Bilateral orbital myositis in a patient with rheumatoid arthritis on treatment with tofacitinib: a report and review of literature.

Orbital myositis is a rare inflammatory condition affecting the extraocular muscles of the eyes. It has also been linked to systemic autoimmune diseases. We present a case of orbital myositis in a 57-year-old male undergoing treatment for rheumatoid arthritis (RA) with tofacitinib, a Janus kinase inhibitor (JAK). Prompt administration of intravenous steroids led to rapid symptom improvement. To date, only six published cases have documented the association between RA and orbital myositis. This is the first description of orbital myositis occurring during treatment with the anti-inflammatory drug tofacitinib, an increasingly used disease-modifying anti-rheumatic drug (DMARD). We review the literature and emphasize the importance of ongoing vigilance regarding adverse events linked to tofacitinib.

Simple method for estimating the fractional Raman contribution.

We propose a novel and simple method for estimating the fractional Raman contribution, fR, based on an analysis of a full model of modulation instability (MI) in waveguides. An analytical expression relating fR to the MI peak gain beyond the cutoff power is explicitly derived, allowing for an accurate estimation of fR from a single measurement of the Raman gain spectrum.

Point-by-point femtosecond laser micro-processing of independent core-specific fiber Bragg gratings in a multi-core fiber.

Four 3rd order fiber Bragg gratings were inscribed into separate cores of a 7 core multi-core fiber using the point-by-point inscription technique. A 1030 nm, 206 ± 5 fs laser was used, operating at a frequency of 1 kHz and pulse energy of 2.1 ± 0.2 µJ. Independent Bragg resonances at λB = 1541.01 ± 0.02, 1547.82 ± 0.02, 1532.66 ± 0.02, and 1537.42 ± 0.02 nm and extinction ratios of 13.97 ± 0.4, 16.02 ± 0.4, 10.08 ± 0.4 and 13.40 ± 0.4 dB were recorded. Our data analysis shows that refractive index changes, Δn, of the order 10-3 were induced. Core-specific inscription of fiber Bragg gratings in a multi-core fiber can provide a flexible and versatile platform to address the needs of recent space division multiplexed transmission and optical sensor networks.

40 Gb/s indoor optical wireless system enabled by a cyclically arranged optical beamsteering receiver.

Indoor optical wireless communication with optical beamsteering capability is currently attracting a lot of attention. One major two-dimensional (2D) optical beamsteering scheme is realized by 2D grating or its active counterpart, which is usually based on a spatial light modulator (SLM). However, there is a fundamental trade-off between the field of view (FoV) and power efficiency due to the inherent feature of gratings. In this Letter, we propose a new class of 2D beamsteering, named cyclically arranged optical beamsteering (CAO-BS), which can break that trade-off. Traditional 2D gratings extend the optical beam in the Cartesian coordinates (1D grating in horizontal + 1D grating in vertical), while CAO-BS extends the optical beam in the polar coordinates (1D grating + angular rotation). Since only 1D grating is engaged, the power efficiency increases with the number of grating lobes reduced. In the polar coordinates, the angle rotation tuning in a SLM is quasi-continuous in a full 2π range. The CAO-BS is demonstrated at the receiving end in an indoor experimental system. The FoV is 18° by 360° in polar coordinates without any additional mechanical parts. Based on the CAO-BS, 40 Gbit/s on-off keying data is also successfully transmitted over 1 km single-mode fiber and 0.5 m free space.

Orbital angular momentum beam excitation using an all-fiber weakly fused mode selective coupler.

Orbital angular momentum beam excitation through direct phase-matched coupling is experimentally demonstrated using an all-fiber weakly fused mode selective coupler consisting of a single-mode fiber and a ring-core fiber. Experimental results showing the excited OAM mode purity of up to 75% measured through the standard ring technique not only demonstrate the proof of concept but also provide a baseline for further improvement.

Pathogenic Escherichia coli and enteric viruses in biosolids and related top soil improvers in Italy.

