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We study the socio-economic determinants of perceptions toward intimate partner violence (IPV), utilizing a novel dataset covering eight countries: Armenia, Belarus, Georgia, Latvia, Poland, Russia, Sweden, and Ukraine. We identify factors that are correlated with perceptions of violence in transition countries and contrast them with the results obtained for Sweden, a non-transition country characterized by higher levels of gender equality and less conservative social norms. Within transition countries we also explore the specificities of former countries of the Soviet Union (FSU) and Poland. Our analysis shows significant linkages between demographic, social and economic variables and the likelihood of identifying abusive behaviour, especially in transition countries. Our findings suggest that, in transition countries, action can be taken to partially offset more conservative social norms and, potentially, contribute to changing social norms in the longer term. These actions should be tailored to the specific national context.

The use of erythritol as a food sweetener has spread significantly from Japan throughout the world. We describe a case of severe anaphylaxis due to immediate-type allergy to erythritol that was diagnosed with in vitro basophil activation tests and in vivo skin tests.

IntroductionMacrophages play a key role in most of the inflammatory diseases such as Rheumatoid Arthritis (RA), but the mechanism underlying their pathogenesis is still under study. Among stem cells, human dental pulp stem cells (hDPSCs) have attracted attention due to their easy accessibility and immunomodulatory properties, making them a promising adjuvant therapy. In this study, we aimed to evaluate the capacity of hDPSCs to modulate the phenotypes of primary human macrophages. Additionally, we sought to observe the differences induced on macrophages when cultured directly with hDPSCs or through a cell culture insert, mimicking the paracrine communication pathway.MethodsMonocytes, isolated from buffy coats, were differentiated into pro-inflammatory M1 and anti-inflammatory M2 macrophages. Subsequently, they were cultured with hDPSCs either directly or via a cell-culture insert for 48 hours. Finally, they were analyzed for protein, gene expression, cytokines levels and immunofluorescence.ResultsIn our study, we have demonstrated that, hDPSCs, even without priming, can reduce TNFα levels and enhancing IL-10 release in pro-inflammatory macrophages, both through direct contact and paracrine signaling. Furthermore, we found that their effects are more pronounced when in cell-to-cell contact through the decrease of NF-kB and COX-2 expression and of CD80/PD-L1 colocalization. HDPSCs, when in contact with macrophages, showed enhanced expression of NF-kB, COX-2, ICAM-1, PD-L1, FAS-L, TNFα and IFNγ.ConclusionWe showed that hDPSCs exert immunomodulatory effects on pro-inflammatory macrophages, with cell-to-cell contact yielding a more pronounced outcome compared to paracrine signaling. Our work highlights the immunomodulatory properties of hDPSCs on activated pro-inflammatory macrophages and the potential therapeutic role in inflamed tissue.

IntroductionAsthma is a chronic inflammatory respiratory disease often associated with comorbidities. Among cardiovascular comorbidities, arterial hypertension seems to create an additional health burden in asthmatics. However, evidence on this relationship is lacking.ObjectiveOur study aims to evaluate the characteristics of hypertensive asthmatics, focusing on the role of inflammation as a possible link between these diseases.MethodsWe conducted a monocentric retrospective analysis consecutively including asthmatics who underwent induced sputum (IS) at our asthma referral center. Patients were divided in two groups according to presence or absence of history of hypertension. Clinical, functional, and inflammatory (airway and systemic) data were collected.ResultsData on two hundred and sixty asthmatic patients were analyzed. Seventy-nine (30.4%) of them had a diagnosis of hypertension requiring a specific pharmacological treatment. Asthmatics with hypertension were more frequently male (p = 0.047), older (p 0.05); distribution of comorbidities and lung function impairment (forced expiratory volume in the first second (FEV1) and forced vital capacity (FVC); all p

This research investigates the suitability of PRISMA and Sentinel-2 satellite imagery for retrieving topsoil properties such as Organic Matter (OM), Nitrogen (N), Phosphorus (P), Potassium (K), and pH in croplands using different Machine Learning (ML) algorithms and signal pre-treatments. Ninety-five soil samples were collected in Quzhou County, Northeast China. Satellite images captured soil reflectance data when bare soil was visible. For PRISMA data, a Linear Mixture Model (LMM) was used to separate soil and Photosynthetic Vegetation (PV) endmembers, excluding Non-Photosynthetic Vegetation (NPV) using Band Depth values at the 2100 nm absorption peak of cellulose. Sentinel-2 bare soil reflectance spectra were obtained using thresholds based on NDVI and NBR2 indices. Results showed PRISMA data provided slightly better accuracy in retrieving topsoil nutrients than Sentinel-2. While no optimal predictive algorithm was best, absorbance data proved more effective than reflectance. PRISMA results demonstrated potential for predicting soil nutrients in real scenarios.

