Severe Streptococcus equi Subspecies zooepidemicus Outbreak from Unpasteurized Dairy Product Consumption, Italy.

During November 2021-May 2022, we identified 37 clinical cases of Streptococcus equi subspecies zooepidemicus infections in central Italy. Epidemiologic investigations and whole-genome sequencing showed unpasteurized fresh dairy products were the outbreak source. Early diagnosis by using sequencing technology prevented the spread of life-threatening S. equi subsp. zooepidemicus infections.

A cross-sectional research on female workers examining the loss of productivity caused by mild, moderate and severe fibromyalgia.

OBJECTIVES: To assess (a) the impacts of fibromyalgia (FM) symptoms on patients' ability to work and (b) the relationship between FM severity states and lost productivity from the perspective of patients. METHODS: FM female patients were retrospectively evaluated for this cross-sectional study. FM severity was determined using the revised Fibromyalgia Impact Questionnaire (FIQR). Work Productivity and Activity Impairment-Fibromyalgia (WPAI-FM) was used to evaluate patients' employment status. Differences across FM severity states were evaluated using the one-way analysis of variance (ANOVA) and chi-square or Fisher's exact test. The Pearson's r test was performed for the correlation analysis. RESULTS: The study included 209 subjects, 64 (30.6%) had mild, 64 (30.6%) had moderate, and 81 (38.8%) had severe FM; 57.9% were working full-time, and 42.1% were working part-time. According to WPAI-FM the work productivity and activity impairment resulted: absenteeism 7.03%; presenteeism 44.35%; activity impairment 47.24%; overall work productivity loss 58.23%. Disease severity was associated with decreased work productivity. Presenteeism, overall work productivity loss, and activity impairment demonstrated significant correlations with FIQR and PainDETECT Questionnaire. CONCLUSIONS: FM severity is associated to a reduced job productivity. Early identification and treatment of FM may provide a window of opportunity for job preservation.

Salvianolic Acid B Strikes Back: New Evidence in the Modulation of Expression and Activity of Matrix Metalloproteinase 9 in MDA-MB-231 Human Breast Cancer Cells.

Salvianolic acid B (SalB) is a bioactive compound from Salviae miltiorrhizae, one of the most important traditional herbal medicines widely used in several countries for the treatment of cardiovascular diseases. The aim of this study was to evaluate the in vitro effect of SalB on the expression and the activity of matrix metalloproteinase 9 (MMP-9), a zinc-dependent proteolytic enzyme, in human MDA-MB-231 breast cancer cells. This cellular model is characterized by a marked invasive phenotype, supported by a high constitutive expression of MMPs, especially gelatinases. SalB was first of all evaluated by in silico approaches primarily aimed at predicting the main pharmacokinetic parameters. The most favorable interaction between the natural compound and MMP-9 was instead tested by molecular docking analysis that was subsequently verified by an enzymatic inhibition assay. MDA-MB-231 cells were treated with SalB 5 µM and 50 µM for 24 h and 48 h. The conditioned media obtained from treated cells were then analyzed by gelatin zymography and reverse zymography to, respectively, evaluate the MMP-9 activity and the presence of TIMP-1. The expression of the enzyme was then evaluated by Western blot on conditioned media and by analysis of transcripts through reverse transcriptase-polymerase chain reaction (RT-PCR). The in silico approach showed the ability of SalB to interact with the catalytic zinc ion of the enzyme, with a plausible competitive mode of action. The analysis of conditioned culture media showed a reduction in MMP-9 activity and the concomitant decrease in the enzyme concentration, partially confirmed by analysis of transcripts. SalB showed the ability to modulate the function of MMP-9 in MDA-MB-231 cells. To our knowledge, this is the first time in which the role of SalB on MMP-9 in a highly invasive cellular model is investigated. The obtained results impose further and more specific evaluations in order to obtain a better understanding of the biochemical mechanisms that regulate the interaction between this natural compound and the MMP-9.

Development and Validation of a New Tool in Predicting In-Hospital Mortality for Hip-Fractured Patients: The PRIMOF Score.

