A bioinspired and sustainable route for the preparation of Ag-crosslinked alginate fibers decorated with silver nanoparticles

Functional materials obtained through green and sustainable routes are attracting particular attention due to the need to reduce the environmental impact of the chemical industry. In this work we propose a bioinspired approach for the preparation of alginate fibers containing silver nanoparticles (AgNPs), to be used for antimicrobial purposes. We demonstrate that filiform polymeric structures with length of a few meters can be easily obtained by extruding an alginate solution in an aqueous Ag+-containing bath (i.e. wet spinning) and that treating the fibers with freshly-squeezed lemon juice leads to the formation of AgNPs homogeneously distributed within the polymeric network. Using mixtures of ascorbic and citric acid to mimic lemon juice composition we highlight the influence of the aforementioned molecules on the nanoparticles formation process as well as on the properties of the fibers. Varying the amount of citric and ascorbic acid used for the treatment allows to finely tune the thermal, morphological and water absorption properties of the fibers. This evidence, along with the possibility to easily monitor the preparation through FT-IR spectroscopy, endows the fibers with a high application potential in several fields such as wound healing, water/air purification and agriculture.

Effect of Atmospheric Pressure Plasma Jet Treatments on Magnesium Phosphate Cements: Performance, Characterization, and Applications

Atmospheric pressure plasma treatments are nowadays gaining importance to improve the performance of biomaterials in the orthopedic field. Among those, magnesium phosphate-based cements (MPCs) have recently shown attractive features as bone repair materials. The effect of plasma treatments on such cements, which has not been investigated so far, could represent an innovative strategy to modify MPCs' physicochemical properties and to tune their interaction with cells. MPCs were prepared and treated for 5, 7.5, and 10 min with a cold atmospheric pressure plasma jet. The reactive nitrogen and oxygen species formed during the treatment were characterized. The surfaces of MPCs were studied in terms of the phase composition, morphology, and topography. After a preliminary test in simulated body fluid, the proliferation, adhesion, and osteogenic differentiation of human mesenchymal cells on MPCs were assessed. Plasma treatments induce modifications in the relative amounts of struvite, newberyite, and farringtonite on the surfaces on MPCs in a time-dependent fashion. Nonetheless, all investigated scaffolds show a good biocompatibility and cell adhesion, also supporting osteogenic differentiation of mesenchymal cells.

Adherence to inhaled corticosteroids and long-acting β2-agonists in asthma: A MASK-air study

INTRODUCTION

Adherence to controller medication is a major problem in asthma management, being difficult to assess and tackle. mHealth apps can be used to assess adherence. We aimed to assess the adherence to inhaled corticosteroids+long-acting β2-agonists (ICS+LABA) in users of the MASK-air® app, comparing the adherence to ICS+formoterol (ICS+F) with that to ICS+other LABA.

MATERIALS AND METHODS

We analysed complete weeks of MASK-air® data (2015-2022; 27 countries) from patients with self-reported asthma and ICS+LABA use. We compared patients reporting ICS+F versus ICS+other LABA on adherence levels, symptoms and symptom-medication scores. We built regression models to assess whether adherence to ICS+LABA was associated with asthma control or short-acting beta-agonist (SABA) use. Sensitivity analyses were performed considering the weeks with no more than one missing day.

RESULTS

In 2598 ICS+LABA users, 621 (23.9%) reported 4824 complete weeks and 866 (33.3%) reported weeks with at most one missing day. Higher adherence (use of medication ≥80% of weekly days) was observed for ICS+other LABA (75.1%) when compared to ICS+F (59.3%), despite both groups displaying similar asthma control and work productivity. The ICS+other LABA group was associated with more days of SABA use than the ICS+F group (median=71.4% versus 57.1% days). Each additional weekly day of ICS+F use was associated with a 4.1% less risk in weekly SABA use (95%CI=-6.5;-1.6%;p=0.001). For ICS+other LABA, the percentage was 8.2 (95%CI=-11.6;-5.0%;p<0.001).

