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IntroductionParkinson’s disease (PD) is the second most prevalent neurodegenerative disease. Complementary and alternative therapies are increasingly utilized to address its complex multisystem symptomatology. Art therapy involves motoric action and visuospatial processing while promoting broad biopsychosocial wellness. The process involves hedonic absorption, which provides an escape from otherwise persistent and cumulative PD symptoms, refreshing internal resources. It involves the expression in nonverbal form of multilayered psychological and somatic phenomena; once these are externalized in a symbolic arts medium, they can be explored, understood, integrated, and reorganized through verbal dialogue, effecting relief and positive change.Methods42 participants with mild to moderate PD were treated with 20 sessions of group art therapy. They were assessed before and after therapy with a novel arts-based instrument developed to match the treatment modality for maximum sensitivity. The House-Tree-Person PD Scale (HTP-PDS) assesses motoric and visuospatial processing–core PD symptoms–as well as cognition (thought and logic), affect/mood, motivation, self (including body-image, self-image, and self- efficacy), interpersonal functioning, creativity, and overall level of functioning. It was hypothesized that art therapy will ameliorate core PD symptoms and that this will correlate with improvements in all other variables.ResultsHTP-PDS scores across all symptoms and variables improved significantly, though causality among variables was indeterminate.DiscussionArt therapy is a clinically efficacious complementary treatment for PD. Further research is warranted to disentangle causal pathways among the aforementioned variables, and additionally, to isolate and examine the multiple, discrete healing mechanisms believed to operate simultaneously in art therapy.

Shallow, small-rate releases of ethanol-blended fuels from underground storage tanks (USTs) may be quite common and result in subsurface CH4 generation. However, vadose zone transport of CH4 generated from these fuel releases is poorly understood, despite the potential to promote vapor intrusion or create explosion hazards. In this study, we simulated shallow CH4 generation with a controlled subsurface CH4 release from July 2014 to February 2015 to characterize subsurface CH4 migration and surface emissions and to determine environmental controls on CH4 fate and transport. July 2014 through November 2014 was an extended period of drought followed by precipitation during December 2014. Throughout the experiment, under varied CH4 injection rates, CH4 formed a radially symmetrical plume around the injection point. Surface efflux during the drought period of the experiment was relatively high and stable, with approximately 10 to 11 and 34 to 52% of injected CH4 reaching the ground surface during the low-and high-rate injections, respectively. Following the period of precipitation and increased soil moisture, efflux dropped and stabilized at approximately 1% of injected CH4, even as soil moisture began to decrease again. Tracer and inhibitor experiments and estimates of soil diffusivity suggest that microbial CH4 oxidation was responsible for the observed drop in efflux. The decrease in efflux only after soil moisture increased suggests a strong environmental control over the transport and oxidation of vadose zone CH4.

Abstract Regenerative life support systems for space crews recycle waste into water, food, and oxygen using different organisms. The European Space Agency’s MELiSSA program uses the cyanobacterium Limnospira indica PCC8005 for air revitalization and food production. Before space use, components’ compatibility with reduced gravity was tested. This study introduced a ground analog for microgravity experiments with oxygenic cyanobacteria under continuous illumination, using a random positioning machine (RPM) setup. L. indica PCC8005 grew slower under low-shear simulated microgravity, with proteome analysis revealing downregulation of ribosomal proteins, glutamine synthase, and nitrate uptake transporters, and upregulation of gas vesicle, photosystem I and II, and carboxysome proteins. Results suggested inhibition due to high oxygen partial pressure, causing carbon limitation when cultivated in low-shear simulated microgravity. A thicker stagnant fluid boundary layer reducing oxygen release in simulated microgravity was observed. These findings validate this RPM setup for testing the effects of non-terrestrial gravity on photosynthetic microorganisms.

BACKGROUND: Angiosarcoma (AS) of the breast is very rare, accounting for 1% of all soft tissue breast tumors. AS may present as primary tumors of the breast or as secondary lesions usually associated with previous radiotherapy. Commonly, secondary AS affects older women (median age 67-71 years) with a clinical history of breast cancer. The preferred site of onset of RIAS is the edge of radiation fields, where radiation doses and tumor necrosis may be heterogeneous, resulting in a DNA damage and instability. Radical surgery is the treatment of choice, but no clear consensus exists on surgical management of breast AS. CASE REPORT: We describe an atypical case of relapsed RIAS after radical mastectomy, treated with new surgery and, considering the higher risk of recurrence, subsequent adjuvant chemotherapy with weekly paclitaxel. CONCLUSIONS: The frequency of radiation-induced angiosarcomas (RIAS) after breast-conserving surgery and radiotherapy has been increased to 0.14-0.5% among long survivors. Nevertheless, even if RIAS continues to be prognostically an extremely unfavorable cancer due to a high rate of recurrence, distant spread, and median overall survival (OS) of about 60 months, the benefits of loco-regional breast radiotherapy are clearly higher than the risk in developing angiosarcoma. [ABSTRACT FROM AUTHOR]

