Statins Effects on Blood Clotting: A Review.

Statins are powerful lipid-lowering drugs that inhibit cholesterol biosynthesis via downregulation of hydroxymethylglutaryl coenzyme-A reductase, which are largely used in patients with or at risk of cardiovascular disease. Available data on thromboembolic disease include primary and secondary prevention as well as bleeding and mortality rates in statin users during anticoagulation for VTE. Experimental studies indicate that statins alter blood clotting at various levels. Statins produce anticoagulant effects via downregulation of tissue factor expression and enhanced endothelial thrombomodulin expression resulting in reduced thrombin generation. Statins impair fibrinogen cleavage and reduce thrombin generation. A reduction of factor V and factor XIII activation has been observed in patients treated with statins. It is postulated that the mechanisms involved are downregulation of factor V and activated factor V, modulation of the protein C pathway and alteration of the tissue factor pathway inhibitor. Clinical and experimental studies have shown that statins exert antiplatelet effects through early and delayed inhibition of platelet activation, adhesion and aggregation. It has been postulated that statin-induced anticoagulant effects can explain, at least partially, a reduction in primary and secondary VTE and death. Evidence supporting the use of statins for prevention of arterial thrombosis-related cardiovascular events is robust, but their role in VTE remains to be further elucidated. In this review, we present biological evidence and experimental data supporting the ability of statins to directly interfere with the clotting system.

Evolution of the surface atomic structure of multielement oxide films: curse or blessing?

Atomically resolved scanning tunneling microscopy (STM) and X-ray photoelectron spectroscopy (XPS) are used to gain atomic-scale insights into the heteroepitaxy of lanthanum-strontium manganite (LSMO, La1-xSrxMnO3-δ, x ≈ 0.2) on SrTiO3(110). LSMO is a perovskite oxide characterized by several composition-dependent surface reconstructions. The flexibility of the surface allows it to incorporate nonstoichiometries during growth, which causes the structure of the surface to evolve accordingly. This happens up to a critical point, where phase separation occurs, clusters rich in the excess cations form at the surface, and films show a rough morphology. To limit the nonstoichiometry introduced by non-optimal growth conditions, it proves useful to monitor the changes in surface atomic structures as a function of the PLD parameters and tune the latter accordingly.

The Evaluation of the Balance Test and MuscleLab Test for the Early Detection of Femoroacetabular Impingement.

Femoroacetabular impingement (FAI) is a common source of hip pain affecting a wide range of subjects. In this work, we assessed two tests, namely the balance test and the MuscleLab test, in comparison with the flexion-abduction-external rotation (FABER) and flexion-adduction-internal rotation (FADIR) tests, in order to evaluate the functionality of the neural-musculoskeletal system of the subjects affected by FAI based on the measurement of biomechanical parameters. Our goal was to investigate the early detection of an altered hip joint and to monitor pathology progression over time. A total of 52 subjects, 29 females and 23 males, with an average age of 42 ± 13 years presenting hip impingement diagnosed using X-ray, were enrolled. Twenty-eight patients without signs of hip impingements were used as the control group. The balance test, which evaluates the capacity of a person to keep the orthostatic position against terrestrial gravity, and the MuscleLab test, which measures the force and power generated by active muscles during a movement, as well as FABER and FADIR tests, were performed in each subject. The balance and MuscleLab tests presented 100% sensitivity and higher sensitivity in FAI diagnosis, with 72.9% and 70.4%, respectively, in comparison with those obtained using FABER and FADIR tests, with 59.6% and 67.3%, respectively. The evaluation of the neural-musculoskeletal system using the balance and MuscleLab tests can help in the early detection of the severity of hip impingements and the assessment of non-operative treatments used over time.

The chemistry of a fossilised elephant tooth: Domenico Morichini and the discovery of dental fluoride.

On the occasion of the 250th anniversary of the birth of the Italian physician, Domenico Morichini (1773-1836), this study aims to commemorate this illustrious figure, who made a great contribution to the history of dentistry through his discovery of the presence of fluoride in dental enamel. Starting from a chemical analysis of the components of the enamel and osseous part of a fossilised elephant tooth discovered in Rome in 1802, Morichini demonstrated the presence of high amounts of fluoride, not only in these remains, but also in samples of human teeth. The Italian doctor, a Professor of Chemistry at the Sapienza University of Rome, also affirmed the importance of his discovery from a clinical perspective, as it enabled a better understanding of the chemical composition of enamel, changes in which he saw as the cause of most dental diseases. Morichini was a talented clinician and scientist, who also made contributions in other medical-scientific fields, as one of the first to suggest the electromagnetic nature of solar radiation based on experiments that were replicated internationally.

