Piloting an evidence-based intervention for HIV prevention among street youth in Eldoret, Kenya.

OBJECTIVES: This study presents findings from piloting an adapted evidence-based intervention, Stepping Stones and Creating Futures, to change street-connected young people's HIV knowledge, condom-use self-efficacy, and sexual practices. METHODS: Eighty street-connected young people participated in a pre- and post-test mixed methods design in Eldoret, Kenya. The primary outcome of interest was HIV knowledge. Secondary outcomes included condom-use self-efficacy and sexual practices. Multiple linear regression models for change scores with adjustment for socio-demographic variables were fitted. Qualitative and quantitative findings are presented together, where integration confirms, expands on, or uncovers discordant findings. RESULTS: Participants had a significant increase in HIV knowledge from pre- to post-intervention. The median HIV knowledge score pre-intervention was 11 (IQR 8-13) and post-intervention 14 (IQR 12-16). Attendance was significantly associated with HIV knowledge change scores. Qualitatively participants reported increased HIV and condom-use knowledge and improved condom-use self-efficacy and health-seeking practices. CONCLUSIONS: Our findings support the potential for further testing with a rigorous study design to investigate how best to tailor the intervention, particularly by gender, and increase the overall effectiveness of the program.

Consumption of whole grain food and its determinants in a general Italian population: Results from the INHES study.

BACKGROUND AND AIMS: Whole grain (WG) food consumption is associated with lower risk of cardiovascular disease, cancer and neurological diseases. The aim of this study was to assess the consumption of WG food and its major demographic, socioeconomic, psychosocial and behavioral determinants in a general Italian population. METHODS AND RESULTS: Data were from the Italian Nutrition & Health Survey (INHES), a telephone-based survey established in 2010-2013 including 9422 participants aged ≥5 years from all over Italy. WG food intake was assessed by the European Food Propensity Questionnaire and included bread, pasta, breakfast cereals, biscuits and WG soups. WG consumption was categorized as none, occasional (<1 time/week) and regular (≥1 time/week). Overall, 26.9% of the sample reported a regular consumption of WG food (27.2% of adults aged 20-97 y, and 21.9% of children/adolescents aged 5-19 y). In both age-groups, the major food source contributing to total WG intake was WG bread followed by WG pasta. Among adults, greater consumption of WG was associated with healthier lifestyle (e.g. sport activity), and higher educational level. Eating meals outside of the house in adults, and spending >2 h/day watching TV in children/adolescents were inversely associated with WG intake. CONCLUSIONS: The percentage of WG consumers in Italy in 2010-2013 appears to be quite low and still below that recorded in other countries of Europe where consumption is frequently over 50 percent. WG consumption is likely to be influenced by socioeconomic status and is associated with a number of psychosocial factors, meal patterns and eating-related behaviors.

Bridging the academic and practice/policy gap in public health: perspectives from Scotland and Canada.

This article presents a critical commentary of specific organizational models and practices for bridging 'the gap' between public health research and policy and practice. The authors draw on personal experiences of such models in addition to the wider knowledge translation and exchange literature to reflect on their strengths and weaknesses as implemented in Scotland and Canada since the early 1990s.

Fish intake is associated with lower cardiovascular risk in a Mediterranean population: Prospective results from the Moli-sani study.

