δ13 C values in archaeological 14 C-AMS dated charcoals: assessing mid-Holocene climate fluctuations and human response from a high-resolution isotope record (Arslantepe, Turkey)

RATIONALE

Past climate has always influenced human adaptation to the environment. In order to reconstruct palaeoclimate fluctuations and their role in the evolution of Near Eastern societies during the mid-Holocene, high-resolution Δ13 C records from fossil wood remains at the archaeological site of Arslantepe (eastern Turkey) have been developed.

METHODS

After chemical treatment, δ13 C values were measured by sample combustion flow using a FLASH EA-CHNS instrument interfaced with a Delta V isotope ratio mass spectrometer via a CONFLO III. Two replicates per sample were analysed. The measurement precision was evaluated by propagating variations of the δ13 C values of samples and V-PDB standards, whereas the accuracy was checked by a quality control sample. To account for changes in atmospheric CO2 , Δ13 C values were calculated. In addition, 14 C/12 C ratios were measured by means of ann AMS system (3 MV tandem accelerator).

RESULTS

Mean Δ13 C curves of deciduous Quercus and Juniperus from archaeological levels between 4700 and 2000 BC (Arslantepe periods VIII-VI D) were produced, where the isotope values were ordered by the available RC ages. Interspecific variations of evergreen vs deciduous plants were postulated for the juniper Δ13 C values being higher than 3‰. The seasonal rainfall amount was recorded by the juniper remains, while the water table levels were obtained from the oak samples.

CONCLUSIONS

The local climate experienced times of enhanced/reduced precipitation in concert with regional trends. Anomalies in the air mass circulation from the Mediterranean basin also produced oscillations of rainfall amount. In such a frame the Rapid Climate Change dry events had a consistent signature in the Arslantepe Δ13 C record, thus potentially contributing to social or organisational changes at the site.

Antarctic ice sheet discharge driven by atmosphere-ocean feedbacks at the Last Glacial Termination

Reconstructing the dynamic response of the Antarctic ice sheets to warming during the Last Glacial Termination (LGT; 18,000–11,650 yrs ago) allows us to disentangle ice-climate feedbacks that are key to improving future projections. Whilst the sequence of events during this period is reasonably well-known, relatively poor chronological control has precluded precise alignment of ice, atmospheric and marine records, making it difficult to assess relationships between Antarctic ice-sheet (AIS) dynamics, climate change and sea level. Here we present results from a highly-resolved ‘horizontal ice core’ from the Weddell Sea Embayment, which records millennial-scale AIS dynamics across this extensive region. Counterintuitively, we find AIS mass-loss across the full duration of the Antarctic Cold Reversal (ACR; 14,600–12,700 yrs ago), with stabilisation during the subsequent millennia of atmospheric warming. Earth-system and ice-sheet modelling suggests these contrasting trends were likely Antarctic-wide, sustained by feedbacks amplified by the delivery of Circumpolar Deep Water onto the continental shelf. Given the anti-phase relationship between inter-hemispheric climate trends across the LGT our findings demonstrate that Southern Ocean-AIS feedbacks were controlled by global atmospheric teleconnections. With increasing stratification of the Southern Ocean and intensification of mid-latitude westerly winds today, such teleconnections could amplify AIS mass loss and accelerate global sea-level rise.

A new surgical technique for the treatment of scaphotrapezial arthritis associated with trapeziometacarpal arthritis: the narrow pseudoarthrosis

We describe a technique for treating Eaton stage IV osteoarthritis of the first ray, which is a development of our previously published technique for treating trapeziometacarpal arthritis. This simple technique is based on a limited resection arthroplasty of the first trapeziometacarpal and the scaphotrapezial joints, with the aim of inducing the formation of a narrow pseudoarthrosis at both sites. A total of 26 consecutive patients were treated for Eaton stage IV arthritis at a mean follow-up of 4.7 years (range 3.2-6.6). There were statistically significant improvements in all clinical parameters: mean appositional and oppositional pinch strength, mean DASH score (65 points pre-operatively to 8.7 points at final follow-up), and in mean visual analogue scale score (8.6 to 0.2 points). Although a larger cohort and a longer follow-up will be necessary to evaluate this new technique fully, these results encourage us to believe that the limited excision arthroplasty of the trapeziometacarpal and scaphotrapezial joints is a viable alternative to the existing surgical treatments for stage IV thumb arthritis.