CONCLUSIONS

In asthma patients adherent to the MASK-air app, adherence to ICS+LABA was high. ICS+F users reported lower adherence but also a lower SABA use and a similar level of control.

Rhinitis associated with asthma is distinct from rhinitis alone: The ARIA-MeDALL hypothesis

Asthma, rhinitis and atopic dermatitis (AD) are interrelated clinical phenotypes that partly overlap in the human interactome. The concept of "one-airway-one-disease", coined over 20 years ago, is a simplistic approach of the links between upper- and lower-airway allergic diseases. With new data, it is time to reassess the concept. This article reviews (i) the clinical observations that led to Allergic Rhinitis and its Impact on Asthma (ARIA), (ii) new insights into polysensitisation and multimorbidity, (iii) advances in mHealth for novel phenotype definition, (iv) confirmation in canonical epidemiologic studies, (v) genomic findings, (vi) treatment approaches and (vii) novel concepts on the onset of rhinitis and multimorbidity. One recent concept, bringing together upper- and lower-airway allergic diseases with skin, gut and neuropsychiatric multimorbidities, is the "Epithelial Barrier Hypothesis". This review determined that the "one-airway-one-disease" concept does not always hold true and that several phenotypes of disease can be defined. These phenotypes include an extreme "allergic" (asthma) phenotype combining asthma, rhinitis and conjunctivitis. Rhinitis alone and rhinitis and asthma multimorbidity represent two distinct diseases with the following differences: (i) genomic and transcriptomic background (Toll-Like Receptors and IL-17 for rhinitis alone as a local disease; IL-33 and IL-5 for allergic and non-allergic multimorbidity as a systemic disease), (ii) allergen sensitisation patterns (mono- or pauci-sensitisation versus polysensitisation), (iii) severity of symptoms and (iv) treatment response. In conclusion, rhinitis alone (local disease) and rhinitis with asthma multimorbidity (systemic disease) should be considered as two distinct diseases, possibly modulated by the microbiome, and may be a model for understanding the epidemics of chronic and auto-immune diseases.

N-Doped Carbon Dot Hydrogels from Brewing Waste for Photocatalytic Wastewater Treatment

The brewery industry annually produces huge amounts of byproducts that represent an underutilized, yet valuable, source of biobased compounds. In this contribution, the two major beer wastes, that is, spent grains and spent yeasts, have been transformed into carbon dots (CDs) by a simple, scalable, and ecofriendly hydrothermal approach. The prepared CDs have been characterized from the chemical, morphological, and optical points of view, highlighting a high level of N-doping, because of the chemical composition of the starting material rich in proteins, photoluminescence emission centered at 420 nm, and lifetime in the range of 5.5-7.5 ns. With the aim of producing a reusable catalytic system for wastewater treatment, CDs have been entrapped into a polyvinyl alcohol matrix and tested for their dye removal ability. The results demonstrate that methylene blue can be efficiently adsorbed from water solutions into the composite hydrogel and subsequently fully degraded by UV irradiation.

Dynamics of Water and Other Molecular Liquids Confined Within Voids and on Surface of Lignin Aggregates in Aging Bio Crude Oils

Neutron scattering methods were employed to study the microscopic structure and dynamics of Bio Crude Oils (BCOs) and their lignin fractions. The structure of the carbonaceous aggregates was investigated using Small Angle Neutron Scattering to reveal a fractal hierarchy as well as a growth of the aggregates as the aging of the BCO proceeds. Elastic Neutron Scattering measurements indicate that BCO liquid phase, comprised of water and other hydrogenated molecular liquids, is in a state of extreme confinement. Quasi-Elastic Neutron Scattering yields information on the molecular motions, indicating that long range translational diffusion is suppressed and only localized dynamics take place on the tens of picosecond time range. The obtained results provide quantitative information on the molecular activity, as aging proceed, in these reactive materials of relevance as potential renewable energy sources.