BACKGROUND AND AIMS: Fish consumption reportedly reduces the risk of heart disease, but the evidence of cardiovascular advantages associated with fish intake within Mediterranean cohorts is limited. The aim of this study was to test the association between fish intake and risk of composite coronary heart disease (CHD) and stroke in a large population-based cohort adhering to Mediterranean Diet. METHODS AND RESULTS: Prospective analysis on 20,969 subjects free from cardiovascular disease at baseline, enrolled in the Moli-sani study (2005-2010). Food intake was recorded by the Italian version of the EPIC food frequency questionnaire. Hazard ratios were calculated by using multivariable Cox-proportional hazard models. During a median follow-up of 4.3 years, a total of 352 events occurred (n of CHD = 287 and n of stroke = 66). After adjustment for a large panel of covariates, fish intake ≥4 times per week was associated with 40% reduced risk of composite CHD and stroke (HR = 0.60; 95%CI 0.40-0.90), and with 40% lower risk of CHD (HR = 0.60; 95%CI 0.38-0.94) as compared with subjects in the lowest category of intake (<2 times/week). A similar trend of protection was found for stroke risk although results were not significant (HR = 0.62; 95%CI 0.26-1.51). When fish types were considered, protection against the composite outcome and CHD was confined to fatty fish intake. CONCLUSIONS: Fish intake was associated with reduced risk of composite fatal and non-fatal CHD and stroke in a general Mediterranean population. The favourable association was likely to be driven by fatty fish.

Anomaly detection for a vibrating structure: A subspace identification/tracking approach.

Mechanical devices operating in noisy environments lead to low signal-to-noise ratios creating a challenging signal processing problem to monitor the vibrational signature of the device in real-time. To detect/classify a particular type of device from noisy vibration data, it is necessary to identify signatures that make it unique. Resonant (modal) frequencies emitted offer a signature characterizing its operation. The monitoring of structural modes to determine the condition of a device under investigation is essential, especially if it is a critical entity of an operational system. The development of a model-based scheme capable of the on-line tracking of structural modal frequencies by applying both system identification methods to extract a modal model and state estimation methods to track their evolution is discussed along with the development of an on-line monitor capable of detecting anomalies in real-time. An application of this approach to an unknown structural device is discussed illustrating the approach and evaluating its performance.

Food group consumption in an Italian population using the updated food classification system FoodEx2: Results from the Italian Nutrition & HEalth Survey (INHES) study.

BACKGROUND AND AIM: Dietary habits evolve over time, being influenced by many factors and complex interactions. This work aimed at evaluating the updated information on food group consumption in Italy. METHODS AND RESULTS: A total of 8944 (4768 women and 4176 men) participants aged >18 years from all over Italy recruited in 2010-13 (Italian Nutrition & HEalth Survey, INHES) was analyzed. The recruitment was performed using computer-assisted-telephone-interviewing and one-day 24-h dietary recall retrieved from all participants. The updated, second version, of FoodEx2 food classification system was applied to extract data on food group consumption. The participation rate was 53%; 6.2% of the participants declared to follow a special diet, the most prevalent being hypo-caloric diets (55.7% of special diets). Men compared to women presented significantly higher intakes of "grains and grain-based products", "meat and meat products", "animal and vegetable fats and oils and primary derivatives" and "alcoholic beverages" (P for all<0.001); moreover, men had lower intakes of "milk and dairy products", "water and water-based beverages" and "products for non-standard diets, food imitates and food supplements" (P for all<0.001). Differences in food group intake among age groups, geographical regions and educational level groups were also identified (P for all<0.05). CONCLUSIONS: Data on the consumption of more than 70 food groups and sub-groups were illustrated in different strata. The present analysis could be considered as an updated source of information for future nutrition research in Italy and in the EU.

Lentivirus-induced 'Smart' dendritic cells: Pharmacodynamics and GMP-compliant production for immunotherapy against TRP2-positive melanoma.