LEVEL OF EVIDENCE

4.

Nutrition and Osteoporosis: Preliminary data of Campania Region of European PERsonalised ICT Supported Service for Independent Living and Active Ageing

BACKGROUND

Bone impairment and malnutrition are associated with significant disability and mortality. PERSSILAA is an European project developing health services to detect and prevent frailty in older adults by addressing cognitive, physical and nutritional.

METHODS

Subjects underwent anthropometric measurements, calcaneal quantitative ultrasound (QUS) scan and PREDIMED (PREvención con DIeta MEDiterránea) questionnaire.

AIM

To investigate the association between adherence to the Mediterranean Diet (MD) and bone health.

RESULTS

87 subjects (4 males and 83 females) 70.1±4.9 aged, were examined. Mean Body Mass Index (BMI) was 28.7±4.7(kg/m(2)): in particular 28 subjects (32.2%) resulted obese, 42 (48.3%) overweight, and only 17 (19.5%) with normal weight. Mean T score was -1.2±1.2: in particular 13 subjects (14.9%) resulted osteoporotic; 43 (49.5%) osteopenic; and 31 (35.6%) with normal bone mineral density. Regarding adherence to MD, 9 subjects (10.3%) were poorly adherent; 41 (47.2%) average adherent; 37 (42.5%) highly adherent. T-score was associated with PREDIMED score and osteoporotic subjects presented the lowest PREDIMED score (5.8±2.2).

CONCLUSIONS

These preliminary data show a significant correlation between the adherence to the MD and bone health parameters. The association between MD and bone health highlights the potential beneficial effects of nutritional interventions promoting a Mediterranean food pattern, as safe adjuvant treatment in ageing.

Trapeziometacarpal narrow pseudarthrosis: a new surgical technique to treat thumb carpometacarpal joint arthritis

We describe a technique that arose from the observation of the clinical outcome of failed arthrodeses of the thumb carpometacarpal joint. In these cases a pseudoarthrosis developed which, surprisingly, rarely lead to a poor clinical outcome. Thus we developed a simple technique which deliberately caused the formation of a narrow pseudoarthrosis in the carpometacarpal joint. We present a retrospective review of 248 consecutive patients treated for Eaton stages II and III osteoarthritis. We observed a statistically significant improvement in mean appositional and oppositional pinch strength, mean DASH score (63.8 pre-operatively to 10.5 at final follow-up), and the mean pain score (8.3 to 0.2). We conclude that trapeziometacarpal limited excision arthroplasty is a simple and reliable alternative to existing surgical techniques for treating Stage II or III thumb carpometacarpal joint arthritis.

Spinal deformity index in patients with type 2 diabetes

The objective of this study is to investigate bone metabolism, density, and quality in patients with diabetes type 2 using DEXA and spinal deformity index (SDI), a surrogate index of bone quality. Fifty-six patients with type 2 diabetes were studied; exclusion criteria were diseases and medications that affect bone and mineral metabolism. Mean age was 65 ± 7 years. Mean diabetes duration was 10 ± 7 years and mean HbA1C was 6.6 ± 0.5 %. BMI was 30 ± 4. Fifty-six sex, age, and BMI matched served as controls. All subjects underwent a clinical and biochemical examination. Spinal and femoral neck BMD were measured by DEXA, and a spine radiography was performed to assess vertebral fractures and to calculate SDI. Mean serum 25-OH vitamin D levels were 19.6 ± 3.7 ng/ml in patients and 30 ± 14 ng/ml in controls (p < 0.01). PTH serum levels were 47.9 ± 40 pg/ml in patients versus 37 ± 5.3 pg/ml in controls (p < 0.01). At lumbar spine there was a significant difference between patients and controls only for T-score (p = <0.01), while at femoral neck there was a difference in BMD (p < 0.01) and in T-score (p < 0.01). Radiological vertebral fractures were found in 46 % of patients and 17 % of controls (p < 0.05). SDI was higher in patients than in controls (p < 0.05). The percentage of fractures with T-score BMD greater than -2.5 was 69 % in patients and 10 % in controls (p < 0.05). As a conclusion, BMD was similar in patients and in controls, while SDI value was higher in patients; therefore, SDI was more specific than BMD for the diagnosis of osteoporosis due to metabolic diseases.

