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Background Workplace exercise interventions showed good results, but lack of time was often reported as a barrier to participation. To overcome this problem, several studies attempted to implement short high-intensity interval training (HIT) within the workplace. Objectives The aim of this systematic review is to explore the feasibility and effectiveness of HIT interventions within the workplace setting. Data sources A systematic literature search was conducted in PubMed and SPORTDiscus to identify articles related to HIT within the workplace. Study eligibility criteria Only interventions that consisted of HIT programmes within the workplace and tested at least one physiological, psychological, or work-related outcome were included. Results Seven studies (317 participants) met the inclusion criteria. HIT interventions lasted 6–12 weeks, with a frequency of 2–4 sessions/week and a duration of 8–30 min per session. Feasibility was qualitatively investigated in four studies, with key positive aspects reported for HIT time-appeal, the sense of competence driven by individual intensity, and improved intention to exercise; five studies reported adherence rates > 80%. Small-to-large effect sizes were reported for improvements in cardiorespiratory and muscular fitness. Small-to-medium effect sizes were reported for blood parameters and health-related quality of life. Conclusions HIT interventions in the workplace showed limited effectiveness in improving health-related outcomes, while promising results regarding feasibility were reported, mainly due to the time-efficiency and the positive post-exercise psychosocial responses. However, further high-quality studies involving more participants are still needed to make firm conclusions on HIT effectiveness and feasibility compared to other types of exercise in this context.

Infection with severe acute respiratory syndrome coronavirus 2 associates with diverse symptoms, which can persist for months. While antiviral antibodies are protective, those targeting interferons and other immune factors are associated with adverse coronavirus disease 2019 (COVID-19) outcomes. Here we discovered that antibodies against specific chemokines were omnipresent post-COVID-19, were associated with favorable disease outcome and negatively correlated with the development of long COVID at 1 yr post-infection. Chemokine antibodies were also present in HIV-1 infection and autoimmune disorders, but they targeted different chemokines compared with COVID-19. Monoclonal antibodies derived from COVID-19 convalescents that bound to the chemokine N-loop impaired cell migration. Given the role of chemokines in orchestrating immune cell trafficking, naturally arising chemokine antibodies may modulate the inflammatory response and thus bear therapeutic potential.

This study aimed to assess if, during incremental exercise, considering individual characteristics can make the relationship between the percentages of heart rate (HRR) and oxygen uptake (

Numerous athletes compete at a high level without consuming animal products; although a well-planned vegan diet might be appropriate for all stages of the life cycle, a few elements need to be addressed to build a balanced plant-based diet for an athlete, particularly in bodybuilding, in which muscle growth should be maximised, as athletes are judged on their aesthetics. In this observational study, nutritional intakes were compared in a cohort of natural omnivorous and vegan bodybuilders, during two different phases of preparation. To this end, 18 male and female bodybuilders (8 vegans and 10 omnivores) completed a food diary for 5 days during the bulking and cutting phases of their preparation. A mixed-model analysis was used to compare macro- and micronutrient intakes between the groups in the two phases. Both vegans and omnivores behaved similarly regarding energy, carbohydrate, and fat intakes, but vegans decreased their protein intake during the cutting phase. Our results suggest that vegan bodybuilders may find difficulties in reaching protein needs while undergoing a caloric deficit, and they might benefit from nutritional professionals’ assistance to bridge the gap between the assumed proteins and those needed to maintain muscle mass through better nutrition and supplementation planning.

Objective To analyse the available evidence about the use of rituximab (RTX) and other biologic agents in eosinophilic granulomatosis with polyangiitis (EGPA) patients and to provide useful findings to inform the design of future, reliable clinical trials. Methods A systematic review was performed. A systematic search was conducted in PubMed/MEDLINE, Scopus, Web of Science and the Cochrane library databases on RTX, and an extensive literature search was conducted on other biologic agents. Results Forty-five papers pertinent to our questions were found: 16 retrospective cohort studies, 8 case series, 3 prospective cohort studies and 18 single case reports, for a total of 368 EGPA patients. More than 80% of evaluable patients achieved complete or partial remission with a tendency towards a higher rate of complete response in the pANCA-positive subgroup. Conclusion Although the majority of the evaluable EGPA patients treated with RTX appears to achieve complete remission, we strongly believe that a number of sources of heterogeneity impair a clear interpretation of results and limit their transferability in clinical practice. Differences in design, enrolment criteria, outcome definition and measurement make a comparison among data obtained from studies on RTX and other biologic agents unreliable.

INTRODUCTION According to current guidelines, the intensity of health-enhancing aerobic exercise should be prescribed using a percentage of heart rate reserve (%HRR), which is considered to be more closely associated (showing a 1:1 relation) with the percentage of oxygen uptake reserve (%V˙O2R) rather than with the percentage of maximal oxygen uptake (%V˙O2max) during incremental exercise. However, the associations between %HRR and %V˙O2R and between %HRR and %V˙O2max are under debate; hence, their actual relationships were investigated in this study. METHODS Data from each stage of a maximal incremental exercise test performed by 737 healthy and physically inactive participants of the HERITAGE Family Study were screened and filtered then used to calculate the individual linear regressions between %HRR and either %V˙O2R or %V˙O2max. For each relationship, the mean slope and intercept of the individual linear regression were compared with 1 and 0 (i.e., the identity line), respectively, using one-sample t-tests. The individual root mean square errors of the actual versus the 1:1 predicted %HRR were calculated for both relationships and compared using a paired-sample t-test. RESULTS The mean slopes (%HRR-%V˙O2R, 0.972 ± 0.189; %HRR-%V˙O2max, 1.096 ± 0.216) and intercepts (%HRR-%V˙O2R, 8.855 ± 16.022; %HRR-%V˙O2max, -3.616 ± 18.993) of both relationships were significantly different from 1 and 0, respectively, with high interindividual variability. The average root mean square errors were high and revealed that the %HRR-%V˙O2max relationship was more similar to the identity line (P < 0.001) than the %HRR-%V˙O2R relationship (7.78% ± 4.49% vs 9.25% ± 5.54%). CONCLUSIONS Because both relationships are different from the identity line and using a single equation may not be appropriate to predict exercise intensity at the individual level, a rethinking of the relationships between the intensity variables may be necessary to ensure that the most suitable health-enhancing aerobic exercise intensity is prescribed.

