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In this paper, we report the scientific experience of HELMeTO 2020, the second edition of the International Workshop on Higher Education Learning Methodologies and Technologies Online, held virtually in Bari (Italy) in September 2020 because of the COVID-19 pandemic. The call received 59 proposals from nine countries, 39 papers were accepted to the virtual workshop and 26 full papers were finally selected to be published in the proceedings. The workshop illustrated a fast-developing scenario in which the epidemic emergency accelerated the dissemination and consolidation of online learning in higher education. A specific focus of the workshop can be identified as students' learning experience, with studies on tutoring and active learning approaches, personalized solutions supported by data analysis, virtual reality and an in-depth analysis of human-computer interactions.

Laboratory teaching in sport and exercise sciences universities is of fundamental importance as it provides students with the necessary hands-on skills that are indispensable to future kinesiologists. However, due to the COVID-19 pandemic, students in lockdown missed the opportunity to acquire laboratory skills. Here we report the solutions adopted by a blended exercise science Master's degree program of an online Italian university to ensure didactic continuity in the practice-oriented activities during the period of the COVID-19 lockdown. In order to mitigate this issue, laboratory sessions were replaced with online workshops and students' satisfaction levels in this regard were investigated in the present study using an online survey conducted on 101 students during lockdown. The survey consisted of 7-point Likert scale items focusing on computer usage (CU), learning satisfaction (LS), social interaction (SI), and perceived value (PV). The analysis of the results revealed a good level of learning satisfaction of the students. Conversely, students perceived a moderate level of social interaction and had a moderate perception that online workshops can enhance their learning abilities. In conclusion, the results of the present study seem to indicate that online workshops can be considered a good and acceptable compromise during an emergency, although face-to-face activities remain the preferable learning delivery modality when dealing with the acquisition of hands-on skills.

Objectives To investigate pregnancy outcomes in women with autoimmune rheumatic diseases (ARD) in the Italian prospective cohort study P-RHEUM.it.Methods Pregnant women with different ARD were enrolled for up to 20 gestational weeks in 29 Rheumatology Centres for 5 years (2018–2023). Maternal and infant information were collected in a web-based database.Results We analysed 866 pregnancies in 851 patients (systemic lupus erythematosus was the most represented disease, 19.6%). Maternal disease flares were observed in 135 (15.6%) pregnancies. 53 (6.1%) pregnancies were induced by assisted reproduction techniques, 61 (7%) ended in miscarriage and 11 (1.3%) underwent elective termination. Obstetrical complications occurred in 261 (30.1%) pregnancies, including 2.3% pre-eclampsia. Two cases of congenital heart block were observed out of 157 pregnancies (1.3%) with anti-Ro/SSA. Regarding treatments, 244 (28.2%) pregnancies were treated with glucocorticoids, 388 (44.8%) with hydroxychloroquine, 85 (9.8%) with conventional synthetic disease-modifying anti-rheumatic drugs and 122 (14.1%) with biological disease-modifying anti-rheumatic drugs. Live births were 794 (91.7%), mostly at term (84.9%); four perinatal deaths (0.5%) occurred. Among 790 newborns, 31 (3.9%) were small-for-gestational-age and 169 (21.4%) had perinatal complications. Exclusive maternal breast feeding was received by 404 (46.7%) neonates. The Edinburgh Postnatal Depression Scale was compiled by 414 women (52.4%); 89 (21.5%) scored positive for emotional distress.Conclusions Multiple factors including preconception counselling and treat-to-target with pregnancy-compatible medications may have contributed to mitigate disease-related risk factors, yielding limited disease flares, good pregnancy outcomes and frequency of complications which were similar to the Italian general obstetric population. Disease-specific issues need to be further addressed to plan preventative measures.

Stem and progenitor cells have been observed to contribute to regenerative processes in acute renal failure and chronic kidney disease. Recent research has delved into the intricate mechanisms by which stem and progenitor cells exert their influence on kidney diseases. Understanding how these cells integrate with the existing renal architecture and their response to injury could pave the way for innovative treatment strategies aimed at promoting kidney repair and regeneration. Overall, the role of stem and progenitor cells in kidney diseases is multifaceted, with their ability to contribute to tissue regeneration, immune modulation, and the maintenance of renal homeostasis. Here, we review the studies that we have available today about the involvement of stem and progenitor cells both in regenerative therapies and in the causes of renal diseases, as well as in natural healing mechanisms, taking into account the main kidney disorders, such as IgA nephropathy, lupus nephritis, diabetic nephropathy, C3 glomerulopathy, focal segmental glomerulosclerosis, idiopathic membranous nephropathy, anti-glomerular basement membrane glomerulonephritis, and ANCA-associated crescentic glomerulonephritis. Moreover, based on the comprehensive data available in the framework of the specific kidney diseases on stem cells and renal progenitors, we hypothesize a possible role of adult renal progenitors in exacerbating or recovering the illness.