Abstract Background High blood eosinophils seem to predict exacerbations and response to inhaled corticosteroids (ICS) treatment in patients with chronic obstructive pulmonary disease (COPD). The aim of our study was to prospectively evaluate for 2 years, blood and sputum eosinophils in COPD patients treated with bronchodilators only at recruitment. Methods COPD patients in stable condition treated with bronchodilators only underwent monitoring of lung function, blood and sputum eosinophils, exacerbations and comorbidities every 6 months for 2 years. ICS was added during follow-up when symptoms worsened. Results 63 COPD patients were enrolled: 53 were followed for 1 year, 41 for 2 years, 10 dropped-out. After 2 years, ICS was added in 12/41 patients (29%) without any statistically significant difference at time points considered. Blood and sputum eosinophils did not change during follow-up. Only FEV1/FVC at T0 was predictive of ICS addition during the 2 year-follow-up (OR:0.91; 95% CI: 0.83–0.99, p = 0.03). ICS addition did not impact on delta (T24-T0) FEV1, blood and sputum eosinophils and exacerbations. After 2 years, patients who received ICS had higher blood eosinophils than those in bronchodilator therapy (p = 0.042). Patients with history of ischemic heart disease increased blood eosinophils after 2 years [p = 0.03 for both percentage and counts]. Conclusions Blood and sputum eosinophils remained stable during the 2 year follow-up and were not associated with worsened symptoms or exacerbations. Almost 30% of mild/moderate COPD patients in bronchodilator therapy at enrollment, received ICS for worsened symptoms in a 2 year-follow-up and only FEV1/FVC at T0 seems to predict this addition. History of ischemic heart disease seems to be associated with a progressive increase of blood eosinophils.

Abstract Randomized controlled trials (RCTs) are the gold standard to establish the benefit-risk ratio of novel drugs. However, the evaluation of mature results often takes many years. We hypothesized that the addition of Bayesian inference methods at interim analysis time points might accelerate and enforce the knowledge that such trials may generate. In order to test that hypothesis, we retrospectively applied a Bayesian approach to the HOVON 132 trial, in which 800 newly diagnosed AML patients aged 18 to 65 years were randomly assigned to a “7 + 3” induction with or without lenalidomide. Five years after the first patient was recruited, the trial was negative for its primary endpoint with no difference in event-free survival (EFS) between experimental and control groups (hazard ratio [HR] 0.99, p = 0.96) in the final conventional analysis. We retrospectively simulated interim analyses after the inclusion of 150, 300, 450, and 600 patients using a Bayesian methodology to detect early lack of efficacy signals. The HR for EFS comparing the lenalidomide arm with the control treatment arm was 1.21 (95% CI 0.81–1.69), 1.05 (95% CI 0.86–1.30), 1.00 (95% CI 0.84–1.19), and 1.02 (95% CI 0.87–1.19) at interim analysis 1, 2, 3 and 4, respectively. Complete remission rates were lower in the lenalidomide arm, and early deaths more frequent. A Bayesian approach identified that the probability of a clinically relevant benefit for EFS (HR

Abstract Seborrheic dermatitis (SD) affects 2–5% of the global population, with imbalances in the skin microbiome implicated in its development. This study assessed the impact of an oily suspension containing Lactobacillus crispatus P17631 and Lacticaseibacillus paracasei I1688 (termed EUTOPLAC) on SD symptoms and the skin mycobiome-bacteriome modulation. 25 SD patients were treated with EUTOPLAC for a week. Symptom severity and skin mycobiome-bacteriome changes were measured at the start of the treatment (T0), after seven days (T8), and three weeks post-treatment (T28). Results indicated symptom improvement post-EUTOPLAC, with notable reductions in the Malassezia genus. Concurrently, bacterial shifts were observed, including a decrease in Staphylococcus and an increase in Lactobacillus and Lacticaseibacillus. Network analysis highlighted post-EUTOPLAC instability in fungal and bacterial interactions, with increased negative correlations between Malassezia and Lactobacillus and Lacticaseibacillus genera. The study suggests EUTOPLAC's potential as a targeted SD treatment, reducing symptoms and modulating the mycobiome-bacteriome composition.