Background and Objectives: The improved life expectancy was associated to the increased in the incidence of hip fractures among elderly people. Subjects suffering hip fractures frequently show concomitant conditions causing prolonged lengths of stay and higher in-hospital mortality. The knowledge of factors associated to in-hospital mortality or adverse events can help healthcare providers improve patients' outcomes and management. The aim of this study was to develop a score to predict in-hospital mortality among hip fractured patients. Materials and Methods: Cases were selected from hospital admissions that occurred during the period 2006-2015 in Abruzzo region, Italy. The study population was split into two random samples in order to evaluate the accuracy of prediction models. A multivariate logistic regression was performed in order to identify factors associated to in-hospital mortality. All diagnoses significantly associated to in-hospital mortality were included in the final model. Results: The PRIMOF ranged between 0 and 27 and was divided into four risk categories to allow the score interpretation. An increase in odds ratio values with the increase in PRIMOF score was reported in both study groups. Conclusions: This study showed that a simple score based on the patient' clinical comorbidities was able to stratify the risk of hip-fractured patients in terms of in-hospital mortality.

Stepwise endo-/epicardial catheter ablation for atrial fibrillation: The Mediterranea approach.

BACKGROUND: Outcomes of catheter ablation (CA) among patients with nonparoxysmal atrial fibrillation (AF) are largely disappointing. OBJECTIVE: We sought to evaluate the feasibility, effectiveness, and safety of a single-stage stepwise endo-/epicardial approach in patients with persistent/longstanding-persistent AF. METHODS: We enrolled 25 consecutive patients with symptomatic persistent (n = 4) or longstanding-persistent (n = 21) AF and at least one prior endocardial procedure, who underwent CA using an endo-/epicardial approach. Our anatomical stepwise protocol included multiple endocardial as well as epicardial (Bachmann's bundle [BB] and ligament of Marshall ablations) components, and entailed ablation of atrial tachycardias emerging during the procedure. The primary outcome was freedom from any AF/atrial tachycardia episode after a 3-month blanking period. The secondary outcome was patients' symptom status during follow-up. RESULTS: The stepwise endo-/epicardial approach allowed sinus rhythm restoration in 72% of patients, either directly (n = 6, 24%) or after AF organization into atrial tachycardia (n = 12, 48%). BB's ablation was commonly implicated in arrhythmia termination. After a median follow-up of 266 days (interquartile range, 96 days), survival free from AF/atrial tachycardia was 88%. Antiarrhythmic drugs could be discontinued in 22 patients (88%). As compared to baseline, more patients were asymptomatic at 9-month follow-up (0% vs. 56%, p = .02). Five patients (20%) developed mild medical complications, whereas one subject (4%) had severe kidney injury requiring dialysis. CONCLUSION: A single-stage endo-/epicardial CA resulted in favorable rhythm and symptom outcomes in a cohort of patients with symptomatic persistent/longstanding-persistent AF and one or more prior endocardial procedures. Epicardial ablation of BB was commonly implicated in procedural success.

Clustering of blood cell count abnormalities and future risk of death.

BACKGROUND: The identification of novel predictors of poor outcome may help stratify cardiovascular risk. Aim was to evaluate the individual contribution of blood cell count parameters, as well as their clustering, on the risk of death and cardiovascular events over the long term in the population-based Malmö Diet and Cancer Study cohort. METHODS: In 30,447 individuals (age 57 ± 8 years), we assessed the incidence of all-cause death (primary endpoint) and major adverse cardiovascular events (MACE, secondary outcome measure) according to absence or presence of one, two and three factors at baseline out of the following: anaemia, leukocytosis and thrombocytosis. Median follow-up was 16 years. RESULTS: The percentages of all-cause death were 19.5% in individuals without factors, 21.3% in those with one factor, 27.4% with two and 46.4% with three (log-rank test P < .001). The crude incidence of MACE was 28.0%, 29.2%, 35.5% and 57.1%, respectively (log-rank test P < .001). At multivariate analysis, we found a stepwise increase in overall mortality with increasing number of prevalent factors (one factor: HR 1.23, 95% CI 1.14-1.31, P < .001; two factors: 1.61, 1.37-1.89, P < .001; three factors: 2.69, 1.44-5.01, P = .002, vs no factor). Similar findings were observed for the incidence of MACE (one factor: adjusted HR 1.18, 95% CI 1.11-1.24, P < .001; two factors: 1.52, 1.33-1.76, P < .001; three factors: 2.03, 1.21-3.67, P < .001, vs no factor). CONCLUSIONS: The easily assessable clustering of anaemia, leukocytosis and thrombocytosis heralds higher incidence of death and adverse cardiovascular events.

