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Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors. This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (N = 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels. Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI). Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.

Disparities in the health services delivered to sexual and gender minority (SGM) individuals are widespread across health service disciplines. Many health service providers do not have the knowledge, comfort, or skills necessary to provide health services to SGM individuals. The objective of the current systematic review was to review the correlates of competency (defined as knowledge, attitude, and skill) that health service providers possess for working with SGM individuals. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses was utilized to guide search and reporting strategies. PsycInfo/PsycArticles, PubMed/Medline, and Google Scholar databases were searched to find studies that addressed health service providers’ competency working with SGM individuals. There were 31 studies included in the review. Approximately half of the studies utilized the full definition of competency (knowledge, attitude, and skill). The most common competency assessed was knowledge, and the least common was skill. The majority of the studies addressed health service providers in the social sciences. Health service education needs to emphasize competency working with SGM individuals. Of particular importance is developing skill sets, as many providers reported that they did not have the skills necessary to provide culturally competent health services to SGM individuals.

Objective This paper advances understanding of the kink community by examining mental health and coping-self efficacy (CSE) variation by gender and sexual orientation. Design Adult members of the National Coalition for Sexual Freedom (N = 332) completed an online cross-sectional health assessment. Main outcome measures The assessment included the Coping Self-Efficacy (CSE) Scale; Depression and Anxiety Stress Scale-21; and Alcohol Use Disorders Identification Test. Results Transgender and non-binary persons reported consistently low coping beliefs and poor mental health. Queer sexual minority persons reported low CSE thought stopping and high anxiety. Several CSE thought stopping moderation effects on mental health were observed. Conclusions Findings may inform clinical implications, as bolstering coping-related beliefs and skills via cognitive-behavioral therapy may offer mental health benefit to kink practitioners.

Suicidal thoughts and behaviors (STBs) remain a pressing public health problem for transgender and gender diverse (TGD) persons. The goal of this study was to apply social-ecological and minority stress frameworks to identify individual and interpersonal-level TGD-specific STB risk and protective factors.This is a secondary analysis of the 2015 United States Transgender Health Survey, a comprehensive cross-sectional health assessment of a national sample of TGD adults (N = 27,658). Chi-square and Analysis of Variance (ANOVA) were used to identify bivariate correlates of 12-month and lifetime suicidal ideation (SI) and suicide attempt (SA). Logistic regression was employed to identify the strongest STB risk and protective factors across levels.Sexual minority identification, racial minority identification, and having a disability were lifetime STB risk factors. TGD identity, sexual minority identification, racial minority identification (SA only), lower education, lower income, military experience, having a disability, and being uninsured were 12-month STB risk factors. Psychological distress was the most robust STB risk factor. Workplace discrimination, family rejection, healthcare discrimination, and childhood bias-based victimization were lifetime STB risk factors. All forms of discrimination and victimization (with the exception of family rejection for SI) were 12-month STB risk factors. Family and coworker support were protective factors for lifetime SA (but not SI) and all 12-month STBs. Being less out about TGD identity was a protective factor for STBs (except for 12-month SI).Findings support social-ecological and minority stress STB risk frameworks. Recommendations are provided for a comprehensive approach to TGD suicide prevention.

The purpose of this paper is to examine the accountability mechanisms for Banking Union institutions. Leaving rule making tasks in the background, the goal of this paper is to examine closely the adjudication activity of Banking Union authorities, and to shed light on the problems stemming from the growing political dimension of decisions taken by agencies, which are characterised by technical content. The paper aims at demonstrating that existing accountability instruments, which relate to the exercise of power on the part of the Single Supervisory Board and the Single Resolution Board as for supervision and resolution, can be suitable for the financial market and that they provide a good level of protection of credit institutions’ interests. While enhancing accountability, these instruments also encourage and strengthen the legitimacy of the authorities that are under examination.

