A simple foot pedal device in a horizontal bore imaging facility replicates weightbearing outcomes for Hallux Valgus patients.

BACKGROUND: Weightbearing images are important to the diagnosis of foot pathologies as are the three dimensional views available from CT and MRI. Standard three-dimensional imaging hardware, however, does not have a simple tool to obtain weightbearing images. The current research aimed to design, build and test a simple device to apply load in a horizontal bore imaging facility. METHODS: With the immediate need in hallux valgus studies, hallux valgus subjects were imaged using the new loading device, which could be easily transported and had no additional electronics. RESULTS: Testing showed that the usual angular measures of the foot (intermetatarsal and hallux valgus) replicated the results from the standard of care standing plain film results. With application of load, HV angle changed from 29.9° non-weightbearing to 32.2° weightbearing, while IM angle changed from nonweightbearing 15.8° to weightbearing 16.5°. CONCLUSION: The pedal-like device can provide weightbearing images in a horizontal bore MRI facility.

Landau-Type Theory of Planar Crystal Plasticity.

We show that nonlinear continuum elasticity can be effective in modeling plastic flows in crystals if it is viewed as a Landau theory with an infinite number of equivalent energy wells whose configuration is dictated by the symmetry group GL(2,Z). Quasistatic loading can be then handled by athermal dynamics, while lattice-based discretization can play the role of regularization. As a proof of principle, we study dislocation nucleation in a homogeneously sheared 2D crystal and show that the global tensorial invariance of the elastic energy foments the development of complexity in the configuration of collectively nucleating defects. A crucial role in this process is played by the unstable higher symmetry crystallographic phases, typically thought to be unrelated to plastic flow.

Multicomponent Electron-Hole Superfluidity and the BCS-BEC Crossover in Double Bilayer Graphene.

Superfluidity in coupled electron-hole sheets of bilayer graphene is predicted here to be multicomponent because of the conduction and valence bands. We investigate the superfluid crossover properties as functions of the tunable carrier densities and the tunable energy band gap E_{g}. For small band gaps there is a significant boost in the two superfluid gaps, but the interaction-driven excitations from the valence to the conduction band can weaken the superfluidity, even blocking the system from entering the Bose-Einstein condensate (BEC) regime at low densities. At a given larger density, a band gap E_{g}∼80-120 meV can carry the system into the strong-pairing multiband BCS-BEC crossover regime, the optimal range for realization of high-T_{c} superfluidity.

An unanticipated role for survivin in organ transplant damage.

Ischemia/reperfusion (I/R) injury is a major determinant of graft survival in kidney transplantation. Survivin, an inhibitor of apoptosis that participates in the control of mitosis and cell cycle progression, has been implicated in renal protection and repair after I/R injury; however, no study has been performed in the transplant setting. We investigated the role of survivin in modulating posttransplant I/R injury in syngeneic and allogeneic kidney grafts, and studied whether protection from I/R injury impacted on the recipient immune system, on chronic allograft nephropathy and rejection. We used genetically engineered mice with survivin haploinsufficiency and WT mice in which survivin over-expression was induced by gene-delivery. Survivin haploinsufficiency in syngeneic grafts was associated with exuberant I/R tissue injury, which triggered inflammation eventually resulting in graft loss. Conversely, survivin over-expression in the grafts minimized I/R injury and dysfunction in syngeneic grafts and in a clinically relevant fully MHC-mismatched allogeneic combination. In the latter, survivin over-expression translated into limited anti-donor adaptive immune response and less long-term allograft injury with protection from renal parenchymal damage. Our data support survivin over-expression in the graft as a novel target for protocols aimed at limiting tissue damage at the time of transplant ultimately modulating the recipient immune system.

The risk of transfusion-transmitted HIV from blood donations of men who have sex with men, 12 months after last sex with a man: 2005-2007 estimates from England and Wales.