The impact of gender on diabetes-related lower extremity amputations: An Italian regional analysis on trends and predictors.

BACKGROUND: Diabetes-related lower extremity amputations (LEAs) are a major public health issue. The aim of the study was to evaluate trends by gender and predictors of LEAs in an Italian region. METHODS: Data were collected from hospital discharge records between 2006 and 2015. Gender- and age-adjusted standardised hospitalisation rates for major and minor amputations were calculated. Poisson regression model was performed to estimate trends in LEAs. RESULTS: Hospitalisation rates decreased for minor amputations both among males (-30.0%) and females (-5.3%), while the major amputation rates decreased only for males (-44.7%). Males were at higher risk of undergoing major (IRR 1.41, 95%CI 1.19-1.67) and minor (IRR 1.62, 95%CI 1.45-1.82) amputations. Peripheral vascular disease was the leading predictor of major and minor amputations. CONCLUSION: A significant reduction of LEAs was observed only for males. Identifying their predictable factors may help caregivers to provide higher standards of diabetes care.

VITREOUS PROSTAGLANDIN E2 CHANGES AFTER TOPICAL ADMINISTRATION OF DICLOFENAC 0.1%, INDOMETHACIN 0.5%, NEPAFENAC 0.3%, AND BROMFENAC 0.09.

PURPOSE: To evaluate the vitreous concentration of different nonsteroidal anti-inflammatory drugs (NSAIDs) after topical administration and the related prostaglandin E2 (PGE2) levels in patients undergoing pars plana vitrectomy. METHODS: A prospective, randomized, investigator-masked study was performed. One hundred four patients scheduled for a pars plana vitrectomy for an epiretinal membrane or a macular hole were randomized to receive topical diclofenac 0.1%, indomethacin 0.5%, nepafenac 0.3%, bromfenac 0.09%, or placebo 3 days before surgery. At the beginning of surgery, a sample of undiluted vitreous was collected in each patient to assess NSAIDs concentration and PGE2 levels. RESULTS: The median vitreous concentrations were 203.35 (interquartile range 146.54-264.18) pg/mL for diclofenac, 243.45 (interquartile range 156.96-365.37) pg/mL for nepafenac, 438.21 pg/mL (interquartile range, 282.52-645.87) for its active metabolite amfenac, 350.14 (interquartile range, 290.88-481.95) pg/mL for indomethacin, and 274.59 (245.43-358.25) pg/mL for bromfenac. Vitreous PGE2 levels were significantly lower for all the NSAIDs groups compared with the control group (P < 0.001). A statistically significant higher vitreous PGE2 level was found in the diclofenac group compared with the other NSAIDs groups (P < 0.05). CONCLUSION: Topical NSAIDs achieve sufficient vitreous concentration to decrease vitreous PGE2 levels compared with the control group. The different efficacy in reducing PGE2 concentration may affect the management of posterior segment inflammation.

Dietary supplementation of Saanen goats with dried licorice root modifies chemical and textural properties of dairy products.

The aim of the present study was to evaluate the effect of dietary integration with dried licorice root on the chemical-nutritional qualities of goat milk and cheeses. The study was conducted for 60 d, during which 30 Saanen goats were divided into 2 groups: a control group (CG) that received a standard diet and an experimental group (LG+) whose diet was supplemented with licorice. At the end of the study, milk samples were collected to determine chemical-nutritional compositions and fatty acid (FA) profiles. Cheeses produced with CG and LG+ bulk milk were analyzed for chemical-physical parameters after 3 (T3) and 30 (T30) d of ripening. A different FA profile and a significant increase in protein and casein were observed in LG+ milk samples compared with CG milk. Regarding cheeses, an increase of proteins and fat was found in LG+ cheeses, which also were harder, more elastic, and more gummy than the CG samples after both 3 and 30 d of ripening. A different protein profile was detected in the 2 groups without significant variations in casein fractions (αS2-casein and ß-casein) during ripening. Moreover, greater oxidative stability was found in LG+ cheeses at both T3 and T30. Different families of volatile compounds were detected in T30 cheeses obtained from both groups. A significant reduction of octanoic acid and an increase in nonanal and ketones were found in LG+ T3 cheeses, whereas the LG+ T30 cheeses were characterized by a significant decrease of hexanoic acid an increase of 3-methyl-1-butanol and acetoin. We concluded that it is possible to assert that dietary integration with dried licorice root modified chemical and technological properties of goat cheeses, reducing lipid oxidation during ripening and inducing changes in texture that could improve consumer acceptability, although further studies are needed from this point of view.

