The Wnt-dependent master regulator NKX1-2 controls mouse pre-implantation development

Embryo size, specification, and homeostasis are regulated by a complex gene regulatory and signaling network. Here we used gene expression signatures of Wnt-activated mouse embryonic stem cell (mESC) clones to reverse engineer an mESC regulatory network. We identify NKX1-2 as a novel master regulator of preimplantation embryo development. We find that Nkx1-2 inhibition reduces nascent RNA synthesis, downregulates genes controlling ribosome biogenesis, RNA translation, and transport, and induces severe alteration of nucleolus structure, resulting in the exclusion of RNA polymerase I from nucleoli. In turn, NKX1-2 loss of function leads to chromosome missegregation in the 2- to 4-cell embryo stages, severe decrease in blastomere numbers, alterations of tight junctions (TJs), and impairment of microlumen coarsening. Overall, these changes impair the blastocoel expansion-collapse cycle and embryo cavitation, leading to altered lineage specification and developmental arrest.

The Life Project of People with Autism and Intellectual Disability: Investigating Personal Preferences and Values to Enhance Self-Determination

People with autism and intellectual disabilities, much like individuals with typical development, share a fundamental right and aspiration to realise their own life projects. However, this natural pursuit is uniquely challenging for individuals with autism and intellectual disabilities due to their communication and adaptive hurdles. This growing need has prompted the development of a specific procedure for crafting life projects geared toward enhancing their quality of life. In the present work, we will describe the six key steps and the corresponding assessment, support, and verification tools essential for establishing and actualising the life project for individuals with disabilities, as conceptualised by the Italian Society of Neurodevelopmental Disorders (SIDIN). We will start by delineating diverse preference and value assessment procedures, showcasing an array of tools tailored to accommodate the distinct characteristics of adaptive and communicative functioning in individuals with disabilities. Following this, we will provide a succinct overview of support needs assessment tools. Subsequently, we will introduce the Ecological Life Balance, which serves as an integrative tool for harmonising various assessment systems. We will propose methods for defining existential goals that prioritise quality of life and suggest strategies for implementing support plans. Lastly, we will delve into the methodologies for monitoring and verifying outcomes in the final section.

ICU ENVIRONMENTAL SURFACES ARE A RESERVOIR OF FUNGI: SPECIES DISTRIBUTION IN NORTHERN ITALY

BACKGROUND

Preventing and reducing nosocomial infections is a public health goal. Concern about healthcare-associated fungal infections has increased in recent years, due to the emergence and spread of new pathogens, increasing antifungal resistance and outbreaks in hospital settings.

AIM

This study investigated the presence of medically-relevant fungal species on environmental surfaces in 12 intensive care units of 8 hospitals in Milan, Italy.

METHODS

Environmental samplings, using contact plates on surfaces near bed stations and medical workstations, were conducted between November 2019 and January 2020. Fungi isolated were identified and some were tested in vitro for antifungal susceptibility.

FINDINGS

A total of 401 environmental samples were collected from 61 bed stations and 17 medical workstations. Positive samples were found in all hospitals except one, with positivity rates ranging from 4% to 24.2%. Filamentous fungi were found mainly on infusion pumps (23.2%) and patient tables (21.2%), whereas yeasts were mainly on computers (25%) and floors (10.9%). Fungi were isolated from 12% of total samples. Filamentous fungi, mainly Aspergillus fumigatus, grew in 70.8% of positive samples, and yeasts in 27.1%, mainly Candida parapsilosis (42.8%) and C. glabrata (28.6%). Fungi were detected both near patients' beds and on surfaces at workstations, indicating potential for environment-to-patient, patient-to-patient and healthcare workers-to-patient transmission CONCLUSIONS: This study highlights that surveillance in hospital settings through environmental sampling may be an important component of fungal infection prevention.