Optimal use of agricultural land leads to increased productivity and paves the way for sustainable agriculture. The land suitability assessment (LSA) is known as the basic scientific solution in this regard and has been widely used. This study takes a new approach to LSA based on the cultivated crops and their land production potential (LPP). The Honam region of Lorestan Province in western Iran was selected as a case study, where various plants including orchards and crop types (e.g., rainfed wheat, irrigated wheat, barley, chickpea, alfalfa, clover, and garlic) were cultivated. A map of crop types was first produced using the time series of Sentinel-1 synthetic aperture radar and Sentinel-2 optical imagery in the context of a feature-level fusion classification approach based on the support vector machine (SVM) algorithm. The LSA was then performed using the Food and Agriculture Organization method, and the LPP for plants was estimated using climate, soil, and landscape requirements. The SVM-derived crop type map gave acceptable performance with an overall accuracy of 92% and 86% kappa coefficient. Meanwhile, the clover and alfalfa had the highest (96%) and lowest (66%) accuracy, respectively. The LSA showed that slope, temperature, and soil physical properties such as texture, structure, and coarse fragments resulted in a significant reduction in LPP compared to potential yield. These limitations lowered the land suitability for chickpea, wheat, and garlic and made the land unsuitable for chickpea. Despite the limitations, over 60% of the studied lands for alfalfa, clover, barley, and wheat were in the suitable and moderately suitable classes.

Objective: To investigate the long-term effects of intravenous neridronate treatment in patients with complex regional pain syndrome type 1 (CRPS) in a real-life setting. Methods: We conducted a retrospective study on consecutive CRPS patients treated at our hospital from February 2018 to July 2023. All were treated within three months of the onset of CRPS symptoms. The Patient-Reported Outcomes Measurement Information System 29-Item Health Profile (PROMIS-29) version 2.1 was administered. The main outcome of interest was the evolution of the PROMIS-29 scores from baseline to the last follow-up visit. Patients were categorized as “complete responders” or “non-complete responders”. The association of clinical and demographic variables with a complete response was analyzed using chi-square tests and univariate logistic regression. Results: Thirty-six patients were included, with a median follow-up time of 4.8 years. A significant improvement was noted in the mean numerical pain rating scale (from 6.4 ± 1.9 to 3.1 ± 2.4, p < 0.001), as well as across all PROMIS-29 domains. Physical function improved from 34.2 ± 4.9 to 49.2 ± 9.9, p < 0.001; anxiety from 58.0 ± 6.7 to 49.6 ± 6.9, p < 0.001; depression from 55.3 ± 6.3 to 47.7 ± 6.6, p < 0.001; fatigue from 55.7 ± 7.7 to 50.9 ± 8.7, p < 0.001; sleep disturbance from 53.8 ± 6.8 to 51.3 ± 6.6, p = 0.034; social roles and activities from 41.8 ± 5.2 to 51.8 ± 8.9, p < 0.001; and pain interference from 64.1 ± 5.9 to 52.4 ± 9.9, p < 0.001. The likelihood of achieving a complete response was associated with the male sex, foot or ankle injuries (compared to hand and wrist injuries), and a younger age. No association was found with the type of inciting event or with the body mass index. Conclusions: Our real-life data indicate that early treatment with neridronate leads to substantial benefits in patients affected by CRPS type 1. The strongest responses are seen in young patients, males, and those with lower limb involvement.

Abstract Background We recently reported results of the prospective, open‐label HOVON‐100 trial in 334 adult patients with acute lymphoblastic leukemia (ALL) randomized to first‐line treatment with or without clofarabine (CLO). No improvement of event‐free survival (EFS) was observed, while a higher proportion of patients receiving CLO obtained minimal residual disease (MRD) negativity. Aim In order to investigate the effects of CLO in more depth, two multi‐state models were developed to identify why CLO did not show a long‐term survival benefit despite more MRD‐negativity. Methods The first model evaluated the effect of CLO on going off‐protocol (not due to refractory disease/relapse, completion or death) as a proxy of severe treatment‐related toxicity, while the second model evaluated the effect of CLO on obtaining MRD negativity. The subsequent impact of these intermediate events on death or relapsed/refractory disease was assessed in both models. Results Overall, patients receiving CLO went off‐protocol more frequently than control patients (35/168 [21%] vs. 18/166 [11%], p = 0.019; HR 2.00 [1.13–3.52], p = 0.02), especially during maintenance (13/44 [30%] vs. 6/56 [11%]; HR 2.85 [95%CI 1.08–7.50], p = 0.035). Going off‐protocol was, however, not associated with more relapse or death. Patients in the CLO arm showed a trend towards an increased rate of MRD‐negativity compared with control patients (HR MRD‐negativity: 1.35 [0.95–1.91], p = 0.10), which did not translate into a significant survival benefit. Conclusion We conclude that the intermediate states, i.e., going off‐protocol and MRD‐negativity, were affected by adding CLO, but these transitions were not associated with subsequent survival estimates, suggesting relatively modest antileukemic activity in ALL.