Introduction: This study aims to evaluate the persistence, treatment adherence and drug cost associated with biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) in the management of psoriatic arthritis (PsA) in Italy, with a focus on biosimilar drugs. Methods: This was a retrospective observational study involving eight hospital pharmacies, between January 2017 and December 2020, on naïve patients with at least one b/tsDMARD dispensation indicated for PsA. Patients were followed up for 12 months and persistence and adherence were evaluated by proportion of days covered (PDC). The originator and biosimilar for adalimumab and etanercept were compared. Furthermore, the real annual cost per patient based on adherence to therapy was calculated. Results: Patients initiating b/tsDMARDs for PsA had a mean persistence of 263 days and 48.6% remained persistent for 1 year. Adherent patients (PDC ≥ 0.8) were 47.6% for the overall population. Similar persistence and adherence were observed between patients treated with the adalimumab originator and its biosimilar, while patients treated with the etanercept originator showed lower persistence and adherence compared to those treated with its biosimilar (mean persistence: 222 vs. 267 days, patient persistent at 1 year: 29.4% vs. 51.5%, mean PDC: 0.53 vs. 0.70, adherent patients: 23.5% vs. 51.5%). The average annual drug cost ranged from €8,724 (etanercept) to €14,783 (ustekinumab), with an annual saving of more than €2,500 by using biosimilars. Conclusion: Poor adherence to medications contributes to suboptimal clinical outcomes. The comparison between biosimilar and originator offers further evidence in support of the biosimilar to optimizing resources in healthcare.

Summary: Spirulina is the commercial name for edible cyanobacteria of the genus Limnospira. The taxonomy of this genus is confusing with four species distributed in two lineages. Furthermore, the species Limnospira fusiformis has been cited as toxic by potentially producing microcystins. Taxonomic ambiguity combined with suspected health concerns constitute a major issue for spirulina producers. In a collection of six cultivars and one ecotype, we identified strains of the two lineages through metagenetic and morphological analyses. We demonstrated that the genus Limnospira only comprises two distinct species according to genomic comparisons of three genomes obtained in this study and 19 reference genomes. We showed that the V3-V4 region of the 16S rRNA gene is sufficient to identify the genus Limnospira and to distinguish the two species. Toxinogenesis investigations on eleven genomes from each Limnospira species revealed no genes involved in cyanotoxin synthesis, reflecting the inability of this genus to produce microcystins.

Abstract Regenerative life support systems (RLSS) will play a vital role in achieving self-sufficiency during long-distance space travel. Urine conversion into a liquid nitrate-based fertilizer is a key process in most RLSS. This study describes the effects of simulated microgravity (SMG) on Comamonas testosteroni, Nitrosomonas europaea, Nitrobacter winogradskyi and a tripartite culture of the three, in the context of nitrogen recovery for the Micro-Ecological Life Support System Alternative (MELiSSA). Rotary cell culture systems (RCCS) and random positioning machines (RPM) were used as SMG analogues. The transcriptional responses of the cultures were elucidated. For CO2-producing C. testosteroni and the tripartite culture, a PermaLifeTM PL-70 cell culture bag mounted on an in-house 3D-printed holder was applied to eliminate air bubble formation during SMG cultivation. Gene expression changes indicated that the fluid dynamics in SMG caused nutrient and O2 limitation. Genes involved in urea hydrolysis and nitrification were minimally affected, while denitrification-related gene expression was increased. The findings highlight potential challenges for nitrogen recovery in space.

BACKGROUND: Glioblastoma (GBM) is a highly lethal disease despite integrated treatment comprising radiotherapy plus concomitant and adjuvant temozolomide, with a median overall survival of less than 15 months. For recurrent glioblastoma, there is yet no standard therapy, considering that Bevacizumab have failed to improve overall survival (OS) while regorafenib had a little benefit over standard chemotherapy. In addition, the disease control rate is almost exclusively stability, with a poor objective response rate. CASE REPORT: Here we present a case of rapid response to regorafenib in early glioblastoma progression at the end of adjuvant radiotherapy: after a single cycle of regorafenib the patient observed an impressive improvement in clinical condition, disappearance of headaches and a clear reduction of neoplastic tissue in MRI. A brief review about new radiological patterns in Magnetic Resonance Imaging (MRI) related to the introduction in clinical practice of antiangiogenic drugs and tyrosine kinase inhibitors has also been carried out. CONCLUSIONS: Regorafenib was certainly a first turning point in the second-line treatment of GBM, showing longer response rates and mostly disease stability than bevacizumab. A switch-maintenance strategy with tyrosine kinase inhibitors may represent a valid second-line therapeutic option. [ABSTRACT FROM AUTHOR]

A novel approach to the analysis and classification of time series signals using statistical models of reconstructed phase spaces is introduced. This is shown to be viable and effective alternative to traditional signal classification approaches, particularly for signals with strong nonlinear characteristics.

Rome is vulnerable to chemical, biological, radiological, nuclear, and explosive (CBRNe) attacks. The study evaluates Rome’s advanced emergency departments’ state of emergency plans for massive influx of injures (PEIMAF) plans for CBRNe attacks. We propose a chemical attack on Saint Peter’s Square during the Pope’s General Assembly and its effects. The National Stockpile Antidotes’ activation and territorial distribution timing work well for chemical attacks. We also estimated activation timing. Our data show that despite a good organization, travel times can be improved. We also believe that all major Roman hospitals must develop the PEIMAF, which should be followed by an organized training plan involving theoretical teaching and indoor and outdoor simulation to train hospital staff and evaluate PEIMAF weaknesses and vulnerabilities. The effectiveness and efficiency of first aid depend on timing, and each PEIMAF analyzed, while coherent and adequate for internal purposes, fails to integrate with the other hospitals. Integration can speed up National Stockpile Antidotes delivery and save lives. For the best CBRNe response, detailed intervention protocols must be created, updated daily, and exercised.