While several studies have investigated winter-time air pollution with a wide range of concentration levels, hardly any results are available for longer time periods covering several winter-smog episodes at various locations; e.g., often only a few weeks from a single winter are investigated. Here, we present source apportionment results of winter-smog episodes from 16 air pollution monitoring stations across Switzerland from five consecutive winters. Radiocarbon (14C) analyses of the elemental (EC) and organic (OC) carbon fractions, as well as levoglucosan, major water-soluble ionic species and gas-phase pollutant measurements were used to characterize the different sources of PM10. The most important contributions to PM10 during winter-smog episodes in Switzerland were on average the secondary inorganic constituents (sum of nitrate, sulfate and ammonium = 41 ± 15%) followed by organic matter (OM) (34 ± 13%) and EC (5 ± 2%). The non-fossil fractions of OC (fNF,OC) ranged on average from 69 to 85 and 80 to 95% for stations north and south of the Alps, respectively, showing that traffic contributes on average only up to ~ 30% to OC. The non-fossil fraction of EC (fNF,EC), entirely attributable to primary wood burning, was on average 42 ± 13 and 49 ± 15% for north and south of the Alps, respectively. While a high correlation was observed between fossil EC and nitrogen oxides, both primarily emitted by traffic, these species did not significantly correlate with fossil OC (OCF), which seems to suggest that a considerable amount of OCF is secondary, from fossil precursors. Elevated fNF,EC and fNF,OC values and the high correlation of the latter with other wood burning markers, including levoglucosan and water soluble potassium (K+) indicate that residential wood burning is the major source of carbonaceous aerosols during winter-smog episodes in Switzerland. The inspection of the non-fossil OC and EC levels and the relation with levoglucosan and water-soluble K+ shows different ratios for stations north and south of the Alps (most likely because of differences in burning technologies) for these two regions in Switzerland., Atmospheric Chemistry and Physics, 14 (24), ISSN:1680-7375, ISSN:1680-7367

A reversed-phase HPLC method has been developed for the urinary determination of mutagenic 2,4- and 2,6-toluendiamines. These amines are degradation products of polyurethane, a material used to cover textured silicone breast implants. FMOC-Cl was used as fluorescent derivatising agent in order to obtain a limit of detection of 15 ng/ml in urine. Pre-treatment of urine samples was by liquid/liquid extraction and urine specimens of patients after surgury were analysed.

Summary: Resume: Zusammenfassung Relations between availability of light and reproductive activity in several of the most damaging summer weeds (Abutilon theophrasti Medicus, Datura stramonium L., Sorghum halepense L. Pers.) were studied, in order to investigate seed production capacity of these weed species in the unfavourable conditions occurring under a crop canopy simulated by shade cloths. Decrease in seed production under shading appeared to be due to a decrease in the number of fruits per plant, while the quantity of seed per fruit proved to be fairly stable. Biomass partitioning within the plant reduced the percentage of dry matter accumulated in reproductive organs, leading to a marked decrease in the harvest index. Further-more, shading caused a species-dependent delay in onset of the flowering and ripening stages. In Datura stramonium shading led to a greater de-crease in seed production and, consequently, in the harvest index than in the other species examined. Finally, laboratory tests demonstrated that the percentage of dormant seeds remained unmodified in all species examined. Effet de l'ombragesur la reproduction et quelques caracteristiques morphologiques de Abutilon theophrasti Medicus, Datura stramonium E. et Sorghum halepense L. Pers. Les relations entre la fourniture de lumiere et l'activite reproductrice de quelques unes des mauvaises herbes les plus importantes (Abutilon tiieophrasti Medicus, Datura stramonium L., Sorghum halepense L. Pers.) ont eteetudiees en vue de determiner leur capacitea produire des graines dans les conditions defavorables qui prevalent sous les couverts vegetaux. La diminution de la production de graines etait due a une diminution du nombre de fruit par plante, alors que la quantite de graines par fruits restait a peu pres stable. La distribution de la biomasse dans la plante conduisait a une diminution du pour-centage de matiere seche accumulee dans les organes reproducteurs, ce qui se traduisait par une diminution de l'indice de recolte. De plus, l'ombrage causait un retard (variable selon l'espece) du debut de la floraison et de la maturation. Chez Datura stramonium, l'ombrage conduisait a la reduction la plus importante de la production de graines (et par consequent de l'indice de recolte). Enfin, des tests en laboratoire ont montre que le pourcentage de graines dormantes n'etait modifie chez aucune des especes testees. Einflus von Beschattung auf Vermehrung und morphologische Eigenschaften von Abutilon theophrasti Medicus, Datura stramonium E. und Sorghum halepense (E.) Pers. An einigen sommerannuellen Unkrautem (Abutilon theophrasti Medicus, Datura stramonium L. und Sorghum halepense (L.) Pers.) wurde die Beziehung zwischen der Lichtverfugbarkeit und der Samenproduktion dieser Arten unter den ungunstigen Bedingungen der Beschattung in einem Kulturpflanzenbestand, die durch Beschattungsgewebe simuliert wurde, untersucht. Die Abnahme der Samenproduktion bei Beschattung ist durch die geringere Fruchtzahl pro Pflanze bedingt; die Samenzahl pro Frucht erwies sich als ziemlich stabil. Die Biomasseverteilung in den Pflanzen fuhrte zu einer Abnahme der Trockenmasse der Reproduktionsorgane und damit zu einem deutlich kleineren Ertragsindex. Auserdem wurden durch die Beschattung der Bluhbeginn und das Reifestadium verzogert. Bei Datura stramonitim war die Abnahme der Samenbildung und somit des Ertragsindex starker als bei den anderen Arten. Der Anteil dormanter Samen blieb bei alien Arten durch die Beschattung einbeeinflust.

