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The food consumption of adolescents has changed nowadays, with an increase in ultra-processed food that in general shows higher calories and lower nutrients. Because of this, the objective of this study was to investigate the impacts of a 12-week multi-professional family versus isolated intervention on the food level processing of overweight adolescents. A randomized clinical trial study was carried out in which adolescents (n = 43; mean aged 13.73 years) who were divided into FG—family group (n = 21; the adolescents performed the activities with their parents) and IG—isolated group (n = 22; the adolescents performed the activities alone). The parameters measured before and after 12 weeks of multi-professional intervention (physical exercise, nutrition and psychoeducation) were: body mass, height and body mass index-BMI. The level of food processing was analyzed using a three-day food recall (24hR), classified according to the Food Guide for the Brazilian Population (fresh, minimally, processed and ultra-processed foods). The main results show that there was only a significant reduction in the consumption of processed foods (FG: 7.93%; IG: 49.73%) and ultra-processed foods (FG: 35.06%; IG: 67.16%) in grams (FG: 22.29%; IG: 65.23%) and calories (p < 0.05; for all comparisons). The consumption of fresh foods in grams (FG:61.97%; IG: 147.13%) and calories (FG: 147.13%; IG: 118.03%) and minimally processed foods (FG: 27.45%; IG: 14.64%) in grams increased significantly (p < 0.05; for all comparisons). However, no significant differences were observed between all variables analyzed for the groups, nor any interaction (p > 0.05). In conclusion, both groups who participated in the activities showed positive changes with increased consumption of fresh foods and reduced consumption of processed foods, without difference between them.

Some commercial base isolators have been introduced in the last four decades to protect buildings from vibration and earthquakes. Typically, they are constituted by several alternating layers of rubber pads and steel (elastomeric isolator) interposed by two continuous pads, limiting vertical deformability. At the same time, they exhibit good deformation capacity in the horizontal direction when subjected to a seismic load. A very effective seismic isolator shall satisfy the following functions: good performance under all service loads, vertical and horizontal; provide enough horizontal flexibility to reach the target natural period for the isolated structure; recentering capability after the ground motion so that no residual horizontal displacement can downgrade the serviceability of the structure; provide an adequate level of energy dissipation (damping) to control the displacement that could damage other structural members. Steel-reinforced elastomeric isolators (SREIs) are the most used method of seismic isolation. Since these devices are generally too expensive due to the need to introduce thick steel plates for their supports and the high energy consumed for the manufacturing process, they are not suitable for ordinary residential buildings, especially in developing countries. Compared with SREIs, fiber-reinforced elastomeric isolators (FREIs) have considerably lower weight and can be installed between the structure in elevation and the foundation without any bonding or fastening in the so called unbonded application (UFREI), reducing costs hugely. Furthermore, without steel supports, the shear load is transferred through the friction generated between the isolator and the structure surfaces, improving the dissipation energy of the devices. The main feature of such a UFREIs is the large deformability thanks to the rollover deformation and the favorably lower lateral stiffness compared to the bonded isolator. In this paper, a series of experimental tests of the rubber compound and numerical analyses of UFREIs made of high damping rubbers (HDR) combined with glass fiber reinforcement have been performed. A HDR made of Natural Rubber and Ethylene Propylene Diene Monomer (NREPDM) blend has been considered. Finite Element shear test results have shown good dynamic performances of the proposed device.