Thrombocytosis in children

In healthy pediatric subjects normal count platelet ranges between 250,000 μL and 450,000 μL. An elevated platelet count greater than 2 SD defines a condition of thrombocytosis. On a clinical level, thrombocytosis is classified "mild" at a platelet count between >500,000 μL and <700,000 μL; "moderate" at a platelet count between >700,000/μL and <900,000/μL; "severe" at a platelet count >900,000/μL; and "extreme" at a platelet count >1,000,000/μL. Thrombocytosis can be classified as primary or secondary. Primary thrombocytosis is divided into familial and essential. Primary thrombocytosis is an extremely rare clonal disease in childhood with incidence of one per million children, i.e., 60 times lower than in adults. It is classified as a myeloproliferative disorder with polycythemia vera, chronic myeloid leukaemia and myelofibrosis and may be associated with thrombotic or haemorrhagic events. Platelet count is generally above 1,000,000/μL. The median age at diagnosis is about 11 years. On the contrary, secondary or reactive thrombocytosis (RT) is very common in pediatric age, occurring in 3-13% of hospitalized children because of several causes. Generally, it is a reactive process caused by infection, chronic inflammation, iron deficiency, tissue damage, cancer, drugs and surgical or functional splenectomy. Thrombocytosis is mild in 72-86% of children, moderate in about 6-8%, and extreme in 0.5-3%. Consultation with a pediatric hematologist is required if elevation of platelet count persists, is unexplained or symptomatic. In the majority of cases no treatment is necessary, and the patient must be only closely monitored.

The roles of parathyroid hormone in bone remodeling: prospects for novel therapeutics

The aim of this review is to focus on the roles of PTH in bone remodeling. PTH plays a central role in regulating calcium-phosphate metabolism and its production increases in response to low serum calcium levels. A continue hypersecretion of PTH, as occurs in primary hyperparathyroidism, leads to bone resorption. On the other hand, there is clear evidence of the anabolic properties of PTH.When administered at a low dose and intermittently, this hormone seems to be able to exert positive effects on bone volume and microarchitecture. The effects of PTH are mediated by PTH/PTH-related protein receptor, a G protein that can activate the cAMP-dependent protein kinase (PK)A and calcium-dependent PKC; the activation of PKA account for most of the PTH anabolic action. The anabolic actions of PTH involve direct effects on osteoblasts and indirect effects mediated by activation of skeletal growth factors (IGF-I) and inhibition of growth factor antagonists, such as sclerostin. PTH enhances the number and the activation of osteoblast through 4 pathways: increasing osteoblast proliferation and differentiation, decreasing osteoblast apoptosis and reducing the negative effects of peroxisome proliferator activator (PPAR)γ receptor on osteoblast differentiation. Moreover PTH enhances the Wnt-β catenin pathway, that is central to osteogenesis and bone formation, inhibiting sclerostin. Finally, PTH induces the synthesis of IGF-I and, due to its prodifferentiating and pro-survival effects on osteoblasts, this could be a key mediator of PTH effect on osteoblasts. In conclusion, the intermittent administration of PTH has a pleiotropic anabolic effect on bone; further studies about mechanisms of action of PTH could be a starting point to new osteoporosis treatments.

Elevated dietary linoleic acid increases gastric carcinoma cell invasion and metastasis in mice

BACKGROUND

Dietary (n-6)-polyunsaturated fatty acids influence cancer development, but the mechanisms have not been well characterised in gastric carcinoma.