Computer image guidance is one of the most significant technologic advancements in the spine surgery, because preoperative or intraoperative images can be used for multiplanar, three-dimensional intraoperative navigation.We performed a prospective clinical study to assess the accuracy of pedicle screw insertion using an optoelectronic navigation system (SurgiGATE Spine 2.1 Medivision). The study population included 29 patients with diverse disorders of the thoraco- lumbar spine (degenerative 54%, spondylolisthesis 21%, fractures 14%, scoliosis 7% and spondylodiscitis 4%). One patient was excluded from the study because problems with the specific instruments or the computer system. Pre and post-operative axial computed tomography images were obtained for each patient and analyzed by two independent radiologists to placement accuracy. The correct location was defined accord to Heary scale in 5 grades.163 image-guided thoraco-lumbar pedicle screws were placed 29 in the thoracolumbar spine and 134 in the lumbosacral spine. We achieved a completely intraosseous placement (Grade I) in 99.4% of lumbosacral spine screws and 100% of thoracolumbar spine screws. Only one misplaced screw (Grade III) in the pedicle of L III in the concavity of a scoliosis was reported. No implant related complications were noted.The low rate of misplaced screws in this prospective study compares favorably with previously published results. Our initial results indicate that Image-guided spinal surgery is a safe technique which improves surgical performance during posterior transpedicle stabilization.

Introducción. La cirugía guiada por imagen es uno de los más importantes avances tecnológicos dentro de la cirugía del Raquis ya que permite al cirujano realizar una navegación multiplanar tridimensional en tiempo real en el interior de una vértebra. Material y métodos. Realizamos un estudio clínico prospectivo no randomizado sobre la fiabilidad en la colocación de tornillos pediculares mediante un sistema de navegación optoelectrónico (SurgiGATE Spine 2.1 Medivision). Se estudiaron veintinueve pacientes intervenidos por diferentes patologías en columna toracolumbar incluyendo: degenerativas (54%), espondilolistesis (21%), fracturas (14%), escoliosis (7%) y espondilodiscitis (4%). Un paciente fue eliminado del estudio debido a un fallo técnico en el equipo de navegación. Se obtuvieron imágenes de TC pre y postoperatorias de cada paciente y éstas fueron evaluadas por dos neurorradiólogos independientes. La colocación correcta se definió de acuerdo a la escala de Heary en 5 grados. Resultados. Se colocaron 163 tornillos, 29 en la columna toracolumbar y 134 en la columna lumbosacra. Hemos conseguido una colocación totalmente intraósea (Grado I) en el 99,4% de tornillos en la columna lumbosacra y en un 100% en la columna toracolumbar. Se comprobó el error de colocación (Grado III) en un pedículo de L3 en la concavidad de una escoliosis. No se observaron complicaciones relacionadas con los implantes. Conclusiones. El bajo porcentaje de tornillos mal colocados en este estudio se compara favorablemente con los resultados publicados en la literatura. Nuestros resultados indican que la cirugía guiada por imagen aplicada a la cirugía del raquis es una técnica segura para la fijación transpedicular.