IntroductionAquaCrop is a water-driven crop growth model that simulates aboveground biomass production in croplands. This study aimed to identify the driving parameters of the AquaCrop model for the model calibration and simplification to fill the research gap in intermediate environmental conditions between sub-tropical sub-humid and temperate sub-humid climates for silage maize.MethodsTo this end, we applied global sensitivity analysis (GSA) by combining the Morris method and the Extended Fourier Amplitude Sensitivity Test (EFAST) on crop yield output. The process involved a field sampling of soil and crop of silage maize carried out in the agricultural fields of Ghale-Nou, southern Tehran, Iran, in the summer of 2019 in order to measure certain model parameters.Results and discussionIn compliance with the Morris method, 30 parameters were identified as the least sensitive, while results from the EFAST test showed 9 parameters as contributing to the highest sensitivities in the model. The results clearly point to the capacity of employing a combination of both methods to attain a more efficient model calibration. Particular root, soil, canopy development, and biomass production parameters were influential and merit attention during calibration. Instead, parameters describing crop responses to water stress were acting rather insensitive in this study condition. The insights gained from this study, i.e., assessing parameter ranges and distinguishing between less sensitive and more sensitive parameters based on environmental and crop conditions, have the potential to be applied to other crop growth models with caution.

RESUMO Residir nas proximidades de áreas verdes e em regiões com altos índices de caminhabilidade contribui para diminuir o risco de doenças, mas existem poucos estudos longitudinais em países de baixa e média rendas. Em São Paulo houve uma política importante de implementação de ciclovias e já é conhecido o efeito protetor das práticas de atividades físicas em doenças como a hipertensão arterial. Para verificar as relações entre possíveis mudanças na exposição às ciclovias a até 1 km das residências com as práticas de Atividade Física no Lazer (AFL), utilizamos dados de uma coorte onde foram avaliadas n=1.431 pessoas entre 2014/2015 e 2020/2021. As AFL e a hipertensão foram avaliadas por questionários. A disponibilidade de ciclovias a até 1 km dos endereços residenciais foi avaliada entre 2015 e 2020 por georreferenciamento e foram calculadas as mudanças no período. Foram realizadas associações estatísticas bivariadas e análises multiníveis. Houve aumento na hipertensão (de 26,2% para 35,6%) e na AFL (de 36,4% para 47,6%), mas foram associadas inversamente em ambos os períodos (p

Despite its high importance for crop yield prediction and monitoring, early-season crop mapping is severely hampered by the absence of timely ground truth. To cope with this issue, this study aims at evaluating the capability of PRISMA hyperspectral satellite images compared with Sentinel-2 multispectral imagery to produce early- and in-season crop maps using consolidated machine and deep learning algorithms. Results show that the accuracy of crop type classification using Sentinel-2 images is meaningfully poor compared with PRISMA (14% in overall accuracy (OA)). The 1D-CNN algorithm, with 89%, 91%, and 92% OA for winter, summer, and perennial cultivations, respectively, shows for the PRISMA images the highest accuracy in the in-season crop mapping and the fastest algorithm that achieves acceptable accuracy (OA 80%) for the winter, summer, and perennial cultivations early-season mapping using PRISMA images. Moreover, the 1D-CNN algorithm shows a limited reduction (6%) in performance, appearing to be the best algorithm for crop mapping within operational use in cross-farm applications. Machine/deep learning classification algorithms applied on the test fields cross-scene demonstrate that PRISMA hyperspectral time series images can provide good results for early- and in-season crop mapping.

RESUMO As mudanças na força de trabalho rural mundial ocorreram, a partir de 1980, sobretudo, com o aumento da participação feminina no trabalho assalariado. Foi realizada uma revisão integrativa da literatura publicada entre os anos de 2010 a 2020 a respeito das condições de trabalho e saúde de trabalhadoras rurais. As bases de dados consultadas foram BVS, SciELO e PubMed, e 43 estudos, 11 nacionais e 32 internacionais, foram analisados. Os resultados apontam uma diversidade de atividades de trabalho exercidas por mulheres rurais, de forma assalariada, autônoma e em cooperativas, bem como atividades não remuneradas. As condições de trabalho em empregos assalariados, em geral, são precarizadas, com contratos temporários, baixos salários e longas jornadas de trabalho. No trabalho autônomo e em cooperativas, os estudos relatam maior controle das atividades, autonomia financeira e maior satisfação das trabalhadoras. Destacou-se, em todas as formas de trabalho, a divisão sexual e a sobrecarga de trabalho com o acréscimo às atividades produtivas, das atividades reprodutivas não remuneradas, serviço doméstico e de cuidado. Distúrbios osteomusculares, sofrimentos e adoecimentos mentais, alta exposição e intoxicações por agrotóxicos e a violência no ambiente de trabalho e doméstico foram identificados como preponderantes nas relações saúde-trabalho vivenciadas por essas trabalhadoras rurais.