Pollution of the marine environment by microfibers is considered a problem for ecosystem conservation. The amount of microplastic, localization of sources, and associated ecotoxicity are well known in the literature. Wastewater from washing machines is the main source of microplastic fibers in the aquatic environment, and fabrics made from recycled plastic are widely reused. The circular economy also promotes recycling of dyed natural wool materials as a basis for making new clothing, but in this case, less research has been conducted on the behaviour and effects of recycled wool microfibers in marine ecosystems. MWool® (MW) and MWool® carded (MWc) products made from recycled wool fibers were tested in mesocosms to investigate the biodegradation of wool fibers over a 260-day period and the effects of this process on marine ecosystems in terms of microfiber inputs and the ecotoxicological effects of by-products and chemicals released during degradation. The early degradation process was associated with the loss of artificial pigments from the dyed wool, particularly pink and red, which occurred within 30–90 days of exposure. Mean release of microparticles into contact water is significantly different from control (T0, p < 0.01) at 90 days MWc (36.6 mg/L) and 180 days MW (42.9 mg/L). The biodegradation process is accompanied by swelling of wool fibers, which is associated with a significant increase in mean wool thickness (p < 0.05, 18.8 ± 2.1 µm at T0 vs. 24.0 ± 7.1 µm). In both cases, the contact water was not associated with signs of ecotoxicity for the marine species tested in this study (Phaeodactylum tricornutum, Brachionus plicatilis, and Paracentrotus lividus).

Inflammation is a key contributor to both the initiation and progression of tumors, and it can be triggered by genetic instability within tumors, as well as by lifestyle and dietary factors. The inflammatory response plays a critical role in the genetic and epigenetic reprogramming of tumor cells, as well as in the cells that comprise the tumor microenvironment. Cells in the microenvironment acquire a phenotype that promotes immune evasion, progression, and metastasis. We will review the mechanisms and pathways involved in the interaction between tumors, inflammation, and nutrition, the limitations of current therapies, and discuss potential future therapeutic approaches.

(1) Background: almond peels are rich in polyphenols such as catechin and epicatechin, which are important anti-free-radical agents, anti-inflammatory compounds, and capable of breaking down cholesterol plaques. This work aims to evaluate the biological and technological activity of a “green” dry aqueous extract from Sicilian almond peels, a waste product of the food industry, and to develop healthy nutraceuticals with natural ingredients. Eudraguard® Natural is a natural coating polymer chosen to develop atomized formulations that improve the technological properties of the extract. (2) Methods: the antioxidant and free radical scavenger activity of the extract was rated using different methods (DPPH assay, ABTS, ORAC, NO). The metalloproteinases of the extracts (MMP-2 and MMP-9), the enhanced inhibition of the final glycation products, and the effects of the compounds on cell viability were also tested. All pure materials and formulations were characterized using UV, HPLC, FTIR, DSC, and SEM methods. (3) Results: almond peel extract showed appreciable antioxidant and free radical activity with a stronger NO inhibition effect, strong activity on MMP-2, and good antiglycative effects. In light of this, a food supplement with added health value was formulated. Eudraguard® Natural acted as a swelling substrate by improving extract solubility and dissolution/release (4) Conclusions: almond peel extract has significant antioxidant activity and MMP/AGE inhibition effects, resulting in an optimal candidate to formulate safe microsystems with potential antimetabolic activity. Eudraguard® Natural is capable of obtaining spray-dried microsystems with an improvement in the extract‘s biological and technological characteristics. It also protects the dry extract from degradation and oxidation, prolonging the shelf life of the final product.

Problem solving requires the application of critical reading and thinking skills and the use of relevant strategies to reach a solution. Independent learners are able to apply taught strategies across contexts and often complete challenging tasks unassisted. The purpose of this paper is to explain how a process of analysis of assignments and evaluation can be applied in reading, writing, and with modifications in mathematics. This work draws on genre-based strategies, on oral language and dialogic pedagogy, and demonstrates how they can be applied across the curriculum to support students' transfer of knowledge and skills from writing instruction to responses to reading and mathematics aiding them in reflection and eventually independence. Further, the paper provides guidelines for teachers' explanations to promote critical thinking, questioning, and goal setting.

Pulsed electromagnetic fields (PEMF) are employed as a non-invasive medicinal therapy, especially in the orthopedic field to stimulate bone regeneration. However, the effect of PEMF on skeletal muscle cells (SkMC) has been understudied. Here, we studied the potentiality of 1.5 mT PEMF to stimulate early regeneration of human SkMC. We showed that human SkMC stimulated with 1.5 mT PEMF for four hours repeated for two days can stimulate cell proliferation without inducing cell apoptosis or significant impairment of the metabolic activity. Interestingly, when we simulated physical damage of the muscle tissue by a scratch, we found that the same PEMF treatment can speed up the regenerative process, inducing a more complete cell migration to close the scratch and wound healing. Moreover, we investigated the molecular pattern induced by PEMF among 26 stress-related cell proteins. We found that the expression of 10 proteins increased after two consecutive days of PEMF stimulation for 4 h, and most of them were involved in response processes to oxidative stress. Among these proteins, we found that heat shock protein 70 (HSP70), which can promote muscle recovery, inhibits apoptosis and decreases inflammation in skeletal muscle, together with thioredoxin, paraoxonase, and superoxide dismutase (SOD2), which can also promote skeletal muscle regeneration following injury. Altogether, these data support the possibility of using PEMF to increase SkMC regeneration and, for the first time, suggest a possible molecular mechanism, which consists of sustaining the expression of antioxidant enzymes to control the important inflammatory and oxidative process occurring following muscle damage.