Effect of Different In2O3(111) Surface Terminations on CO2 Adsorption.

In2O3-based catalysts have shown high activity and selectivity for CO2 hydrogenation to methanol; however, the origin of the high performance of In2O3 is still unclear. To elucidate the initial steps of CO2 hydrogenation over In2O3, we have combined X-ray photoelectron spectroscopy and density functional theory calculations to study the adsorption of CO2 on the In2O3(111) crystalline surface with different terminations, namely, the stoichiometric, reduced, and hydroxylated surface. The combined approach confirms that the reduction of the surface results in the formation of In adatoms and that water dissociates on the surface at room temperature. A comparison of the experimental spectra and the computed core-level shifts (using methanol and formic acid as benchmark molecules) suggests that CO2 adsorbs as a carbonate on all three surface terminations. We find that the adsorption of CO2 is hindered by hydroxyl groups on the hydroxylated surface.

The effect of differently modulated communications on the covid-19 pandemic in the young population.

BACKGROUND: Media communication during the covid-19 pandemic has been relevant for the population to receive information about the ongoing number of cases, deaths, and social restriction measures. Notably, the effects of the communication methods on young adults during the covid-19 pandemic have not been studied. Therefore the present study aimed to investigate the influence of communication modality about covid-19 on the perception of risk and judgment among young adults. METHODS: A double-blind cross-sectional study was designed. Three hundred four subjects (age range19-25 years old) saw a 4-minute video concerning data communication on the covid-19 pandemic and compiled an online questionnaire about their perceptions. Two videos were randomized, one presenting the covid-19 data negatively (HARD video) while the other showed a positive ongoing resolution of the pandemic (SOFT video). Association tests and nominal logistic regression were used to evaluate differences in responses among the two groups. RESULTS: The two videos lead to different reactions. Participants showed higher disagreement concerning the video content in the "SOFT" group compared to the "HARD" group. The responses of the "SOFT" group were more to be optimistic (OR=2.87, 95% CI 1.311-6.27) than those who had seen the "HARD" video. The sense of helplessness was lower in the "SOFT" compared "HARD" group (OR=3.02, 95% CI 1.311-6.96). The perception of fear was higher for the "HARD" group (OR=2.91, 95% CI 1.21-7-02). DISCUSSION: The modality of data presentation influenced the perception and feelings about the covid-19 pandemic. Likely, pre-existing perception of a pessimistic perspective was present in both groups; thus, the video did not lead to any change in the behavior. CONCLUSIONS: The phobic or counter-phobic reactions shown in the study participants highlighted the importance of the reliability of the information received and how previous feelings may influence the perception of the information.

Volunteering in an emergency project in response to the COVID-19 pandemic crisis: the experience of Italian midwives.

OBJECTIVES: During the first wave of the COVID-19 pandemic, the Region of Lombardy in Italy and its Regional Emergency Service (Azienda Regionale Emergenza Urgenza [AREU]) created a dedicated 24/7 free phone service to help the Lombard population. After an invitation from their professional order, local midwives collaborated on the AREU project as volunteers to address the needs of women from antenatal to postnatal periods. The aim of this article was to explore the experiences of midwives who volunteered in the AREU project. STUDY DESIGN: This was a qualitative study using an interpretative phenomenological approach (IPA). METHODS: The experiences of midwives volunteering in AREU (N = 59) were explored using audio diaries. Written diaries were also offered as an alternative. Data collection took place between March and April 2020. Midwives were provided with semistructured guidance that indicated the main areas of interest of the study. The diaries were thematically analysed following a temporal criterion; a final conceptual framework was created from emerging themes and subthemes. RESULTS: The following five themes were identified: (1) choosing to join the volunteer project, (2) the day-to-day difficulties, (3) strategies to cope with the unexpected, (4) professional relationships and (5) reflecting on the personal experience. CONCLUSIONS: This is the first study to investigate the experiences of Italian midwives who volunteered in a public health project during a pandemic/epidemic. According to participants, taking part in the volunteer activities was informed by and impacted on both their professional and personal lives. Overall, the experiences of midwives who volunteered in AREU were positive and of humanitarian value. Providing midwifery services within a multidisciplinary team for the benefit of public health represented both a challenge and personal/professional enrichment.