Background: to research retrospectively the efficacy of Erenumab’s treatment, thus allowing to describe a summary more in line with the reality observed every day in clinical practice, relative to a sample of patients widely heterogeneous. The study aims to confirm the efficacy of Erenumab, in terms of reduction of migraine days per month, from baseline to month 12 of treatment. Additional objectives included a reduction in the number of days of symptomatic drug use and change from baseline in the Migraine Disability Assessment Score Questionnaire (MIDAS), Methods: the analysis included all patients treated for 12 months with Erenumab during the year 2019–2020. The population analyzed consists of twenty-six patients from the Neurology outpatient clinic in Fossombrone. Several quantitative and qualitative variables were recorded by reading the medical records of the patients. The MIDAS was administered to patients to assess the disability related to migraine, Results: at the end of treatment, a statistically significant reduction in the mean number of monthly migraine days, acute medication use per month, and MIDAS questionnaire score was observed, Conclusions: as a preventive treatment of episodic and chronic migraine, our analysis data confirm the efficacy of Erenumab for the prevention of the migraine. The success is achieved in 96% of cases.

Nomophobia, a form of behavioral addiction, is uncontrolled, obsessive fear of being disconnected from the mobile phone network. Excessive use of smartphone during care, a source of errors and distractions, is among the top ten risks related to the use of technologies in healthcare. The study aims to investigate the presence of nomophobia among nurses and students of the Degree in Nursing and any differences based on gender, age group and seniority.A cross-sectional quantitative descriptive study conducted at Università Politecnica delle Marche and Azienda Ospedali Riuniti Marche Nord departments; the NMP-Q questionnaire (Nomophobia Questionnaire) was administered to a non-probabilistic sample of nurses and nursing students. The data were analyzed using descriptive and inferential non-parametric statistical measurements.A total of 280 questionnaires were returned, 141 for students and 139 for nurses. The mean total score for students and nurses was moderate and overlapping (M=79.9 vs. 79.3, p0.05), with no difference by gender and course year (p0.05); in the sample of nurses score is higher in men (M=89.8 vs. 76.0, p=0.037), under 30 (M=72.0) and over 50 years (M=83.1, p=0.021). The comparison between the two groups shows higher percentages of moderate nomophobic grade among students (+17pp), mild (+8.2 pp) and severe (+7.4 pp) among nurses, without significant gender differences.In the perspective of proper risk management, the level of nomophobia found in both groups should not be underestimated. This study highlights the importance of monitoring the phenomenon, adopting information and awareness-raising policies aimed at healthcare personnel as early as university training: distracting factors associated with the over-use of smartphones in the workplace make nurses, particularly newly graduates and with less expertise, more vulnerable and more exposed to the risk of error.

This study aimed to evaluate the cardiometabolic effects of a home-based lifestyle intervention (LI) in breast cancer survivors (BCSs) during the COVID-19 lockdown. In total, 30 BCSs (women, stages 0–II, non-metastatic, aged 53.5 ± 7.6 years, non-physically active, normal left ventricular systolic function) with a risk factor for recurrence underwent a 3-month LI based on nutrition and exercise. Anthropometrics, Mediterranean diet adherence, physical activity level (PAL), cardiorespiratory fitness (VO2max), echocardiographic parameters, heart rate variability (average standard deviation of NN intervals (ASDNN/5 min) and 24 h very- (24 hVLF) and low-frequency (24 hLF)), and metabolic, endocrine, and inflammatory serum biomarkers (glycemia, insulin resistance, progesterone, testosterone, and high-sensitivity C-reactive protein (hs-CRP)) were evaluated before (T0) and after (T1) the LI. After the LI, there were improvements in: body mass index (kg/m2: T0 = 26.0 ± 5.0, T1 = 25.5 ± 4.7, p = 0.035), diet (Mediet score: T0 = 6.9 ± 2.3, T1 = 8.8 ± 2.2, p &lt, 0.001), PAL (MET-min/week: T0 = 647 ± 547, T1 = 1043 ± 564, VO2max (mL·min−1·kg−1: T0 = 30.5 ± 5.8, T1 = 33.4 ± 6.8, signs of diastolic dysfunction (participants: T0 = 15, T1 = 10, p = 0.007), AS-DNN/5 min (ms: T0 = 50.6 ± 14.4, T1 = 55.3 ± 16.7, p = 0.032), 24 hLF (ms2: T0 = 589 ± 391, T1 = 732 ± 542, p = 0.014), glycemia (mg/dL: T0 = 100.8 ± 11.4, T1 = 91.7 ± 11.0, insulin resistance (HOMA-IR score: T0 = 2.07 ± 1.54, T1 = 1.53 ± 1.11, p = 0.005), testosterone (ng/mL: T0 = 0.34 ± 0.27, T1 = 0.24 ± 0.20, p = 0.003), hs-CRP (mg/L: T0 = 2.18 ± 2.14, T1 = 1.75 ± 1.74, p = 0.027). The other parameters did not change. Despite the home-confinement, LI based on exercise and nutrition improved cardiometabolic health in BCSs.