Cisplatin is one of the most effective chemotherapeutic agents strongly associated with nephrotoxicity. Tubular adult renal progenitor cells (tARPC) can regenerate functional tubules and participate in the repair processes after cisplatin exposition. This study investigated the molecular mechanisms underlying the protective effect of tARPC on renal epithelium during cisplatin nephrotoxicity. By performing a whole-genome transcriptomic analysis, we found that tARPC, in presence of cisplatin, can strongly influence the gene expression of renal proximal tubular cell [RPTEC] by inducing overexpression of CYP1B1, a member of the cytochrome P450 superfamily capable of metabolizing cisplatin and of hypoxia/cancer-related lncRNAs as MIR210HG and LINC00511. Particularly, tARPC exerted renoprotection and regeneration effects via extracellular vesicles (EV) enriched with CYP1B1 and miR-27b-3p, a well-known CYP1B1 regulatory miRNA. The expression of CYP1B1 by tARPC was confirmed by analyzing biopsies of cisplatin-treated renal carcinoma patients that showed the colocalization of CYP1B1 with the tARPC marker CD133. CYP1B1 was also overexpressed in urinary EV purified from oncologic patients that presented nephrotoxicity episodes after cisplatin treatment. Interestingly CYP1B1 expression significantly correlated with creatinine and eGFR levels. Taken together, our results show that tARPC are able to counteract cisplatin-induced nephrotoxicity via CYP1B1 release through EV. These findings provide a promising therapeutic strategy for nephrotoxicity risk assessment that could be related to abundance of renal progenitors.

Abstract Antibiotics that inhibit bacterial protein or nucleic acid synthesis and function can exert an off-target action on mitochondria (mitotoxic antibiotics), making actively dividing mammalian cells dependent on uridine and pyruvate supplementation. Based on this rationale, we carried out, for the first time, a randomized pilot study in 55 patients with asymptomatic bacteriuria or positive sperm culture, each treated with a single mitotoxic antibiotic with or without oral supplementation of uridine + pyruvate (Uripyr, Mitobiotix, Italy). The in vivo and ex vivo data show a a 3.4-fold higher value in the differential (before and after the antibiotic treatment) lymphocytes count and a 3.7-fold increase in the percentage of dividing T cells, respectively, in the Uripyr vs the control group. Our findings lay the groundwork to enhance the synergy between antibiotics and the immune system in order to optimize the administration protocols and widen the application potentials of antibiotic therapies as well as to re-evaluate old “forgotten” molecules to fight bacterial infections in the antibiotics resistance era.

Our immune system actively fights bacteria and viruses, and it must strike a delicate balance between over- and under-reaction, just like Daedalus and Icarus in Greek mythology, who could not escape their imprisonment by flying too high or too low. Both human amniotic epithelial and mesenchymal stromal cells and the conditioned medium generated from their culture exert multiple immunosuppressive activities. They have strong immunomodulatory properties that are influenced by the types and intensity of inflammatory stimuli present in the microenvironment. Notably, very recently, the immunomodulatory activity of human adult renal stem/progenitor cells (ARPCs) has been discovered. ARPCs cause a decrease in Tregs and CD3+ CD4− CD8− (DN) T cells in the early stages of inflammation, encouraging inflammation, and an increase in the late stages of inflammation, favoring inflammation quenching. If the inflammatory trigger continues, however, ARPCs cause a further increase in DN T cells to avoid the development of a harmful inflammatory state. As in the flight of Daedalus and Icarus, who could not fly too high or too low to not destroy their wings by the heat of the sun or the humidity of the sea, in response to an inflammatory environment, stem cells seem to behave by paying attention to regulating T cells in the balance between immune tolerance and autoimmunity. Recognizing the existence of both suppressive and stimulatory properties, and the mechanisms that underpin the duality of immune reaction, will aid in the development of active immunotherapeutic approaches that manipulate the immune system to achieve therapeutic benefit.

The prokaryotic, viral, fungal, and parasitic microbiome exists in a highly intricate connection with the human host. In addition to eukaryotic viruses, due to the existence of various host bacteria, phages are widely spread throughout the human body. However, it is now evident that some viral community states, as opposed to others, are indicative of health and might be linked to undesirable outcomes for the human host. Members of the virome may collaborate with the human host to retain mutualistic functions in preserving human health. Evolutionary theories contend that a particular microbe’s ubiquitous existence may signify a successful partnership with the host. In this Review, we present a survey of the field’s work on the human virome and highlight the role of viruses in health and disease and the relationship of the virobiota with immune system control. Moreover, we will analyze virus involvement in glomerulonephritis and in IgA nephropathy, theorizing the molecular mechanisms that may be responsible for the crosslink with these renal diseases.

(1) Background: Eudraguard® Natural (EN) and Protect (EP) are polymers regulated for use in dietary supplements in the European Union and the United States to carry natural products, mask unpleasant smells and tastes, ameliorate product handling, and protect products from moisture, light, and oxidation. Moreover, EN and EP can control the release of encapsulated compounds. The aim of this work was the development, preparation, and control of Eudraguard® spray-drying microparticles to obtain powders with easy handling and a stable dietary supplement containing a polar functional extract (SOE) from Sorbus domestica L. leaves. (2) Methods: SOE was characterized using HPLC, NMR, FTIR, DSC, and SEM methods. Furthermore, the SOE’s antioxidant/free radical scavenging activity, α-glucosidase inhibition, MTT assay effect on viability in normal cells, and shelf life were evaluated in both the extract and final formulations. (3) Results: The data suggested that SOE, rich in flavonoids, is a bioactive and safe extract; however, from a technological point of view, it was sticky, difficult to handle, and had low aqueous solubility. Despite the fact that EN and EP may undergo changes with spray-drying, they effectively produced easy-to-handle micro-powders with a controlled release profile. Although EN had a weaker capability to coat SOE than EP, EN acted as a substrate that was able to swell, drawing in water and improving the extract solubility and dissolution/release; however, EP was also able to carry the extract and provide SOE with controlled release. (4) Conclusion: Both Eudraguard® products were capable of carrying SOE and improving its antioxidant and α-glucosidase inhibition activities, as well as the extract stability and handling.