Transcription-mediated supercoiling regulates genome folding and loop formation

The chromatin fiber folds into loops, but the mechanisms controlling loop extrusion are still poorly understood. Using super-resolution microscopy, we visualize that loops in intact nuclei are formed by a scaffold of cohesin complexes from which the DNA protrudes. RNA polymerase II decorates the top of the loops and is physically segregated from cohesin. Augmented looping upon increased loading of cohesin on chromosomes causes disruption of Lamin at the nuclear rim and chromatin blending, a homogeneous distribution of chromatin within the nucleus. Altering supercoiling via either transcription or topoisomerase inhibition counteracts chromatin blending, increases chromatin condensation, disrupts loop formation, and leads to altered cohesin distribution and mobility on chromatin. Overall, negative supercoiling generated by transcription is an important regulator of loop formation in vivo.

[Women's perception, preconceptions, and information preferences for the limitations of breast cancer screening and overdiagnosis: a think-aloud study on the new information materials of the Agency for Health Protection of the Metropolitan Area of Milan]

BACKGROUND

communicating breast cancer screening (BCS) limits and overdiagnosis implies providing complete and balanced information to allow informed decision-making.

OBJECTIVES

to describe women's perceptions, preconceptions, and information preferences regarding the breast cancer screening (BCS) programme paper and web information materials of the Agency for Health Protection of the Metropolitan Area of Milan (Lombardy Region, Northern Italy).

DESIGN

qualitative, descriptive study.

SETTING AND PARTICIPANTS

participants' voluntary recruitment took place in the registration departments of three hospitals. Participants were purposively recruited based on sociodemographic characteristics of the target population of the programme (44 women aged 40-74 years, living in the Metropolitan Area of Milan). In each material type subgroup, different health literacy levels and age classes were included, until thematic saturation was reached.

MAIN OUTCOME MEASURES

thematic analysis of qualitative data collected during think-aloud interviews.

RESULTS

the thematic analysis identified 5 main themes: 1. validation of the information reported in the materials, according to the interviewees' personal experiences;2. information preferences of particular subgroups of women, which led to a tailored approach for the web materials;3. negative emotions elicited while receiving information regarding BCS limits, which guided the rewriting of certain definitions; 4. disproportioned risk perception, with greater weight attributed to the risk of false negative results than the risk of overdiagnosis; 5. organizational preferences regarding the type and frequency of the provided tests and the age limits of the programme.

CONCLUSIONS

in the present sample of women living in the Metropolitan Area of Milan, knowledge and comprehension of overdiagnosis are scarce. The main reasons for distrust in the BCS programme rely on the preexisting beliefs regarding the most appropriate tests and age limits. These beliefs were established from previously received information, inconsistent with that officially provided by the programme.

Neurodevelopmental disorders and development of project of lifein a lifespan perspective: between habilitation and quality of life

For some years, the term "project of life" has become widely used in the field of neurodevelopmental disorders, and, at the same time, it has begun to make its way in many social and health planning documents. However, beyond its relatively widespread use, this term does not yet possess an adequate and shared frame of the main underlying decision-making processes. In particular, there is a need to identify the crucial questions for orienting the choice of goals within the adolescent transition, which represents the complex hinge between childhood and adulthood. Moreover, adulthood, which is often completely devoid of culturally and socially shared references, is still critical precisely because of the lack of future direction prompts usually represented by the stages of development. In this case, the themes of quality of life functioning as a guiding compass appear pertinent and much more relevant. The present contribution is, therefore, an attempt to present, in a unitary manner, the decision-making processes and questions at the basis of a construct of "project of life" shared within the scientific and associative communities.

Stress and wellbeing among professionals working with people with neurodevelopmental disorders. Review and intervention perspectives

Supporting individuals with NDD is extremely demanding, with significant exposure to critical contexts and events, and painful ongoing experiences. Stress and burnout condition is a main concern with growing interest in research, despite the lack of consensus on theoretical explanatory models and modification standards.The paper provides an up-to-date review of risk factors and involved processes, and presents evidence-based procedures and protocols to implement effective preventive actions addressing both organizational and individual factors. The aim is to offer a global understanding of the subject and offer examples of practical plans to increase the impact on the quality of life of clients and staff members.

