Diatom motility and nuclear alterations are affected by sediment elutriates of agricultural streams.

Diatoms respond to toxicants in lotic systems, and they are commonly considered to be sensitive indicators in environmental safety assessment. In addition to the structural characteristics of the algal populations, recent studies have shown that endpoints such as nuclear anomalies or diatom motility measures can be affected quickly by environmental changes. We sought to determine if cell density, cell size, nuclear anomalies and motility of the diatom Nitzschia palea were useful indicators of sediment quality from agricultural streams. For this purpose, we exposed cultures of the diatom to elutriates from sediments of a stream that flows through an intensive agricultural area, and measured the responses of the populations for 7 days in laboratory tests. The bioassays showed that motility measures in Nitzschia palea and the condition of their nuclear membranes rapidly reflected the effects of sediment quality after only 48 h of exposure; mean cell density and length were affected by day 7. The sediment elutriates affected cell movements by shortening the total path length and decreasing cell velocity; they also increased the number of cells with nuclear membrane breakage. Our results from these bioassays show that diatom motility measurements and the condition of the nuclei might be indicators that respond faster to impacts than the traditional structural parameters, such as cell density, specific composition of the assemblage or diversity metrics of the algal communities more often used in biomonitoring.

Comparative cardiovascular safety of strontium ranelate and bisphosphonates: a multi-database study in 5 EU countries by the EU-ADR Alliance.

Strontium ranelate use, compared with oral bisphosphonates, is not associated with increased risk of AMI in patients with no contraindications for SR use. However, current strontium ranelate (compared with current bisphosphonate) appears associated with 25-30% excess risk of VTE and 35% excess risk of CVDeath. INTRODUCTION: Evaluate the risk of cardiac and thromboembolic events among new users of SR and oral BPs without contraindications for SR. METHODS: We conducted three multi-national, multi-database (Aarhus-Denmark, HSD-Italy, IPCI-Netherlands, SIDIAP-Spain, THIN-UK) case-control studies nested within a cohort of new users of SR/BP. We matched cases of acute myocardial infarction (AMI), venous thromboembolism (VTE), and cardiovascular death (CVDeath), up to 10 controls on gender, year of birth, index date, and country. Conditional logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (CIs) according to current SR vs current BP use and current vs past SR use, adjusting for potential confounders. Data were pooled using random effects meta-analysis. RESULTS: No excess risk of AMI (5477 cases/54,674 controls) was found with current SR vs current BP (OR 0.89 (95%CI 0.70, 1.12)) nor with current vs past SR use (0.71(0.56, 0.91)). For VTE (5614 cases/6036 controls), an excess risk was found with current SR compared with current BP use, 1.24 (0.96, 1.61), and current vs past SR use, 1.30 (1.04, 1.62). For CVDeath (3019 cases/29,871 controls), an increased risk was seen with current SR vs current BP use, 1.35 (1.02, 1.80), but not with current vs past SR use (0.68 (0.48, 0.96)). CONCLUSION: In patients without contraindications for SR, we found no evidence of an increased risk of AMI but a 25-30% excess risk of VTE and a 35% excess risk of CVDeath with current SR vs current BP users. This is despite a reduction in risk in CVDeath with current vs past SR users. The latter disparity could still be partially explained by cessation of preventative therapies in end-of-life or residual confounding by indication.

Correction to: Impact of risk minimisation measures on the use of strontium ranelate in Europe: a multi-national cohort study in 5 EU countries by the EU-ADR Alliance.

The original version of this article, published on 26 November 2019 contained a mistake.

Impact of risk minimisation measures on the use of strontium ranelate in Europe: a multi-national cohort study in 5 EU countries by the EU-ADR Alliance.