The risk of transfusion-transmitted HIV infection under (i) permanent exclusion and (ii) 12-month deferral of MSM in England and Wales during 2005-2007 was estimated. Assuming equal compliance with both scenarios, estimated risk under a 12-month deferral (0.228/million donations [range 0·168-0·306/million donations]) was only marginally greater (0·5%) than that under lifetime exclusion (0·227/million donations [range 0·157-0.318/million donations]), with one extra-HIV infectious donation every 455 years. Poorer compliance of MSM with a 12-month deferral would be expected to increase the estimated risk, whereas improved compliance could decrease risk by up to 29·1%.

[Cancer risk among shift workers: a review]. / Rischio oncogeno nei lavoratori a turni: analisi della letteratura.

INTRODUCTION: According to IARC, shift work resulting in disruption of circadian rhythm is a probable human carcinogen (Group 2A). METHODS: We examined the scientific literature on the carcinogenic risk among shift workers for risk assessment purposes. RESULTS: Clock genes polymorphisms might contribute with suppression of melatonin synthesis, immuno-suppression from sleep deprivation, individual habits associated with shift work, and low vitamin D levels, in increasing risk of breast cancer, prostate cancer and lymphoma among shift workers. CONCLUSION: Although the epidemiological evidence seems scanty, the hypothesis that shift work-related sleep deprivation would contribute to increasing cancer risk seems based on solid ground.

[Hepatitis B vaccination coverage and booster dose: results from a survey on healthcare students]. / Copertura vaccinale anti-epatite B e dose di rinforzo: risultati di uno studio su una popolazione universitaria.

This study assessed the immunisation status against hepatitis B in healthcare students and residents, before their hospital internship, as suggested by the "National Immunization Prevention Plan 2012-2014". The concentration of antibodies against hepatitis B was measured in 2,491 subjects (70.90% women), born between 1980 and 1993 and visited between January 1st 2000 and July 15th 2012. Personal and serologic data were collected for each subjects. Individuals with antibody less than 10 mIU/mL (327, 13.3%) were given a booster dose and re-tested 2 months later. The multivariate logistic regression evidenced that immunization is influenced by the gender, the age at first vaccination, the time elapsed between first vaccination and antibody measurement. This study confirms the importance of measuring the concentration of antibodies against hepatitis B among healthcare students, even if they have previously been vaccinated, according to the "National Immunization Prevention Plan 2012-2014".

Neonatal mouse immunity against group B streptococcal infection by maternal vaccination with recombinant anti-idiotypes.

We investigated whether immunization with recombinant anti-idiotypic antibody fragments mimicking the conformation of the capsular antigen can protect against infection by group B streptococcus, an important neonatal pathogen. Single-chain fragment-variable anti-idiotypes competed with the type III carbohydrate for binding to type-specific antibodies and elicited, in mice, the production of protective immunoglobulins reacting against the type III polysaccharide. Moreover, maternal immunization with soluble or phage-displayed fragments protected neonatal mice against streptococcal infection. These data indicate that recombinant anti-idiotypic antibodies may be useful in developing protein images of relevant carbohydrate epitopes and, ultimately, in preventing infections by encapsulated bacteria.

[The use of municipality-level data on mortality in Italy: SENTIERI Project]. / L'utilizzo dei dati di mortalità a livello comunale in Italia: Progetto SENTIERI.

In Italy, complete municipality-level data on specific-cause mortality have been available at central level since 1980; Italy's National Institute of Statistics (Istat) collects data from all municipalities using two sources: i) the Office of Vital Statistics; and ii) the Civil Status Office. The Office of Vital Statistics records data on events such as births, deaths and migration for the population with official residence in the municipality, with the aim of describing the resident population's structure and composition. The Civil Status Office records data on the demographic dynamics (not only marital status but also causes of death); the data refer to the population living in the municipality, independently of official residence. Changes in the status of a municipality (e.g., the creation of a new municipality or the unification of diverse municipalities) are often not recorded simultaneously by these two offices, so that the data do not correspond.

[Methods for mortality analysis in SENTIERI Project]. / Materiali e metodi dell'analisi della mortalità nel Progetto SENTIERI.