Correlation between fall risk increasing drugs (FRIDs) and fall events at a rehabilitation hospital

Background and aim Falls and fall-related injuries are a major public health issue which needs global attention due to its clinical and socioeconomic impact. Important risk factors for falls are polypharmacy and the assumption of so-called Fall Risk Increasing Drugs (FRIDs). Aims of our study were to investigate the associations between falls and the use of medications among inpatients by conducting a retrospective case-control study in a rehabilitation hospital in Northern Italy in 2018. Methods A Conditional Logistic Regression was performed to analyze the impact that 13 types of FRIDs individually and the number of administrated FRIDs had on the risk of falling. A second regression model was obtained adjusting the case-control matching for CIRS, Morse and Barthel scores. Results We identified 148 cases and 444 controls. 3 types of FRIDs were significantly correlated (p < 0,05) with an increased risk of falling: Antipsychotics, Antidepressants, Diuretics. Antidepressants were the only type of FRID significantly correlated (p=0,008) even in the model adjusted for CIRS, Morse and Barthel scores. The unadjusted model showed that the addition of one type of FRID to therapy was significantly associated with the fall event (p<0.05). Conclusion Assumption of drugs, in particular antidepressant and polypharmacy, can play a role in hospital falling. The fall risk assessment tools available, suffer from low specificity and sensitivity and do not assess these risk factors. A holistic approach with a multidimensional evaluation of the patient through screening tools, functional assessment tools and a full medical evaluation should be pursued to improve prediction.

DNA methylation changes in genes involved in inflammation and depression in fibromyalgia: a pilot study

OBJECTIVES

The present pilot study aims to investigate DNA methylation changes of genes related to fibromyalgia (FM) development and its main comorbid symptoms, including sleep impairment, inflammation, depression and other psychiatric disorders. Epigenetic modifications might trigger or perpetuate complex interplay between pain transduction/transmission, central pain processing and experienced stressors in vulnerable individuals.

METHODS

We conducted DNA methylation analysis by targeted bisulfite NGS sequencing testing differential methylation in 112 genomic regions from leukocytes of eight women with FM and their eight healthy sisters as controls.

RESULTS

Tests for differentially methylated regions and cytosines brought focus on the GRM2 gene, encoding the metabotropic glutamate receptor2. The slightly increased DNA methylation observed in the GRM2 region of FM patients may confirm the involvement of the glutamate pathway in this pathological condition. Logistic regression highlighted the simultaneous association of methylation levels of depression and inflammation-related genes with FM.

CONCLUSIONS

Altogether, the results evidence the glutamate pathway involvement in FM and support the idea that a combination of methylated and unmethylated genes could represent a risk factor to FM or its consequence, more than single genes. Further studies on the identified biomarkers could contribute to unravel the causative underlying FM mechanisms, giving reliable directions to research, improving the diagnosis and effective therapies.

The Master Regulator Protein BAZ2B Can Reprogram Human Hematopoietic Lineage-Committed Progenitors into a Multipotent State

Bi-species, fusion-mediated, somatic cell reprogramming allows precise, organism-specific tracking of unknown lineage drivers. The fusion of Tcf7l1^-/- murine embryonic stem cells with EBV-transformed human B cell lymphocytes, leads to the generation of bi-species heterokaryons. Human mRNA transcript profiling at multiple time points permits the tracking of the reprogramming of B cell nuclei to a multipotent state. Interrogation of a human B cell regulatory network with gene expression signatures identifies 8 candidate master regulator proteins. Of these 8 candidates, ectopic expression of BAZ2B, from the bromodomain family, efficiently reprograms hematopoietic committed progenitors into a multipotent state and significantly enhances their long-term clonogenicity, stemness, and engraftment in immunocompromised mice. Unbiased systems biology approaches let us identify the early driving events of human B cell reprogramming.