In metastatic colorectal cancer (MCRC), mucinous histology has been associated with poor response rate and prognosis. We investigated whether bevacizumab combined with different chemotherapy regimens may have an impact on clinical outcomes of MCRC patients with mucinous histology. 685 MCRC patients were classified in mucinous adenocarcinoma (MC) and non-mucinous adenocarcinoma (NMC) and were treated with first-line bevacizumab plus fluoropyrimidine (FP)-based, oxaliplatin (OXA)-based, irinotecan (IRI)-based, or FOLFOXIRI. Ninety-four (13.7%) patients had MC. With a median follow-up of 50 months, MC patients had a median overall survival (OS) of 28.2 months compared with 27.7 months for the NMC group [hazard ratio (HR) = 0.92; 95% confidence interval (CI) 0.70–1.19, P = 0.530]. The overall response rates for MC and NMC were 41.5% (95% CI 31.5–51.4) and 62.4% (95% CI 58.4–66.3), respectively (Chi-square test, P

Despite the knowledge gap regarding the risk-benefit ratio of the electronic cigarette (e-cig), its use has grown exponentially, even in teenagers. E-cig vapor contains carcinogenic compounds (eg, formaldehyde, acetaldehyde, and acrolein) and free radicals, especially reactive oxygen species (ROS) that cause toxicological effects, including DNA damage. The role of e-cig voltage customization on molecule generation has been reported, but the effects of the resistance on e-cig emissions and toxicity are unknown. Here, we show that the manipulation of e-cig resistance influences the carbonyls production from nonnicotine vapor and the oxidative and inflammatory status in a rat model. Fixing the voltage at the conventional 3.5 V, we observed that the amount of the selected aldehydes increased as the resistance decreased from 1.5 to 0.25 Ω. Under these conditions, we exposed Sprague Dawley rats to e-cig aerosol for 28 days, and we studied the pulmonary inflammation, oxidative stress, tissue damage, and blood homeostasis. We found a perturbation of the antioxidant and phase II enzymes, probably related to the increased ROS levels due to the enhanced xanthine oxidase and P450-linked monooxygenases. Furthermore, frames from scanning electron microscope showed a disorganization of alveolar and bronchial epithelium in 0.25 Ω group. Overall, various toxicological outcomes, widely recognized as smoke-related injuries, can potentially occur in e-cig consumers who use low-voltage and resistance device. Our study suggests that certain “tips for vaping safety” cannot be established, and encourages further independent investigations to help public health agencies in regulating the e-cig use.

Reverse integration in sports is a kind of integration in which athletes with disabilities outnumber their non-disabled counterparts. A new sport that reflects the concept of reverse integration is...

Hypothalamo-pituitary-adrenal axis activity and cortisol patterns are likely to play a role in shift work tolerance, i.e., ability to adapt to shift work without suffering stress-related consequences. Yet, the evidence is scanty. Here, salivary cortisol output during night shifts and leisure days was assessed in fast-forward rotating shift work nursing staff (

Background: Achilles tendinopathy (AT) affects ca. 10 million recreational runners in Europe, the practice of hyaluronic acid (HA) infiltration is being increasingly adopted. The aim of this pilot study was to monitor the effects of a three-local time-spaced injections regimen of HA in the treatment of AT in middle-aged runners combining for the first time viscoelastometric, biochemical, and functional methodologies with routine clinical examinations. Methods: Eight male runners (Age 49.3 ± 3.9), diagnosed for unilateral AT, were given three ultrasound (US) guided peritendinous HA injections at the baseline (T0) and every fifteenth day with a follow-up on the forty-fifth day (T1, T2, and T3). At all-time points patients were assessed for viscoelastic tone and stiffness, maximal voluntary isometric contraction (MVIC), and pain level (Likert scale 0–5). The peritendinous effusions of the injured tendon were collected at T0 and T2 to quantify the volume variations and the IL-1β and MMP-3 levels. Results: At T0 MVIC and pain score were significantly lower and higher, respectively, in injured tendons. The volume, IL-1β and MMP-3 levels decreased in the course of treatment and the clinical endpoints ameliorated over time. Tone, stiffness, and functional performance also varied significantly at T2 and T3, as compared to T0. Conclusions: The sequential peritendinous injections of HA were effective in the amelioration of the clinical symptoms, as well as of the functional and viscoelastic state associated with AT. The determination of the viscoelastometric state may help to precisely evaluate the healing process in AT patients.

The present work provides arguments for the involvement of anti‐vector immunity and of SARS‐CoV‐2 variants on the efficacy of ChAdOx1 nCoV‐19 vaccine. First, it is suggested that anti‐vector immunity takes place as homologous vaccination with ChAdOx1 nCoV‐19 vaccine is applied and interferes with vaccine efficacy when the interval between prime and booster doses is less than 3 months. Second, longitudinal studies suggest that ChAdOx1 nCoV‐19 vaccine provides suboptimal efficacy against SARS‐CoV‐2 Alpha variant, which appears to have an increased transmissibility among vaccinated people. At the moment, ChAdOx1 nCoV‐19 vaccine is able to reduce the severity of symptoms and transmissibility. However, if the vaccinated individuals do not maintain physical preventive measures, they could turn into potential spreaders, thus suggesting that mass vaccination will not quickly solve the pandemic. Possible consequences of SARS‐CoV‐2 evolution and of repeated anti‐SARS‐CoV‐2 vaccinations are discussed and adoption of an influenza‐like vaccination strategy is suggested.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) seroprevalence in cancer patients may vary widely dependent on the geographic area and this has significant implications for oncological care. The aim of this observational, prospective study was to assess the seroprevalence of SARS-CoV-2 IgM/IgG antibodies in solid cancer patients referred to the academic institution of the Marche Region, Italy, between 1 July and 26 October 2020 and to determine the accuracy of the rapid serological test. After performing 3767 GCCOV-402a rapid serological tests on a total of 949 patients, seroconversion was initially observed in 13 patients (1.4%). Ten (77% of the total positive) were IgG-positive, 1 (8%) were IgM-positive and 2 (15%) IgM-positive/IgG-positive. However, only 7 out of 13 were confirmed as positive at the reference serological test (true positives), thus seroprevalence after cross-checking was 0.7%. No false negatives were reported. The kappa value of the consistency analysis was 0.71. Due to rapid serological test high false positive rate, its role in assessing seroconversion rate is limited, and the standard serological tests should remain the gold standard. However, as rapid test negative predictive value is high, GCCOV-402a may instead be useful to monitor patient immunity over time, thus helping to assist ongoing vaccination programs.