A modified surgical ablation line for atrial fibrillation. The Bachmann line.

Surgical treatment of atrial fibrillation generally consists in the isolation of the pulmonary veins ("box-lesion"). Bachmann's bundle is a cardiac structure that may play an important role in the genesis of the atrial fibrillation. Surgical isolation of such bundle has not been reported before. We aim to describe how to perform minimally invasive epicardial pulmonary vein isolation along with the isolation of the Bachmann's bundle. Adding the surgical ablation line of Bachmann's bundle is a feasible, fast, and easy procedure that may be contribute to the reduction of atrial fibrillation relapses.

Proteolytic Volatile Profile and Electrophoretic Analysis of Casein Composition in Milk and Cheese Derived from Mironutrient-Fed Cows.

The aim of the study was to evaluate the proteolytic process in Caciocavallo cheese obtained from Friesian cows fed zinc, selenium, and iodine supplementation. Thirty-six Friesian cows, balanced for parity, milk production, and days in milk, were randomly assigned to four groups. The control group (CG) was fed with a conventional feeding strategy, while the three remaining groups received a diet enriched with three different trace elements, respectively zinc (ZG), selenium (SG), and iodine (IG). At the end of the experimental period, samples of milk were collected and used to produce Caciocavallo cheese from each experimental group. Cheese samples were then analyzed after 7 and 120 days from the cheese making in order to obtain information on chemical composition and extent of the proteolytic process, evaluated through the electrophoretic analysis of caseins and the determination of volatiles profile. Both milk and cheese samples were richer in the amount of the microelement respectively used for the integration of the cattle's diet. The zymographic approach was helpful in evaluating, in milk, the proteolytic function performed by endogenous metalloenzymes specifically able to degrade gelatin and casein; this evaluation did not highlight significant differences among the analyzed samples. In cheese, the electrophoretic analysis in reducing and denaturing condition showed the marked ability of ß-casein to resist the proteolytic action during ripening, whereas the dietary selenium supplementation was shown to perform a protective action against the degradation of S1 and S2 isoforms of α-casein. The analysis of the volatile profile evidenced the presence of compounds associated with proteolysis of phenylalanine and leucine. This approach showed that selenium was able to negatively influence the biochemical processes that lead to the formation of 3-methyl butanol, although the identification of the specific mechanism needs further investigation.

Volatile Profile in Yogurt Obtained from Saanen Goats Fed with Olive Leaves.

The aim of this study was to evaluate the development of volatile compounds in yogurt samples obtained from goats fed a dietary supplementation with olive leaves (OL). For this purpose, thirty Saanen goats were divided into two homogeneous groups of 15 goats each: a control group that received a standard diet (CG) and an experimental group whose diet was supplemented with olive leaves (OLG). The trial lasted 28 days, at the end of which the milk of each group was collected and used for yogurt production. Immediately after production, and after 7 days of storage at 4 °C in the absence of light, the yogurt samples were characterized in terms of fatty acid profile, oxidative stability and volatile compounds by the solid-phase microextraction (SPME)-GC/MS technique. Dietary OL supplementation positively affected the fatty acid composition, inducing a significant increase in the relative proportion of unsaturated fatty acids, mainly oleic acid (C18:1 cis9) and linolenic acid (C18:3). With regard to the volatile profile, both in fresh and yogurt samples stored for 7 days, the OL supplementation induced an increase in free fatty acids, probably due to an increase in lipolysis carried out by microbial and endogenous milk enzymes. Specifically, the largest variations were found for C6, C7, C8 and C10 free fatty acids. In the same samples, a significant decrease in aldehydes, mainly heptanal and nonanal, was also detected, supporting-at least in part-an improvement in the oxidative stability. Moreover, alcohols, esters and ketones appeared lower in OLG samples, while no significant variations were observed for lactones. These findings suggest the positive role of dietary OL supplementation in the production of goats' milk yogurt, with characteristics potentially indicative of an improvement in nutritional properties and flavor.

Volatile Flavor Compounds in Cheese as Affected by Ruminant Diet.