Recent investigations have shown that severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is able to resist on the surfaces and that the diffusion occurs through droplets that can remain suspended in the air as an aerosol.The ozone generated in situ from oxygen is an active ingredient with a ‘biocidal’ action, but little is known about its capacity to inactivate specifically SARS-CoV-2.Here we show, for the first time, the efficiency of the ozone treatment to neutralize the SARS-CoV-2 present in nasopharynx secretion samples with high viral load.Our data show that ozone is effective in SARS-CoV-2 elimination.

Background: Given the potential risk of unhealthy weight management, the monitoring of body composition in athletes is advised. However, limited data reveal how body composition measurements can benefit athlete health and, in particular, respiratory function. The aim of this study is to evaluate the impact of body composition on pulmonary function in a population of adult athletes. Methods: Data from 435 competitive adult athletes regarding body compositions parameters and spirometry are retrospectively analyzed. Results: Our study population consists of 335 males and 100 female athletes. Muscle mass and fat-free mass are significantly and positively associated with forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC) in the male and female population, while waist-to-height ratio is negatively associated with FEV1, FVC, and FEV1/FVC in the male population. In multivariable analysis, muscle mass and fat-free mass show significant association with FEV1 and FVC in both males and females (p < 0.05), and waist-to-height ratio is significantly and inversely associated with FEV1 and FVC in males (p < 0.05). Conclusions: Fat-free mass and muscle mass are positively and independently associated with FEV1 and FVC in athletes of both genders, and waist-to-height ratio is inversely associated with FEV1 and FVC only among male athletes. These findings suggest that body composition in athletes may be helpful in monitoring respiratory function.

Dactylitis – a hallmark clinical feature of psoriatic arthritis (PsA) – that occurs in 30–50% of PsA patients, is a marker of disease severity for PsA progression, an independent predictor of cardiovascular morbidity and impairs the motor functions of PsA patients. There is a paucity of evidence for the treatment due to the absence of randomized controlled trials assessing dactylitis as a primary endpoint and current practice arises from the analysis of dactylitis as a secondary outcome. Corticosteroid (CS) injections for dactylitis in PsA patients are a therapeutic treatment option for patients with isolated dactylitis or for patients with flares in tendon sheaths, despite stable and effective systemic treatment. The aim of this narrative review is to briefly illustrate the clinical aspects of dactylitis in PsA, the imaging and clinimetric tools used to diagnose and monitor dactylitis, the current treatment strategies and principally to provide a comprehensive picture of the clinical efficacy and safety with ultrasound-guide and blind techniques of CS injections for dactylitis in PsA patients.

The pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) causing coronavirus disease 2019 (COVID-19), resulting in acute respiratory disease, is a worldwide emergency. Because recently it has been found that SARS-CoV is dependent on host transcription factors (TF) to express the viral genes, efforts are required to understand the molecular interplay between virus and host response. By bioinformatic analysis, we investigated human TF that can bind the SARS-CoV-2 sequence and can be involved in viral transcription. In particular, we analysed the key role of TF involved in interferon (IFN) response. We found that several TF could be induced by the IFN antiviral response, specifically some induced by IFN-stimulated gene factor 3 (ISGF3) and by unphosphorylated ISGF3, which were found to promote the transcription of several viral open reading frame. Moreover, we found 22 TF binding sites present only in the sequence of virus infecting humans but not bat coronavirus RaTG13. The 22 TF are involved in IFN, retinoic acid signalling and regulation of transcription by RNA polymerase II, thus facilitating its own replication cycle. This mechanism, by competition, may steal the human TF involved in these processes, explaining SARS-CoV-2's disruption of IFN-I signalling in host cells and the mechanism of the SARS retinoic acid depletion syndrome leading to the cytokine storm. We identified three TF binding sites present exclusively in the Brazilian SARS-CoV-2 P.1 variant that may explain the higher severity of the respiratory syndrome. These data shed light on SARS-CoV-2 dependence from the host transcription machinery associated with IFN response and strengthen our knowledge of the virus's transcription and replicative activity, thus paving the way for new targets for drug design and therapeutic approaches.

Sepsis-induced acute kidney injury (AKI) is a frequent complication in critically ill patients, refractory to conventional treatments. Aberrant activation of innate immune system may affect organ damage with poor prognosis for septic patients. Here, we investigated the efficacy of polymethyl methacrylate membrane (PMMA)-based continuous hemofiltration (CVVH) in modulating systemic and tissue immune activation in a swine model of LPS-induced AKI. After 3 h from LPS infusion, animals underwent to PMMA-CVVH or polysulfone (PS)-CVVH. Renal deposition of terminal complement mediator C5b-9 and of Pentraxin-3 (PTX3) deposits were evaluated on biopsies whereas systemic Complement activation was assessed by ELISA assay. Gene expression profile was performed from isolated peripheral blood mononuclear cells (PBMC) by microarrays and the results validated by Real-time PCR. Endotoxemic pigs presented oliguric AKI with increased tubulo-interstitial infiltrate, extensive collagen deposition, and glomerular thrombi; local PTX-3 and C5b-9 renal deposits and increased serum activation of classical and alternative Complement pathways were found in endotoxemic animals. PMMA-CVVH treatment significantly reduced tissue and systemic Complement activation limiting renal damage and fibrosis. By microarray analysis, we identified 711 and 913 differentially expressed genes with a fold change >2 and a false discovery rate