The role in germination of the maternal pre-existing far-red absorbing form of phytochrome (Pfr) was studied in seeds harvested at different developmental stages. Datura stramonium seeds acquired marked dormancy in the later ripening stages, independently of phytochrome phototransformation. However, the balance between stimulators, such as Pfr, and inhibitors (probably abscissic acid and/or phenolic substances) in the stage prior to complete dehydration appeared to play a crucial role in the degree of progeny dormancy. Enrichment of the far-red (FR) wavelength (simulated canopy light) induced light-dependent dormancy if stage IV progeny were incubated in darkness in suboptimal conditions. In contrast, natural storage of seeds in soil led to a uniform degree of dormancy. An increase in photosensitivity owing to storage in soil appeared to be linked to simultaneous loss of inhibitors. It should be noted, however, that this extreme sensitivity to very low Pfr levels (724 nm monochromatic light pulse) was acquired only by seeds stored deep in the soil (typical very low fluence response). It is postulated that these reactions are induced by an elevated quantity of phytochrome typical of etiolated tissue, in conditions of near-absence of inhibitors.

A recently developed ultrasonographic technique was described to evaluate the anterior urethra in 10 men suspected to have urethral stenoses. With the patient in frog leg position, during a perfusion of the urethra with saline through a catheter positioned at the beginning of the urethra, penile, transscrotal and transperineal scanning of the urethra was obtained. In all patients a diagnosis of urethral stenoses was made. After sonographic evaluation all patient underwent retrograde urethrogram and internal urethrotomy, that confirmed the diagnosis made by ultrasound. The urethral ultrasound provides valuable informations about the number, extent, position of the strictures and eventual scarring of the periurethral tissue. Urethral ultrasonography can be used as alternative imaging modality to the conventional radiological techniques.

Naphthoquinones are known to inhibit 5-lipoxygenase. In particular, CGS 8515 (methyl 2-[(3,4-dihydro-3,4-dioxo-1-naphthalenyl)amino]benzoate) has been studied in detail. However this potent and selective 5-lipoxygenase inhibitor has a short duration of action and poor bioavailability. To improve the duration of action we have prepared a series of carbon substituted naphthoquinones. Several members of this series have demonstrated potent in vitro inhibition of 5-LO (IC50's less than 10(-6) M) and at doses of 1 mg/kg iv completely inhibited LTB4 production measured in ex vivo A23187-stimulated blood from dogs. The duration of action measured by the ex vivo assay was improved up to threefold over CGS 8515.

Publisher Summary This chapter provides an overview of the features and the objectives of the Italian Sirio satellite program and the characteristics of its systems. The principal objective is to investigate the applicability of frequencies above 10 GHz to satellite communication systems through an SHF propagation and communication experiment. Sirio is a spin-stabilized geostationary satellite with a mechanically despun antenna for the propagation and communication experiment. The nominal spin rate is 90 rpm. The Sirio program is developed in the frame of the Italian space program by the Consiglio Nazionale delle Ricerche (CNR). Project management is at the Servizio Attivita Spaziali (SAS) of CNR, while the experimental activity is under the scientific direction of the Centro Telecomunicazioni Spaziali of CNR at the Politecnico di Milano. Prime contractorship for the Sirio satellite has been entrusted to Compagnia Industriale Aerospaziale while the contractorship for the Sirio Operation Control Center and for the Sirio SHF ground stations has been entrusted to Telespazio. Telespazio is also giving technical and administrative assistance to CNR for the development of the program. NASA will take care of the satellite launch.