Extensive research has been conducted concerning the determination and characterization of volatile compounds contributing to aroma and flavor in cheese. Considerable knowledge has been accumulated on the understanding of the mechanisms through which these compounds are formed during ripening, as well as on the optimization of the methodological approaches which lead to their detection. More recently, particular attention has been given to the aromatic properties of milk and cheeses obtained from lactating dairy ruminants fed experimental diets, characterized, for instance, by the addition of trace elements, natural supplements, or agricultural by-products rich in bioactive compounds. The purpose of this review is to summarize the major families of volatile compounds most commonly found in these types of dairy products at various ripening stages, describing in greater detail the role of animal diet in influencing the synthesis mechanisms most commonly responsible for cheese flavor determination. A large number of volatile compounds, including carboxylic acids, lactones, ketones, alcohols, and aldehydes, can be detected in cheese. The relative percentage of each compound depends on the biochemical processes that occur during ripening, and these are mainly mediated by endogenous enzymes and factors of bacterial origin whose function can be strongly influenced by the bioactive compounds taken by animals with the diet and released in milk through the mammary gland. Further evaluations on the interactions between volatile compounds and cheese matrix would be necessary in order to improve the knowledge on the synthesis mechanisms of such compounds; in addition to this, more should be done with respect to the determination of synergistic effects of flavor compounds, correlating such compounds to the aroma of dairy products.

Zinc supplementation of lactating dairy cows: effects on chemical-nutritional quality and volatile profile of Caciocavallo cheese.

OBJECTIVE: The aim of the present study was to investigate the effect of dietary zinc supplementation of Friesian cows on chemical-nutritional and aromatic properties of Caciocavallo cheese after 7 days (C7) and 120 days (C120) of ripening. METHODS: Twenty eight Friesian cows, balanced for parity, milk production and days in milk, were randomly assigned to 2 groups. The control group (CG) was fed with a conventional complete diet, while the experimental group (zinc group, ZG) received a daily zinc supplementation of 60 mg for kg of dry complete feed. During the experimental period, the milk yield was monitored and samples of milk and caciocavallo cheese were collected and analyzed for chemical-nutritional composition and aromatic profile. RESULTS: The enrichment of dairy cows diet with zinc, did not influence milk yield and composition, however a marked reduction of somatic cell count was evidenced. Both in milk and cheese the ZG samples were characterized by a lower concentration of satured fatty acids and an increase in oleic, vaccenic and rumenic acids. The aromatic profile of dairy products was also positively affected by dietary zinc intake, with an increase in concentration of carboxylic acids, esters and lactones. CONCLUSION: The present results suggest a positive role of dietary zinc intake in improving the quality of bovine milk and related cheese, in particular for the increase in concentration of bioactive fatty acids such as rumenic acid. The changes evidenced in cheese through the analysis of the volatile profile, would be consistent with the development of interesting organoleptic properties, although further evaluations should be performed to confirm the consumer acceptability of these changes.

Chemical-nutritional characteristics and aromatic profile of milk and related dairy products obtained from goats fed with extruded linseed.

OBJECTIVE: This study aimed to evaluate the effect of dietary integration with extruded linseed (EL) on fatty acid (FA) and aromatic profile of goat cheese after 60 (T60) days of ripening. METHODS: Thirty goats were divided in two groups. The control group (CG) was fed with conventional diet, whereas the experimental group (EL+) was fed with conventional diet supplemented with 10% of EL. Milk samples were collected on 30 and 60 days of trial to determinate chemical-nutritional composition and FA profile. At the end of experiment, six cheese-making session (3 for each group) were carried out using a pooled milk sample obtained from the 15 goat of each group. At 60 days of ripening, cheeses were analyzed for chemical-nutritional composition, FA and aromatic profile. RESULTS: An increase in the milk production, protein, fat and lactose were evidenced in the EL+ goats. Conversely, a reduction of somatic cells was observed in the EL+ compared with the CG. However, no variation was observed for urea and casein levels content in milk samples, and no changes in protein and lipid content were found for cheeses in the two experimental groups. Dietary supplementation with EL modified the FA profile of milk. There was a decrease in saturated fatty acids (SFA) and an increase in polyunsaturated fatty acids (PUFA). Chemical composition of T60 cheese did not differ between the two groups but a different FA profile was observed. In particular, in T60 cheese obtained from EL+ milk, an increase in short-chain FA (SCFA) and a decrease in medium and long-chain FA (MCFA and LCFA) were observed. The EL diet led to cheeses with butanoic acid 2 time higher compared to CG cheeses. Moreover, a greater presence of aldehyde compounds and alcohols were observed in the cheeses of experimental group. CONCLUSION: The present study pointed out that EL supplementation may improve the chemical and physical qualities of goat milk and cheeses.

