sequestration. This hypothesis was tested by evaluating short-term CO2-C emissions from a Rhodic Nitisol under contrasting soil disturbance levels (disturbed (DS) and undisturbed soil (US)) top-dressed with mineral or organic fertilizers (urea (UR), raw swine slurry (RS),anaerobically digested swine slurry (ADS), and composted swine slurry (CS)). Soil CO2 emission was evaluated for 64 days using static chambers where gas samples were collected and analysed by photoacoustic infrared spectroscopy. Soil water-filled pore space (WFPS), temperature and meteorologi-cal data were concomitantly registered and a first-order exponential decay model was used to assess the decomposition of organic fertilizers and CO2 emissions induced by soil disturbance. Soil CO2-C emission was correlated with soil temperature, while limiting soil aeration impaired CO2-C efflux when WFPS >0.6 cm3cm3. Disturbance increased soil CO2-C efflux (36.3 2.2 kg CO2-C ha1 day1) in relation to US (33.3 1.6 kg CO2-C ha1 day1). Extra labile C input through RS amendment induced an increased soil CO2-C efflux for a longer period (t1/2 = 16.9 and 9.6 days in DS and US treatments, respectively), resulting in higher CO2-C emissions than soil amended with other fertilizers. The recalcitrant C input by ADS and CS had limited effect on soil CO2-C emissions. CS presented a genuine potential for substantial soil organic C accumulation while offsetting increased CO2-C emissions in comparison to RS amended soils. Made available in DSpace on 2019-07-19T00:39:40Z (GMT). No. of bitstreams: 1 final7472.pdf: 548953 bytes, checksum: 44398277d60ad5170f481c3f0a38e082 (MD5) Previous issue date: 2015

A sustained regional system for marine monitoring and forecasting needs an enduring collaboration among the neighbouring countries, supported by the willingness to share efforts, resources and knowledge. MedGOOS, the Mediterranean association of marine organisations, fosters institutional cooperation for the establishment of the Global Ocean Observing System (GOOS) in the region. A special emphasis is on the early dialogue between all the countries to ensure common ownership, and equal benefits and opportunities to all the riparian coastal peoples. MAMA, a 3-year thematic network project shared by leading marine research institutions from all the Mediterranean countries, is putting in place the institutional and scientific platform to establish operational oceanography in the region.

Sustainable development requires the intelligent management of the marine environment, to protect the marine ecosystem, minimise the impacts of climate change and anthropogenic influences, and provide benefits for a wide range of users. Routine ocean monitoring and forecasting based on sound science, long term and adaptive monitoring,, and co-operation between nations, is the main tool for such a management. The assets and needs of all countries have to be identified, as well as the constraints impeding data exchange and marine observations in the EEZs. The challenge is to build a monitoring system based on up-to-date science and technology, and adapted to the specificity of the basin for the benefit of different users in all Mediterranean countries. It is necessary to involve all riparian countries in the process of building the Mediterranean monitoring system. A strengthened and dedicated link between the scientific community and the public authorities is moreover necessary to provide a sound scientific background for policy decisions based on environmental monitoring. Building on these concepts the Mediterranean network to Assess and upgrade the Monitoring and forecasting Activity in the region (MAMA), funded under the EESD Programme of the 5th FP, and involving partners from all the Mediterranean countries, aims to establish the multi-national network that will prepare the institutional linkages and regional platform for such an integrated and sustained monitoring system in the region. The project builds on the trans-national pooling of scientific and technological resources and provides a concerted basin-scale effort towards the planning and design of the initial ocean observing system in the Mediterranean. The system-wide approach of MAMA is expected to trigger an enhanced motivation on the relevance of systematic marine observations for the sustainable and shared use of the marine resources of the Mediterranean Sea. These catalytic ingredients constitute the thrust of MAMA and an enabling asset to the future projection into long-term commitments at governmental level.

Background Autoimmune Polyglandular Syndrome type 1 (APS-1) is a rare recessive inherited disease, caused by AutoImmune Regulator (AIRE) gene mutations and characterized by three major manifestations: chronic mucocutaneous candidiasis (CMC), chronic hypoparathyroidism (CH) and Addison’s disease (AD). Methods Autoimmune conditions and associated autoantibodies (Abs) were analyzed in 158 Italian patients (103 females and 55 males; F/M 1.9/1) at the onset and during a follow-up of 23.7 ± 15.1 years. AIRE mutations were determined. Results The prevalence of APS-1 was 2.6 cases/million (range 0.5–17 in different regions). At the onset 93% of patients presented with one or more components of the classical triad and 7% with other components. At the end of follow-up, 86.1% had CH, 77.2% AD, 74.7% CMC, 49.5% premature menopause, 29.7% autoimmune intestinal dysfunction, 27.8% autoimmune thyroid diseases, 25.9% autoimmune gastritis/pernicious anemia, 25.3% ectodermal dystrophy, 24% alopecia, 21.5% autoimmune hepatitis, 17% vitiligo, 13.3% cholelithiasis, 5.7% connective diseases, 4.4% asplenia, 2.5% celiac disease and 13.9% cancer. Overall, 991 diseases (6.3 diseases/patient) were found. Interferon-ω Abs (IFNωAbs) were positive in 91.1% of patients. Overall mortality was 14.6%. The AIRE mutation R139X was found in 21.3% of tested alleles, R257X in 11.8%, W78R in 11.4%, C322fsX372 in 8.8%, T16M in 6.2%, R203X in 4%, and A21V in 2.9%. Less frequent mutations were present in 12.9%, very rare in 9.6% while no mutations in 11% of the cases. Conclusions In Italy, APS-1 is a rare disorder presenting with the three major manifestations and associated with different AIRE gene mutations. IFNωAbs are markers of APS-1 and other organ-specific autoantibodies are markers of clinical, subclinical or potential autoimmune conditions.