INTRODUCTION: In May 2013 and March 2014, the European Medicines Agency (EMA) issued two decisions restricting the use of strontium ranelate (SR). These risk minimisation measures (RMM) introduced new contraindications and limited the indications of SR therapy. The EMA required an assessment of the impact of RMMs on the use of SR in Europe. Methods design: multi-national, multi-database cohort Setting: electronic medical record databases based on hospital (Denmark) and primary care provenance (Italy, Spain, the Netherlands, UK). PARTICIPANTS: the database source populations were included for population-based analyses, and SR users for patient-level analyses. INTERVENTION: New RMMs included contraindications (ischaemic heart disease, peripheral arterial disease, cerebrovascular disease, uncontrolled hypertension) and restricted SR indication to severe osteoporosis with initiation by experienced physician and not as first line anti-osteoporosis therapy. METHODS: Prevalence and incidence rates of SR use in the population; prevalence of contraindications and restricted indications in SR users, plus 1-year therapy persistence. Drug use measures were calculated in three periods for comparison: reference (2004 to May 2013), transition (June 2013 to March 2014) and assessment (from April 2014 to end 2016). RESULTS: The study population included 143 million person-years(PY) of follow-up and 76,141 incident episodes of SR treatment. Average monthly prevalence rates of SR use dropped by 86.4% from 62.6/10,000 PY (95 CI 62.4-62.9) in the reference to 8.5 (8.5-8.6) in the assessment period. Similarly, the incidence rate of SR use fell by 97.3% from 7.4/10,000 PY (7.4-7.4) to 0.2 (0.2-0.2) between the reference and assessment period. The prevalence of any contraindication decreased, whilst the prevalence of restricted indications increased in these periods. One-year persistence decreased in the assessment compared with reference period. CONCLUSIONS: Our study demonstrates a substantial impact of the regulatory action to restrict use of SR in Europe: SR utilisation overall decreased strongly. The proportion of patients fulfilling the restricted indications, without contraindications, increased after the proposed RMMs.

Synchronization of time of ovarian follicular development in llamas (Lama glama) using a protocol based on GnRH and PGF2α.

The aim of this study was to evaluate the effectiveness of a protocol based on GnRH and PGF2α to synchronize the emergence of a new wave of ovarian follicular development in llamas and, therefore, when a new dominant follicle develops. Llamas (n = 18) were assigned to growing, mature or regressing follicle groups according to the phase of the follicular wave at the beginning of treatment. The protocol was initiated with a GnRH analogue (GnRHa) injection on Day 0 followed 7 days later with a d-cloprostenol injection and a second GnRHa injection on Day 10. Ovulation rate after the first GnRHa treatment, day of new follicle emergence, mean plasma progesterone concentration and percentage of animals with a newly developed dominant follicle ≥ 7 mm on Day 10 were evaluated. Ovulation rate after the first GnRHa was less in the regressing than mature and growing follicle groups and new follicular wave emergence occurred earlier in the regressing follicle group than in the other two groups. Mean plasma progesterone concentration in females that had ovulations after the first GnRHa injection was similar. The percentage of animals that had a new follicle ≥ 7 mm on Day 10 was not different among groups and the overall percentage was 66.6%. The total synchronization rate for development of a new wave of follicular development on Day 10 was greater in females having ovulations after the first GnRHa injection than in those that did not have ovulations. In conclusion, the protocol used in the present study was useful for synchronizing ovarian follicular development in 66% of the llamas regardless of the phase of the follicular wave development at the beginning of treatment.

Changes in extra-virgin olive oil added with Lycium barbarum L. carotenoids during frying: Chemical analyses and metabolomic approach.

In this work, an Italian extra-virgin olive oil (EVOO) sample and the same sample added with a carotenoid-rich nutraceutical extract from Lycium barbarum L. (EVOOCar) were subjected to a frying process to comparatively assess chemical and physical changes and heat stability. Oxidation progress was monitored by measuring oil quality changes such as peroxide value, free acidity, K232, K268, and fatty acid composition as well as minor compound content, phenols, α-tocopherol, and carotenoids. An UHPLC/QTOF-MS metabolomics approach discriminated the two oil samples based on their chemical changes during frying, identifying also the phenolic classes most exposed to statistically significant variations. Partial least square discriminant analysis and volcano analysis were applied together to identify the most significant markers allowing group separation. The decrease in total phenolic content was lower in EVOOCar than in EVOO during frying. Monounsaturated and polyunsaturated fatty acids showed a significant percentage loss, 3.7% and 17.2%, respectively, in EVOO after 180min frying at 180°C, while they remained constant or slightly changed in EVOOCar. Zeaxanthin added to the oil rapidly decreased during the frying process. These findings showed that the addition of a carotenoid extract from L. barbarum can help to improve the oxidative stability of extra-virgin olive oil.