Chemical-nutritional parameters and volatile profile of eggs and cakes made with eggs from ISA Warren laying hens fed with a dietary supplementation of extruded linseed.

OBJECTIVE: The aim of this study was to evaluate the chemical-nutritional parameters, oxidative stability and volatile profile of eggs and cakes made with eggs from laying hens fed with a dietary supplementation of extruded linseed. METHODS: Two thousand ISA Warren laying hens were randomly divided into two groups: a control group was fed with a standard diet while the experimental group received the same diet supplemented with 7% of extruded linseed. The trial lasted 84 days, in which three samplings of laid eggs were performed. Samples of eggs and food systems arising from eggs were then analyzed in order to obtain information about ß-carotene and total flavonoid content, antioxidant activity, fatty acid profile, lipid oxidation, and volatile profile. RESULTS: Linseed induced the increase of α-linolenic acid with consequent reduction of the ω-6/ω-3 ratio (4.3:1 in egg yolk); in addition to this, was evidenced the cholesterol reduction and the significant increase in total flavonoids and ß-carotene, although no variations were detected in antioxidant capacity. Even in cooked products there was not only a direct effect of linseed in increasing α-linolenic acid, but also in inducing the reduction of cholesterol and its major oxidation product, 7-ketocholesterol. The dietary linseed integration was also shown to affect the volatile profile of baked products. CONCLUSION: Data confirmed that dietary supplementation with extruded linseed resulted in food products with interesting implications for human health. With regard to the volatile profile of baked products it would be necessary undertake further sensorial analysis in order to evaluate any variations on flavor and consumer acceptability.

Paediatric ambulatory care sensitive hospitalisation and Italian deprivation index: retrospective multilevel analysis of administrative data from 2008 to 2018 in the Abruzzo Region (Southern Italy).

OBJECTIVES: to estimate and analyse the trend of paediatric hospitalisations for Ambulatory Care Sensitive Conditions (ACSCs) from 2008 to 2018 in a region of southern Italy and to assess the association with the socio-economic deprivation index (DI). DESIGN: retrospective observational study. SETTING AND PARTICIPANTS: ACSC hospitalisations in children (<=18 years) were identified. Discharges for ACSC of the Abruzzo Region from 2008 to 2018 were selected and the deprivation index of the municipality of residence was assigned to the hospital discharge record where the patient's residence was reported. MAIN OUTCOME MEASURES: the rate of paediatric preventable admissions (PPHs) related to ACSC, standardized by age and gender with the direct method, was calculated for the years of observation. The average annual percentage change (AAPC) was calculated with a trend analysis. In addition, the odds ratios (ORs) of hospitalisation for ACSC were calculated using a hierarchical logistic regression model. RESULTS: 252,513 hospitalisations were examined, of which 16,264 (6.4%) attributable to ACSC. During the study period, the hospitalisation rate decreased from 8.59 per 1,000 to 6.12 per 1,000 residents, with an AAPC of -3.7, which was statistically significant (p<0.05). Furthermore, an association was highlighted between hospitalisations related to ACSC and the deprivation of the municipality of residence. Using as a comparison people residing in the municipalities belonging to the first quintile, the least deprived, the strength of the association between PPHs and DI increased from the third quintile (OR 1.13; CI95% 1.02-1.24) up to the fifth quintile, most deprived (OR 1.14; CI95% 1.01-1.30). CONCLUSIONS: paediatric patients residing in Abruzzo have a risk of undergoing a preventable hospitalisation associated with an ACSC which depends on the deprivation index of the municipality of residence. Although it is difficult to evaluate the mechanisms involved in the relationship between economic deprivation and hospitalisation, DI can be useful to identify the areas which are most at risk on which to prioritize public health interventions.

Host-microbiota interactions shed light on mortality events in the striped venus clam Chamelea gallina.

