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Daniele Maggioni,1 Annamaria Cimicata,1 Antonella Praticò,1 Roberta Villa,1 Ferdinando Marco Bianchi,1,2 Silvia Busoli Badiale,1 Claudio Angelinetta1 1Bio Basic Europe Srl, Milan, Italy; 2Dermo-Cosmetic and Medical R&D Center of Bio Basic Europe Srl, Milan, ItalyCorrespondence: Annamaria Cimicata Tel +39 02 4155729Fax +39 0242174243Email annamariacimicata@libero.itIntroduction: Rosacea is a chronic multifactorial skin disorder mainly affecting facial skin with an estimated prevalence of about 5% worldwide. Its main symptoms, occurring early during pathology development, are skin dehydration, redness, erythema, and telangiectasia. Given the lack of a resolutive cure, therapeutic approaches able to relieve the main symptoms are needed.Purpose: The aim of this research article is to evaluate the beneficial effect of a topical product (Serum BK46) on rosacea symptoms.Patients and Methods: A monocentric single-arm, non-blinded study was performed to assess the clinical effect of Serum BK46 in relieving the main symptoms of rosacea: skin dryness, increased trans epidermal water loss (TEWL), redness, and abnormal vascularization. Twenty patients with mild to moderate rosacea were enrolled in the study and asked to apply the product twice per day for 56 days. Skin moisturization, TEWL, and erythema index were instrumentally assessed at baseline and following 24 h and 14, 28 and 56 days of treatment. Clinical parameters, including redness and telangiectasia imperfection visibility, were evaluated on a 5-point scale by a specialized dermatologist at baseline and after 14, 28, and 56 days of treatment. Finally, the visibility of vessel diameter was evaluated at baseline and after 28 and 56 days of treatment.Results: Serum BK46 application restored skin hydration and prevented the loss of water by the skin. Long-term treatment with Serum BK46 significantly reduced skin redness, erythema index, and the visibility of telangiectasia imperfections and superficial vessels. The investigated product’s clinical effect was demonstrated by both instrumental and clinical evaluation. Furthermore, Serum BK46 was completely tolerated and no adverse effects were recorded.Conclusion: The moisturizing and skin barrier restoring action of Serum BK46 has been clearly proven in patients displaying mild to moderate rosacea; thus, this product is a good candidate for rosacea treatment.Keywords: rosacea, topical product, transepidermal water loss, skin redness, telangiectasia

BackgroundDietary assessment is usually performed through imprecise tools, leading to error-prone associations between diet and health-related outcomes. Metabolomics has been applied in recent years to develop biomarkers of food intake (BFIs) and to study metabolites in the diet-microbiome crosstalk. Candidate BFIs exist to detect intake of meat and to a lesser extent dairy, but validation and further development of BFIs are needed. Here, we aim to identify biomarkers that differentiate between intakes of red meat and dairy, to validate previously reported BFIs for these foods, and to explore the effect of protein-matched meals on selected microbial metabolites.MethodsWe conducted a randomized, controlled, cross-over single-meal study comparing a meal with highly fermented yogurt and cheese, and a meal with beef and pork meatballs. Postprandial urine samples from 17 subjects were collected sequentially after each meal up to 24 h and analyzed by untargeted metabolomics through ultra-high-performance-liquid chromatography (UHPLC) coupled via electrospray (ESI) source to a qTOF mass spectrometer. Univariate (repeated measures ANOVA) and multivariate (PLSDA, ML-PLSDA) data analyses were used to select BFIs differentiating the two meals. 3-Indoxyl sulfate, p-cresol sulfate, and several other microbial amino acid catabolites were additionally explored within the urine profiles.ResultsThirty-eight markers of meat and dairy intake were selected and are presented along with their excretion kinetics. Carnosine, taurine, and creatine, as well as hydroxyproline-based dipeptides are confirmed as meat BFIs. For dairy, previously reported metabolites such as acyl-glycines are confirmed, while proline-based dipeptides are reported as novel putative BFIs. Microbial metabolites showed only marginal evidence of differential formation after the two meals.ConclusionThis study allowed us to validate the postprandial kinetics of previously suggested biomarkers of meat and dairy intake and to identify new potential biomarkers. The excretion kinetics are useful to ensure that the collection of urine covers the correct time window in future dietary studies. The BFIs add to the existing body of biomarkers and may further be used in combination to provide a more reliable assessment of meat and dairy intake. Proteolytic microbial metabolites should be further investigated to assess the effect of different protein sources on health.