Resume Objectifs La therapie fœtale fait aujourd’hui partie de l’offre de soins pour certaines malformations de pronostic severe. La place de ces interventions emergentes dans le parcours prenatal est encore peu connue. L’objectif de cette etude est de decrire le parcours decisionnel des patientes confrontees a la possibilite de recourir a une intervention in utero emergente. Methodes Nous avons mene une etude descriptive retrospective monocentrique au sein du service de diagnostic prenatal de l’hopital Necker-Enfants Malades. Les informations recueillies concernaient l’eligibilite ou non a une chirurgie et les issues de grossesse des patientes adressees pour myelomeningocele, hernie de coupole diaphragmatique, stenose aortique et uropathie obstructive basse. Resultats Toutes indications confondues, 70 % des patientes eligibles ont souhaite la realisation d’une chirurgie fœtale. Ce taux etait inferieur en cas de myelomeningocele avec 21 % de consentement, compare aux autres pathologies : 69 % pour les hernies de coupole diaphragmatique, 90 % pour les stenoses aortiques et 76 % pour les uropathies. En cas d’abstention, la majorite des patientes (86 %) se sont dirigees vers une interruption medicale de grossesse (IMG). Dans 14 % des cas, l’indication chirurgicale n’etait pas retenue, car les patientes avaient ete adressees trop tardivement. Conclusion Le choix d’une chirurgie fœtale varie selon les pathologies. Elle offre une option supplementaire acceptable et une alternative pour les couples pour lesquels l’IMG est exclue. L’orientation vers un centre expert doit etre rapide, afin de determiner la place d’une intervention fœtale dans le projet de grossesse et de ne pas priver les couples de ce recours.

The research aims to illustrate a vulnerability approach extended for the aggregate masonry buildings belonging to an urban area of the city of Latronico (Basilicata Region). The area was examined taking into account the predominant building typology according to the investigation line WP2 “Inventory of existing structural typology” of the Italian ReLUIS project. The propensity at damage of the masonry stock was done according to a survey form conceived for clustered typologies. A damage scenario was provided according to the hazard map concerning the study area. To this purpose, three seismic events were evaluated with variable magnitudes and epicentre distances, by adopting a seismic intensity prediction equation. Fragility curves were estimated relating the macroseismic observation to the PGA, providing an overview of the asset exposed at risk. The achieved outcomes were discussed in relation to the fragility functions concerning the BTM, highlighting the differences in terms of the expected damage.

The safeguarding of the historical and cultural heritage is one of the main research topics that has been addressed in recent years. Particular attention was given to the development of structural health monitoring systems that allowed the real time acquisition of different physical quantities that are stored in a cloud and compared with the health limit values of the structures obtained from numerical analysis previously carried out. One of the major problems highlighted by the use of these systems is related to the position and quantity of smart sensors to be used within the structure to be monitored. To avoid this, in this paper an Optimal Sensors Placement method was applied to a case study located in China. In particular, the positioning of the sensors was identified through an optimization workflow that adopt a Multi Objective Optimization engine called “Octopus” in Grasshopper3D. The identified optimal solutions have made it possible to detect the areas of the structure that will be subject to collapse during a seismic event.

As an important historical relic of human being, masonry pagoda is the great significance in the eastern and western architectural cultures. Most of the existing masonry pagodas in China which have been seriously damaged urgently need detailed structural safety assessment, repair and reinforcement. The paper choose a Chinese masonry pagoda as a case, conducted a series simulation analysis with Abauqs. Through numerical simulation, the seismic performance of the pagoda can be evaluated, which can not only predict the hidden danger and weak link in its structure, but also provide useful reference for the reinforcement and repair of the pagoda. It also adopts a very convenient 3D CAD method to quickly assess the seismic vulnerability of existing masonry pagoda according the reference.

The international cultural and historical heritage is often subject to degradation and damage. The main causes contributing to these phenomena are the chemical and mechanical actions due to acid rain, environmental pollution, and earthquakes. Other causes are the cycles of freezing and thawing that induce the manifestation of internal stresses leading to the deterioration of the material and the collapse of structural parts. In the field of architectural restoration, this problem has been addressed by two main solutions. The first involves cleaning processes that leave the missing parts visible; the second consists of introducing reproductions of the missing parts, creating a clear distinction between pre-existing and new elements. In both cases, the seismic behavior of the structure is modified; in the second solution, the added elements do not contribute to the structural strength since they are made of plaster or stucco. This work aims at presenting a preliminary study on the creation of replacements of missing elements within damaged heritage buildings. The work is structured in two distinct phases. In the first phase, specific cubic specimens, created with a 3D printer, are produced and subjected to uniaxial compression tests. The experimental campaign is carried out in order to provide useful information regarding the 3D material engineering constants that are currently absent in the literature. In the second phase, the experimental results are used in a numerical model to calibrate the mechanical properties of an equivalent homogeneous material.