AIMS: To investigate the presence of genomic traits associated with a set of enteric viruses as well as pathogenic Escherichia coli in top soil improvers (TSI) from Italy. METHODS AND RESULTS: Twenty-four TSI samples originating from municipal sewage sludges, pig manure, green and household wastes were analysed by real time PCR for the presence of hepatitis E virus (HEV), porcine and human adenovirus (HuAdV), norovirus, rotavirus and diarrhoeagenic E. coli. None of the samples was found positive for HEV or rotavirus. Four samples were positive for the presence of nucleic acids from human norovirus, two of them being also positive for HuAdV. Real time PCR screening gave positive results for many of the virulence genes characteristic of diarrhoeagenic E. coli in 21 samples. These included the verocytotoxin-coding genes, in some cases associated with intimin-coding gene, and markers of enteroaggregative, enterotoxigenic and enteroinvasive E. coli. CONCLUSIONS: These results provide evidence that enteric viruses and pathogenic E. coli may be released into the environment through the use of sludge-derived TSI. SIGNIFICANCE AND IMPACT OF THE STUDY: The results highlight that the TSI-related environmental risk for the food chain should be more deeply assessed.

Cluster categorization of urban roads to optimize their noise monitoring.

Road traffic in urban areas is recognized to be associated with urban mobility and public health, and it is often the main source of noise pollution. Lately, noise maps have been considered a powerful tool to estimate the population exposure to environmental noise, but they need to be validated by measured noise data. The project Dynamic Acoustic Mapping (DYNAMAP), co-funded in the framework of the LIFE 2013 program, is aimed to develop a statistically based method to optimize the choice and the number of monitoring sites and to automate the noise mapping update using the data retrieved from a low-cost monitoring network. Indeed, the first objective should improve the spatial sampling based on the legislative road classification, as this classification is mainly based on the geometrical characteristics of the road, rather than its noise emission. The present paper describes the statistical approach of the methodology under development and the results of its preliminary application to a limited sample of roads in the city of Milan. The resulting categorization of roads, based on clustering the 24-h hourly L Aeqh, looks promising to optimize the spatial sampling of noise monitoring toward a description of the noise pollution due to complex urban road networks more efficient than that based on the legislative road classification.

Simultaneous measurement of the microscopic dynamics and the mesoscopic displacement field in soft systems by speckle imaging.

The constituents of soft matter systems such as colloidal suspensions, emulsions, polymers, and biological tissues undergo microscopic random motion, due to thermal energy. They may also experience drift motion correlated over mesoscopic or macroscopic length scales, e.g. in response to an internal or applied stress or during flow. We present a new method for measuring simultaneously both the microscopic motion and the mesoscopic or macroscopic drift. The method is based on the analysis of spatio-temporal cross-correlation functions of speckle patterns taken in an imaging configuration. The method is tested on a translating Brownian suspension and a sheared colloidal glass.

Dual mode fused optical fiber couplers suitable for mode division multiplexed transmission.

We experimentally demonstrate 2 × 2 and 3 × 3 fused fiber couplers made from dual mode fiber. A unique mode dependent power transfer characteristics as a function of pulling length is obtained that support various optical functionalities. Exploiting this we demonstrate several devices of interest for mode division multiplexed data transmission including LP11 mode filter, LP11 mode tap coupler, and 50:50 power splitter for both LP01 and LP11 modes.

Impact of body mass index and waist circumference on the cardiovascular risk and all-cause death in a general population: data from the PAMELA study.

BACKGROUND AND AIMS: Elevated values of body mass index (BMI) and waist circumference (WC) are associated with an augmented cardiovascular (CV) risk. It is debated, however, whether and to what extent this depends on the body fat increase 'per se' or on the related cardiometabolic alterations. METHODS AND RESULTS: In 2005 subjects randomly selected from the general population of Monza (Italy), we assessed BMI, WC, office, home and 24 h blood pressure (BP), heart rate and metabolic variables. The impact of BMI and WC on the incidence of CV events, CV and all-cause mortality was estimated during a 148-month follow-up. Progressively higher values of BMI and WC were associated with a progressive increase in office, home and 24 h BP and in erratic BP variability (P < 0.0001 for trend). Metabolic variables were directly and significantly (P < 0.0001) related to BMI and WC, while an inverse significant relationship was detected with high-density lipoprotein (HDL)-cholesterol. The incidence of CV events, CV and all-cause deaths increased progressively from the lowest to the highest quintile of BMI and WC (P for trend always <0.005). Baseline BMI and WC higher by respectively 1 kg m⁻² and 1 cm were associated with an increased risk of CV events, CV and all-cause death by 8%, 12% and 7% (for baseline BMI) and 4%, 5% and 4% (for baseline WC), respectively. After adjustment for confounders, only the increased risk of CV death related to higher baseline BMI remained significant (hazard ratio (HR) 1.062, confidence interval (CI) 95% 1.003-1.126, P < 0.05). CONCLUSION: The adverse prognostic impact of the accumulation of body fat is mediated by the associated haemodynamic and metabolic alterations. Baseline values of BMI, however, are an independent predictor of CV mortality.