Monocyte-derived conventional dendritic cells (ConvDCs) loaded with melanoma antigens showed modest responses in clinical trials. Efficacy studies were hampered by difficulties in ConvDC manufacturing and low potency. Overcoming these issues, we demonstrated higher potency of lentiviral vector (LV)-programmed DCs. Monocytes were directly induced to self-differentiate into DCs (SmartDC-TRP2) upon transduction with a tricistronic LV encoding for cytokines (granulocyte macrophage colony stimulating factor (GM-CSF) and interleukin-4 (IL-4)) and a melanoma antigen (tyrosinase-related protein 2 (TRP2)). Here, SmartDC-TRP2 generated with monocytes from five advanced melanoma patients were tested in autologous DC:T cell stimulation assays, validating the activation of functional TRP2-specific cytotoxic T lymphocytes (CTLs) for all patients. We described methods compliant to good manufacturing practices (GMP) to produce LV and SmartDC-TRP2. Feasibility of monocyte transduction in a bag system and cryopreservation following a 24-h standard operating procedure were achieved. After thawing, 50% of the initial monocyte input was recovered and SmartDC-TRP2 self-differentiated in vitro, showing uniform expression of DC markers, detectable LV copies and a polyclonal LV integration pattern not biased to oncogenic loci. GMP-grade SmartDC-TRP2 expanded TRP2-specific autologous CTLs in vitro. These results demonstrated a simpler GMP-compliant method of manufacturing an effective individualized DC vaccine. Such DC vaccine, when in combination with checkpoint inhibition therapies, might provide higher specificity against melanoma.

Near infrared photolysis of a Ru polypyridyl complex by upconverting nanoparticles.

NaYF4:Yb(3+)/Er(3+)nanocrystals upconvert near infrared light (980 nm) into higher energy visible photons capable of effecting the photodissociation of the monodentate pyridyl ligand in cis-[Ru(bpy)2(py)2]Cl2: opening an opportunity for advancing the use of photoactivatable metal complexes in medicine and biology.

Dos nuevos casos de enfermedad de Creutzfeldt-Jakob esporádica en Madrid, España / Two new cases of sporadic Creutzfeldt-Jakob disease in Madrid, Spain

Introducción. La enfermedad de Creutzfeldt-Jakob es una encefalopatía espongiforme transmisible, en la que típicamente se produce el acúmulo de una isoforma alterada de la proteína priónica en el cerebro. La forma esporádica se caracteriza por presentar una demencia rápidamente progresiva, con síntomas y signos de afectación piramidal, extrapiramidal, cerebelosa, cortical y presencia de mioclonías. El diagnóstico se basa en los hallazgos clínicos en combinación con los resultados típicos del electroencefalograma, estudio de líquido cefalorraquídeo o la neuroimagen. Casos clínicos. Presentamos dos casos detectados entre los años 2008 y 2010 en el Hospital del Henares, en Coslada. Caso 1: mujer con pérdida de fuerza progresiva en las extremidades, cambio en su comportamiento con labilidad emotiva y tendencia al aislamiento. Valorada inicialmente como una paciente psiquiátrica, en los meses posteriores presentó una situación de inmovilidad absoluta con tendencia al mutismo. El fallecimiento se produjo a los seis meses del inicio de los síntomas. Caso 2: varón con cuadro progresivo de alteración de la visión en forma de hemianopsia homónima derecha, dificultad para la emisión del lenguaje, mareo e inestabilidad. Progresivamente manifestó un síndrome cerebeloso con mioclonías generalizadas hasta su fallecimiento, 10 semanas después del inicio de los síntomas. En ambos casos el electroencefalograma mostró un patrón típico y la proteína 14-3-3 fue positiva en el estudio de líquido cefalorraquídeo. Conclusión. Nos ha llamado la atención una incidencia tan elevada en tan corto período y en un área sanitaria de apenas 170.000 habitantes (AU)