An experimental and numerical analysis of the structural behaviour of a barrel tuff masonry vault strengthened by a Fiber Reinforced Cementitious Matrix (FRCM) reinforcement system it is proposed. The geometry and the materials of the vault are representative of some historical constructions in Apulia (Italy). The vault, under the action of the self-weight and of a distributed load representative of the infill, has been first damaged by differential settlement of abutments, and then repaired and strengthened by FRCM composites. Finally the structure has been subjected to a increasing concentrated load on the extrados. A 3D heterogeneous FE Abaqus numerical model describing the above mentioned experimental conditions is carried out in order to reproduce the response of the FRCM reinforced vault. The obtained experimental and numerical results allows for discussing the structural behaviour of the reinforced vault, and then the effectiveness of the employed reinforcement.

Several works have shown different aspects of the use of the plant Moringa oleifera. However, few review studies bring an approach to its use in food preparation, specifying its role as a functional food and its use as a natural additive, focusing on food biochemistry and including sensory acceptance and safety. Composed by multiple bioactive substances, Moringa oleifera has the potential to be used as a food additive, mainly as a preservative with the potential to prevent lipid oxidation and other unwanted chemical reactions that lead to product deterioration. Furthermore, it can improve the physicochemical characteristics of food, increasing its quality and shelf life. It also promotes nutritional improvement, elevating protein, mineral, and vitamin levels. Despite this, the sensorial characteristics of this plant result in a low consumer acceptance of the fortified products, which is a problem for the food industry. Apart from inconclusive works, some data involving Moringa’s safety are contradictory, resulting in its commercialization prohibition in Brazil in 2019. This review focused on important data about Moringa use to contribute to the literature and to the food industry, describing information about this medicinal plant effects on food products.

Rubber is well known as the basic material for some structural devices, such as seaport fenders and seismic isolators. In practice, to seismically isolate a structure it is necessary to interpose between the foundation and the superstructure a rubber device that increases the period of the superstructure, a feature that allows the structure to be ''transparent'' to the seismic excitation. A seismic isolator is constituted typically by a package of several rubber pads 1–2 cm thick vertically interspersed with either steel laminas or FRP dry textiles suitably treated. In this latter case the isolator is called FREI (Fiber Reinforced Elastomeric Isolator). FREIs exhibit light weight, easy installation and low cost. In this study, recycled rubber in the form of reactivated EPDM has been used to produce very low cost FREIs, combined with glass fiber reinforcement. To be ready for structural application, the rubber used must be vulcanized correctly to properly create the polymer crosslinking. However, all rubber mechanical properties are strongly affected by curing temperature and curing time. Here, the mechanical properties of a typology of FREI conceived and produced by the authors in prototypes are evaluated through a series of experimental tests and numerical computations, taking into account the different levels of vulcanization degree. Shore A hardness test, uniaxial tensile test, and relaxation test have been conducted and verified through Finite Element (FE) modeling. All collected data allow to precisely determine the curing time and temperature to use in the industrial production to obtain optimal output mechanical properties for FREIs.

Fetal therapy is part of the available care offer for several severe malformations. The place of these emergent prenatal interventions in the prenatal path of care is poorly known. The objective of this study is to describe the decision-making process of patients facing the option of an emergent in utero intervention.We have conducted a retrospective monocentric descriptive study in the department of maternal-fetal medicine of Necker Hospital. We collected data regarding eligibility or not for fetal surgery and the pregnancy outcomes of patients referred for myelomeningocele, diaphragmatic hernia, aortic stenosis and low obstructive uropathies.All indications combined, 70% of patients opted for fetal surgery. This rate was lower in the case of myelomeningocele with 21% consent, than in the other pathologies: 69% for diaphragmatic hernias, 90% for aortic stenoses and 76% for uropathy. When fetal intervention was declined, the vast majority of patients opted for termination of pregnancy: 86%. In 14% of the considering fetal surgery, the patient was referred too far.The acceptance rate for fetal surgeries depends on condition. It offers an additional option and is an alternative for couples for which termination of pregnancy (TOP) is not an option. Timely referral to an expert center allows to discuss the place of a fetal intervention and not to deprive couples of this possibility.