Background In combination with dexamethasone, lenalidomide is prescribed in the oral treatment of Multiple Myeloma for patients who have received at least one previous therapy. Objective The objective of this study is to evaluate medication adherence to lenalidomide of Multiple Myeloma patients, as well as Progression Free Survival and Overall Survival one year from the beginning of the treatment. Setting The study was carried out in Pescara Hospital, in Italy. All Multiple Myeloma patients who began lenalidomide therapy between January 1, 2012 and June 30, 2016 were included in our study. Methods Adherence to treatment was calculated by using the ratio between the Received Daily Dose and the Prescribed Daily Dose. Effectiveness in real world has been evaluated as Progression Free Survival and Overall Survival one year from the beginning of the treatment. Main outcomes measure: We assessed medication adherence and effectiveness of lenalidomide in the treatment of Multiple Myeloma. Results Adherence to the overall mean treatment was 0.73 ± 0.15, relative to 81 patients evaluated in our study. 32% of patients achieved an adherence equal to or greater than 80%. Real-life effectiveness in terms of Progression Free Survival and Overall Survival showed values of ​​53.75% and 88%, respectively, one year from the beginning of treatment. Conclusion The analysis of adherence in Multiple Myeloma patients treated with lenalidomide one year from the beginning of therapy reveal a concerning lack of adherence. Moreover, the lack of correlation of the levels of adherence with patient-related variables shows that, in the case of Multiple Myeloma, adherence is not related to personal, social and environmental characteristics that may determine each patient’s correct treatment implementation, but is directly influenced by disease evolution.

Social isolation has adverse effects on mental health, physical exercise, and dietary habits. This longitudinal observational study aimed to investigate the effects of mood states and exercise on nutritional choices, on 176 college students (92 males, 84 females, 23 &plusmn, 4 years old) during the COVID-19 lockdown. During 21 days, nutrition and exercise were daily monitored, and the mood states assessed. A factor analysis was used to reduce the number of nutritional variables collected. The relationships between exercise, mood and nutrition were investigated using a multivariate general linear model and a mediation model. Seven factors were found, reflecting different nutritional choices. Exercise was positively associated with fruit, vegetables and fish consumption (p = 0.004). Depression and quality of life were, directly and inversely, associated with cereals, legumes (p = 0.005, p = 0.004) and low-fat meat intake (p = 0.040, p = 0.004). Exercise mediated the effect of mood states on fruit, vegetables and fish consumption, respectively, accounting for 4.2% and 1.8% of the total variance. Poorer mood states possibly led to unhealthy dietary habits, which can themselves be linked to negative mood levels. Exercise led to healthier nutritional choices, and mediating the effects of mood states, it might represent a key measure in uncommon situations, such as home-confinement.

Male and female firefighters work side-by-side in the same in strenuous and risky conditions. Anthropometrics, physiological, and reaction time (mean of reaction time -MRT-, and errors made -E) parameters of 12 Female and 13 Male firefighters were compared. Effect of overload (step test with and without equipment) on the MRT and E were analyzed on 3 trials (T1 = 1-1s, T2 = 0.5-1s, T3 = 0.5–0.5s), compared with a pre-test condition (basal). T-test between males and females was applied to assess differences (p

Background: Multiple studies have been conducted to investigate Tocilizumab in patients with cOVID-19 pneumonitis. However, published reports show conflicting results, largely due to weak retrospective designs and heterogeneity in critical methodological issues.Methods: This open-label trial was structured according to the Simon’s optimal two-stage design in order to clarify which patients could really benefit from anti-IL6 strategies and how a future randomized trial should be designed to provide reliable and unequivocal results. 46 patients received a single infusion of Tocilizumab. Inclusion criteria were: SARS-CoV2 infection diagnosed by rt-PCR, multifocal interstitial pneumonia, need of oxygen therapy (FiO2 50%) to maintain SO2 >93%, recent (within the last 24 hours) worsening of lung function. Clinical outcomes were established a priori to assess whether a patient responded to treatment. A low number of carefully chosen clinical and biological markers was measured in order to test their predictive values. Primary end point was early and sustained clinical response. Results: Twenty-one (46%) patients fulfilled pre-defined response criteria. Lower levels of IL-6 at 24 hours after tocilizumab infusion (p=0.049) and higher baseline values of PaO2/FiO2 (p=0.008) predicted a favorable clinical response. Patients not improving at 72 hours were also non-responder at day 7. 11/25 of non-responder patients were intubated and 7 died. High levels of vWF were detected in all sera, with a tendency towards higher concentrations in the non-responder group. Conclusions: Objective clinical response rate overcame the pre-defined threshold of 30%. Efficacy of tocilizumab to improve respiratory function in selected patients with severe COVID-19 pneumonitis warrants investigations in randomized trials. Trial registration: NCT 04315480