First case of Mycobacterium marseillense lymphadenitis in a child.

BACKGROUND: Nontuberculous mycobacteria (NTM) are pathogens that commonly affect the paediatric population and its most frequent manifestation is a cervicofacial lymphadenopathy. With the improvement of technologies, new species have been recently identified. CASE PRESENTATION: We report the first case of NMT lymphadenitis in a child caused by Mycobacterium marseillense, a newly described species belonging to Mycobacterium avium complex. CONCLUSIONS: Improving the identification of these newly discovered mycobacteria, further information will be available about their clinical involvement and their best treatment.

Non-tuberculous mycobacteria: epidemiological pattern in a reference laboratory and risk factors associated with pulmonary disease.

The diseases caused by non-tuberculous mycobacteria (NTM), in both AIDS and non-AIDS populations, are increasingly recognized worldwide. Although the American Thoracic Society published the guidelines for diagnosis of NTM pulmonary disease (NTM-PD), the diagnosis is still difficult. In the first part of the study, we collected data on NTM isolates in the Mycobacteriology Laboratory of Careggi Hospital (Florence, Italy) and analysed the epidemiological data of NTM isolates. Then, to analyse the risk factors associated to NTM-PD, we studied the presence of ATS/IDSA criteria for NTM-PD in patients who had at least one positive respiratory sample for NTM and were admitted to the Infectious Disease Unit and the Section of Respiratory Medicine. We selected 88 patients with available full clinical data and, according to ATS/IDSA criteria, classified 15 patients (17%) as NTM-PD cases and 73 as colonized patients (83%). When comparing colonized and NTM-PD patients we did not find significant differences of age, gender and comorbidity. We observed that Mycobacterium avium and M. intracellulare were statistically associated with NTM-PD (P = 0·001) whereas M. xenopi was statistically associated with colonization. Although the number of studied patients is limited, our study did not identify risk factors for NTM-PD that could help clinicians to discriminate between colonization and disease. We underline the need of close monitoring of NTM-infected patients until the diagnosis is reasonably excluded. Further larger prospective studies and new biological markers are needed to identify new useful tools for the diagnosis of NTM-PD.

Authentication of Coffea arabica according to Triacylglycerol Stereospecific Composition.

Stereospecific analysis is an important tool for the characterization of lipid fraction of food products. In the present research, an approach to characterize arabica and robusta varieties by structural analysis of the triacylglycerol (TAG) fraction is reported. The lipids were Soxhlet extracted from ground roasted coffee beans with petroleum ether, and the fatty acids (FA) were determined as their corresponding methyl esters. The results of a chemical-enzymatic-chromatographic method were elaborated by a chemometric procedure, Linear Discriminant Analysis (LDA). According to the total and intrapositional FA composition of TAG fraction, the obtained results were able to characterize roasted pure coffee samples and coffee mixtures with 10% robusta coffee added to arabica coffee. Totally correct classified samples were obtained when the TAG stereospecific results of the considered coffee mixture (90 : 10 arabica/robusta) were elaborated by LDA procedure.

Risk of prostate cancer in low-dose aspirin users: A retrospective cohort study.

A growing body of evidence indicates that use of low-dose aspirin (LDA) reduces the risk of certain adenocarcinomas. While there are several and consistent findings on the protective effect of LDA on colorectal and other cancers, few and conflicting evidence is available on prostate cancer (PCa). The aim of this study was to assess whether LDA reduces the incidence rate of PCa. We conducted a nationwide, population-based, retrospective cohort study by using Health Search IMS Health Longitudinal Patient Database (HSD). Patients with ischemic cardio- or cerebrovascular disease (index date) were identified. Time-dependent multivariable Cox proportional hazard models were adopted to estimate Hazard Ratios (HRs) and related 95% confidence intervals (95% CI) of PCa associated with use of LDA. The exposure was lagged by one year to consider the latency of drug effect on the outcome onset. Within a cohort 13,453 patients, the overall incidence rate of PCa was 2.5 per 1,000 person-years. Use of LDA was associated with a decreased incidence rate of PCa (HR = 0.64; 95% CI: 0.48-0.86), which was primarily driven by a frequency of LDA use equal to or higher than twice per week (HR = 0.60; 95% CI: 0.43-0.83). Such an association was more pronounced (HR = 0.43; 95% CI: 0.21-0.91) when LDA was used for five or more years. Our findings indicate that LDA use might be associated with a reduction of risk of PCa in patients with cardio- or cerebrovascular diseases.