Among the numerous biological parameters which are considered useful to assay the function of the feto-placental unit, the assay of urinary oestriol is widely accepted.

Glycosylated haemoglobin (Hb A1) was measured by ion-exchange column chromatography in 70 normal subjects, 40 diabetics and 83 patients with chronic renal failure, including 54 on chronic dialysis. The results, compared with glycemic balance and renal function, suggest that the coexisting occurrence of any kind of chronic renal failure can really interfere with the blood level of the fast haemoglobin fractions, disclosing new interesting perspectives of diagnostic and clinic employment.

Publisher Summary This chapter provides an overview of the features and the objectives of the Italian Sirio satellite program and the characteristics of its systems. The principal objective is to investigate the applicability of frequencies above 10 GHz to satellite communication systems through an SHF propagation and communication experiment. Sirio is a spin-stabilized geostationary satellite with a mechanically despun antenna for the propagation and communication experiment. The nominal spin rate is 90 rpm. The Sirio program is developed in the frame of the Italian space program by the Consiglio Nazionale delle Ricerche (CNR). Project management is at the Servizio Attivita Spaziali (SAS) of CNR, while the experimental activity is under the scientific direction of the Centro Telecomunicazioni Spaziali of CNR at the Politecnico di Milano. Prime contractorship for the Sirio satellite has been entrusted to Compagnia Industriale Aerospaziale while the contractorship for the Sirio Operation Control Center and for the Sirio SHF ground stations has been entrusted to Telespazio. Telespazio is also giving technical and administrative assistance to CNR for the development of the program. NASA will take care of the satellite launch.

Publisher Summary This chapter provides an overview of the features and the objectives of the Italian Sirio satellite program and the characteristics of its systems. The principal objective is to investigate the applicability of frequencies above 10 GHz to satellite communication systems through an SHF propagation and communication experiment. Sirio is a spin-stabilized geostationary satellite with a mechanically despun antenna for the propagation and communication experiment. The nominal spin rate is 90 rpm. The Sirio program is developed in the frame of the Italian space program by the Consiglio Nazionale delle Ricerche (CNR). Project management is at the Servizio Attivita Spaziali (SAS) of CNR, while the experimental activity is under the scientific direction of the Centro Telecomunicazioni Spaziali of CNR at the Politecnico di Milano. Prime contractorship for the Sirio satellite has been entrusted to Compagnia Industriale Aerospaziale while the contractorship for the Sirio Operation Control Center and for the Sirio SHF ground stations has been entrusted to Telespazio. Telespazio is also giving technical and administrative assistance to CNR for the development of the program. NASA will take care of the satellite launch.

The sensibility of Ps. aeruginosa strains to several antibiotics has been tested in vitro. The strains have been divided into two groups: a group of 162 cases from the Hospital and a group of 42 cases from the outside. Then the percentage of resistance to each antibiotic of the cases in both groups has been calculated, and so has the significance of the differences between the percentages, whenever a difference has been found out. The strains from the Hospital have proved to be significantly more resistant to neomycin, nalidixid acid, chloramphenicol, demetilclortetracyclin, rifampicin, whereas the strains from the outside have shown greater resistance to colimicin and gentamicin. All the other differences between percentages haven't proved to be significant.