Over 313,000 SARS-CoV-2 positive cases have been confirmed in Italy as of 30 September 2020, and the number of deaths exceeding thirty-five thousand makes Italy among the list of most significantly affected countries in the world. Such an enormous occurrence of infections and death raises the urgent demand for effective available treatments. Discovering the cellular/molecular mechanisms of SARS-CoV-2 pathogenicity is of paramount importance to understand how the infection becomes a disease and how to plan any therapeutic approach. In this regard, we performed an in silico analysis to predict the putative virus targets and evidence the already available therapeutics. Literature experimental results identified angiotensin-converting enzyme ACE and Spike proteins particularly involved in COVID-19. Consequently, we investigated the signalling pathways modulated by the two proteins through query miRNet, the platform linking miRNAs, targets, and functions. Our bioinformatics analysis predicted microRNAs (miRs), miR-335-5p and miR-26b-5p, as being modulated by Spike and ACE together with histone deacetylate (HDAC) pathway. Notably, our results identified ACE/ACE2-ATR1-Cholesterol-HDAC axis signals that also matched with some available clinical data. We hypothesize that the current and EMA-approved, SARS-CoV-2 off-label HDAC inhibitors (HDACis) drugs may be repurposed to limit or block host-virus interactions. Moreover, a ranked list of compounds is provided for further evaluation for safety, efficacy, and effectiveness.

Over 180.000 SARS-COV-2 positive cases have been confirmed in Italy as April 20, with the number of deaths exceeding 23 thousand, making Italy the second Country for world COVID-19 deaths. Such enormous occurrence of infected and dead people raises the urgent demand of effective fast available treatments to control and diminish this pandemic. Discovering the cellular/molecular mechanisms of SARS-COV-2 pathogenicity is of paramount importance to understand how the infection becomes a disease and for therapeutically approaching it. From literature data, through a bioinformatics approach, an in silico analysis was performed, to predict the putative virus targets and evidence the already available therapeutics. Literature experimental results identified angiotensin-converting enzyme ACE and Spike proteins particularly involved in COVID-19. We thus investigate on the signaling pathways modulated by the two proteins through query miRNet, the platform linking miRNAs, targets and functions. We predicted microRNAs (miRs), miR-335-5p and miR-26b-5p, as being modulated by Spike and ACE together with deacetylate histones pathway HDAC. Our results matched with the available clinical data. We hypothesize the current and EMA-approved, SARS-COV-2 off-label, HDAC inhibitors (HDACis) drugs may be repurposed to limit or block host-virus interactions. A ranked list of compounds is given that can be tested.

Beach volleyball is an intermittent team sport played under high temperature and humidity. Given that some nutritional supplements can enhance sports performance, this study aimed to evaluate the quantity and the heterogeneity of the nutritional supplementation practices of amateur (n = 69) and professional (n = 19) beach volley athletes competing in the Italian National Championship, an online form was used to collect data about the supplementation habits. The latent class analysis was used to find sub-groups characterised by different habits regarding supplements consumption. The most frequently used supplements (more than once a week) are vitamins B and C (39.2% of athletes), protein (46.8%), and caffeine (36.9%). The latent class analysis revealed three different sub-groups of athletes: the first class (56.7%) included athletes who were used to take very few supplements, the second class (17.0%) was characterised by higher consumption of supplements and the third class (26.2%) was in the middle between the others two. Groups were characterised not only by the quantity but also by the category of supplements used. Our results highlighted a high heterogeneity in supplementation habits. A pragmatic approach to supplements and sports foods is needed in the face of the evidence that some products can usefully contribute to enhancing performance.

A healthy lifestyle is based on a correct diet and regular exercise. Little is known about the effect of different types of exercise on dietary preferences. To address the question of whether high-intensity interval training (HIIT) could modulate spontaneous food choices, an experimental study was carried out on 32 young, healthy normal-weight subjects. The spontaneous diet of each subject has been monitored over nine weeks of indoor-cycling training, divided into three mesocycles with an incremental pattern: total energy intake, macronutrients and micronutrients have been analysed. A two-way mixed model has been used to assess differences in dietary variables, a principal factor analysis has been performed to identify sample subgroups. An increased energy intake (+17.8% at T3, p &lt, 0.01) has been observed, although macronutrients&rsquo, proportions did not vary over time, without differences between sexes. An increase of free fat mass was found in the last mesocycle (+3.8%), without an augmentation of body weight, when, despite the increased training load, a stabilization of energy intake occurred. Three different subgroups characterized by different dietary modifications could be identified among participants that showed a common trend towards a healthier diet. Nine weeks of HIIT promoted a spontaneous modulation of food choices and regulation of dietary intake in young normal-weight subjects aged 21&ndash, 24. Importantly, this life-period is critical to lay the foundation of correct lifestyles to prevent metabolic diseases and secure a healthy future with advancing age.