Background: Lemierre syndrome is a rare, potentially fatal complication of oropharyngeal infections characterized by septic thrombophlebitis of the internal jugular vein. It primarily affects healthy adolescents and young adults. Its incidence declined after the antibiotic era, but it may have resurged in recent decades, likely due to judicious antibiotic use and increasing bacterial resistance. Prompt diagnosis and treatment are imperative to prevent significant morbidity and mortality. Methods: Lemierre syndrome has been called “the forgotten disease,” with a reported incidence of around 3.6 cases per million. The mean age at presentation is around 20 years old, though it can occur at any age. Lemierre Syndrome follows an oropharyngeal infection, most commonly pharyngitis, leading to septic thrombophlebitis of the internal jugular vein. F. necrophorum is the classic pathogen, though other organisms are being increasingly isolated. Metastatic infections, especially pulmonary, are common complications. Contrast-enhanced CT of the neck confirming internal jugular vein thrombosis is the gold standard for diagnosis. Long-course broad-spectrum IV antibiotics covering anaerobes are the mainstays of the disease’s treatment. Anticoagulation may also be considered. Mortality rates are high without treatment, but most patients recover fully with appropriate therapy. Conclusions: Lemierre syndrome should be suspected in patients with prolonged pharyngitis followed by unilateral neck swelling and fevers. Early diagnosis and prompt antibiotic therapy are key, given the potential for disastrous outcomes if untreated. An increased awareness of Lemierre syndrome facilitates its timely management.

Precision agriculture (PA) is a farming management concept that aims to provide agronomic, economic, and environmental benefits. One of the fields of research in PA is the delineation of Management Unit Zones (MUZs). MUZs are the sub-division of fields featuring an inter-zonal variation delineated by agronomists for on-field PA operations. To develop MUZs, three factors typically need to be considered: input multi-dimensional data, procedures to process the information, and the optimal number of zones a field should be divided into. PA uses digital technologies to collect and analyze a large amount of data, outline MUZs, monitor crops, and carry out site-specific crop management. Web-based spatial decision support systems (WB-SDSS) can provide users with tools that ease the complex procedures for PA. The objective of this study is twofold: on the one hand, we developed a free and open source (FOSS) WB-SDSS to facilitate the implementation and use of such tools for delineating MUZs and monitoring crops; on the other, a MUZs outline procedure was developed based on Sentinel-2 and Planetscope time series data, and spatio-temporal dynamic clustering model using fuzzy c-means. Our study highlighted that the WB-SDSS might be a helpful solution for harmonizing data collected from different sources, easing the implementation and use of complex geospatial procedures for PA, and delineating MUZs. We tested the system on a particularly representative farm in the Emilia Romagna region (Northern Italy), with 512 hectares of durum wheat crops. Using the WB-SDSS, we quickly delineated homogeneous zones for 27 fields in the study area during the phenological cycle of durum wheat (November 2018-June 2019).