Neurodegenerative diseases are driven by several mechanisms such as inflammation, abnormal protein aggregation, excitotoxicity, mitochondrial dysfunction and oxidative stress. So far, no therapeutic strategies are available for neurodegenerative diseases and in recent years the research is focusing on bioactive molecules present in food. In particular, extra-virgin olive oil (EVOO) phenols have been associated to neuroprotection. In this study, we investigated the potential antioxidant and neuroprotective activity of two different EVOO extracts obtained from Quercetano cultivar trees grown in two different areas (plain and hill) of the Tuscany region (Italy). The different geographical origin of the orchards influenced phenol composition. Plain extract presented a higher content of phenyl ethyl alcohols, cinnammic acids, oleacein, oleocanthal and flavones, meanwhile, hill extract was richer in lignans. Hill extract was more effective in protecting differentiated SH-SY5Y cells from peroxide stress thanks to a marked upregulation of the antioxidant enzymes heme oxygenase 1, NADPH quinone oxidoreductase 1, thioredoxin Reductase 1 and glutathione reductase. Proteomic analysis revealed that hill extract plays a role in the regulation of proteins involved in neuronal plasticity and activation of neurotrophic factors such as BDNF. In conclusion, these data demonstrate that EVOOs can have important neuroprotective activities, but these effects are strictly related to their specific phenol composition.

Background The aim of this study was to investigate the impact of anti-HBc (HBcAb) positivity on the progression of liver fibrosis (Fibrosis-4 score >3.25) in the Italian cohort of HIV-infected individuals naïve to antiretroviral treatment (ICONA). Methods All patients with FIB-4 Results Patients who were HBcAb+/HCV-/HBs antigen (HBsAg)- and HCV+/HBcAb+/HBsAg- or HBsAg+/HBcAb+/HCV- had CD4+ cell counts below the nadir and significantly higher prevalence of AIDS diagnosis at baseline than the other groups (P < .0001). A Cox regression model adjusted for age, HIV transmission mode, country of birth, and alcohol consumption showed a higher relative risk (HR) of progression to FIB-4 >3.25 in HCV+/HBcAb+/HBsAg- patients (HR, 7.2; 95% CI, 3 8–13.64). Conclusions HBcAb+ contributes to liver damage in HIV+/HCV+/HBcAb+/HBsAg- subjects. A careful monitoring for signs of previous HBV infection is needed in this kind of patients.

Objectives To describe: (i) factors associated with rapid and delayed ART initiation; (ii) rates of 12 week virological response; and (iii) virologically controlled retention in care by 1 year from ART initiation according to timing of start in a real-life setting. Methods All individuals in the Icona cohort diagnosed with HIV in 2016–17 who initiated ART were grouped according to the time between HIV diagnosis and ART initiation: Group 1, ≤7 days; Group 2, 8–14 days; Group 3, 15–30 days; Group 4, 31–120 days; and Group 5, >120 days. Multivariable logistic regression models were used to identify factors associated with: (i) the probability of rapid (Group 1) and very delayed (Group 5) ART initiation; (ii) the 12 week virological response (by a modified snapshot algorithm); and (iii) the probability of retention in care at 1 year (on ART with HIV-RNA Results A total of 1247 individuals were included [82 (6.6%) in Group 1, 115 (9.2%) in Group 2, 267 (21.4%) in Group 3, 641 (51.4%) in Group 4 and 142 (11.4%) in Group 5]. Main predictors of rapid ART start (Group 1) were low CD4 cell count and high HIV-RNA at first contact with the infectious diseases centre. There was no association between probability of virological response and timing of ART initiation. Overall, 90% of individuals remained on ART after 1 year, 91% with undetectable HIV-RNA. Participants of Italian nationality, those with higher CD4 cell count and lower HIV-RNA at ART initiation were more likely to be retained in care after 1 year. Conclusions In our high-income observational setting, we did not observe differences in the 1 year rate of virological response and retention in care according to timing of ART initiation.