The ability of four enterococcal strains to survive human digestion and maintain their antibiotic resistance (AR) traits was investigated to determine the health risk posed by seafood-borne streptomycin-, erythromycin-, tetracycline- and gentamycin-resistant enterococci. After demonstrating ant(6)-I, ermB, tetO and aac(6′)-aph(2″) gene transferability by mating assays, strains were inoculated into a mussel homogenate which underwent in vitro digestion. Digestion reduced plate counts by 2–3 log; qPCR counts decreased by 1.5 log (E. faecium 22571/2), 2.5 log (E. faecalis 113324) or did not decrease (E. faecium 125745 and 6767/2). The much lower plate than qPCR counts seen in E. faecium suggested a viable-but-non-culturable (VBNC) subpopulation. Replica plating on antibiotic-supplemented agar and qPCR demonstrated that maintenance of AR traits was antibiotic-dependent, with a variable amount of erythromycin-, tetracycline- and gentamycin-resistant colonies and no streptomycin-resistant colonies. The seeking of unexpressed/lost AR genes in cells turned antibiotic-susceptible after digestion, identified aac(6′)-aph(2″) in all colonies of E. faecalis 113324 and E. faecium 6767/2, in the 40% of 125745 and in none of the E. faecium 22571/2. In conclusion, after digestion the AR traits of antibiotic-resistant (also VBNC) enterococci contained in seafood may be maintained and transferred to the human microbiota and from it to intestinal pathogens.

Background The MILES and ELVIS studies showed that vinorelbine is one of the best options for elderly patients with advanced non-small-cell-lung cancer (NSCLC). Oral vinorelbine at standard schedule (60-80 mg/m2/weekly) has good activity in terms of response rates and progression-free survival. In recent years, a metronomic schedule of oral vinorelbine (40-50 mg/m2 three times a week, continuously) has been studied in phase II trials, especially in unfit and elderly patients. In the MOVE trial metronomic oral vinorelbine had a clinical benefit [partial response (PR)+stable disease (SD) >12 weeks] in 58.1% of patients with mild toxicity. On this basis, in 2017 we started a phase II study with metronomic oral vinorelbine in elderly (over 70 years) or unfit [Eastern Cooperative Oncology Group performance score (ECOG-PS) of 2] patients with locally/advanced and metastatic NSCLC. Primary aims were clinical benefit (PR+SD ≥6 months) and toxicity; secondary aims were progression-free survival and overall survival. Patients and methods A total of 25 patients entered the study: 11 with local/advanced and 14 with metastatic NSCLC (five squamous and 20 adenocarcinoma). None of the patients had epidermal growth factor receptor (EGFR) mutations, anaplastic lymphoma kinase (ALK) translocation, or programmed death ligand 1 (PDL1) expression; those with squamous carcinoma did not have PDL1 expression. The median age was 79 (range=44-90) years. The PS was 0 in 12 patients (48%), 1 in four patients (16%) and 2 in nine patients (36%). Oral vinorelbine was administered at 40 mg three times a week continuously. Results Clinical benefit was achieved in eight patients (32%). Objective responses were partial response in two patients (8%), stable disease in seven (28%), progressive disease in nine (36%); seven patients were not evaluable for response (28%). Median progression-free survival was 2 months; median overall survival was 4 months but four out of eight patients with clinical benefit were still alive at 18 months. Overall survival at 1 year was 32%. Toxicity was mild: only one patient experienced grade 4 neutropenia, one grade 3 peripheral neuropathy, four grade 2 asthenia, one grade 2 mucositis, and one grade 2 diarrhoea. The dose needed to be reduced to 30 mg/m2/three times a week in three patients. Conclusion Our study confirmed the activity and safety of metronomic oral vinorelbine in patients with wild-type local/advanced and metastatic NSCLC unsuitable for treatment with standard i.v. chemotherapy, allowing patients a comfortable home-based therapy, thereby avoiding frequent hospital visits.

The aim of this study was to analyze the efficacy of berberine taken alone or in other formulations (with silymarin or other mixtures) on dyslipidemia through a systematic review of the literature and a meta-analysis. A systematic investigation was conducted on 19 studies that were selected based on inclusion and exclusion criteria. Both controlled trials (n = 12) and cross-sectional trials (n = 7) were included. The following formulations were examined: berberine used alone (n = 5), berberine combined with silymarin (n = 8), and other mixture containing berberine (n = 6). A meta-analysis was performed using a fixed-effects model and meta-regression. Total cholesterol (TC), low-density lipoprotein (LDL) cholesterol, high-density lipoprotein (HDL) cholesterol, and triglycerides were considered. Moreover, possible associations of each parameter with age and the dose and duration of the treatment were analyzed. The data obtained showed a significant reduction in TC and LDL cholesterol for each formulation. A reduction in triglycerides was also observed for both TC and LDL but with a smaller impact. As regards HDL, a slight increase was observed, but it was not statistically significant. The formulation of berberine in association with silymarin was found to have the greatest impact on TC, LDL, HDL, and triglycerides. The greater efficacy of the formulation consisting of berberine associated with silymarin can probably be accounted for by the fact that the latter increases the bioavailability of berberine. However, it is necessary to carry out further clinical studies to better define the efficacy of the treatment and which patients show the best response.

Background Computerized Clinical Decision Support Systems (CCDSS) are information technology tools, designed to improve clinical decision-making. Telemedicine is a health care service delivery using videoconferencing, telephone or messaging technologies. Objectives Our project aimed at testing the effectiveness of a composite CCDSS and telemedicine approach designed to treat depression in primary care. Methods This cluster randomized trial involved four GP clinics located in Northern Italy. Two clinics were assigned to the experimental protocol, and two served as controls. The study compared the telemedicine group (TG), in which GPs had access to a CCDSS platform, with the control group (CG) in which GPs provided treatment as usual (TAU). Patients scoring ≥11 on Patient Heath Questionnaire and ≥26 on the Inventory of Depressive Symptomatology-Self-Report were eligible for participation. Patients were also administered the World Health Organization Quality of Life-BREF to assess quality of life and Medical Interview Satisfaction Scale 21 to assess satisfaction with the medical interview. Results Overall, 2810 patients were screened and 66 in the experimental group and 32 in the CG passed the screening stages and met inclusion criteria. The percentage of remitters at 6 months was significantly higher in the TG than in the CG group (24.1% versus 3.1%, χ 2 = 6.6, P = 0.01). This difference remained significant after adjusting for baseline confounders. Physical and psychological quality of life improved significantly from baseline in both groups. Patients reported, on average, good satisfaction with the medical interview. Conclusions Our study showed that a combined CCDSS and telemedicine approach may be more effective than the TAU offered by GPs to patients with depression. Trial registration The trial was registered on https://clinicaltrials.gov/ on 5 October 2012 with identifier: NCT01701791. The first participant was enrolled on 5 May 2014 and the study was completed on May 2016.