Carbon-Nanohorn Based Nanofluids for a Direct Absorption Solar Collector for Civil Application.

Direct solar absorption has been often considered in the past as a possible solution for solar thermal collectors for residential and small commercial applications. A direct absorption could indeed improve the performance of solar collectors by skipping one step of the heat transfer mechanism in standard devices and having a more convenient temperature distribution inside the collector. Classical solar thermal collectors have a metal sheet as absorber, designed such that water has the minimum temperature in each transversal section, in order to collect as much solar thermal energy as possible. On the other hand, in a direct configuration, the hottest part of the system is the operating fluid and this allows to have a more efficient conversion. Nanofluids, i.e., fluids with a suspension of nanoparticles, such as carbon nanohorns, could be a good and innovative family of absorbing fluids owing to their higher absorption coefficient compared to the base fluid and stability under moderate temperature gradients. Moreover, carbon nanohorns offer the remarkable advantage of a reduced toxicity over other carbon nanoparticles. In this work, a three-dimensional model of the absorption phenomena in nanofluids within a cylindrical tube is coupled with a computational fluid dynamics (CFD) analysis of the flow and temperature field. Measured optical properties of nanofluids at different concentrations have been implemented in the model. Heat losses due to conduction, convection and radiation at the boundaries are considered as well.

Oxidative modifications of conjugated and unconjugated linoleic acid during heating.

The oxidative stability of conjugated linoleic (CLA) and linoleic (LA) acids in different chemical forms (free acids, methyl esters and homogeneous triacylglycerols) was compared. All model systems were heated at 180°C for different times (15, 30, 45 and 60min). The primary oxidation products were evaluated by spectrophometric analysis, while the volatile compounds were determined by solid phase micro-extraction (SPME), coupled with gas chromatography-mass spectrometry (HRGC-MS). The isomer profile modifications were investigated by silver-ion high performance liquid chromatography (Ag(+)-HPLC) equipped with an UV detector. Generally, peroxide values decreased during the heating time. Among the volatiles, saturated aldehydes were the most represented compounds. Isomerization of cis,trans and trans,cis CLA to trans,trans isomers was observed mainly for the methyl form of CLA. The three different chemical forms of LA never showed isomerization phenomena.

Use and treatment modalities for SSRI and SNRI antidepressants in Italy during the period 2003-2009.

OBJECTIVES: This drug utilization study aims to evaluate the incidence and prevalence of prescribed antidepressants (SSRIs or SNRIs) and to describe treatment modalities in Italy during the period 2003-2009. METHODS: This retrospective analysis on the prescription and treatment modalities of SSRIs or SNRIs is based on an Italian general practice database, which includes data on about 1,000,000 patients. Eligible patients should have age≥18 years, and ≥1 year of clinical history. Prevalence, incidence of use and adherence were calculated for SSRIs and SNRIs and for the individual agents. RESULTS: The prevalence of SSRI use increased from 7.5% (2003) to 13.1% (2009) while the prevalence of SNRI use increased from 0.8% to 2.5%. The most evident increase was reported for escitalopram (+2.78%). The number of new antidepressant users (incidence rate) showed a modest decrease for SSRIs (-0.3%) and a slight increase for SNRIs (+0.9%). A higher percentage of continuers was reported for SSRIs versus SNRIs (15.1% vs 13.0%). Escitalopram was associated with the highest percentage of continuers and with the highest number of days of uninterrupted treatment. Overall, over 10% of antidepressant users switched their first choice during one year of follow-up. Escitalopram was associated with the highest frequency of 'high' adherers (28.5%). CONCLUSIONS: SSRIs may be regarded as the elective treatment for depression. Of the SSRIs, escitalopram seems to be associated with the highest number of days of uninterrupted treatment, the lowest proportion of switchers and the highest adherence. This consideration might have practical relevance when comparing escitalopram to other SSRIs and to venlafaxine and duloxetine.