Introduction. Creutzfeldt-Jakob disease is a transmissible spongiform encephalopathy, in which there is typically an accumulation of an altered isoform of the prion protein in the brain. The sporadic form is characterised by presenting a rapidly progressive dementia, with signs and symptoms of pyramidal, extrapyramidal, cerebellar and cortical involvement, as well as the presence of myoclonias. Diagnosis is based on the clinical findings in combination with the typical results of an electroencephalogram, cerebrospinal fluid study or neuroimaging. Case reports. We report two cases detected between the years 2008 and 2010 in the Hospital del Henares, in Coslada, Madrid. Case 1: a female with progressive loss of strength in her limbs, change in her behaviour with mood swings and a tendency towards seeking to isolate herself. Although initially considered a psychiatric patient, in the months that followed she became absolutely immobile with a tendency towards mutism. Death occurred six months after the onset of symptoms. Case 2: a male with a progressive picture of altered vision in the form of right homonymous hemianopia, difficulty in verbally expressing language, dizziness and instability. The patient gradually developed a cerebellar syndrome with generalised myoclonias until his death, 10 weeks after the onset of symptoms. In both cases, the electroencephalogram showed a typical pattern and 14-3-3 protein was positive in the cerebrospinal fluid study. Conclusions. Such a high incidence over such a short period of time and in a health district of barely 170,000 inhabitants seems rather surprising (AU)

[Two new cases of sporadic Creutzfeldt-Jakob disease in Madrid, Spain]. / Dos nuevos casos de enfermedad de Creutzfeldt-Jakob esporadica en Madrid, Espana.

INTRODUCTION: Creutzfeldt-Jakob disease is a transmissible spongiform encephalopathy, in which there is typically an accumulation of an altered isoform of the prion protein in the brain. The sporadic form is characterised by presenting a rapidly progressive dementia, with signs and symptoms of pyramidal, extrapyramidal, cerebellar and cortical involvement, as well as the presence of myoclonias. Diagnosis is based on the clinical findings in combination with the typical results of an electroencephalogram, cerebrospinal fluid study or neuroimaging. CASE REPORTS: We report two cases detected between the years 2008 and 2010 in the Hospital del Henares, in Coslada, Madrid. Case 1: a female with progressive loss of strength in her limbs, change in her behaviour with mood swings and a tendency towards seeking to isolate herself. Although initially considered a psychiatric patient, in the months that followed she became absolutely immobile with a tendency towards mutism. Death occurred six months after the onset of symptoms. Case 2: a male with a progressive picture of altered vision in the form of right homonymous hemianopia, difficulty in verbally expressing language, dizziness and instability. The patient gradually developed a cerebellar syndrome with generalised myoclonias until his death, 10 weeks after the onset of symptoms. In both cases, the electroencephalogram showed a typical pattern and 14-3-3 protein was positive in the cerebrospinal fluid study. CONCLUSIONS: Such a high incidence over such a short period of time and in a health district of barely 170,000 inhabitants seems rather surprising.

A retrospective pilot study on the development of cognitive, behavioral and functional disorders in a sample of patients with early dementia of Alzheimer type.

This pilot study retrospectively analyzes the evolution of cognitive-behavioral symptoms and functional autonomy in a sample of patients with early diagnosis of probable Alzheimer's disease (AD). One hundred patients with early mild cognitive impairment (MCI) were considered and submitted to a multidimensional evaluation: the 53% presented probable AD. These 53 subjects were evaluated for cognitive performance by using the mini mental examination (MMSE), behavioral functions by the neuropsychiatric inventory (NPI) and functional dependence by the activities of daily living (ADL) and the instrumental ADL (IADL) scales at basal time and after 6-12 months. Results were analyzed according to the duration of therapy with acetyl-cholinesterase inhibitors (ACHEI) and to the timing of the beginning with respect to the diagnosis. AD patients treated with ACHEI at the moment of the diagnosis, showed a statistically significant improvement in MMSE (2.7+/-1.5) after 6 months (p=0.012) which was maintained even after 12 months. Subjects beginning ACHEI at the visit of 6 months showed a statistically worsened MMSE, even after 6 months of therapy (-2.8+/-1.7, p=0.026). We conclude that the timing of administration of ACHEI therapy in mild AD is essential to obtain beneficial effects on cognitive decline.

[Echography problems in acute scrotum: torsion of the hydatid of Morgagni]. / Problematiche ecografiche nello scroto acuto: torsione dell'idatide del Morgagni.

The A.A. discuss about a clinical case of acute scrotum in which the echographical aspects aren't been exhaustived for the etiology. Surgical exploration showed Morgagni's hydatid torsion while the echography doubted between acute phlogosis and neoplasia.