Introduction: The continuous increase of antimicrobial resistance (AMR) requires antimicrobial stewardship programs (ASPs) to optimize antimicrobial use, including selection, dose, duration, and way of administration. Methods and Results: An “Antimicrobial Stewardship Team” (AST) was established at “F. Miulli” Hospital of Bari. The AST is a multidisciplinary group formed by a pharmacist, an infectious disease specialist, a microbiologist, an anesthetist and a hygienist. The AST has started a clinical path of professional interactions and optimization of antimicrobial use. The AST was focused on surgical antibiotic prophylaxis, planning events/meetings with 13 wards of “F. Miulli” hospital and writing 13 operating guidelines. The AST was focused on antimicrobial therapies too. On this occasion, the AST did not organize events or meetings but was focused on professional interactions with clinicians to optimize the antimicrobial use in the treatment of multi-drug resistant (MDR) pathogens. A reduction of antimicrobial use (defined daily dose, DDD) and pharmaceutical expenditure was reached in surgical wards during 2017-2018, while, in the same period, an increase of antimicrobial use (DDD) and pharmaceutical expenditure was observed in non-surgical wards. Conclusions: The “Antimicrobial Stewardship Team” programs are essential to monitor the hospital economic resources and to support the purchase of the innovative antimicrobial therapies to treat multi-drug resistant pathogens.

Textile industries are in the spotlight due to the heavy environmental impacts along their products’ life cycle and, at the same time, they are a priority sector in the new circular economy action plan of the European Commission. In this framework, the Italian company Manteco SpA has developed a value chain based on the recycling of pre- and post-consumer discarded textiles, wh0se output is a secondary wool fiber named MWool®. This study develops an environmental analysis of recycled wool fibers through the Life Cycle Assessment (LCA) methodology, mainly using primary data. A parallel LCA is developed of virgin wool fiber, mostly based on literature data. Sensitivity analyses have been carried out: (i) to capture the uncertainty associated with virgin fibers’ impacts and (ii) to evaluate how MWool® impacts vary according to the origin and treatment of recycled textiles. Finally, the Circular Footprint Formula (CFF) has been applied to consider also a possible decay in quality typically affecting recycled fibers. Results show that recycled wool fibers have significantly lower environmental impacts than virgin fibers, even when the most unfavorable scenarios are considered. As climate change is concerned, 1 kg of MWool® has a carbon footprint of 0.1–0.9 kg CO2 eq., while producing virgin fibers releases 10–103 kg CO2 eq. Using the CFF, it emerges that recycled wool fibers can save about 60% of the impacts of virgin fibers. This study contributes to filling data gaps regarding LCAs applied to the textile sector, which is more and more in the spotlight and needs to address these environmental issues.

Background: Brucellosis is the most common global bacterial zoonotic disease. Italian annual 2015 report on animal brucellosis control that was submitted to the Integrated National Plan of the Italian Health Ministry showed that the Italian region with the highest prevalence and incidence of brucellosis was Sicily (3.3%). This study aims to demonstrate the burden of disease and the epidemiological trend of human and animal brucellosis in Messina, Sicily, from 1997 to 2016. Methods: The analysis was conducted in the twenty-years 1997–2016. We examined the computerised and paper registers of the Messina Provincial Health Agency n.5 to evaluate human and animal brucellosis reports. Results: 1462 cases of human brucellosis were reported with an important outbreak in 2016 in which were reported 137 cases while the prevalence of infected cattle and sheep/goats decreased from 3.8% and 8%, respectively, in 1997 to 1.7% for both in 2016. A statistically significant correlation was observed between the decrease of both animal and human cases during the considered period. Conclusions: Our study demonstrate that brucellosis is still present in Sicily with a number of cases identified in both animals and humans and it hypothesises a large number of probable underreported cases. Our findings confirm the need to improve knowledge of the risks associated with consuming raw milk and its derivatives, mainly from sheep and goats, and demonstrates that public health would benefit from cooperation between human and veterinary health services. Keywords: Brucellosis, Zoonosis, Epidemiology, Public Health

Urethral stenosis is a pathological condition that consists in the narrowing of the urethral lumen because of the formation of scar tissue. Unfortunately, none of the current surgical approaches represent an optimal solution because of the high stricture recurrence rate. In this context, we preliminarily explored the potential of an insoluble type-I collagen from horse tendon as scaffolding material for the development of innovative devices for the regeneration of injured urethral tracts. Non-porous collagen-based substrates were produced and optimized, in terms of crosslinking density of the macromolecular structure, to either provide mechanical properties compliant with the urinary tract physiological stress and better sustain tissue regeneration. The effect of the adopted crosslinking strategy on the protein integrity and on the substrate physical–chemical, mechanical and biological properties was investigated in comparison with a decellularized matrix from porcine small intestinal submucosa (SIS patch), an extensively used xenograft licensed for clinical use in urology. The optimized production protocols allowed the preservation of the type I collagen native structure and the realization of a substrate with appealing end-use properties. The biological response, preliminarily investigated by immunofluorescence experiments on human adult renal stem/progenitor cells until 28 days, showed the formation of a stem-cell monolayer within 14 days and the onset of spheroids within 28 days. These results suggested the great potential of the collagen-based material for the development of scaffolds for urethral plate regeneration and for in vitro cellular studies.