Assessing 5-year incidence rates and determinants of osteoporotic fractures in primary care.

PURPOSE: To assess the gender and age-related 5-year incidence rates of osteoporotic fractures, and their related predictors, in a primary care setting. METHODS: We obtained information from the Health Search-CSD Longitudinal Patients Database (HSD). This is an Italian General Practice data repository which comprises information given by computer-based patient records of a selected group of over 900 Primary Care Physicians (PCPs). We selected all patients aged 50 to 85 years, who were actively included into the PCP's list at the beginning of the enrolment period (1st January 2002-31st December 2003). We excluded individuals who were registered in the PCPs' list for less than 1 year before the entry date (Index date) into the cohort, as well as those who were diagnosed with Paget disease or malignant neoplasm. Participants were followed up until the occurrence of osteoporotic fracture, one of the exclusion criteria, or the end of the study period. RESULTS: The 5-year rates (per 1000 person-years) of any osteoporotic fracture were 11.56 (95% C.I. 11.33 to 11.77) among females, and 4.91 (95% C.I. 4.75 to 5.07) among males. For hip fractures, the overall incidence rates were 3.23 (95% C.I. 3.11 to 3.34) among females and 1.21 (95% C.I. 1.12 to 1.28) among males, respectively. Advanced age, history of fracture, use of corticosteroids, rheumatoid arthritis, BMI<=20, presence of osteoporosis, gastrointestinal and chronic hepatic disease, depression, chronic obstructive pulmonary disease, use of anticonvulsants and a higher number of co-medications, increased the risk of any osteoporotic fractures. CONCLUSIONS: The use of primary care data confirms a higher incidence of osteoporotic fractures among females vs. males as well as in older individuals. Predictors of osteoporotic fractures were consistent with FRAX® algorithm. Given the clinical utility of a simple score for the assessment of absolute fracture risk among osteoporotic patients, its assessment and validation in the Italian HSD could potentially provide an applicable prediction tool.

Improved HRGC separation of cis, trans CLA isomers as Diels-Alder adducts of alkyl esters.

This paper reports the separation of four isomers of conjugated linoleic acid (CLA), c,t/t,c-8,10; c,t/t,c-9,11; c,t/t,c-10,12; c,t/t,c-11,13, after reaction of esterification with aliphatic alcohols of different chain length and adduct formation with 4-methyl-1,2,4-triazoline-3,5-dione (MTAD). The high resolution gas chromatographic analyses were carried out using a simple 50-m cyanopropyl polysiloxane capillary column both with a flame ionization detector and a mass spectrometer. The resolution between the two pair of isomers: c,t/t,c-9,11 and c,t/t,c-10,12 and between c,t/t,c-10,12 and c,t/t,c-11,13 isomers were good for all the investigated alkyl esters and increased with the chain length of alcohol esterified to carboxylic moiety of CLA isomers. The most interesting result was relative to the c,t/t,c-8,10 and c,t/t,c-9,11 isomers, critical pair of isomers also when analyzed with a 120-m cyanopropyl polysiloxane capillary column; their resolution also increased from methyl to hexyl esters of CLA isomers and reached an acceptable value (0.8) in the case of hexyl esters. The best resolutions of the four considered CLA isomers were obtained with the hexyl esters of MTAD adducts of the isomers, without excessive analysis time. This method was useful and simple to evaluate the profile of the four main c,t isomers in commercial CLA samples.

Real time monitoring of alcoholic fermentation with low-cost amperometric biosensors.

Screen-printed glucose, ethanol and fructose biosensors, coupled with portable instrumentation, and their application to monitor micro-alcoholic fermentations (micro-ALFs) in red wine is described. For the fabrication of glucose and ethanol biosensors, graphite screen-printed sensors modified with Prussian Blue were coupled with oxidase enzymes while for the fructose biosensor, a bare screen-printed sensor was coated with fructose dehydrogenase and phenazine methansulphate was used as electrochemical mediator. The working range, reproducibility of probe fabrication and biosensor stability were all evaluated. After a recovery study, performed analysing fortified must-wine samples, the biosensors were employed to monitor micro-ALFs induced by the inoculation of two different strains of Saccharomyces cerevisiae. During the red micro-ALFs, samples of must-wine were collected and analysed by use of both biosensors and spectrophotometric kits. The data obtained demonstrated that a biosensor-based system could represent a useful tool to assist winemakers during wine production.