ObjectivesTo evaluate the incidence and risk factors for liver enzyme elevations (LEE) in patients initiating first-line ART in the ICONA prospective observational cohort, between June 2009 and December 2017.Patients and methodsIn total, 6575 ART-naive patients were selected, initiating two NRTIs with the third drug being a boosted PI (n=2436; 37.0%), an NNRTI (n=2384; 36.3%) or an integrase strand transfer inhibitor (INSTI) (n=1755; 26.7%). HBV surface antigen and HCV RNA were detected in 3.9% and 5.8% of the study population. Inverse probability weighted Cox regression analysis was used to calculate the HRs, according to first-line regimen, for LEE, defined as ALT or AST increases of ≥2.5× upper limit of normal (ULN) for patients with normal baseline values or ≥2.5× baseline for patients with higher baseline values.ResultsOne hundred and eighty-three LEE occurred over 20722 patient-years of follow-up. After adjusting for the main confounders, the risk of LEE halved with INSTIs compared with NNRTIs (HR 0.46, 95% CI 0.25–0.86), with a significant reduction in the raltegravir group (HR 0.11, 95% CI 0.02–0.84 using the NNRTI class as reference). HRs for LEE were significantly higher in subjects with HBV or HCV coinfection, in patients with poorly controlled HIV infection and in those who acquired HIV through homosexual transmission.ConclusionsIn our study, INSTI use almost halved the risk of LEE compared with other regimens. This finding could be particularly important for choosing ART in patients with risk factors for liver toxicity such as HCV and HBV coinfections.

Aim This study systematically reviews the recent literature on the role of definitive radiotherapy (RT) in the management of vaginal cancer (VC) and presents comprehensive data on clinical outcomes and toxicity. Methods The authors performed a literature search using PubMed (2007–2016) to identify all prospective and retrospective studies that have been published on RT in invasive VC. Results Of the 199 identified studies, 13 met the inclusion criteria. All studies had a retrospective design. Overall, 793 patients (median, 45; range, 26–138) were included. A high heterogeneity was found across studies in terms of RT techniques, assessment criteria, and reported outcomes. The majority of the patients were treated with a combination of external beam RT and brachytherapy (74.2%). Acute and late grade ≥3 toxicity rates ranged from 0.0% to 24.4% (median, 8.7%) and from 0.0% to 22.5% (median, 12.8%), respectively. The 5-year local control rates ranged between 39% and 79%. The 5-year overall survival ranged between 34% and 71.0% (median, 63.5%). Early stage of the disease (International Federation of Gynecology and Obstetrics stages I–II vs. III–IV), small tumor size ( Conclusion Only retrospective studies, in a limited number, have been published on RT in VC in the past decade, with significant heterogeneity in terms of treatment characteristic and evaluation criteria. Clinical results were strongly influenced by tumor stage. Prospective randomized studies are needed to improve patients’ outcomes, especially in advanced-stage disease. Implications for Practice This study systematically reviews the recent literature on the role of definitive radiotherapy in the management of vaginal cancer and presents comprehensive data on clinical outcome and toxicity. The prognosis of patients is dismal, with a 5-year overall survival of approximately 50%. Early stage of the disease, small tumor size, previous hysterectomy, high pretreatment/treatment hemoglobin levels, and patients’ age were correlated with a better clinical outcome. A brachytherapy boost should be delivered, especially in patients with higher-stage disease. The addition of concurrent weekly cisplatin should be considered in most patients, and transfusion should be used to maintain high hemoglobin levels.

This study investigated the interaction between the novel ceramide analog AL6 and gemcitabine in MIA PaCa-2 and PANC-1 pancreatic cancer cell lines, harboring different polymorphic variants of the gemcitabine catabolism enzyme cytidine deaminase (CDA). AL6 dose-dependently inhibited cell growth, induced apoptosis and synergistically enhanced the cytotoxic activity of gemcitabine. Moreover, it triggered apoptosis, which was significantly enhanced by the combination, and increased the ratio between gene expression of the activating enzyme deoxycytidine kinase (dCK) and CDA, potentially favoring gemcitabine activity. In conclusion, AL6 displays synergistic cytotoxic activity, enhances apoptosis, and favorably modulates enzymes involved in gemcitabine metabolism, supporting future investigation of this combination in pancreatic cancer.

Feathers of Flamingo chicks were sampled in six west Mediterranean wetlands in order to assess bird exposure to metals in their natal areas. This survey, started in 2008, is to date in progress. Here we discuss sample handling and analytical methods, and present first results of Mercury analysis. Our results suggest that Mercury is more concentrated in the feathers of birds growing in the Cagliari surrounding wetlands.