Appropriate admission to rehabilitation: definition of a set of criteria through the Delphi Method

Background

Controlling inappropriateness of care, a widespread phenomenon, should be a global target in order to improve the quality of care, save money and ensure system sustainability. Inappropriateness is a relevant issue in public health and in rehabilitation medicine specifically. In fact, admitting a patient to a rehabilitation hospital or unit is a complex decision also due to the absence of shared and objective admission criteria. Aim of this study is to define clinical admission criteria and rules in rehabilitation medicine.

Methods

A three-round Delphi survey was conducted on a sample of rehabilitation medicine experts skilled in both rehabilitation and healthcare organization. The two initial rounds consisted of an electronic online questionnaire concerning appropriateness of admission to intensive rehabilitation while in the third one a report of the results was provided to the participants. The experts had to score their agreement with each item in the questionnaires, based on either a Likert scale or a dichotomous statement. Consensus between the experts was assessed.

Results

A total of 53 health professionals completed the Delphi survey. 19 out of 20 Italian regions were represented. The first round consisted of 8 multiple-choice questions questionnaire. The second round was designed thanks to the suggestions provided by the panelists in the previous one and consisted of a twelve items questionnaire. At the end of the survey, eight criteria of appropriateness of admission to rehabilitation were identified and five rules defining an appropriate admission to a rehabilitation facility were elaborated.

Conclusions

This study represents an attempt to create a worthwhile and reliable tool for a more conscious clinical practice in admission to rehabilitation, based on a set of shared criteria and rules.

Key messages

Improving appropriateness in healthcare delivery must be a primary goal in public health and in rehabilitation medicine specifically. Delphi method was applied to define shared clinical admission criteria and rules in rehabilitation.

Relationship between falls and Fall Risk Increasing Drugs. A retrospective case control study

Background

Falls and fall-related injuries are a major public health issue which needs global attention due to its clinical and socioeconomic impact. Inpatient falls are the most common adverse event in hospital. Important risk factors for falls are polypharmacy and the assumption of so-called Fall Risk Increasing Drugs (FRIDs). Aims of our study were to investigate the associations between falls and the use of medications among inpatients by conducting a retrospective case-control study in a rehabilitation hospital in Northern Italy in 2018.

Methods

Three unique control for each faller, matched by age, sex and hospitalization ward, were selected. A Conditional Logistic Regression was performed to analyze the impact that 13 types of FRIDs individually and the number of administrated FRIDs had on the risk of falling. A second regression model was obtained adjusting the case-control matching for CIRS, Morse and Barthel scores.

Results

We identified 148 cases and 444 controls. 3 types of FRIDs were significantly correlated (p &lt; 0,05) with an increased risk of falling: Antipsychotics [OR:1,98;CI 95%:1,01-3,89], Antidepressants [OR:2,18;CI 95%:1,32-3,59], Diuretics [OR:1,71;CI 95%:1,09-2,68]. Antidepressants were the only type of FRID significantly correlated (p = 0,008) even in the model adjusted for CIRS, Morse and Barthel scores [OR:2,00;CI 95%:1,20-3,34]. The unadjusted model showed that the addition of one type of FRID to therapy was significantly associated with the fall event (p &lt; 0.05) [OR:1.21;CI 95%: 1.05 - 1.40].

Conclusions

Assumption of drugs and polypharmacy could play a role in hospital falling. Recently developed fall risk assessment tools suffer from low specificity and sensitivity and do not assess these risk factors. A holistic approach with a multidimensional evaluation of the patient through screening tools, functional assessment tools and a full medical evaluation should be improved.

Key messages

Drugs may represent an important variable in determining the risk of falls in hospitalized patients, but they should not be considered alone. Screening tools for fall risk should take into account polypharmacy such as other intrinsic and extrinsic risk factors within an holistic approach.

A reasoned action approach to understand vaccination intention among healthcare professions students

Background

Understanding the predictors of vaccination intention among healthcare workers, including students in healthcare professions (SHPs), is crucial for policy making and for the development of evidence-driven training programs. The reasoned action approach (RAA) model includes three components to predict intention: attitude (experiential/instrumental), perceived norm (injunctive/descriptive), and perceived behavioral control (capacity/autonomy). We aimed to investigate the predictors of seasonal Flu vaccination intention among SHPs of the University of Milan.