METHODS

We used two in vivo models to investigate the effects of these common dietary components on tumour metastasis. In a model of experimental metastasis, immunocompromised mice were fed diets containing linoleic acid (LA) at 2% (LLA), 8% (HLA) or 12% (VHLA) by weight and inoculated intraperitoneally (i.p.) with human gastric carcinoma cells (OCUM-2MD3). To model spontaneous metastasis, OCUM-2MD3 tumours were grafted onto the stomach walls of mice fed with the different diets. In in vitro assays, we investigated invasion and ERK phosphorylation of OCUM-2MD3 cells in the presence or absence of LA. Finally, we tested whether a cyclooxygenase (COX) inhibitor, indomethacin, could block peritoneal metastasis in vivo.

RESULTS

Both the HLA and VHLA groups showed increased incidence of tumour nodules (LA: 53%; HLA: 89%; VHLA: 100%; P<0.03); the VHLA group also displayed increased numbers of tumour nodules and higher total volume relative to LLA group in experimental metastasis model. Both liver invasion (78%) and metastasis to the peritoneal cavity (67%) were more frequent in VHLA group compared with the LLA group (22% and 11%, respectively; P<0.03) in spontaneous metastasis model. We also found that the invasive ability of these cells is greatly enhanced when exposed to LA in vitro. Linoleic acid also increased invasion of other scirrhous gastric carcinoma cells, OCUM-12, NUGC3 and MKN-45. Linoleic acid effect on OCUM-2MD3 cells seems to be dependent on phosphorylation of ERK. The data suggest that invasion and phosphorylation of ERK were dependent on COX. Indomethacin decreased the number of tumours and total tumour volume in both LLA and VHLA groups. Finally, COX-1, which is known to be an important enzyme in the generation of bioactive metabolites from dietary fatty acids, appears to be responsible for the increased metastatic behaviour of OCUM-2MD3 cells in the mouse model.

CONCLUSION

Dietary LA stimulates invasion and peritoneal metastasis of gastric carcinoma cells through COX-catalysed metabolism and activation of ERK, steps that compose pathway potentially amenable to therapeutic intervention.

Isotopic evidences for microbiologically mediated and direct C input to soil compounds from three different leaf litters during their decomposition

We show the potentiality of coupling together different compound-specific isotopic analyses in a laboratory experiment, where (13)C-depleted leaf litter was incubated on a (13)C-enriched soil. The aim of our study was to identify the soil compounds where the C derived from three different litter species is retained. Three (13)C-depleted leaf litter (Liquidambar styraciflua L., Cercis canadensis L. and Pinus taeda L., delta(13)C(vsPDB) approximately -43 per thousand), differing in their degradability, were incubated on a C4 soil (delta(13)C(vsPDB) approximately -18 per thousand) under laboratory-controlled conditions for 8 months. At harvest, compound-specific isotope analyses were performed on different classes of soil compounds [i.e. phospholipids fatty acids (PLFAs), n-alkanes and soil pyrolysis products]. Linoleic acid (PLFA 18:2omega6,9) was found to be very depleted in (13)C (delta(13)C(vsPDB) approximately from -38 to -42 per thousand) compared to all other PLFAs (delta(13)C(vsPDB) approximately from -14 to -35 per thousand). Because of this, fungi were identified as the first among microbes to use the litter as source of C. Among n-alkanes, long-chain (C27-C31) n-alkanes were the only to have a depleted delta(13)C. This is an indication that not all of the C derived from litter in the soil was transformed by microbes. The depletion in (13)C was also found in different classes of pyrolysis products, suggesting that the litter-derived C is incorporated in less or more chemically stable compounds, even only after 8 months decomposition.

[Needlestick and sharps injuries among nursing students: an emerging occupational risk]

The biohazard represents a major occupational risk among workers in the health sector, this risk is not only exclusive for healthcare workers but involve also nursing students. The study reports data of a survey on injuries from accidental puncture in a group of 223 students of the third year of Nursing of Bari University. The 18% of students say they have suffered over the past 12 months an accidental puncture with sharp instruments. The cutting device most frequently involved is the needle from the syringe and insulin. The most at risk are the recovered and disposal of the needle. The biohazard in training is further compounded by factors such as lack of experience and skill manuals consolidated combined with a non perception of the risk. In the obligation of protection, training and information to students of Nursing, the University must implement programs aimed at both knowledge of the risks to which they are exposed, as well as security procedures to contain an emerging risk, which one of injury from sharp instruments, which are exposed young students not yet in employment.