The methods of mortality analysis in Italian polluted sites (IPS) are described. The study concerned 44 IPSs; each one included one or more municipalities. Mortality at municipality level was studied in the period 1995-2002, using the following indicators: crude rate, standardized rate, standardized mortality ratio (SMR), and SMR adjusted for an ad hoc deprivation index. Regional populations were used as reference for indirect standardization. The deprivation index was constructed using the 2001 national census variables representing the following socioeconomic domains: education, unemployment, dwelling ownership, overcrowding. Mortality indicators were computed for 63 single or grouped causes. The results for all the 63 analysed causes of death are available for each IPS, and in this Chapter the results for each IPS for causes selected on the basis of a priori evidence of risk from local sources of environmental pollution are presented. The procedures and results of the evidence evaluation have been published in the 2010 Supplement of Epidemiology & Prevention devoted to SENTIERI.

[SENTIERI Project: rationale and objectives]. / Razionale e obiettivi del Progetto SENTIERI.

SENTIERI Project (Mortality study of residents in Italian polluted sites) studied mortality of residents in the sites of national interest for environmental remediation (Italian polluted sites--IPSs). IPSs are in proximity of either active or dismissed industrial areas, near dumping sites of industrial and hazardous waste or incinerators. SENTIERI Project described and evaluated the mortality of the populations residing in IPSs and it specifically focused on causes of death for which environmental exposure is suspected or ascertained to play an etiologic role. The epidemiological evidence of the causal association was classified a priori into one of these three categories: Sufficient (S), Limited (L) and Inadequate (I). The study results will allow the priorities setting in remediation intervention, so as to prevent adverse health effects from environmental exposure. At the time of 2001 Census, about 10%of Italian population resided in the 44 IPSs included in SENTIERI; the mortality analysis was carried out for the years 1995-2002 for 63 causes of death. The study results for the 44 IPSs are here commented and read on the basis the a priori evaluation of the epidemiological evidence in terms of strength of the causal association, and taking into account the limits of a geographic study design and its implied complexities. The procedures and results of the evidence evaluation have been presented in a 2010 Supplement of Epidemiology & Prevention devoted to SENTIERI.

[SENTIERI Project: discussion and conclusions]. / Progetto SENTIERI: discussione e conclusioni.

SENTIERI Project is the first comprehensive study of the health impact of residence in Italian polluted sites (IPSs). The present Chapter examines the main validity aspects of the present mortality investigation and the evaluation of causality of the observed associations; in addition, some recommendations for public health intervention and research priorities in epidemiological studies on environment and health are given. Exposure ascertainment is a key aspect when an ecological study design is adopted in environmental epidemiology, therefore any exposure potentially affecting the population at study should be described in detail. This is here discussed. SENTIERI is an ecological study, based on a priori hypotheses, in which each IPS's types of exposure were described with specific attention to human exposure. Though, when commenting the results, the problem of concurrent air pollution exposure and/or industrial activities implying occupational risk, if present in the IPSs, was taken into account. Socioeconomic status is a determinant of health and disease, therefore in SENTIERI the Standardized Mortality Ratios were computed both crude and adjusted for an ad hoc deprivation index. About 60% versus an expected 40% of IPSs residents are in the two most deprived quintiles of the index. This hints to a possible problem of environmental justice that should be taken into account when planning remediation intervention. The mortality results here presented are a first step in the epidemiological IPSs' characterization, and some developments have been made or planned. Firstly, a mortality analysis was performed combining mortality data in IPSs presenting similar pollution, i.e. asbestos, or industrial hazardous wastes or dumping sites; secondly, the mortality analysis will be extended beyond 2002, namely the year when ICD X started to be in use in Italy. In addition, disease prevalence will be investigated using hospital discharge records; cancer incidence and congenital anomalies incidence will be studied in IPSs in which a Cancer Register or a Congenital Anomalies Register are active. The above described activities will lead to a more valid estimate of the disease burden of IPSs residents, and allow to identify priorities of remediation activities. The method adopted in SENTIERI, specifically the ecological design and the use of mortality data at municipal level, in general does not grant the evaluation of the causal association between environmental exposure and adverse health effects. However, it allows etiological observations that make unacceptable the delay of remediation intervention.