Methods

We spread an e-survey to all medical residents and first- and last-year SHPs (medicine, nursery, midwifery, healthcare assistance and prevention techniques). The strength of association between measures of RAA components (as well as sociodemographic data, past vaccination behavior, vaccination knowledge, and perceived vaccination facilitation strategies), and vaccination intention was estimated using uni- and multivariate logistic regression models.

Results

Among 5743 invited SHPs, 884 participated in the survey and were included in the descriptive analyses (52,3% medical residents, 19,9% medicine, 21,1% nursing, 3,6% healthcare assistance, 2,7% prevention techniques and 0,5% midwifery students). Twenty-nine psycho-attitudinal items with an overall Cronbach alpha &gt;0.7 were included in the analyses. The regression analyses were performed on 751 subjects who filled in completely the survey. Past vaccination behavior, vaccination knowledge, experiential attitudes, and perceived vaccination facilitation strategies were positive predictors of Flu vaccination intention (OR 8.16, 2.42, 1.96 and 1.15 respectively, p &lt; 0.05).

Conclusions

Our results indicated knowledge, experiential attitudes and facilitation strategies as modifiable predictors of vaccination intention among SHPs. Targeted and lasting interventions are needed in order to pursue a change in the strongest predictor, past vaccination behavior.

Key messages

Past vaccination is the strongest predictor of vaccination intention among students in healthcare professions. Knowledge, attitudes and perceived facilitators predict vaccine propensity among students in healthcare professions.

Appropriateness of admission to rehabilitation: definition of a set of criteria and rules through the application of the Delphi method

BACKGROUND

Controlling inappropriateness of care is an essential issue, especially in rehabilitation medicine. In fact, admitting a patient to a rehabilitation hospital or unit is a complex decision also due to the absence of shared and objective admission criteria.

AIM

The aim was to define clinical admission criteria and rules in rehabilitation medicine.

DESIGN

Survey based on the application of the Delphi method on a sample of rehabilitation medicine experts.

SETTING

Administration of electronic online questionnaires concerning appropriateness of admission to intensive rehabilitation.

POPULATION

Volunteer sample of 53 experts with the following inclusion criteria: being members of the Italian Society of Physical and Rehabilitation Medicine, having practical experience in the research field, agreeing to the confidentiality of the information and being skilled in both rehabilitation and healthcare organization.

METHODS

A three-round Delphi survey was conducted according to international guidelines. The two initial rounds consisted of an electronic online questionnaire while in the third one a report of the results was provided to the participants. The experts had to score their agreement with each item in the questionnaires, based on either a Likert scale or a dichotomous statement. Consensus between the experts was assessed.

RESULTS

A total of 53 health professionals completed the Delphi survey. 19 out of 20 Italian regions were represented. The first round consisted of 8 multiple-choice questions. The second round was designed according to the suggestions provided by the panelists in the previous one and consisted of a twelve items questionnaire. At the end of the survey, seven criteria of appropriateness of admission to rehabilitation were identified and five rules defining an appropriate admission to a rehabilitation facility were elaborated.

CONCLUSIONS

This study represents an attempt to create a worthwhile and reliable tool for a more conscious clinical practice in admission to rehabilitation, based on a set of shared criteria and rules.

CLINICAL REHABILITATION IMPACT

To increase appropriateness of admission to rehabilitation. Improving appropriateness in healthcare delivery must be a primary goal in order to improve healthcare quality, save money and ensure system sustainability.

Consumption of sexually explicit internet material and its effects on minors' health: latest evidence from the literature

BACKGROUND

Nowadays adolescents and children are more and more exposed to sexually explicit internet material (SEIM), but most parents and healthcare professionals neglect this issue. The aim of the present study is to evaluate the impact of online pornography on minors' health with a specific focus on the effects produced on their behavioural, psychophysical and social development.