Antonio Scarpa (1752-1832): His Contribution to the History of Surgery.

BACKGROUND: Antonio Scarpa (1752-1832) is generally remembered for his discoveries in the field of anatomy, but he also provided some important contributions to the history of surgery. METHODS: We analyzed main treatises written by Scarpa, highlighting how he contributed to the development of modern surgery. RESULTS: Scarpa made great innovations in three branches of surgery: abdominal surgery (hernia), orthopedics (clubfoot) and vascular surgery (aneurism). Furthermore, he contributed to the birth of modern ophthalmology.

Gaspare Aselli (1581-1625) and Lacteis Venis: Four Centuries From the Discovery of Lymphatic System.

The first half of the seventeenth century may be seen as the turning point of knowledge of human anatomy and physiology, as also demonstrated by the works by William Harvey (1578-1657) on the circulation of the blood. This article aims to present biographic context of the surgeon Gaspare Aselli (1581-1625) and his rather fortuitous discovery of the lacteals in Milan in 1622, that contributed to the comprehension of the lymphatic system. The experimentation on living animals (anatomia animata, living anatomy), and particularly the vivisection used by Gaspare Aselli provided the basis for much of the subsequent investigation of the human physiology. In particular, the discovery of lymphatics challenged the basis of the Galenic doctrine, denying the liver the central role it had formerly been granted in transforming food into blood and revolutionized the ancient hepatocentrism in favor of the modern concept of cardiocentrism.

Water Structures Reveal Local Hydrophobicity on the In2O3(111) Surface.

Clean oxide surfaces are generally hydrophilic. Water molecules anchor at undercoordinated surface metal atoms that act as Lewis acid sites, and they are stabilized by H bonds to undercoordinated surface oxygens. The large unit cell of In2O3(111) provides surface atoms in various configurations, which leads to chemical heterogeneity and a local deviation from this general rule. Experiments (TPD, XPS, nc-AFM) agree quantitatively with DFT calculations and show a series of distinct phases. The first three water molecules dissociate at one specific area of the unit cell and desorb above room temperature. The next three adsorb as molecules in the adjacent region. Three more water molecules rearrange this structure and an additional nine pile up above the OH groups. Despite offering undercoordinated In and O sites, the rest of the unit cell is unfavorable for adsorption and remains water-free. The first water layer thus shows ordering into nanoscopic 3D water clusters separated by hydrophobic pockets.

Animal magnetism in Italy during the nineteenth century: the conflicting relationship with the Catholic Church.

This article explores the relationship between the Catholic Church and animal magnetism. At the beginning of the nineteenth century, the Catholic Church had first tried to stem the rise of animal magnetism in a vague manner, but after a few decades, it eventually put a genuine veto in place. This measure was founded upon the dangers to morality and faith arising from the progressive polarization of the original doctrine in forms related to esotericism. Among the causes of the condemnation by the Congregation of the Holy Office, the primary ones were the naturalist interpretation of the miracles described in the Gospels and in the New Testament, and the possibility of falling under the control of a demonic spirit.

The birth of experimental physiology.

The year 2023 marks the 300th anniversary of the death of Antonio Maria Valsalva (1666-1723). Valsalva was a leading physician across the 17th and 18th centuries, specifically for his focus on experimental physiology, the science dealing with the normal functioning of bodily organs as a basis for a better understanding of diseases, symptoms, and care. He used a top-down systematic approach typical of the Enlightenment, rather than a heuristic one ("trial-and-error"), which became feasible after the long-lasting ban on dissecting human corpses was lifted. Valsalva's main interest was exploring the complex structure of the human ear, to which he dedicated a specific treatise, De Aure Humana. He understood the issues inherent in the imbalance in pressure between the outer and inner ear and found ways to exploit it to get rid of purulent fluid by deliberately raising the inside pressure with his maneuver. Time was however not yet ripe to see the broader importance that the Valsalva maneuver would achieve, not just in otorhinolaryngology, but also in cardiology and other fields of medicine. Although Valsalva's name is usually associated with his maneuver, his contributions to the history of medicine were broader: he discovered several anatomical parts (i.e., the sinuses of Valsalva), built the basis for the development of pathological anatomy, introduced advances in surgery, and promoted compassionate care of patients affected by mental diseases.NEW & NOTEWORTHY Antonio Maria Valsalva (1666-1723) was a pioneer in experimental physiology between the 17th and 18th centuries. The Valsalva maneuver is still a popular academic topic and has broad applications not only in physiology research, but also in the diagnosis and therapy of various diseases. The celebration of 300 years from his death could be a timely occasion to commemorate the scientific works of this illustrious scientist.