The aim of this study is to explore the relationship between individual-level factors and cycling for transportation in a cohort of participants living in São Paulo city, Brazil. The same participants (n = 1,431 adults) were interviewed in 2014/2015 (Wave 1) and 2020/2021 (Wave 2) as part of the ‘São Paulo Health Survey-ISA: Physical Activity and Environment’. For the longitudinal transport cycling binary outcome, participants who reported cycling at both time-points and those who were cycling at Wave 2 only were coded as a positive longitudinal pattern for cycling. Those who were not cycling at either Waves, and those who were cycling at Wave 1 only, were grouped into a negative pattern for cycling. The relationship between the longitudinal patterns for transport cycling and sociodemographics, health characteristics, and behaviors at Wave 1 were tested using bivariate analysis, and the significant individual-level factors were then examined in a multivariable binary logistic regression model. The odds of being classified in the positive cycling pattern were lower for women [OR = 0.09; 95 % CI = 0.04–––0.19], and higher for persons aged 30 – 39 [OR = 3.25; 95 % CI = 1.38–––7.66], those who owned a bicycle [OR = 2.00; 95 % CI = 1.13–––3.54], and those who engaged in ≥ 120 min/week of transport walking [OR = 2.07; 95 % CI = 1.24–––3.47] or leisure-time physical activity [OR = 1.77; 95 % CI = 1.02–––3.06]. Cycling interventions and promotion should target women, the mid-aged and involve facilitating bicycle access. Advocacy for physical activity interventions is needed to influence transport cycling.

A 44-year-old athletic man presented in 2009 with severe low back pain. Dual-energy x-ray absorptiometry revealed severe osteoporosis; serum testosterone was 189 ng/dL while serum estradiol (E2) measured by liquid chromatography/ mass spectrometry was 8 pg/mL. DNA was extracted and sequenced from a blood sample from the patient since his maternal first cousin also had low bone mass and both patients were screened for aromatase dysfunction by PCR analysis for the CYP19A1 gene, which encodes aromatase. No known pathologic mutations were observed in the coding exons, but novel single nucleotide polymorphisms were detected both in the proband and in his cousin. Treatment with topical testosterone started in August 2010. Over the next 8 years, testosterone dosage was varied and switched from topical gel to injections and maintained on depo-injections of testosterone at about 60 mg once per week. Re-examination in March 2012 included a brain MRI to exclude pituitary lesions; hyperparathyroidism was ruled out (normal serum parathyroid hormone, calcium, and calcium to phosphorous ratio) and celiac disease was excluded (negative transglutaminase antibodies). Follow-up in October 2018 showed improved bone mineral density of the lumbar spine by 29% and of the left femoral hip by 15% compared to baseline measurements. This reveals the importance of measuring serum E2 for making the correct diagnosis, as well as for monitoring a therapeutic effect. Herein, we propose treatment of male osteoporosis where serum E2 levels are below about 20 pg/mL with testosterone to reverse osteoporosis.

Georgia is a small, open, developing economy, situated in a key geopolitical area at the crossroads between Europe and Asia, striving to achieve greater energy and national security. Achieving energy security, however, can be challenging for a country poorly endowed with fossil fuels and with limited interactions with broader international energy markets. Georgia, luckily, has the potential to dramatically increase its energy security in the coming decades by means of greater integration with its neighbours and European energy markets, and building on the current emphasis on (and support for) energy transition and decarbonisation initiatives to fight climate change, leveraging its endowment of renewable energy sources and its strategic location between Europe and Asia.

Architectural modernism appeared in cities of the Kingdom of Yugoslavia during the end of the twenties and beginning of the thirties of the XXth century with different manifestations but within a quite coherent cultural scenario. In those years, most of the Yugoslavian cities were transforming themselves and they were all searching for a new identity, where a new architectural “style” had a substantial importance. The cultural life in these cities was extremely rich and open to external influences, also due to the presence of young architects and academics that had studied abroad and were eager to bring in their own towns their personal experiences. Zagreb was certainly one of the most active cities from an economical, social and cultural point, a city where urban transformations and architectural innovation were reinforcing each other. The unique example of the residential development along Novakova street must be seen as a very early attempt of creating a modern identity, also in relationship to other important European experiences, first with the Weissenhof in Stuttgart.

Research biobanks are non-profit structures that collect, manipulate, store, analyze and distribute systematically organized biological samples and data for research and development purposes. Over the recent years, we have established a biobank, the Rheumatology BioBank (RheumaBank) headed by the Medicine and Rheumatology unit of the IRCCS Istituto Ortopedico Rizzoli (IOR) in Bologna, Italy for the purpose of collecting, processing, storing, and distributing biological samples and associated data obtained from patients suffering from inflammatory joint diseases. RheumaBank is a research biobank, and its main objective is to promote large-scale, high-quality basic, translational, and clinical research studies that can help elucidate pathogenetic mechanisms and improve personalization of treatment choice in patients with rheumatoid arthritis (RA), psoriatic arthritis (PsA) and other spondyloarthritides (SpA).