[EMG and forces during manoeuvring of ceiling-based and floor-based patient transfer devices]. / EMG e forze applicate durante l'utilizzo dei sollevatori per pazienti di tipo carrellato e a soffitto.

A laboratory and on-the-field study was conducted to compare Floor-Based (FB) and Ceiling-Based (CB) patients transfer devices. Pushing and pulling forces were measured by means of computer assisted dynamometer. EMG signals were measured. Standardized patient transfers were setup in the room (bed-chair-door-return). FB devices showed pushing and pulling forces higher than CB ones. CB paths were the smoothest and EMG data related to upper arms and trunk muscles showed stable lower loads for CB. The study suggests that CB patient transfer devices reduced the load. CBs seem the best tools for patient handling.

Combining robotics with enhanced serotonin-driven cortical plasticity improves post-stroke motor recovery.

Despite recent progresses in robotic rehabilitation technologies, their efficacy for post-stroke motor recovery is still limited. Such limitations might stem from the insufficient enhancement of plasticity mechanisms, crucial for functional recovery. Here, we designed a clinically relevant strategy that combines robotic rehabilitation with chemogenetic stimulation of serotonin release to boost plasticity. These two approaches acted synergistically to enhance post-stroke motor performance. Indeed, mice treated with our combined therapy showed substantial functional gains that persisted beyond the treatment period and generalized to non-trained tasks. Motor recovery was associated with a reduction in electrophysiological and neuroanatomical markers of GABAergic neurotransmission, suggesting disinhibition in perilesional areas. To unveil the translational potentialities of our approach, we specifically targeted the serotonin 1A receptor by delivering Buspirone, a clinically approved drug, in stroke mice undergoing robotic rehabilitation. Administration of Buspirone restored motor impairments similarly to what observed with chemogenetic stimulation, showing the immediate translational potential of this combined approach to significantly improve motor recovery after stroke.

The potential for a concerted system for the rapid monitoring of excess mortality throughout Europe.

We present the results of a survey conducted in the context of the project European Monitoring of Excess Mortality for Public Health Action (EuroMOMO), which is being conducted to develop a routine public health mortality monitoring system for the timely detection of excess deaths related to public health threats in Europe. The survey was conducted in 32 European countries using two questionnaires on: i) the existing and planned mortality monitoring systems, and ii) the routine collection of mortality data. Nine existing mortality monitoring systems were identified in seven countries (Belgium, Germany, France (two systems), Italy (two systems), Portugal, Spain, and Switzerland), as well as several systems that were in a pilot or planning state. Each system is described in detail. The results will be used for the subsequent phases of EuroMOMO, in particular for identifying the minimum requirements for the planned European system and for selecting countries to be included in the project's pilot phase.

Cause-specific mortality in classic Kaposi's sarcoma: a population-based study in Italy (1995-2002).

BACKGROUND: Little information is available on the causes of death among persons with classic Kaposi's sarcoma (CKS). METHODS: We conducted a population-based study in Italy to identify deceased persons with CKS and the underlying causes of death among them, by reviewing multiple-causes-of-death records. Standardised mortality ratios (SMRs) and 95% confidence intervals were calculated to compare the distribution of causes to that among the same-age general population of deceased persons. The geographical distribution was also evaluated. RESULTS: Of the 946 deaths among persons with CKS, 65.9% were attributable to non-neoplastic conditions and 21.9% to malignancies. For 12.2%, no lethal pathology was identified and CKS was considered as the underlying cause. In 90% of these cases, there was visceral/nodal involvement, therapy-related complications, or neoplastic cachexia. Among persons with CKS who died of other causes, an excess for lymphoid malignancies emerged (SMR=4.40) (chronic lymphocytic leukaemia (11.03), non-Hodgkin's lymphoma (4.22), Hodgkin's lymphoma (11.80), and multiple myeloma (2.3)), balanced by a deficit for all solid cancers (0.56), with a marked deficit for lung cancer (0.41). We found an excess for respiratory diseases (chronic obstructive pulmonary disease (1.86)) and genitourinary diseases (chronic renal failure (6.47)). There was marked geographical heterogeneity in the distribution of deaths. CONCLUSIONS: Though referring specifically to Italy, the results are informative for other countries and populations and all cases of CKS in general.