The increasing requirements to further reduce pollutant emissions, particularly with regard to the upcoming Euro 7 (EU7) legislation, cause further technical and economic challenges for the development of internal combustion engines. All the emission reduction technologies lead to an increasing complexity not only of the hardware, but also of the control functions to be deployed in engine control units (ECUs). Virtualization has become a necessity in the development process in order to be able to handle the increasing complexity. The virtual development and calibration of ECUs using hardware-in-the-loop (HiL) systems with accurate engine models is an effective method to achieve cost and quality targets. In particular, the selection of the best-practice engine model to fulfil accuracy and time targets is essential to success. In this context, this paper presents a physically- and chemically-based stochastic reactor model (SRM) with tabulated chemistry for the prediction of engine raw emissions for real-time (RT) applications. First, an efficient approach for a time-optimal parametrization of the models in steady-state conditions is developed. The co-simulation of both engine model domains is then established via a functional mock-up interface (FMI) and deployed to a simulation platform. Finally, the proposed RT platform demonstrates its prediction and extrapolation capabilities in transient driving scenarios. A comparative evaluation with engine test dynamometer and vehicle measurement data from worldwide harmonized light vehicles test cycle (WLTC) and real driving emissions (RDE) tests depicts the accuracy of the platform in terms of fuel consumption (within 4% deviation in the WLTC cycle) as well as NOx and soot emissions (both within 20%).

To investigate the usefulness of inertial measurement units (IMUs) in the assessment of motor function of the upper limb (UL) in accordance with the international classification of functioning (ICF). PubMed; Scopus; Embase; WoS and PEDro databases were searched from inception to 1 February 2022. The current systematic review follows PRISMA recommendations. Articles including IMU assessment of UL in stroke individuals have been included and divided into four ICF categories (b710, b735, b760, d445). We used correlation meta-analysis to pool the Fisher Z-score of each correlation between kinematics and clinical assessment. A total of 35 articles, involving 475 patients, met the inclusion criteria. In the included studies, IMUs have been employed to assess the mobility of joint functions (n = 6), muscle tone functions (n = 4), control of voluntary movement functions (n = 15), and hand and arm use (n = 15). A significant correlation was found in overall meta-analysis based on 10 studies, involving 213 subjects: (r = 0.69) (95% CI: 0.69/0.98; p < 0.001) as in the d445 (r = 0.71) and b760 (r = 0.64) ICF domains, with no heterogeneity across the studies. The literature supports the integration of IMUs and conventional clinical assessment in functional evaluation of the UL after a stroke. The use of a limited number of wearable sensors can provide additional kinematic features of UL in all investigated ICF domains, especially in the ADL tasks when a strong correlation with clinical evaluation was found. [ABSTRACT FROM AUTHOR]

Laboratory teaching in sport and exercise sciences universities is of fundamental importance as it provides students with the necessary hands-on skills that are indispensable to future kinesiologists. However, due to the COVID-19 pandemic, students in lockdown missed the opportunity to acquire laboratory skills. Here we report the solutions adopted by a blended exercise science Master’s degree program of an online Italian university to ensure didactic continuity in the practice-oriented activities during the period of the COVID-19 lockdown. In order to mitigate this issue, laboratory sessions were replaced with online workshops and students’ satisfaction levels in this regard were investigated in the present study using an online survey conducted on 101 students during lockdown. The survey consisted of 7-point Likert scale items focusing on computer usage (CU), learning satisfaction (LS), social interaction (SI), and perceived value (PV). The analysis of the results revealed a good level of learning satisfaction of the students. Conversely, students perceived a moderate level of social interaction and had a moderate perception that online workshops can enhance their learning abilities. In conclusion, the results of the present study seem to indicate that online workshops can be considered a good and acceptable compromise during an emergency, although face-to-face activities remain the preferable learning delivery modality when dealing with the acquisition of hands-on skills.

In this paper, we report the scientific experience of HELMeTO 2020, the second edition of the International Workshop on Higher Education Learning Methodologies and Technologies Online, held virtually in Bari (Italy) in September 2020 because of the COVID-19 pandemic. The call received 59 proposals from nine countries, 39 papers were accepted to the virtual workshop and 26 full papers were finally selected to be published in the proceedings. The workshop illustrated a fast-developing scenario in which the epidemic emergency accelerated the dissemination and consolidation of online learning in higher education. A specific focus of the workshop can be identified as students’ learning experience, with studies on tutoring and active learning approaches, personalized solutions supported by data analysis, virtual reality and an in-depth analysis of human–computer interactions.

HIV-positive patients suffer from higher cancer-related mortality compared to the general population. Anal cancer (AC) is considered as a rare form of neoplasm, accounting for 4% of all cancers of the lower gastrointestinal tract in the general population. Approximately 88% of AC cases are associated with human papillomavirus (HPV) infection. This paper purpose is the diagnostic and therapeutic management of AC in HIV infect people.

Objective To evaluate the level of agreement on ultrasonographic (US) lesions among highly experienced sonographers as well as the intraobserver and interobserver reliability of inflammatory and structural US lesions in patients with osteoarthritis (OA) of the foot.Methods After a systematic literature review, a Delphi survey was performed to test definitions of US lesions in OA of the foot, including inflammatory lesions (ie, synovial hypertrophy [SH], joint effusion [JE], power Doppler signal [PD]), and structural abnormalities (ie, cartilage damage [CD] and osteophytes). Subsequently, the reliability of US in assessing the aforementioned lesions was tested on static images as well as during a live exercise. Reliability was assessed by kappa analyses and prevalence-adjusted bias-adjusted kappa (PABAK) on a dichotomous and an ordinal scale.Results Intraobserver and interobserver reliability for SH and JE evaluated by binary scoring was good for both components, while the intraobserver reliability for semiquantitative scoring of SH ranged from moderate in the web-based exercise (PABAK 0.49) to good (PABAK 0.8) in the live exercise. Reliability for CD and PD assessments were respectively good and excellent in all exercises (ranged from PABAK 0.61 to 0.79 for CD and 0.88 to 0.95 for PD). The interobserver reliability for the semiquantitative scoring of osteophytes was fair in the live exercise (PABAK 0.36) and moderate in the static exercise (PABAK 0.60).Conclusions Consensual US definitions were found to be reliable for assessing inflammatory lesions in OA of the foot, while the use of US to assess structural damage requires further studies.