Natural floodplains are characterized by a complex habitat mosaic. However, damming, water storage, and hydropower production affect many floodplains by altering their natural habitat diversity. Field sampling data and imaging spectroscopy are used in combination with statistical models to assess resource allocation strategies of willow stands in perialpine floodplains. Three contrasting floodplain reaches located along two rivers in Switzerland serve as test beds: The Sarine River is partitioned into an upstream and downstream segment under the influence of a dam and a hydropower plant, while the Sense River represents an undisturbed, natural floodplain. Airborne imaging spectrometer data allow mapping of spatially distributed Competitor/Stress tolerator/Ruderal (CSR) strategies using a partial least square modeling approach. Using cross validation, we demonstrate that a statistical modeling approach can reveal variations in CSR scores based on the StrateFy model. Such intraspecific variation of CSR scores cannot be captured by a strategy categorization based solely on the species. Results reveal that willows shifted toward more competition and less stress tolerance along hydrologically altered reaches compared to the willows strategy along the natural control. Moreover, the overall distribution of strategies indicates that stress factors (i.e., limiting growth factors), rather than disturbance (i.e., events leading to partial or total destruction), shape the plant traits of alluvial willow trees. Detailed assessments of resource allocation strategies contribute to a more complete understanding of the continuous and reciprocal shaping between flow regimes, landforms, and alluvial vegetation.

La produzione industriale del succo di agrumi comporta la necessità di smaltire un residuo umido, denominato comunemente 'pastazzo', che rappresenta circa il 60% del peso della frutta processata ed è attualmente utilizzato come fertilizzante in agricoltura o come mangime per gli animali (Shan, 2016). Con l'idea di trasformare un rifiuto in una risorsa, è stata messa a punto una strategia di estrazione ecosostenibile di sostanze bioattive dalle bucce di tre agrumi: arancio, limone e cedro. Il metodo di estrazione tradizionale con acqua calda (Hot Water Extraction, HWE) è stato messo a confronto con la tecnica innovativa di estrazione assistita dalle microonde (Microwave- Assisted Extraction, MAE) (Proestos & Komaitis, 2008). Degli estratti così ottenuti è stata inoltre valutata l'attività antimicrobica e antibiofilm contro dieci diversi batteri rilevanti per il settore sanitario (Nishimura et al., 2017; Fontana et al., 2018), tra cui agenti patogeni opportunistici correlati a infezioni nosocomiali. Sono risultati più attivi gli estratti ottenuti dalla buccia di arancia e limone mediante l'ausilio delle microonde (100 °C, 8 minuti). In particolare, è emerso che gli estratti di buccia di agrumi sono in grado di ridurre la formazione di biofilm potenziando la suscettibilità dei batteri diffusi in ambito sanitario alle procedure di disinfezione. Questo lavoro si aggiunge dunque alla casistica che suggerisce la possibilità di valorizzare gli scarti degli agrumi recuperando sostanze ad alto valore aggiunto.

Growth differentiation factor-15 (GDF-15) improves prognostication in patients with cardiovascular disorders in addition to conventional cardiac markers (N-terminal pro B-type natriuretic peptide [NT-proBNP], troponins [Tns]) and has shown prognostic value in patients with renal diseases. In patients with light chain (AL) amyloidosis, cardiac involvement is the major determinant of prognosis, and cardiac markers define prognosis, whereas biomarkers of renal involvement stratify renal risk. We explored the prognostic importance of serum level of GDF-15 in patients with AL amyloidosis in 2 independent cohorts. The prognostic value of GDF-15 level was initially evaluated in a cohort of 107 consecutive previously untreated patients with AL amyloidosis from Athens, Greece, and was then validated in a second cohort of 202 consecutive previously untreated patients from Pavia, Italy. High GDF-15 level was associated with a higher risk of early death and poor overall survival independently of NT-proBNP and high-sensitivity TnT (hsTnT) or hsTnI levels. At the 6-month landmark, reduction of GDF-15 level ‡25% was associated with improved outcome. GDF-15 level ‡4000 pg/mL was associated with a high risk of progression to dialysis, independently of renal risk defined by estimated glomerular filtration rate and proteinuria, in both cohorts; failure to reduce GDF-15 below this level was associated with increased risk at either the 3- or 6-month landmark, independently of the established renal response or progression criteria. In conclusion, GDF-15 has prognostic implications for different outcomes in patients with AL and adds prognostic information independent of that provided by cardiac and renal risk biomarkers. (Blood. 2018;131(14):1568-1575) © 2018 by The American Society of Hematology