METHODS

A literature search was performed on PubMed and ScienceDirect in March 2018 with the query "(pornography OR sexually explicit internet material) AND (adolescent OR child OR young) AND (impact OR behaviour OR health)". Results published between 2013 and 2018 were analysed and compared with previous evidence.

RESULTS

According to selected studies (n = 19), an association between consumption of online pornography and several behavioral, psychophysical and social outcomes - earlier sexual debut, engaging with multiple and/or occasional partners, emulating risky sexual behaviors, assimilating distorted gender roles, dysfunctional body perception, aggressiveness, anxious or depressive symptoms, compulsive pornography use - is confirmed.

CONCLUSIONS

The impact of online pornography on minors' health appears to be relevant. The issue can no longer be neglected and must be targeted by global and multidisciplinary interventions. Empowering parents, teachers and healthcare professionals by means of educational programs targeting this issue will allow them to assist minors in developing critical thinking skills about pornography, decreasing its use and obtaining an affective and sex education that is more suitable for their developmental needs.

Whole-genome expression analysis of mammalian-wide interspersed repeat elements in human cell lines

With more than 500,000 copies, mammalian-wide interspersed repeats (MIRs), a sub-group of SINEs, represent ∼2.5% of the human genome and one of the most numerous family of potential targets for the RNA polymerase (Pol) III transcription machinery. Since MIR elements ceased to amplify ∼130 myr ago, previous studies primarily focused on their genomic impact, while the issue of their expression has not been extensively addressed. We applied a dedicated bioinformatic pipeline to ENCODE RNA-Seq datasets of seven human cell lines and, for the first time, we were able to define the Pol III-driven MIR transcriptome at single-locus resolution. While the majority of Pol III-transcribed MIR elements are cell-specific, we discovered a small set of ubiquitously transcribed MIRs mapping within Pol II-transcribed genes in antisense orientation that could influence the expression of the overlapping gene. We also identified novel Pol III-transcribed ncRNAs, deriving from transcription of annotated MIR fragments flanked by unique MIR-unrelated sequences, and confirmed the role of Pol III-specific internal promoter elements in MIR transcription. Besides demonstrating widespread transcription at these retrotranspositionally inactive elements in human cells, the ability to profile MIR expression at single-locus resolution will facilitate their study in different cell types and states including pathological alterations.

Identification of RNA Polymerase III-Transcribed SINEs at Single-Locus Resolution from RNA Sequencing Data

Short Interspersed Element (SINE) retrotransposons are one of the most abundant DNA repeat elements in the human genome. They have been found to impact the expression of protein-coding genes, but the possible roles in cell physiology of their noncoding RNAs, generated by RNA polymerase (Pol) III, are just starting to be elucidated. For this reason, Short Interspersed Element (SINE) expression profiling is becoming mandatory to obtain a comprehensive picture of their regulatory roles. However, their repeated nature and frequent location within Pol II-transcribed genes represent a serious obstacle to the identification and quantification of genuine, Pol III-derived SINE transcripts at single-locus resolution on a genomic scale. Among the recent Next Generation Sequencing technologies, only RNA sequencing (RNA-Seq) holds the potential to solve these issues, even though both technical and biological matters need to be taken into account. A bioinformatic pipeline has been recently set up that, by exploiting RNA-seq features and knowledge of SINE transcription mechanisms, allows for easy identification and profiling of transcriptionally active genomic loci which are a source of genuine Pol III SINE transcripts.