Background: Tennis is an intermittent sport, characterized by hundreds of repetitive explosive efforts, including accelerations, and jumps. A single match can last up to 5 hours and players are called to play several matches often separated by less than 48h of recovery. Objective: The study aimed to investigate the effects of a standardized tennis match on perceived fatigue and jump and sprint performances on a group of recreational tennis players and to observe if such variables were affected by residual effects of fatigue 24 hours after the match. Methods: Twelve recreational tennis players performed a 120 min match. Before, immediately after and 24h after the match, players completed a set of three countermovement jumps, three 10m sprints, and reported their perception of general fatigue. Results: Significant differences between the three conditions have been found for the perceived fatigue: indeed fatigue was higher both in the immediate post (F(1,10)= 54.422, η2 = 0.845, p(1,10)= 10.947, η2 = 0.523, p=0.08), with respect to the pre-match condition. No significant differences were detected in the other variables. Conclusion: During a tournament, the performance of tennis players may be weakened and the recovery prejudiced. To identify fluctuations of and factors linked to fatigue may help tennis practitioners to apply adequate recovery strategies with athletes, limiting performance decrements within a tournament, and indirectly preventing injuries.

To evaluate whether the application of the Relationship-based care model as a new treatment, called "Take 5 min", affects the level of anxiety, depression, and perceived quality of nursing care of parents of paediatric patients and the work satisfaction of the nursing staff.Single-blind randomized controlled trial.The trial was performed from February-July 2016. The trial was conducted with one intervention (N = 101) and one control group (N = 90). Nurses applied the treatment named "Take 5 Minutes", which consisted of dedicating some short time (from 5 to 10 min) to the relationship with the parents using specifically designed communication strategies. The primary outcome was the evaluation of anxiety and depression of parents; the secondary was the parent perceived quality of nursing care.In the experimental group, participants had a lower level of anxiety and depression and highlighted that the effect of the "Take 5 Minutes" was proportional to the initial seriousness of parents' anxiety and depression. Higher scores for the perception of the quality of care were given from the parents of the experimental group.The "Take 5 Minutes" treatment offered to parents of paediatric patients demonstrated significant improvements in terms of their anxiety, depression, and perceived quality of nursing care.Caregivers of paediatric patients are subject to psychological disorders such as depression and anxiety. The communication by the nursing community is of fundamental importance in the management of anxiety and depression in the caregivers of hospitalized patients. Caregivers who received the "Take 5 Minutes" treatment demonstrated a significant decrease in anxiety and depression compared with the control group caregivers. The perceived level of quality of nursing care showed a significant increase in the group of caregivers who received the T5M treatment. The RBC model does not require extra costs for health organizations and can be applied during the usual practice of care. Practices such as T5M could become part of paediatric patient care guidelines and nurses should be trained to apply them.Padua Research: ID No. 10,034; ClinicalTrials.gov: ID No. NCT04199429.目的: 评估关系型护理模式(又称“五分钟模式”)作为新的治疗方法是否会对患儿家长的焦虑、抑郁、护理感知质量及护理人员工作满意度等造成影响。 设计: 单盲随机对照试验。 方法: 试验时间为2016年2月至7月。试验过程中,设有一个干预组(N=101)和一个对照组(N=90)。护士采用名为“五分钟模式”的治疗方法,选择专门设计的交流策略,旨在花费短时间,缓和患儿与家长的关系(从5分钟到10分钟不等)。主要结果涉及家长焦虑抑郁的评定,其次是家长对护理质量的感知。 结果: 实验组中,参与者的焦虑和抑郁水平较低,并且参与者强调“五分钟模式”治疗方法的效果与家长最初的焦虑和抑郁程度相关。实验组的家长对护理质量的认知得分更高。 结论: 如果向患儿家长提供“五分钟模式”的治疗方法,其焦虑、抑郁和感知护理质量都将显著改善。 影响: 患儿的照料者容易出现抑郁、焦虑等心理障碍。如果加强护理社区的沟通,护理人员的焦虑和抑郁情绪将得到控制。相较于对照组的护理者,接受“五分钟模式”治疗的护理者的焦虑和抑郁均显著降低。此外,接受“五分钟模式”治疗的护理者对护理质量的感知水平明显提高。如果选择RBC模式,则健康组织无需支付额外费用,并且通常情况下,这一模式可以在护理实践中应用。“五分钟模式”等实践可以用作患儿护理指南,并且,护士应该接受相关培训,以便确保可应用这些实践。 试验注册号: Padua Research:识别号10,034;ClinicalTrials.gov:识别号NCT04199429.

Drugs targeting human topoisomerase II (topoII) are used in clinical practice since decades. Nevertheless, there is an urgent need for new and safer topoII inhibitors due to the emergence of secondary malignancies and the appearance of resistance mechanisms upon treatment with topoII-targeted anticancer drugs. In the present investigation, we report the discovery of a new topoII inhibitor, whose design was based on the structure of the natural product trypthantrin, a natural alkaloid containing a basic indoloquinazoline moiety. This new topoII inhibitor, here numbered compound 5, is found to inhibit topoII with an IC50 of 26.6 ± 4.7 μM. Notably, compound 5 is more potent than the template compound trypthantrin, and even than the widely used topoII-targeted clinical drug etoposide. In addition, compound 5 also exhibits high water solubility, and a promising antiproliferative activity on different tumor cell lines such as acute leukemia, colon, and breast cancer. In light of these results, compound 5 represents a promising lead for developing new topoII inhibitors as anti-cancer therapeutic agents.