Mass mortalities due to disease outbreaks have recently affected a number of major taxa in marine ecosystems. Climate- and pollution-induced stress may compromise host immune defenses, increasing the risk of opportunistic diseases. Despite growing evidence that mass mortality events affecting marine species worldwide are strongly influenced by the interplay of numerous environmental factors, the reductionist approaches most frequently used to investigate these factors hindered the interpretation of these multifactorial pathologies. In this study, we propose a broader approach based on the combination of RNA-sequencing and 16S microbiota analyses to decipher the factors underlying mass mortality in the striped venus clam, Chamelea gallina, along the Adriatic coast. On one hand, gene expression profiling and functional analyses of microbial communities showed the over-expression of several genes and molecular pathways involved in xenobiotic metabolism, suggesting potential chemical contamination in mortality sites. On the other hand, the down-regulation of several genes involved in immune and stress response, and the over-representation of opportunistic pathogens such as Vibrio and Photobacterium spp. indicates that these microbial species may take advantage of compromised host immune pathways and defense mechanisms that are potentially affected by chemical exposure, resulting in periodic mortality events. We propose the application of our approach to interpret and anticipate the risks inherent in the combined effects of pollutants and microbes on marine animals in today's rapidly changing environment.

The impact of homocysteine, B12, and D vitamins levels on functional neurocognitive performance in HIV-positive subjects.

BACKGROUND: The correlation among high levels of total homocysteine, low levels of B12vitamin, and neurocognitive impairment in HIV negative patients has been the main research topic in some of the latest reviews. The aim of this study was to examine if the alteration of homocysteine, B12 vitamin, and D vitamins plasma levels was present in HIV-positive, and their relationship with cognitive function. METHODS: 57 HIV infected were enrolled and underwent the serum measurement of homocysteine, B12, and D vitamins. The neurocognitive evaluation investigated 5 cognitive domains, through a neuropsychological battery test RESULTS: Homocysteine was found to be elevated in 70.2% of cases, B12 vitamin mean levels were low in 8 participants (14.0%), and 8 patients had D hypovitaminosis (14.0%). Abnormal homocysteine levels were associated with worse performance of verbal fluency (p = 0.003) and worse executive function (Stroop E test p = 0.040). The 25-OH D hypovitaminosis was associated with worse performances in executive functions in three different tests: Stroop E (p = 0.049), Trail B (p = 0.035), and Wais Digit Span (p = 0.042). Pathological levels of B12 Vitamin were also associated to worse performances in executive functions (Trail B Test and Wais Digit Span respectively p = 0.002 and 0.029) and with a lower speed in psychomotor processing (Peg Board Test on dominant hand, p = 0.014). CONCLUSIONS: In this study serum homocysteine, B12, and D vitamin levels are associated with neurocognitive performances; in fact low performance neurocognitive was correlated with hyperhomocysteine and low B12vitamin, and D vitamin levels. Evidence of the alteration of these parameters could facilitate the early identification of a neurocognitive impairment.

CORRELATION BETWEEN OUTER RETINAL THICKENING AND RETINAL FUNCTION IMPAIRMENT IN PATIENTS WITH IDIOPATHIC EPIRETINAL MEMBRANES.

PURPOSE: To examine the relationship between retinal layer thickness, retinal sensitivity, and visual function in patients with idiopathic epiretinal membrane using spectral domain optical coherence tomography automated segmentation algorithm. METHODS: Twenty-four eyes with epiretinal membrane and 12 control eyes were enrolled. Ophthalmic evaluations included best-corrected visual acuity, mean retinal sensitivity (MRS) of radial 10° and 4° areas tested with microperimetry, and measurements of 4 retinal layer thicknesses by means spectral domain optical coherence tomography. Relations between retinal layer thickness, MRS, and best-corrected visual acuity values were explored. RESULTS: Compared with controls, MRS (P < 0.001) and best-corrected visual acuity (P < 0.001) values were reduced. In the epiretinal membrane group, MRS of the central 4° values was associated with thickening of the outer nuclear layer (P < 0.05). Furthermore, a correlation was found between the inner nuclear layer thickening and the MRS of the central 4° limited to the inferior quadrant (P < 0.05). The decreased best-corrected visual acuity values were correlated with the thickening of three of four quadrant of the inner nuclear layer, inferior and temporal quadrants of the outer plexiform layer, and finally outer nuclear layer nasal quadrant. CONCLUSION: We found a meaningful correlation between MRS impairment of the central 4° and outer nuclear layer thickness and showed which intraretinal layers mainly contributes to visual acuity loss.