Identification of RNA polymerase III-transcribed Alu loci by computational screening of RNA-Seq data

Of the ∼1.3 million Alu elements in the human genome, only a tiny number are estimated to be active in transcription by RNA polymerase (Pol) III. Tracing the individual loci from which Alu transcripts originate is complicated by their highly repetitive nature. By exploiting RNA-Seq data sets and unique Alu DNA sequences, we devised a bioinformatic pipeline allowing us to identify Pol III-dependent transcripts of individual Alu elements. When applied to ENCODE transcriptomes of seven human cell lines, this search strategy identified ∼1300 Alu loci corresponding to detectable transcripts, with ∼120 of them expressed in at least three cell lines. In vitro transcription of selected Alus did not reflect their in vivo expression properties, and required the native 5′-flanking region in addition to internal promoter. We also identified a cluster of expressed AluYa5-derived transcription units, juxtaposed to snaR genes on chromosome 19, formed by a promoter-containing left monomer fused to an Alu-unrelated downstream moiety. Autonomous Pol III transcription was also revealed for Alus nested within Pol II-transcribed genes. The ability to investigate Alu transcriptomes at single-locus resolution will facilitate both the identification of novel biologically relevant Alu RNAs and the assessment of Alu expression alteration under pathological conditions.

Ureidoglycolate hydrolase, amidohydrolase, lyase: how errors in biological databases are incorporated in scientific papers and vice versa

An opaque biochemical definition, an insufficient functional characterization, an interpolated database description, and a beautiful 3D structure with a wrong reaction. All these are elements of an exemplar case of misannotation in biological databases and confusion in the scientific literature concerning genes and enzymes acting on ureidoglycolate, an intermediate of purine catabolism. Here we show biochemical evidence for the relocation of genes assigned to EC 3.5.3.19 (ureidoglycolate hydrolase, releasing ammonia), such as allA of Escherichia coli or DAL3 of Saccharomyces cerevisiae, to EC 4.3.2.3 (ureidoglycolate lyase, releasing urea). The EC 3.5.3.19 should be more appropriately named ureidoglycolate amidohydrolase and include genes equivalent to UAH of Arabidopsis thaliana. The distinction between ammonia- or urea-releasing activities from ureidoglycolate is relevant for the understanding of nitrogen metabolism in various organisms and of virulence factors in certain pathogens rather than a nomenclature problem. We trace the original fault in database annotation and provide a rationale for its incorporation and persistence in the scientific literature. Notwithstanding the technological distance, yet not surprising for the constancy of human nature, error categories and mechanisms established in the study of the work of amanuensis monks still apply to the modern curation of biological databases.

Identification of RNA polymerase III-transcribed genes in eukaryotic genomes

The RNA polymerase (Pol) III transcription system is devoted to the production of short, generally abundant noncoding (nc) RNAs in all eukaryotic cells. Previously thought to be restricted to a few housekeeping genes easily detectable in genome sequences, the set of known Pol III-transcribed genes (class III genes) has been expanding in the last ten years, and the issue of their detection, annotation and actual expression has been stimulated and revived by the results of recent high-resolution genome-wide location analyses of the mammalian Pol III machinery, together with those of Pol III-centered computational studies and of ncRNA-focused transcriptomic approaches. In this article, we provide an outline of distinctive features of Pol III-transcribed genes that have allowed and currently allow for their detection in genome sequences, we critically review the currently practiced strategies for the identification of novel class III genes and transcripts, and we discuss emerging themes in Pol III transcription regulation which might orient future transcriptomic studies. This article is part of a Special Issue entitled: Transcription by Odd Pols.

Fluconazole in the management of endophthalmitis in disseminated candidosis of heroin addicts

Seven heroin addicts were treated with fluconazole for endophthalmitis. All the patients had cutaneous lesions: deep-seated scalp nodules and/or pustulosis in hairy zones. One patient had an abscess at the venipuncture site. Candida albicans was isolated from all the extraocular sites in all the patients. Five patients were treated with 400 mg of intravenous fluconazole on the first day, followed by 200 mg (i.v.) for one week and finally 200 mg daily orally for a further two weeks. Two patients were treated exclusively with oral fluconazole (400 mg on the first day, followed by 200 mg daily for three consecutive weeks). Tolerance to fluconazole was good and it was not necessary to stop treatment for any patient. All the cutaneous lesions stabilized and healed. The eye lesions cleared completely in all cases, except in one patient in whom vitrectomy was indicated, and in whom there was a poor response to the exclusive treatment with fluconazole and associated corticosteroids.