Pain knowledge among doctors and nurses: a survey of 4912 healthcare providers in Tuscany.

BACKGROUND: The purpose of this investigation was to get an overview of the understanding of doctors and nurses on pain experienced by patients in the hospitals of Tuscany in order to plan education in the weakest areas. METHODS: A questionnaire was distributed to assess the knowledge of pain: it included 13 questions intended for 3631 nurses and 1281 doctors throughout all the hospitals and sanitary concerns in Tuscany. The total percentage of right answers corresponded to 70.2% with a variability among questions ranging between 30.5% and 95.6%. RESULTS: There is a statistically significant difference between the mean number of correct answers of doctors (9.57/13) and nurses (8.87/13). For doctors working in critical areas, the mean is statistically significant in comparison with other areas. For nurses, those working in the surgical and critical areas show a statistically significant difference in comparison to the nurses of the general practice and other areas. CONCLUSION: The data show that general knowledge of patient pain is good (86.5%), but that great gaps exist in the field of opiates (51.4%). Thus, education should focus on this area, as well as on prejudices concerning pain reported from 50.9% of healthcare providers.

HPLC separation and NMR structural elucidation of sn-1,2-, 2,3-, and 1,3-diacylglycerols from olive oil as naphthylethylurethane derivatives.

In this study, sn-1,2-, sn-2,3-, and sn-1,3-diacylglycerols were isolated from olive oil, and their urethane derivatives (urethanes) were prepared. Normal-phase high-performance liquid chromatography (NP-HPLC) separation of the urethane isomers was performed and the separate classes were studied by nuclear magnetic resonance (NMR). The use of 1H NMR and homo- and heteronuclear 2D techniques provided a great amount of information in a very short time, particularly when a high-field NMR instrument (700 MHz) was used. Particularly diagnostic for this kind of compound was the glyceridic moiety that presents typical chemical shifts both for carbon and hydrogen. These studies show the usefulness of NMR spectroscopy to recognize clearly the sn-1,3- and, moreover, sn-1,2- with respect to sn-2,3-diacylglycerols, although very minor differences occur between them.

Endothelial cell function on 2D and 3D micro-fabricated polymer scaffolds: applications in cardiovascular tissue engineering.

Polymeric structures of a polylactide-polycaprolactone blend were micro-fabricated using the Pressure Assisted Microsyringe (PAM) system. Human umbilical vein endothelial cells were cultured on the scaffolds, and apoptosis, cell adhesion, proliferation and metabolism were evaluated. In addition, more specific indicators of endothelial cell function, namely nitric oxide and endothelin production, were also assessed. Thin films of the blend, as well as gelatine-coated glass slides (as controls) were used. The results show that as far as adhesion, apoptosis and metabolism are concerned, the scaffolds do not interfere with cell function compared with gelatin controls. However, the nitric oxide/endothelin ratio was higher than that observed on the gelatin films, suggesting that the scaffolds could be used for engineering small diameter blood vessels without risk of occlusion.

Biocatalyzed acidolysis of soybean oil triacylglycerols to increase oleic acid content.

Lipase catalyzed acidolysis of triacylglycerols (TAG) of soybean oil with oleic acid in organic solvent was studied; immobilized lipase from Rhizomucor miehei was used and the effects of reaction time, incubation temperature and enzyme load on TAG total and positional fatty acid (FA) percentage compositions were investigated. The results show that oleic acid incorporation was high after 24 and 48 h, while after 72 h a lower level of oleic acid in TAG was observed. Moreover, for the reactions carried out at 30 and 40 degrees C, it was observed that the oleic acid level was about 46.5% while ligtly higher values (about 49%) were observed at 50 degrees C; however, under this last condition, the modification of sn-2 position FA composition was higher. Finally, the variable enzyme load resulted also important on the incorporation of oleic acid; in particular, even if the value of 10% (w/w) of enzyme load resulted in a lightly lower incorporation of oleic acid in soybean oil TAG (about 45%), in this situation a minimal modification of sn-2 position FA composition was obtained.