The study aimed to investigate the correlations among immune, haematological, endocrinological markers and fitness parameters, and assess if the physiological parameters could be a predictor of fitness values. Anthropometric, physical evaluations (countermovement jump&mdash, CMJ, 10 m sprint, VO2max, repeated sprint ability&mdash, RSA total time and index) and determination of blood (IL-6, IL-10, IL-17A and tumour necrosis factor) and salivary (testosterone and cortisol) samples parameters in 28 young male soccer players (age: 13.0 &plusmn, 0.2 years, body mass index (BMI): 19.5 &plusmn, 2.2 kg/m2) were analysed. To evaluate the dependence of the variables related to athletic performance, multiple linear regression with backward stepwise elimination was considered. A significant regression equation was found in CMJ (F(5,16) = 9.86, p &lt, 0.001, R2 adjusted = 0.679) and in the RSA index (F(5,16) = 15.39, p &lt, 0.001, R2 adjusted = 0.774) considering only five variables, in a 10 m sprint (F(4,17) = 20.25, p &lt, 0.001, R2 adjusted = 0.786) and in the RSA total time (F(4,17) = 15.31, p &lt, 0.001, R2 adjusted = 0.732) considering only four variables and in VO2max (F(9,12) = 32.09, p &lt, 0.001, R2 adjusted = 0.930) considering nine variables. Our study suggests the use of regression equations to predict the fitness values of youth soccer players by blood and saliva samples, during different phases of the season, short periods of match congestion or recovery from an injury.

Attention-deficit/hyperactivity disorder (ADHD) is a chronic neurobiological condition with onset in childhood. The disorder is characterized by inattention, impulsivity, and/or motor hyperactivity, which often affect the development and social integration of affected subjects. Phenylethylamine (PEA), naturally contained in the Klamath Lake microalgae and concentrated in the Klamin® extract, is an endogenous molecule with a general neuromodulatory activity. It functions as an activator for the neurotransmission of dopamine and other catecholamines, and very low concentrations of PEA may be associated with specific psychological disorders such as ADHD. The aim of our study was to evaluate the efficacy of the Klamin extract in treating a group of subjects diagnosed with ADHD. Thirty subjects, aged 6–15, who had been diagnosed with ADHD according to the DSM-IV TR criteria, were enrolled. The supplement was administered to all the subjects, who reported to an ADHD clinic for routine follow-up visits....

Enterococci are significant nosocomial pathogens, also owing to their antibiotic resistance (AR). They can also be found in coastal marine sediments due to carriage by sewage and agricultural runoff. Clams are filter-feeding molluscs living in sandy bottoms. To investigate the possible role of clams as reservoirs of AR traits transmissible to humans, 46 enterococci isolated from clams collected in the mid-Adriatic Sea were analysed for species distribution, phenotypic/genotypic resistance to a large panel of antibiotics, and carriage of the relevant AR genes; 41 blood isolates collected during the same period were also analysed. Antibiotic-resistant strains and AR genes were more common in blood isolates, whereas Q/D resistance and blaZ were only detected in clam isolates; 24.2% of resistant clam isolates were multidrug resistant (MDR). Biofilm production ability and adhesion to Int407 cells, assayed in selected MDR strains, were both greater in the blood isolates. Our data suggest that enterococci found in clams have a different origin from those found in humans and that they may contribute to spread AR against drugs that are still clinically effective and to the emergence of MDR strains via the food chain. Enterococci should thus be included in the microbiological surveillance of seafood.

Numerous anthropogenic activities take place within or nearby ports, thereby increasing environmental pressure in coastal zone that become the final destination of many environmental contaminants. Thus, port areas are crucial to understand the possible long-term effects of contaminants on metazoans that are at the base of the food webs. The port of Vado Ligure is the outlet to the sea of one of the largest industrial areas of the West Liguria (NW Mediterranean). Sediment quality was evaluated in twenty-eight stations at increasing distance from the port. The nematode fauna was characterised (i.e., assemblage composition, taxonomic diversity and functional traits) and organic matter quantity and composition and contaminant concentrations (heavy-metals, polycyclic aromatic hydrocarbons and heavy, long-chain hydrocarbons) were measured. The area resulted mainly polluted by mercury, followed by arsenic, zinc, and polycyclic aromatic hydrocarbons. The faunal distribution (both from a taxonomical and functional point of view) appeared influenced by the contamination, as well as by sediment granulometry and organic matter content and composition. According to nematode assemblages and environmental variables, two groups of stations showed the most marked differences: one located in front of the Vado Ligure port, characterised by the most contaminated stations, the highest organic matter content, and fine sediments, and the other one, close to Bergeggi Marine Protected Area, characterised by more pristine stations, low organic matter content and coarser sediments. A suite of nematode genera that may be considered as bioindicators of pollution and organic enrichment was selected. Maturity index (MI) resulted negatively affected by contamination, suggesting that the different proportion of the nematode life-strategies is useful in assessing the environmental quality of sediments. The ecological quality status of the sampled stations obtained using abiotic and biotic descriptors (i.e., contamination level, organic matter content and nematode diversity and maturity index) was compared. Both the abiotic and nematode variables showed a general consistency for the stations of the two groups characterised by the highest and the lowest levels of contamination and organic enrichment.