e1295-Hodgkin’s lymphoma in people living with HIV- epidemiology and clinical managementAfter the introduction of combination Antiretroviral Therapy (cART), survival of people living with HIV/AIDS (PLWH) has improved, bringing to the appearance of new health problems. Among these problems, there is an increased risk to develop malignancies. Hodgkin’s lymphoma (HL) is a curable malignancy, suspected to be associated with Epstein-Barr Virus (EBV) infection. Median age of HL incidence in PLWHs is 30 years, after approximately 7 and a half years from the HIV infection diagnosis. HL is significantly more frequent in PLWHs than in the general population. As a matter of fact, the incidence of this disease is 8-fold higher than the general population during the pre-cART era, and the difference worsened, reaching a 13-fold higher incidence during the cART era. Early diagnosis is crucial. The detection of cancer in an early stage improves the outcome of patients, indeed. The aim of this paper was to review the epidemiological characteristics and the diagnostic and therapeutic management of HL in HIV infected patients.

The introduction of ART had a significant impact on PWLH survival. The incidence of AIDS-defining cancers has decreased, but the risk is still higher than general population. Women living with HIV have a high prevalence of HPV infection and related disease, including cervical cancer. HIV-related risk factors, such as immunodeficiency and chronic persistence of infection play an important role in its pathogenesis. HPV vaccine, screening and early antiretroviral therapies, are recommended to reduce the risk of developing cervical cancer. In this review, we considered the studies published about cervical cancer in PLWHA that we found performing a research on PUBMED (Bethesda MD, USA) with the following research terms “Papillomavirus”, “Cervical Cancer”, “HIV infection”, “Screening”, “Vaccination” with the aim to point out the main aspects of cervical cancer in HIV infected women, its management and prophylaxis.

Background. Vaccine hesitancy has increased worldwide with a subsequent decreasing of vaccination rates and outbreaks of vaccine-preventable diseases (i.e. measles, poliomyelitis and pertussis) in several developed countries, including Italy. Design and Methods. We conducted a survey to investigate the attitudes of a parents’ sample about vaccinations by the distribution of questionnaires in six lower secondary schools of the Italian city of Messina. Results. Regarding vaccinations carried out on children, the declared vaccination coverage rates ranged widely between good coverage percentages for some vaccinations (Measles-Mumps-Rubella, Diphtheria-Tetanus-Pertussis), and very low coverage rates for others, especially for “new” vaccinations (HPV, meningococcal, pneumococcal). The vaccinations carried out correlated negatively with both parents’ age and their level of education. Moreover, a favourable parents’ opinion was strongly influenced by a favourable opinion of the physician, while an unfavourable parents’ opinion seemed conditioned by a direct or indirect knowledge of people harmed by vaccines. In addition, our data show that parents do not often know or partially know the real composition of the vaccines and the diseases prevented by vaccinations. Conclusions. Data analysis shows that parents are, theoretically, favourable towards vaccinations but have little knowledge of such practices, sometimes not being unaware of the types of vaccines administrated to their children. Health education and communication of correct information are certainly the cornerstones to improve the situation and to fight the widespread and non-grounded fears about vaccines.

Background: It is often challenging to formulate a reliable prognosis for patients with acute ischemic stroke. The most accepted prognostic factors may not be sufficient to predict the recovery process. In this view, describing the evolution of motor deficits over time via sensors might be useful for strengthening the prognostic model. Our aim was to assess whether an actigraphic-based parameter (Asymmetry Rate Index for the 24 h period (AR2_24 h)) obtained in the acute stroke phase could be a predictor of a 90 d prognosis. Methods: In this observational study, we recorded and analyzed the 24 h upper limb movement asymmetry of 20 consecutive patients with acute ischemic stroke during their stay in a stroke unit. We recorded the motor activity of both arms using two programmable actigraphic systems positioned on patients’ wrists. We clinically evaluated the stroke patients by NIHSS in the acute phase and then assessed them across 90 days using the modified Rankin Scale (mRS). Results: We found that the AR2_24 h parameter positively correlates with the 90 d mRS (r = 0.69, p < 0.001). Moreover, we found that an AR2_24 h > 32% predicts a poorer outcome (90 d mRS > 2), with sensitivity = 100% and specificity = 89%. Conclusions: Sensor-based parameters might provide useful information for predicting ischemic stroke prognosis in the acute phase.