Antibodies as crypts of antiinfective and antitumor peptides.

Antibodies (Abs), often associated with antimicrobial and antitumor agents, have emerged as an important class of novel drugs for antigen-driven therapeutic purposes in diverse clinical settings, including oncology and infectious diseases. Abs commonly give rise in the treated host to anti-Ab responses, which may induce adverse reactions and limit their therapeutic efficacy. Their modular domain architecture has been exploited to generate alternative reduced formats (Fabs, scFvs, dAbs, minibodies, multibodies), essentially devoid of the Fc region. The presence of complementarity determining regions (CDRs) ensures the maintenance of selective binding to antigens and supports their use for biotechnological and therapeutic applications. Paradigmatic Abs mimicking the wide-spectrum antimicrobial activity of a yeast killer toxin (killer Abs) have revealed the existence of a family of Abs exerting a direct in vitro and/or in vivo microbicidal activity. Based on the variable sequence of an antiidiotypic recombinant killer Ab, CDR-related peptides have been synthesized, engineered by alanine-scanning and selected according to antimicrobial, antiviral and immunomodulatory properties. Irrespective of the native Ab specificity, synthetic CDRs from unrelated murine and human monoclonal Abs, have shown to display differential in vitro, in vivo and/or ex vivo antifungal (Candida albicans), antiviral (HIV-1) and antitumor (melanoma cells) activities. Alanine substitution of single residues of synthetic CDR peptides resulted in further differential increased/unaltered/decreased biological activity. The intriguing potential of Abs as source of antiinfective and antitumor therapeutics will be discussed, in light of recent advances in peptide design, stability and delivery.

Granules associated with the chloroplast lamellae of Porphyridium cruentum.

Small granules with a diameter of approximately 350 A are attached to the chloroplast lamellae of the red alga Porphyridium cruentum. To some extent, their size depends on the culture conditions and the age of the cell. It was possible to preserve the granules only with aldehyde prefixation. It can be seen that fixed or negatively stained granules are comprised of smaller subunits. The granules are arranged regularly on the lamellae in repeating rows with a center-to-center granule distance of 400 to 500 A. Attempts at characterization of these chloroplast granules revealed that they are resistant to hydrolysis by ribonuclease and appear to be structurally unaffected by methanol-acetone extraction. Because of their close association with the chloroplast lamellae, they are considered as possible sites of phycobilin concentration. This possibility is supported by two observations: when the phycobilins are removed, the granules disappear; and, when the chlorophyll and stainable membrane portions are selectively removed, the phycobilins and granules are still present. It was found that all other marine red algae examined had granules which were associated with the chloroplast lamellae.

A thermophilic, acidophilic mycoplasma isolated from a coal refuse pile.

A thermophilic, acidophilic procaryote lacking a cell wall has been isolated from a coal refuse pile which had undergone self-heating. Electron micrographs, chemical assays for hexosamine, and the inability of vancomycin to inhibit growth confirm the lack of a cell wall. The apparent ability of the organism to reproduce by budding and the low guanine plus cytosine content of its DNA indicate a relation to the mycoplasmas. The temperature optimum of the organism is 59 degrees C, and growth occurs over a range of 45 degrees to 62 degrees C. No growth occurs at 37 degrees C or at 65 degrees C. The optimum pH for growth is between 1 and 2, and growth occurs between pH 0.96 and 3.5 but does not occur at pH 0.35 and only poorly at pH 4.0. We propose to call this organism Thermoplasma acidophila. The existence of this organism extends considerably the range of habitats in which mycoplasma may occur.