Crown fire damage is a mixture of three principal fire-related components: charred material, scorched foliage, and unaltered green canopy. This study estimated the abundance of these physical alterations in two immediate post-fire Mediterranean forest contexts (Portugal and Italy) by applying linear spectral mixture analysis (LSMA) on Sentinel-2 imagery. The tree crowns fire damage was subsequently mapped, integrating fractional abundance information in a random forest (RF) algorithm, comparing the accuracy resulting from the adoption of generic or image spectral libraries as the primary investigative goal. Although image-derived endmembers resulted in more effectiveness in terms of fire-related components abundance quantification (LMSA-derived RMSE

Durum wheat (Triticum durum Desf.) is one of the most widely cultivated cereal species in the Mediterranean basin, supporting pasta, bread and other typical food productions. Considering its importance for the nutrition of a large population and production of high economic value, its supply is of strategic significance. Therefore, an early and accurate crop yield estimation may be fundamental to planning the purchase, storage, and sale of this commodity on a large scale. Multispectral (MS) remote sensing (RS) of crops using unpiloted aerial vehicles (UAVs) is a powerful tool to assess crop status and productivity with a high spatial–temporal resolution and accuracy level. The object of this study was to monitor the behaviour of thirty different durum wheat varieties commonly cultivated in Italy, taking into account their spectral response to different vegetation indices (VIs) and assessing the reliability of this information to estimate their yields by Pearson’s correlation and different machine learning (ML) approaches. VIs allowed us to separate the tested wheat varieties into different groups, especially when surveyed in April. Pearson’s correlations between VIs and grain yield were good (R2 > 0.7) for a third of the varieties tested; the VIs that best correlated with grain yield were CVI, GNDVI, MTVI, MTVI2, NDRE, and SR RE. Implementing ML approaches with VIs data highlighted higher performance than Pearson’s correlations, with the best results observed by random forest (RF) and support vector machine (SVM) models.

Kawasaki disease (KD) is an acute vasculitis that mainly affects children under 5 years of age, leading to coronary artery alterations (CAAs) in 25% of untreated patients. Macrophage activation syndrome (MAS) is a secondary hemophagocytic lymphohistiocytosis (HLH) that can complicate the acute, subacute, and chronic phases of KD. We retrospectively reviewed three cases of children affected by KD complicated with MAS hospitalized in two pediatric units in Emilia Romagna, a northern region of Italy. Case 1: a previously healthy 23-month-old female with full clinical criteria of KD and a hemorrhagic rash due to MAS during the acute phase of the illness. This patient responded promptly to a high dose of intravenous immune globulin (IVIG) and three pulses of high doses of methylprednisolone (MPD) with improvement in clinical signs and laboratory tests without the development of CAA at any phase of illness. Case 2: a previously healthy 10-month-old female with incomplete KD with persistent fever and maculopapular rash. This patient did not respond to IVIG and developed MAS during the subacute phase, characterized by persistent fever, hypertransaminasemia, hyperferritinemia, and hypofibrinogenemia after two high doses of IVIG and boluses of MPD. The patient responded to the addition of IL-1 blocker and anakinra and did not present CAA alterations during any phase of the illness. Case 3: a previously healthy 26-month-old male with incomplete KD with fever, maculopapular rash, cheilitis, and hyperemic conjunctivitis. This patient developed gallbladder hydrops and CAA in the acute phase and did not respond to two high doses of IVIG and a high dose of MPD. In the subacute phase, this patient was complicated with MAS and responded to intravenous anakinra. During the subacute phase, the patient developed transient aneurysms that regressed during the chronic phase. These cases reiterate that prompt diagnosis and aggressive immunomodulatory treatment can limit the most severe complications of MAS complicating KD. High doses of IVIG and MPD may result in a favorable outcome or more aggressive adjunctive treatment may be needed. Anakinra, cyclosporine, monoclonal antibodies, and plasmapheresis can be used as adjunctive treatment in the case of unresponsive MAS in KD. Notably, MAS, present during the subacute phase in cases 2 and 3, promptly responded to anakinra, an IL-1 blocker, without the use of cyclosporine. Our experience confirms that the IL-1 blocker can be considered an optimal choice after non-response to IVIG and MPD in KD complicating with MAS, avoiding over-treatment with cytotoxic drugs.