Cardiac catheterisation has become an essential tool in the diagnosis and treatment of children with a wide variety of congenital and acquired forms of cardiovascular disease. Despite the clear clinical benefit to the patient, radiation exposure from paediatric cardiac catheterisation procedures (CCPs) may be substantial. Given children's greater sensitivity to radiation and the longer life span during which radiation health effects can develop, an epidemiological cohort study, named Coccinelle or 'Ladybird' (French acronym for 'Cohorte sur le risque de cancer apres cardiologie interventionnelle pediatrique'), is carried out in France to evaluate the risks of leukaemia and solid cancers in this population. A total number of 8000 included children are expected. Individual CCP-related doses will be assessed for each child included in the cohort. For each CCP performed, dosimetric parameters (dose-area product, fluoroscopy time and total number of cine frames) are retrieved retrospectively. Organ doses, especially to the lung, the oesophagus and the thyroid, are calculated with PCXMC software. The cohort will be followed up through linkage with French paediatric cancer registries.

SummaryNon-small cell lung cancer (NSCLC) shows a particular aggressive behaviour. Tumour associated macrophages (TAMs) play an important role in tumour growth and progression and CC ligand 2 (CCL2)/CCR2 axis is markedly involved in their recruitment in the tumour mass from the circulation.The aim of this study was to determine the plasma levels of CCL2 and the expression of CCR2 in the peripheral blood mononuclear cells (PBMCs) of 18 smokers with NSCLC, eight healthy smokers and nine non-smokers. Then, we investigated CCL2 levels in the supernatants of unstimulated and LPS-stimulated PBMC cultures of the same groups of patients.CCL2 levels in plasma and supernatants of PBMC cultures were determined by ELISA. CCR2 expression in PBMC cytospins was assessed by immunocytochemistry.CCL2 plasma levels and CCR2 expression by PBMCs were similar in patients with NSCLC, healthy smokers and non-smokers. In the supernatants of unstimulated PBMC cultures, CCL2 content was not different between the three groups of subjects. Supernatants of LPS-stimulated PBMCs of NSCLC patients showed a higher content of CCL2 as compared to supernatants of non-smokers (p

As toxiinfecções alimentares de origem microbiana têm sido reconhecidas como um problema de saúde pública mais abrangente. Os produtos perecíveis protéicos são considerados importantes em relação ao controle higiênico-sanitário. Portanto, o objetivo deste trabalho foi analisar a qualidade microbiológica do processo produtivo do frango assado. O monitoramento da preparação foi realizado por meio de análises microbiológicas do frango cru e assado, swabs de bancadas, cubas, mãos dos manipuladores. O estudo bacteriológico foi desenvolvido no total de 96 amostras que foram submetidas às seguintes análises microbiológicas: Coliformes totais e fecais, Estafilococos coagulase positivo, Salmonella spp. e Clostrídio Sulfito Redutor somente no frango assado. As amostras das bancadas, cubas e mãos dos manipuladores após a higienização e frango assado demonstraram ausência dos microorganismos pesquisados. Das amostras de frango cru, 9,9% apresentaram Coliformes fecais (>15.000 NMP - limite da legislação) e 6,6%, Estafilococus coagulose positivo. Todas as amostras apresentaram ausência de Salmonella spp. As bancadas e mãos, durante a manipulação do frango, apresentaram contaminação por Coliformes fecais, relacionada à contaminação da matéria-prima. Os resultados demonstram que as etapas do processamento estão com qualidade microbiológica adequada, garantido a segurança do produto final.The alimentary toxinfections of microbial source have been recognized as a larger health public problem. Protein perishable products are considered important in relation to the sanitary-hygiene control. Therefore, the objective of this study was to analyze the microbiological quality of the procedure of roast chicken. The monitoring of roast chicken preparation was carried out through microbiological analyses of swabs counters, vessels, handlers as row and roast chicken. The bacteriological study was developed in a totality of 96 samples that were submitted to the following microbiological analyses: total and fecal Coliforms, coagulase positive Staphylococcus and Salmonella ssp., and Clostridium only in roast chicken. Microbial analyses of counters, vessels and handlers after the hygiene and roast chicken demonstrated no evidence of the microorganisms analyzed. In 9.9% of the row chicken samples, the presence of fecal Coliform were found (>15.000 NMP - law limit) and 6.6% of the samples presented coagulase positive Staphylococcus. All the samples did not present Salmonella ssp. It was detected fecal Coliform contamination in the counters and hands during the handling of the chicken and it was related to the raw material. The results showed that the processing stage were microbiological quality appropriate, guarantying the safety end product.