Slow dynamics and internal stress relaxation in bundled cytoskeletal networks.

Crosslinked and bundled actin filaments form networks that are essential for the mechanical properties of living cells. Reconstituted actin networks have been extensively studied not only as a model system for the cytoskeleton, but also to understand the interplay between microscopic structure and macroscopic viscoelastic properties of network-forming soft materials. These constitute a broad class of materials with countless applications in science and industry. So far, it has been widely assumed that reconstituted actin networks represent equilibrium structures. Here, we show that fully polymerized actin/fascin bundle networks exhibit surprising age-dependent changes in their viscoelastic properties and spontaneous dynamics, a feature strongly reminiscent of out-of-equilibrium, or glassy, soft materials. Using a combination of rheology, confocal microscopy and space-resolved dynamic light scattering, we demonstrate that actin networks build up stress during their formation and then slowly relax towards equilibrium owing to the unbinding dynamics of the crosslinking molecules.

Decreased adrenergic tone in acromegaly: evidence from direct recording of muscle sympathetic nerve activity.

OBJECTIVE: Sympathovagal imbalance has been shown in acromegaly by indirect measurements of adrenergic tone. Data regarding direct measurement of sympathetic activity are lacking as yet. Aim of this study was to assess the adrenergic tone through direct recording of muscle sympathetic nerve activity (MSNA) in acromegalic patients. DESIGN: Fifteen patients (age 26-66 years, eight women) with newly diagnosed active acromegaly without hyperprolactinaemia, pituitary hormone deficiencies, obstructive sleep apnoea and cardiac hypertrophy, and 15 healthy subjects matched for age, sex and body mass index were recruited. After evaluating anthropometric and echocardiographic parameters, anterior pituitary function, glucose and lipid metabolism, and measuring plasma leptin, direct recording of sympathetic outflow via the microneurographic technique was performed. RESULTS: For similar anthropometric and metabolic parameters in patients and controls, HOMA index was significantly increased in the former (4·2 ± 2·39 vs 1·6 ± 0·19, P < 0·001). Surprisingly, this finding of insulin resistance was accompanied by a marked sympathetic inhibition (MSNA 18·3 ± 8·10 vs 37·3 ± 6·48 bursts/min, P < 0·0001, respectively in patients and controls). A reduction in plasma leptin (1·6 ± 1·04 vs 6·5 ± 2·01 µg/l, P < 0·0001) was also recorded in the patients. MSNA was positively correlated with leptin (P < 0·0001). CONCLUSIONS: Newly diagnosed acromegalic patients without cardiac hypertrophy display a decreased sympathetic outflow in spite of insulin resistance. This finding might be related to hypoleptinaemia.

Compact optical microfiber phase modulator.

A compact optical microfiber phase modulator with MHz bandwidth is presented. A micrometer-diameter microfiber is wound on a millimeter-diameter piezoelectric ceramic rod with two electrodes. When a voltage is applied to the piezoelectric ceramic, the rod is strained, leading to a phase change along the microfiber; because of the small size, the optical microfiber phase modulator can have as high as a few MHz bandwidth response.

Clinic blood pressure, ambulatory blood pressure and cardiac structural alterations in nonagenarians and in centenarians.

scant information is available on the alterations in cardiac structure and function characterizing very elderly people as well as on their relationships to clinic and ambulatory blood pressure (BP) values. In 106 subjects aged 95.3 ± 3.7 years (mean ± standard deviation, 89 nonagenarians and 17 centenarians) in good clinical conditions and living in the municipal house in Milan, we measured, along with standard clinical and laboratory variables, clinic BP, 24-h ambulatory BP and echocardiographic parameters. Forty-five of the recruited subjects were normotensive individuals, whereas 61 were treated hypertensive patients. Subjects with an age greater than 90 years showed clinic systolic (SBP) and diastolic BP (DBP) both within the normal range, with values that for clinic SBP were slightly lower than the corresponding 24-h SBP (120.8 ± 15.9 vs 128.0 ± 16.3 mmHg) and for DBP slightly higher (69.7 ± 8.8 vs 64.9 ± 8.0 mmHg). Daytime average mean BP was slightly lower than night-time average mean BP, indicating the attenuation of the BP reduction during night-time. Left ventricular mass index (LVMI) was increased and significantly related to both 24-h and clinic BP values (r = 0.24, p < 0.04 and r = 0.20, p < 0.05). Thus in nonagenarians and centenarians, abnormalities in left ventricular pattern are of frequent detection and may be related both to the ageing process and to BP load.