Possible adverse effects on the cardiovascular system of an antiarrhythmic drug mexiletine.

Mexiletine (MXT) is a drug endowed with a marked antiarrhythmic activity which may be included in 1B class of drugs employed in the therapy of arrhythmias. In experimental cardiovascular research, MXT at very high doses induces a decrease in the arterial blood pressure and cardiac performance of dogs. MXT reduces the carotid baroreceptor responses, the fall in blood pressure following pharadic stimulation of the peripheral trunk of the vagus nerve and it also inhibits catecholamine uptake. All these effects may be related to the local anaesthetic activity which MXT possesses and which need careful consideration in the clinical use of the drug.

N-monosubstituted urethanes and esters of 6-cis-dimethylamino-1,3,3-trimethyl-2-oxabicyclo-[2.2.2]octan-5-trans-ol with hypotensive and other activities.

The synthesis of 6-cis-dimethylamino-1,3,3-trimethyl-2-oxabicyclo[2.2.2]octan-5-trans-ol (III) starting from 1,3,3-trimethyl-6-nitrimino-2-oxabicyclo[2.2.2]octane is described. Starting from aminoalcohol (III), a series of N-substituted urethanes (IV) and esters (V), as well as the rigid analogue of acetylcholine (VII), were prepared. A number of compounds (V) and particularly (IV) showed remarkable hypotensive and bradycardic activities in rats, whereas the p-aminobenzoate (V h) showed infiltration anesthesia in mice comparable to that of lidocaine. Antiarrhythmic activity in mice and antiacetylcholine activity in vitro are also reported.

N-Substituted 1,7,7-trimethyl-2-piperidinobicyclo[2.2.1]hept-2-ene 5-carboxamides and 1,7,7-trimethylbicyclo[2.2.1]heptan-2-one 3-carboxamides with hypotensive and other activities.

The synthesis of N-substituted 1,7,7-trimethyl-2-piperidinobicyclo[2.2.1]hept-2-ene 3 carboxamides (II) by reaction of 1,7,7-trimethyl-2-piperidinobicyclo[2.2.1]hept-2-ene (I) with alkyl and aryl isocyanates, as well as the alkaline hydrolysis of (II) to N-substituted 1,7,7-trimethylbicyclo[2.2.1]heptan-2-one 3 carboxamides (III), are described. A number of compounds (II) and (III) showed strong hypotensive and bradycardiac activities in rats, as well as weak infiltration anesthesia and antiarrhythmic activity in mice. Antiacetylcholine activity in vitro is also reported.

Synthesis and pharmacological activity of derivatives of exo-trimethylenenorbornane, IV.

The syntheses of (+/-)-1-(exo-5,6-trimethylenenorbornan--2-yl)2-propanamine (IV) starting from (exo-5-trimethylenenobornan-2-yl)acetic acid (I) or (exo-5,6-trimethylenenorbornan-2-yl)acetonitrile (II), as well as a series of amides (V) described. None of compounds (IV) and (V) showed amphetamine-like activity in mice.

[Sodium phosphocreatine and the cardiovascular and respiratory systems]. / Fosfocreatina sodica ed apparato cardiovascolare e respiratorio.

In the dog, rat and chick, phosphocreatine-Na has not caused, from an experimental point of view, significative modifications of the cardiovascular- and respiratory-apparatus, of the reactivity of the cardio-regulator centers, of the baroreceptorial carotid-sinus and glomus reactivity, of the gangliar-, muscarinic-, histaminergic-, dopaminergic-, beta-adrenergic- and serotoninergic- vasomotor reactivity; only the vasomotor reactivity of a constrictive-type induced by epinephrine, nor-epinephrine, occlusion of the two common carotid arteries, hypertension and by BaCl2 is moderately reduced. It is interesting to note that the hypotensive response evoked by adenosine was augmented.