We report a fatal case of fulminant myocarditis (FM) in a five-year-old male child. He presented to our Emergency Department having complained fever, vomiting, nausea and abdominal pain from the previous day. The ECG showed broad complex tachycardia unresponsive to treatment with both drugs and all other resuscitation measures and the child died four hours after admission. Post-mortem histological examination showed diffuse infiltration of the myocardium although no viral material could be identified. FM is relatively uncommon and late presentation at an almost irreversible stage unusual. This case indicates the necessity of a rapid transfer to a center with ECMO or MCS, when FM is diagnosed.

Earth- and space-based observations provide synergistic information for space mission encounters by providing data over longer timescales, at different wavelengths and using techniques that are impossible with an in situ flyby. We report here such observations in support of the EPOXI spacecraft flyby of comet 103P/Hartley 2. The nucleus is small and dark, and exhibited a very rapidly changing rotation period. Prior to the onset of activity, the period was ∼16.4 hr. Starting in 2010 August the period changed from 16.6 hr to near 19 hr in December. With respect to dust composition, most volatiles and carbon and nitrogen isotope ratios, the comet is similar to other Jupiter-family comets. What is unusual is the dominance of CO2-driven activity near perihelion, which likely persists out to aphelion. Near perihelion the comet nucleus was surrounded by a large halo of water-ice grains that contributed significantly to the total water production. Fil: Meech, K. J.. Institute for Astronomy; Estados Unidos Fil: A’Hearn, M. F.. University of Maryland; Estados Unidos Fil: Adams, J. A.. Cornell University; Estados Unidos Fil: Bacci, P.. Centro Astronomico di Libbiano; Italia Fil: Bai, J.. Chinese Academy of Sciences; China Fil: Barrera, L.. Universidad Metropolitana de Ciencias de la Educacion; Chile Fil: Battelino, M.. Swedish Space Corporation; Suecia Fil: Bauer, J. M.. Jet Propulsion Laboratory; Estados Unidos Fil: Becklin, E.. Stratospheric Observatory for Infrared Astronomy; Estados Unidos Fil: Bhatt, B.. Indian Institute of Astrophysics; India Fil: Biver, N.. Centre National de la Recherche Scientifique. Observatoire de Paris; Francia Fil: Bockelee Morvan, D.. Centre National de la Recherche Scientifique. Observatoire de Paris; Francia Fil: Bodewits, D.. University of Maryland; Estados Unidos Fil: Bohnhardt, H.. Gobierno de la Republica Federal de Alemania. Max Planck Institut Fur Astrophysik; Alemania Fil: Boissier, J.. Inst. di Radioastronomia; Italia Fil: Bonev, B. P.. Catholic University of America; Estados Unidos Fil: Borghini, W.. Osservatorio Astronomico Naturalistico di Casasco; Italia Fil: Brucato, J. R.. Osservatorio Astrofisico di Arcetri; Italia Fil: Bryssinck, E.. Brixiis Observatory; Bélgica Fil: Buie. M. W.. Southwest Research Institute; Estados Unidos Fil: Canovas, H.. Utrecht University; Países Bajos Fil: Castellano, D.. Unione Astrofili Italiani; Italia Fil: Charnley, S. B.. National Aeronautics And Space Administration; Estados Unidos Fil: Chen, W. P.. National Taiwan Normal University; Corea del Sur Fil: Chiang, P.. Korea Astronomy and Space Science Institute; Corea del Sur Fil: Choi, Y. J.. Korea Astronomy and Space Science Institute; Corea del Sur Fil: Christian, D. J.. California State University; Estados Unidos Fil: Chuang, Y. L.. National Taiwan Normal University; Corea del Sur Fil: Cochran, A. L.. University of Texas; Estados Unidos Fil: Melita, Mario Daniel. Consejo Nacional de Investigaciónes Científicas y Técnicas. Oficina de Coordinación Administrativa Ciudad Universitaria. Instituto de Astronomía y Física del Espacio. - Universidad de Buenos Aires. Facultad de Ciencias Exactas y Naturales. Instituto de Astronomía y Física del Espacio; Argentina