The pelvic anatomy poses great challenges to orthopedic surgeons. Sarcomas are often large in size and typically enclosed in the narrow confines of the pelvis with the close proximity of vital structures. The aim of this study is to report a systematic planned multidisciplinary surgical approach to treat pelvic sarcomas. Seventeen patients affected by bone and soft tissue sarcomas of the pelvis, treated using a planned multidisciplinary surgical approach, combining the expertise of orthopedic oncology and other surgeons (colleagues from urology, vascular surgery, abdominal surgery, gynecology and plastic surgery), were included. Seven patients were treated with hindquarter amputation; 10 patients underwent excision of the tumor. Reconstruction of bone defects was conducted in six patients with a custom-made 3D-printed pelvic prosthesis. Thirteen patients experienced at least one complication. Well-organized multidisciplinary collaborations between each subspecialty are the cornerstone for the management of patients affected by pelvic sarcomas, which should be conducted in specialized centers. A multidisciplinary surgical approach is of paramount importance in order to obtain the best successful surgical results and adequate margins for achieving acceptable outcomes.

Objectives: To assay the presence of the SARS-CoV-2 genome in vaginal, rectal, and placental swabs among pregnant women and in newborn nasopharyngeal swabs and to investigate the immunological response and maternal antibody transfer through the umbilical cord blood and milk of unvaccinated mothers. Methods: Vaginal, rectal, and placental specimens, maternal and neonatal serum, and milk were collected from a wide cohort of pregnant Italian women with confirmed SARS-CoV-2 infection admitted to the hospital between February 25, 2020 and June 30, 2021. Samples were tested in selected reference laboratories according to a shared interlaboratory protocol. Results: Among 1086 enrolled women, the SARS-CoV-2 positive rate detected in all specimens ranged from 0.7% to 8.4%. Respectively, 45.2% of maternal sera collected during pregnancy and 39.7% of those collected at birth tested positive for immunoglobulin G, whereas 50.5% tested positive among neonates. Nasopharyngeal swabs were positive in 0.8% of the newborns, and immunoglobulin G was detected in 3.0% of the milk samples. The highest immunological response was recorded within 30 days during pregnancy and within 60 days of birth and in the neonatal population. Conclusion: Vertical transmission should be considered a rare event; although, a good maternal immunological response and antibodies transfer throughout the umbilical cord blood was detected.

IntroductionPatients with severe COVID-19 often experience long-lasting disabilities that can improve after pulmonary rehabilitation. Moreover patients with severe COVID-19 display thyroid function alterations due to a non-thyroidal illness syndrome (NTIS). The aim of our study was to evaluate thyroid function parameters among patients hospitalized for COVID-19 who were eligible or not to respiratory rehabilitation and their modifications during follow-up.Materials and methodsPost-COVID-19 patients referred to a Respiratory Rehabilitation Unit were evaluated. Outpatients, not candidate for rehabilitation, were enrolled as Control group. Patients who had completed a 4-week-rehabilitation program were enrolled as Rehabilitation Group. All patients were evaluated at T0 (4 weeks after the discharge home in Control Group and after completion of rehabilitation in Rehabilitation Group) and at T1 (3 months after T0).ResultsThe final study group included 39 patients (20 in the Rehabilitation group and 19 in the Control group). Patients in the Rehabilitation Group had more frequently received invasive or non-invasive ventilation, had a longer length-of-stay in referring hospitals, had a higher number of comorbidities and displayed a worse performance at 6-minute-walking-test (6MWT) and Short-Physical-Performance-Battery-test (SPPB). FT3 values were lower at T0 in the Rehabilitation Group, while TSH and FT4 values were similar in the two groups. While no significant modifications in thyroid-function-parameters were observed in the Control Group, a significant increase in FT3 value was observed in the Rehabilitation Group at T1. Participants of both groups had improved the results of 6MWT at T1, while SPPB values improved only in the Rehabilitation Group.ConclusionsCOVID-19 patients after pulmonary rehabilitation experience an increase in FT3 values during follow-up, paralleled with an amelioration of functional capabilities.

IntroductionObesity can worsen fibromyalgia (FM) and very low-calorie ketogenic diet (VLCKD) is a potential therapeutic option for diseases that share clinical and pathophysiological features with FM. In this pilot interventional study, we investigated the effects of VLCKD in obese women with FM.MethodsFemale patients with FM and a body mass index (BMI) ≥ 30 kg/m2 were eligible for VLCKD. The ketogenic phase (T0 to T8) was followed by progressive reintroduction of carbohydrates (T8 to T20). Changes in BMI, Fibromyalgia Impact Questionnaire (FIQ), Hospital Anxiety and Depression Scale (HADS), EuroQol 5D (EQ-5D) and 36-item Short Form Health Survey (SF-36) were evaluated. A change of 14% in FIQ was considered clinically relevant. The longitudinal association between BMI and patient-reported outcomes (PROs) was assessed using generalized estimating equations.ResultsTwenty women were enrolled. Two discontinued the intervention. The mean age of the 18 patients who reached T20 was 51.3 years and mean BMI was 37.2 kg/m2. All patients lost weight during the first period of VLCKD and this achievement was maintained at T20. Mean BMI decreased from 37.2 kg/m2 at T0 to 34.8 kg/m2 at T4, 33.5 kg/m2 at T8 and 32.1 kg/m2 at T20 (p