A Mobile App Leveraging Citizenship Engagement to Perform Anonymized Longitudinal Studies in the Context of COVID-19 Adverse Drug Reaction Monitoring: Development and Usability Study.

BACKGROUND: Over the past few years, studies have increasingly focused on the development of mobile apps as complementary tools to existing traditional pharmacovigilance surveillance systems for improving and facilitating adverse drug reaction (ADR) reporting. OBJECTIVE: In this research, we evaluated the potentiality of a new mobile app (vaxEffect@UniMiB) to perform longitudinal studies, while preserving the anonymity of the respondents. We applied the app to monitor the ADRs during the COVID-19 vaccination campaign in a sample of the Italian population. METHODS: We administered vaxEffect@UniMiB to a convenience sample of academic subjects vaccinated at the Milano-Bicocca University hub for COVID-19 during the Italian national vaccination campaign. vaxEffect@UniMiB was developed for both Android and iOS devices. The mobile app asks users to send their medical history and, upon every vaccine administration, their vaccination data and the ADRs that occurred within 7 days postvaccination, making it possible to follow the ADR dynamics for each respondent. The app sends data over the web to an application server. The server, along with receiving all user data, saves the data in a SQL database server and reminds patients to submit vaccine and ADR data by push notifications sent to the mobile app through Firebase Cloud Messaging (FCM). On initial startup of the app, a unique user identifier (UUID) was generated for each respondent, so its anonymity was completely ensured, while enabling longitudinal studies. RESULTS: A total of 3712 people were vaccinated during the first vaccination wave. A total of 2733 (73.6%) respondents between the ages of 19 and 80 years, coming from the University of Milano-Bicocca (UniMiB) and the Politecnico of Milan (PoliMi), participated in the survey. Overall, we collected information about vaccination and ADRs to the first vaccine dose for 2226 subjects (60.0% of the first dose vaccinated), to the second dose for 1610 subjects (43.4% of the second dose vaccinated), and, in a nonsponsored fashion, to the third dose for 169 individuals (4.6%). CONCLUSIONS: vaxEffect@UniMiB was revealed to be the first attempt in performing longitudinal studies to monitor the same subject over time in terms of the reported ADRs after each vaccine administration, while guaranteeing complete anonymity of the subject. A series of aspects contributed to the positive involvement from people in using this app to report their ADRs to vaccination: ease of use, availability from multiple platforms, anonymity of all survey participants and protection of the submitted data, and the health care workers' support.

Adalimumab and ABP 501 in the Treatment of a Large Cohort of Patients with Inflammatory Arthritis: A Real Life Retrospective Analysis.

The recent introduction of ABP 501, an adalimumab biosimilar, in the treatment of rheumatic diseases was supported by a comprehensive comparability exercise with its originator. On the other hand, observational studies comparing adalimumab and ABP 501 in inflammatory arthritis are still lacking. The main aim of this study is to compare the clinical outcomes of the treatment with adalimumab, both the originator and ABP 501, in a large cohort of patients affected by autoimmune arthritis in a real life setting. We retrospectively analysed the baseline characteristics and the retention rate in a cohort of patients who received at least a course of adalimumab (originator or ABP 501) from January 2003 to December 2020. We stratified the study population according to adalimumab use: naive to original (oADA), naive to ABP 501 (bADA) and switched from original to ABP 501 (sADA). The oADA, bADA and sADA groups included, respectively, 724, 129 and 193 patients. In each group, the majority of patients had a diagnosis of rheumatoid arthritis. The total observation period was 9805.6 patient-months. The 18-month retentions rate in oADA, bADA and sADA was, respectively, 81.5%, 84.0% and 88.0% (p > 0.05). The factors influencing the adalimumab retention rate were an axial spondylarthritis diagnosis (Hazard Ratio (HR) 0.70; p = 0.04), switch from oADA to ABP 501 (HR 0.53; p = 0.02) and year of prescription (HR 1.04; p = 0.04). In this retrospective study, patients naive to the adalimumab originator and its biosimilar ABP 501 showed the same retention rate. Patients switching from the originator to biosimilar had a higher retention rate, even though not statistically significant, when compared to naive.