We examined lobar bronchial biopsies taken from 18 subjects with occupational asthma induced by toluene diisocyanate (TDI) and from nine nonasthmatic control subjects. Two groups of asthmatics were identified on the basis of the duration of exposure to TDI before the onset of symptoms of asthma. Group A (n = 8) developed asthma after 2.4 +/- 0.4 yr of exposure to TDI, and Group B (n = 10) developed asthma after 21.6 +/- 3.1 yr of exposure to TDI. Both groups of asthmatic subjects had increased numbers of inflammatory cells in the airway mucosa compared with subjects in the nonasthmatic control group. Comparison between Groups A and B showed that subjects who developed asthma after short-term exposure had a significantly increased number of mast cells both in epithelium and in lamina propria than did subjects who developed asthma after long-term exposure to TDI (p0.01). Interestingly, the numbers of mast cells both in the epithelium (rs = -0.52, p0.05) and in the lamina propria (rs = -0.81, p0.001) were inversely correlated with the length of exposure to TDI before the onset of asthma. In conclusion, subjects who develop asthma after short-term exposure to TDI have an increased number of mast cells in the airway mucosa, suggesting that these cells may be associated with individual susceptibility differences to offending agents.

The effect of cessation of exposure to toluene diisocyanate (TDI) was studied in six patients with TDI-induced asthma, proved by a positive inhalation challenge with TDI. Bronchial challenges with TDI and methacholine were performed, and lobar bronchial biopsies were taken at diagnosis and 6 months later, after cessation of exposure. Biopsies from four nonasthmatic control subjects were also examined. At diagnosis, asthmatic subjects had thickened reticular basement membrane (p less than 0.05) and increased numbers of mononuclear cells (p less than 0.05) and eosinophils (p less than 0.05) in the lamina propria when compared with control subjects. Electron microscopy showed degranulation of eosinophils and mast cells in asthmatics. Six months after cessation of exposure, the thickness of reticular basement membrane was significantly reduced compared with that at diagnosis (p less than 0.05), and it decreased to values similar to those of control biopsies. Inflammatory cell numbers in bronchial mucosa of asthmatic subjects did not change significantly 6 months after removal from exposure, and degranulation of eosinophils and mast cells was still present. At the end of the study, airway hyperresponsiveness to methacholine and/or sensitivity to TDI persisted in most of the asthmatic patients despite the cessation of exposure and the disappearance of asthmatic symptoms. In conclusion, in patients with occupational asthma induced by TDI, the avoidance of exposure to the sensitizing agent for 6 months is able to reverse the reticular basement membrane thickening in the bronchial mucosa, but the inflammatory cell infiltrate, the specific sensitivity to TDI, and the nonspecific airway hyperreactivity may persist.

This paper describes a tool implemented to automatically reconstruct the pedigree of an isolated population of Northern Italy with the aim of supporting genetic studies. The goal of such studies is to analyze genealogic, clinical and genetic data for genetic dissection of complex diseases. In this context the reconstruction of the population pedigree is fundamental to verify that such population is a genetic isolate and obtain the parental relationships among the individuals participating to the study. The algorithm presented in the paper, from heterogeneous data sources (demographic municipal and parish archives and other data sources), derives the pedigree applying several heuristic rules in a predefined order. One of the main difficulties in performing such task stands in the "record linkage" process that requires the definition of a sufficiently general strategy for managing the ambiguities caused by missing or imprecise/erroneous input data. The paper, finally, presents and discusses the preliminary results obtained by reconstructing the pedigree of four villages from the data collected during the first eighteen months of project.