Resumo Objetivo: analisar a distribuição espacial e temporal dos indicadores de acidentes de trabalho (AT) e de outros agravos à saúde relacionados à produção agropecuária de Mato Grosso, no período de 2008 a 2017. Métodos: trata-se de estudo ecológico, com análise de tendência e correlação entre indicadores de produção agropecuária, florestal, mineral e AT. Resultados: as atividades econômicas do agronegócio com maior contribuição aos AT foram: abate e fabricação de produtos de carnes (16,9%) e agricultura (12,3%). Taxas de AT mais elevadas foram observadas nos municípios considerados os maiores produtores agropecuários (Paranatinga, Barra do Garças, Alta Floresta e Sorriso). Evidenciou-se que 58,4% dos AT no estado foram relacionados ao agronegócio. Foi encontrada correlação positiva e significativa entre o valor adicionado bruto e a taxa de incidência (r = 0,303; p < 0,001), mortalidade (r = 0,368; p < 0,001) e letalidade (r = 0,390; p < 0,001) por AT. Identificou-se tendência crescente na variação percentual anual de 7,3% (IC95%: 6,1;8,6) do esforço produtivo (hectare/habitante), de 6,2% (IC95%: 5,2;7,3) do esforço produtivo (exposição agrotóxico/habitante) e de 6,2% (IC95%: 4,1;8,3) das internações por neoplasias, bem como do crescimento da produção agrícola, dos insumos agrícolas e dos agravos à saúde. Conclusão: a maioria dos AT foram relacionados ao agronegócio, predominantemente nas atividades de frigoríficos e agricultura. Houve correlação positiva entre indicadores de produção agropecuária e de ocorrências e mortes por AT.

Colored dissolved organic matter (CDOM) is a significant constituent of aquatic systems and biogeochemical cycles. Satellite CDOM retrievals are challenging in inland waters, due to overlapped absorption properties of bio-optical parameters, like Total Suspended Matter (TSM). In this framework, we defined an accurate CDOM model using Sentinel2-MSI (S2-MSI) data in Pertusillo Lake (Southern Italy) adopting a classification scheme based on satellite TSM data. Empirical relationships were established between the CDOM absorption coefficient, aCDOM (440), and reflectance band ratios using ground-based measurements. The Green-to-Red (B3/B4 and B3/B5) and Red-to-Blue (B4/B2 and B5/B2) band ratios showed good relationships (R2 ≥ 0.75), which were further improved according to sub-region division (R2 up to 0.93). The best accuracy of B3/B4 in the match-ups between S2-MSI-derived and in situ band ratios proved the exportability on S2-MSI data of two B3/B4-based aCDOM (440) models, namely the fixed (for the whole PL) and the switching one (according to sub-region division). Although they both exhibited good agreements in aCDOM (440) retrievals (R2 ≥ 0.69), the switching model showed the highest accuracy (RMSE of 0.0155 m−1). Finally, the identification of areas exposed to different TSM patterns can assist with refining the calibration/validation procedures to achieve more accurate aCDOM (440) retrievals.

Introduction: In autoimmune diseases, particularly in systemic sclerosis and chronic periaortitis, a strict correlation between chronic inflammation and fibrosis exists. Since the currently used drugs prove mostly effective in suppressing inflammation, a better comprehension of the molecular mechanisms exerted by cell types implicated in fibro-inflammation is needed to develop novel therapeutic strategies. Mesenchymal stromal/stem cells (MSCs) are being matter of deep investigation to unveil their role in the evolution of fibrogenetic process. Several findings pointed out the controversial implication of MSCs in these events, with reports lining at a beneficial effect exerted by external MSCs and others highlighting a direct contribution of resident MSCs in fibrosis progression. Human dental pulp stem cells (hDPSCs) have demonstrated to hold promise as potential therapeutic tools due to their immunomodulatory properties, which strongly support their contribution to tissue regeneration.Methods: Our present study evaluated hDPSCs response to a fibro-inflammatory microenvironment, mimicked in vitro by a transwell co-culture system with human dermal fibroblasts, at early and late culture passages, in presence of TGF-β1, a master promoter of fibrogenesis.Results and Discussion: We observed that hDPSCs, exposed to acute fibro-inflammatory stimuli, promote a myofibroblast-to-lipofibroblast transition, likely based on BMP2 dependent pathways. Conversely, when a chronic fibro-inflammatory microenvironment is generated, hDPSCs reduce their anti-fibrotic effect and acquire a pro-fibrotic phenotype. These data provide the basis for further investigations on the response of hDPSCs to varying fibro-inflammatory conditions.