[The allergic risk in agriculture: current situation and specific high-risk areas]. / Il rischio allergico in agricoltura: situazione attuale e specifici settori ad alto rischio.

Contradictory aspects apparently coexist in relation to the causes of bronchial allergic inflammation in agriculture. It's worth notion that either exposure to inhalable dust and endotoxins or exposure to molecular patterns play a role in such a pathology; in particular endotoxins should protect against the onset of allergic diseases. Likewise, the exposure to pesticides would not lead to allergic asthma, but could facilitate the onset of pollinosis and contact dermatitis in gardeners. Moreover, the risk of anaphylaxis from bee sting would be lower in repeatedly bitten beekeepers if compared to sensitized and less exposed population, while atopy by itself is not evaluable as a risk factor for sensitization to hymenoptera. In conclusion either frequency and strength of exposure or distinctive feature of the subject are able to determine the occurrence of allergic disease in an almost different manner.

[Biological agents in animal breeding: an ancient but still relevant risk]. / Agenti biologici in allevamento: un rischio antico e sempre attuale.

Agricultural activities expose workers to biological risk, due to the close contact that could occur with pathogens' reservoirs, such as soil, animals, manure and animal products. The paper describes factors that have contributed on the reduction or eradication of zoonoses, such as brucellosis, salmonellosis and bovine tuberculosis (monitoring and prevention of animal infectious diseases, industrialization and mechanization of agricultural activities), and on the other hand the emergence of new risks and new diseases (adaptability of microorganisms, generation of new strains, antibiotic resistance, dissemination of vectors). The role of Occupational Medicine in the prevention of zoonoses is discussed.

[Plant protection products: new tools for exposure and risk assessment in agriculture]. / Antiparassitari: nuovi strumenti per la valutazione dell'esposizione del rischio in ambito agricolo.

Our experience in assessment and management of chemical risk in agriculture consists of three lines: i) definition and modeling of the relationships between different exposure determinants to create the possibility of doing risk assessment without measurements ii) identification, from the Acceptable Operator Exposure Levels (AOEL), of provisional biological exposure indices for pesticides; iii) identification of analytical approaches adequate for the production of the measures needed to support the above mentioned activities starting from the use of multi-residue methods, allowing the determination in one run of several active ingredients and metabolites.

[Physically-based model of pesticide application for risk assessment of agricultural workers]. / Valutazione del rischio nell'applicazione in campo di prodotti fitosanitari attraverso modelli a base fisica per la stima dell'esposizione.

Due to their unavoidable toxicity to non-target organisms, including man, the not of Plant Protection Products requires a thorough risk assessment to rationally advise safe use procedures and protection equipment by farmers. Most information on active substances and formulations, such as dermal absorption rates and exposure limits are available in the large body of regulatory data. Physically-based computational models can be used to forecast risk in real-life conditions (preventive assessment by 'exposure profiles'), to drive the cost-effective use of products and equipment and to understand the sources of unexpected exposure.

Theoretical and experimental demonstrations of a microfiber-based flexural disc accelerometer.

The proof-of-concept demonstration of a microfiber-based flexural disc accelerometer is presented. The reduced microfiber size and bending radii give rise to high device compactness and responsivity. A flexural disc accelerometer manufactured from a 10 mm long microfiber showed a performance of ~2.2 rad/g, with the responsivity expected to increase proportionally with the microfiber length.

Highly nonlinear dynamics in a slowly sedimenting colloidal gel.

We use a combination of original light scattering techniques and particles with unique optical properties to investigate the behavior of suspensions of attractive colloids under gravitational stress, following over time the concentration profile, the velocity profile, and the microscopic dynamics. During the compression regime, the sedimentation velocity grows nearly linearly with height, implying that the gel settling may be fully described by a (time-dependent) strain rate. We find that the microscopic dynamics exhibit remarkable scaling properties when time is normalized by the strain rate, showing that the gel microscopic restructuring is dominated by its macroscopic deformation.