Admission to Pediatric Departments for 0/18- year-old patients is an important issue for the best organization of pediatric hospital assistance. Aim of the study. To locate adolescent health care and identify the percentage of adolescent admissions to Pediatric Departments in an Italian region (Tuscany).Adolescent health care in pediatric departments and pediatric admissions (0-18 years old) in 1999 into the reference hospital of Pisa and into 5 other regional hospitals in Tuscany are reported. The percentages of patients, subdivided by age, hospitalyzed in Pediatric Departments have been determined.In 1999 the admissions for subjects aged 0 to 18 years were 12573 of which 4966 adolescents (39.6 %). The percentage of adolescent admissions is not smaller than children's admissions (aged 0 to 1 year: 16.2%; aged 2 to 5 years: 26.2%; aged 6 to 9 years: 17.8%; aged 10 to 14 years: 20.4%; aged 15 to 18 years: 19.2%). Analysis by age demonstrated a continuous decrease of patient percentages admitted to Pediatric Departments with the increased age. A minority of 15/18- year-old subjects has been admitted to Pediatric Departments.The percentage of adolescent admissions is similar to there of children. Most adolescents are admitted to structures unsuitable for assistance to subjects aged 0 to 18 years. These data underline the necessity for a strong recovery of adolescent admissions to pediatric structures also equipping suitable nursing rooms.

Authors refer about an experience in pediatric age after introduction of a routine hepatitis B immunization. They underline the goodness of immune response to vaccine and the doubt about duration of protection.

1 Damage to the bronchial epithelium occurs after the inhalation of toxic substances and allergens, and through virus infections and it may lead to increased desquamation of epithelial cells in bronchoalveolar lavage (BAL). 2 In this study we compared two methods of staining the epithelial cells of BAL, the conventional cytochemical May Grunwald-Giemsa stain (MGG) and an immunocytochemical technique using a monoclonal antibody anti-human cytokeratin (CK) detected with APAAP immuno-alkaline phosphatase. BAL was obtained from 13 subjects and the epithelial cells were cytocentrifuged either immediately after collection (fraction A) or after washing (fraction B). 3 Higher percentages of epithelial cells were identified in fraction A with CK (20.0 ± 5.1 %) than in fraction A with MGG (11.2 ± 2.3%), which recognized only ciliated epithelial cells. In fact a proportion of CK-positive cells (34%) in fraction A were not ciliated. Underestimation of epithelial cells by MGG compared to CK was more pronounced in fraction B (8.0 ± 2.9% and 22.9 ± 3.0%, respectively) as there was a relative loss of ciliated CK+ cells after washings. 4 These results suggest that immunocytochemical staining with an anti-cytokeratin monoclonal antibody is more sensitive than using the MGG stain in detecting epithelial cells in BAL.

We examined the light and electron microscopic structure of lobar bronchial biopsies of nine subjects with occupational asthma induced by toluene diisocyanate (TDI) and of four control nonasthmatic subjects who had never been exposed to TDI. Inflammatory cell numbers were separately assessed in the intact epithelium, in the more superficial layer of the submucosa, and in the total submucosa. Asthmatic subjects had an increased number of inflammatory cells in the airway mucosa compared with control subjects. Eosinophils were significantly increased in all compartments, CD45-positive cells were significantly increased in the epithelium and in the more superficial layer of the submucosa, and mast cells were significantly increased only in epithelium. By electron microscopy eosinophils and mast cells appeared degranulated only in asthmatic patients. In the areas of epithelium that appeared intact by light microscopy, electron microscopy showed that, although the intercellular spaces between columnar cells were similar in asthmatic and control groups, the intercellular spaces between basal cells were significantly wider in patients with asthma. Patients with TDI-induced asthma also had a thicker subepithelial reticular layer, where immunohistochemistry showed the presence of collagen III. In conclusion, in patients with asthma induced by TDI, the airway mucosa shows pathologic features, such as inflammatory cell infiltrate and thickening of subepithelial collagen, similar to those described in atopic asthma.