(1) Background: “Brittle Asthma” was considered an asthma clinical phenotype and deemed to be life-threatening in the early 2000s; then, this definition disappeared. The purpose of this review is to examine what has historically been referred to as this term and see whether it may be applied to modern clinical practice, thus acquiring fresh relevance and meaning. (2) Methods: A non-systematic search of the literature was conducted using both MeSH and free-text phrases. No limitations on the research design or type of publication were applied. (3) Results: Reliable data regarding “Brittle Asthma” are lacking due to the paucity of current data and the few studies available. After a few years of reworking, it was divided into two sub-classes: one characterized by a wide PEF variability despite high-dose therapy and the other by sudden acute attacks in otherwise apparently normal airway functions or well-controlled asthma. Their characteristics were hardly defined because of their low prevalence. Data regarding risk factors, atopy, mechanisms, and treatments were analyzed. (4) Conclusions: Over time, different terminology has been introduced to define asthma severity and control. It would be worth investigating whether the term “Brittle Asthma” previously used may be helpful to find new hints to stratify patients and improve disease management.

Sternal wound complications following cardiac surgery, including sternal dehiscence, mediastinitis, and osteomyelitis, pose significant challenges in terms of management and patient outcomes. We present a case report highlighting the complex management of a patient who underwent open heart surgery for severe aortic valve stenosis, followed by sternal wound dehiscence and sternum osteomyelitis due to extended spectrum beta lactamase (ESBL) producing Klebsiella aerogenes. A multiple myeloma diagnosis was also suspected at the positron emission tomography (PET) scan and confirmed with bone marrow biopsy. Multidisciplinary evaluation of the case led to a comprehensive treatment plan. To control the sternal osteomyelitis, total sternectomy was performed followed by immediate reconstruction with a bone (tibia) graft from the tissue bank and fixation with the minimal hardware possible. A microsurgical latissimus dorsi free flap was required to reconstruct the soft tissue defect. After 6 weeks of antibiotic treatment with ertapenem and fosfomycin based on a culture of intraoperative material, no clinical, imaging, or laboratory signs of infection were seen. Multiple myeloma treatment was then started. At 1 year of follow up, no recurrence of infection occurred, and the reconstruction was stable and closed. Multiple myeloma is under chronic treatment with novel agent combination, with an excellent haematological response.

Nitric oxide is a gas produced in the airways of asthmatic subjects and related to T2 inflammation. It can be measured as fractional nitric oxide (FeNO) in the exhaled air and used as a non-invasive, easy to evaluate, rapid marker. It is now widely used in many settings to determine airway inflammation. The aim of this narrative review is to report relationship between FeNO and the physiopathologic characteristics of asthmatic patients. Factors affecting FeNO levels have also been analysed as well as the impact of corticosteroid, target therapies and rehabilitation programs. Considering the availability of the test, spreading this methodology to low income countries has also been considered as a possibility for evaluating airway inflammation and monitoring adherence to inhaled corticosteroid therapy. PubMed data search has been performed restricted to English language papers. Research was limited to studies in adults unless studies in children were the only ones reported for a particular issue.This revision could be useful to summarize the role of FeNO in relation to asthma characteristics and help in the use of FeNO in different clinical settings particularly in low income countries.

Abstract Background Dental pulp stem cells (DPSCs) are low immunogenic and hold immunomodulatory properties that, along with their well-established multi-potency, might enhance their potential application in autoimmune and inflammatory diseases. The present study focused on the ability of DPSCs to modulate the inflammatory microenvironment through PD1/PD-L1 pathway. Methods Inflammatory microenvironment was created in vitro by the activation of T cells isolated from healthy donors and rheumatoid arthritis (RA) patients with anti-CD3 and anti-CD28 antibodies. Direct and indirect co-cultures between DPSCs and PBMCs were carried out to evaluate the activation of immunomodulatory checkpoints in DPSCs and the inflammatory pattern in PBMCs. Results Our data suggest that the inflammatory stimuli trigger DPSCs immunoregulatory functions that can be exerted by both direct and indirect contact. As demonstrated by using a selective PD-L1 inhibitor, DPSCs were able to activate compensatory pathways targeting to orchestrate the inflammatory process by modulating pro-inflammatory cytokines in pre-activated T lymphocytes. The involvement of PD-L1 mechanism was also observed in autologous inflammatory status (pulpitis) and after direct exposure to pre-activated T cells from RA patients suggesting that immunomodulatory/anti-inflammatory properties are strictly related to their stemness status. Conclusions Our findings point out that the communication with the inflammatory microenvironment is essential in licensing their immunomodulatory properties.