Abstract Hemi-hydranencephaly is a very rare condition characterized by complete or almost near-complete unilateral absence of the cortical cortex, which is filled by a sac of cerebrospinal fluid. Prenatal vascular disruption with occlusion of the carotid artery territories ipsilateral to the damaged brain is the presumed pathogenesis. We have selected nine cases that fit the clinical and pathologic characteristics of hemi-hydranencephaly, demonstrating that destruction of one hemisphere may be not always associated with severe neurologic impairment and may allow an almost normal life. This disorder is an example of a possible prenatal re-organization in which the right and left cerebral hemispheres present functional potentiality to make up the damaged brain. The cases reported in the literature are discussed, including a patient previously reported and followed-up for 10 years. A review of the cases is performed with an evaluation of the most important aspect of this rare and mysterious disorder.

Aim: To investigate the efficacy and tolerability of a cream (Rilastil Xerolact PB) containing a mixture of prebiotics and postbiotics, and to validate the PRURISCORE itch scale in the management of atopic dermatitis. Methods: The study is based on 396 subjects of both sexes in three age groups (i.e., infants, children, adults) suffering from mild/moderate Atopic Dermatitis, recruited from 8 European countries and followed for 3 months. Results: The product demonstrated good efficacy combined with good/very good tolerability in all age groups. In particular, SCORAD, PRURISCORE and IGA scores decreased significantly over the course of the study. The PRURISCORE was preferred to VAS by the vast majority of patients. Conclusion: Even though the role of prebiotics and postbiotics was not formally demonstrated since these substances were part of a complex formulation, it can be reasonably stated that prebiotics and postbiotics have safety and standardization features that probiotics do not have. In addition they are authorized by regulatory authorities, whereas topical probiotics are not.

Abstract Hypoxic-ischemic encephalopathy (HIE) is the most important cause of cerebral damage and long-term neurological sequelae in the perinatal period both in term and preterm infant. Hypoxic-ischemic (H-I) injuries develop in two phases: the ischemic phase, dominated by necrotic processes, and the reperfusion phase, dominated by apoptotic processes extending beyond ischemic areas. Due to selective ischemic vulnerability, cerebral damage affects gray matter in term newborns and white matter in preterm newborns with the typical neuropathological aspects of laminar cortical necrosis in the former and periventricular leukomalacia in the latter. This article summarises the principal physiopathological and biochemical processes leading to necrosis and/or apoptosis of neuronal and glial cells and reports recent insights into some endogenous and exogenous cellular and molecular mechanisms aimed at repairing H-I cerebral damage.

Prolonged prothrombin time increases the risk of bleeding complications in proportion to prolongation severity. We reported the case of a 72-year-old woman with a recent hospitalization for methicillin-susceptible Staphylococcus aureus endocarditis complicated by spondylodiscitis who developed a severe prolongation of clotting time during treatment with cefazolin due to a vitamin K deficiency. Cefazolin is a first-generation cephalosporin active against gram-positive bacteria. Like other cephalosporins, it is potentially able to inhibit the enzymes involved in recycling vitamin K metabolites, leading to a fall in gamma-carboxylation of vitamin K-dependent clotting factors. Clinicians should be aware of the necessity of regular monitoring of clotting times for the duration of antimicrobial therapy, especially in those patients with several risk factors for a poor vitamin K nutritional status. Prompt detection of vitamin K deficiency should be recognized and adequately supplemented.

In both the current and foreseen context of significant development of the electric vehicle (EV) fleet, a future increasing ratio of EVs in the urban traffic is expected, still enhanced in low-emission zones involving bans or restricted access to other vehicles. EVs are known to be quieter than conventional vehicles at low speed because of a low motor noise emission, resulting in a higher prevalence of rolling noise in the environmental noise. EVs differ from conventional vehicles in several parameters that can influence tyre/road noise, like weight and torque. The LIFE E-VIA project objectives consist in developing, implementing and assessing a low-noise road surface for light EV traffic in urban conditions, optimised from an acoustical and life cycle perspective. In parallel, an optimisation of EV tyres is investigated.