Adult Renal Stem/Progenitor Cells (ARPCs) have been recently identified in the human kidney and several studies show their active role in kidney repair processes during acute or chronic injury. However, little is known about their immunomodulatory properties and their capacity to regulate specific T cell subpopulations. We co-cultured ARPCs activated by triggering Toll-Like Receptor 2 (TLR2) with human peripheral blood mononuclear cells for 5 days and 15 days and studied their immunomodulatory capacity on T cell subpopulations. We found that activated-ARPCs were able to decrease T cell proliferation but did not affect CD8+ and CD4+ T cells. Instead, Tregs and CD3+ CD4- CD8- double-negative (DN) T cells decreased after 5 days and increased after 15 days of co-culture. In addition, we found that PAI1, MCP1, GM-CSF, and CXCL1 were significantly expressed by TLR2-activated ARPCs alone and were up-regulated in T cells co-cultured with activated ARPCs. The exogenous cocktail of cytokines was able to reproduce the immunomodulatory effects of the co-culture with activated ARPCs. These data showed that ARPCs can regulate immune response by inducing Tregs and DN T cells cell modulation, which are involved in the balance between immune tolerance and autoimmunity.

The present technical note aimed at enriching the planar linked segment model originally proposed by Chaffin with the prediction of the moment arm and of the orientation of the line of action of the back extensor muscles during symmetric lifting tasks. The prediction equations proposed by van Dieen and de Looze for their single equivalent muscle model were used for such a purpose. Their prediction was based on the thorax-to-pelvis flexion angle as computed from 3D video-based motion capture. In order to make these prediction equations compliant with a two-dimensional analysis, the planar angle formed by the segment joining L5/S1 to the shoulder with the longitudinal axis of the pelvis was introduced. This newly computed planar trunk flexion angle was used to feed van Dieen and de Looze’s equations, comparing the results with the original model. A full-body Plug-in-Gait model relative to 10 subjects performing manual lifting activities using a stoop and a squat technique was used for model validation. A strong association was found between the proposed planar trunk flexion angle and that used by van Dieen and de Looze (r = 0.970). A strong association and a high level of agreement were found between the back extensor muscle moment arm (r = 0.965; bias < 0.001 m; upper limit of agreement (LOA) = 0.002 m; lower LOA < 0.001 m) and the orientation of the line of action (r = 0.970; bias = 2.8°; upper LOA = 5.3°; lower LOA = 0.2°) as computed using the two methods. For both the considered variables, the prediction error fell within the model sensitivity.

Background: Almond skins are rich in bioactive compounds that undergo oxidation/degradation phenomena and are poorly soluble in water, reducing in vivo absorption and bioavailability, factors that influence the pharmacological activity of an active product. We developed a dried acetonic almond skins extract/cyclodextrin complex to improve extract solubility, dissolution rate and biological activity. Methods: A lyophilized acetonic almond skin extract was produced. To optimize complex formulation, phase solubility studies and complex characterization (absorption studies, differential scanning calorimetry (DSC), morphology, solubility studies) were performed. To evaluate a possible use in healthy products, tumor necrosis factor-α levels and reactive oxygen species release, as well as cicloxygenase-2 and inducible nitric oxide synthase expression in intestinal epithelial cells, were also evaluated. Results: Phase solubility studies showed a Bs-type profile. A 1:1 dried acetonic almond skins extract/cyclodextrin ratio was able to improve extract water solubility and dissolution rate (100% in 45 min). The UV-Vis spectra of complex revealed a hypsochromic and hyperchromic effect, probably due to a partial inclusion of extract in cyclodextrin cavity through weak bonds, confirmed by DSC and morphology studies. The technological improvement in the extract characteristics also led to better biological activity. In fact, the complex effectively reduces tumor necrosis factor-α levels with respect to the pure extract and significantly inhibits the reactive oxygen species release, even if only at the lower concentration of 5 μg/mL. Conclusion: The complex was able to overcome solubility problems and could be used in inflammatory disease.

The administration of natural antioxidants is considered to be a prevention strategy for chronic diseases and a useful tool for the healthcare system to reduce the administration of expensive and often not effective treatments. The chemical characterization of a methanolic extract (AJ) of Ajuga reptans L. was performed, and its antioxidant activity was evaluated. AJ and the major compounds, characterized by chromatographic techniques as phenylpropanoids and iridoids, were able to reduce the Reactive Oxygen Species levels in cancer cell lines (melanoma, A375, cervical cancer, HeLa, and alveolar adenocarcinoma, A549), stimulated by E. coli lipopolysaccharide. However, a clinical translation of these results encountered a significant limitation represented by the poor water solubility and bioavailability of the extract and compounds. Consequently, a hydro-soluble powder system (AJEP3) was developed by spray-drying encapsulating AJ into a multi-component solid matrix that is based on L-proline and hydroxyethylcellulose as loading and coating agents, and lecithin as solubility enhancer. The technological approach led to a satisfactory process yield (71.5%), encapsulation efficiency (99.9%), and stability. The in vitro water dissolution rate of the bioactive compounds appeared to be improved with respect to the extract, suggesting higher feasibility in the manufacturing and administration; even the in vitro biological activity of the produced multi-component AJEP3 was clearly enhanced.

An extract obtained from hazelnut shells by-products (HSE) has antioxidant and chemopreventive effects on human melanoma and cervical cancer cell lines, inducing apoptosis by caspase-3 activation. A clinical translation is limited by poor water solubility and low bioavailability. Dried plant extracts often show critical characteristics such as sticky/gummy appearance, unpleasant smell, and instability involving practical difficulties in processing for industrial use. A spray drying method has been applied to transform raw HSE in a microparticulate powder. The biopolymeric matrix was based on l-proline as loading carrier, hydroxyethylcellulose in combination with pectin as coating polymers; lecithin and ethanol were used as solubility enhancers. A Hot-Cold-Hot method was selected to prepare the liquid feed. The thus prepared powder showed good technological properties (solid-state, particle dimensions, morphology, and water dissolution rate), stability, and unchanged chemopreventive effects with respect to the unprocessed HSE.