Cross-linked Porous Gelatin Microparticles with Tunable Shape, Size, and Porosity

Gelatin particles are relevant to many applications in the biomedical field due to their excellent biocompatibility and versatility. When prepared by double emulsion methods, porous microparticles with different architectures can be obtained. Controlling the shape, size, porosity, swelling, and stability against dissolution is fundamental toward their application under physiological conditions. We prepared porous gelatin microparticles from oil-in-water-in-oil emulsions, modifying the gelatin/surfactant ratio and the stirring speed. The effect on structural properties, including surface and inner porosities, was thoroughly assessed by multiple microscopy techniques (optical, electron, and confocal Raman). Selected samples were cross-linked with glutaraldehyde or glyceraldehyde, and their swelling properties and stability against dissolution were evaluated, while the influence of the cross-linking at the nanoscale was studied by scattering of X-rays. Depending on the preparation protocol, we obtained particles with different shapes (irregular or spherical), radii within ∼40 to 90 μm, and porosities up to 10 μm. The cross-linking extends the stability in water from a few minutes up to several days while the swelling ability and the mesh size at the nanoscale of the gelatin network are preserved. The analysis of the experimental results as a function of the preparation parameters demonstrates that microparticles with tunable features can be designed.

3D printable magnesium-based cements towards the preparation of bioceramics

HYPOTHESIS

Among all the materials used so far to replace and repair damaged bone tissues, magnesium silicate bioceramics are one of the most promising, thanks to their biocompatibility, osteoinductive properties and good mechanical stability.

EXPERIMENTS

Magnesium silicate cement pastes were prepared by hydration of MgO mixed with different SiO₂ batches at different Mg/Si molar ratios. Pastes were either moulded or 3D printed to obtain set cements that were then calcined at 1000 °C to produce biologically relevant ceramic materials. Both cements and ceramics were characterized by means of X-ray diffraction, while two selected formulations were thoroughly characterized by means of injectability tests, Raman confocal microscopy, scanning electron microscopy, atomic force microscopy, gas porosimetry, X-ray microtomography and compressive tests.

FINDINGS

The results show that bioceramic scaffolds, namely forsterite and clinoenstatite, can be effectively obtained by 3D printing MgO/SiO₂ cement pastes, paving the way towards important advances in the field of bone tissue engineering.

Physico-Chemical Challenges in 3D Printing of Polymeric Nanocomposites and Hydrogels for Biomedical Applications

Additive manufacturing techniques (i.e., 3D printing) are rapidly becoming one of the most popular methods for the preparation of materials to be employed in many different fields, including biomedical applications. The main reason is the unique flexibility resulting from both the method itself and the variety of starting materials, requiring the combination of multidisciplinary competencies for the optimization of the process. In particular, this is the case of additive manufacturing processes based on the extrusion or jetting of nanocomposite materials, where the unique properties of nanomaterials are combined with those of a flowing matrix. This contribution focuses on the physico-chemical challenges typically faced in the 3D printing of polymeric nanocomposites and polymeric hydrogels intended for biomedical applications. The strategies to overcome those challenges are outlined, together with the characterization approaches that could help the advance of the field.

Sustainable Strategies in the Synthesis of Lignin Nanoparticles for the Release of Active Compounds: A Comparison

The preparation of nanoparticles represents a powerful tool for lignin valorization, as it combines easy methodologies with high application potential. Different synthetic strategies and various lignin sources have been employed in the process. However, the great variability in the lignin structure prevents a direct comparison of the so far reported lignin nanoparticles (LNPs), especially as regards their physicochemical and functional properties. To this purpose, two green protocols, that is, solvent-antisolvent and hydrotropic, were optimized and used to generate LNPs from the same softwood kraft lignin. The nanomaterials were fully characterized to extrapolate structure/property relationships and reveal any differences in the mechanism of self-assembly. Furthermore, tests on methylene blue entrapment capacity and release behavior at two different pH values (2.0 and 7.4) evidenced a clear dependence on the LNPs characteristics and thus on the strategy adopted for their production.

Correlation between work impairment, scores of rhinitis severity and asthma using the MASK-air® App

BACKGROUND

In allergic rhinitis, a relevant outcome providing information on the effectiveness of interventions is needed. In MASK-air (Mobile Airways Sentinel Network), a visual analogue scale (VAS) for work is used as a relevant outcome. This study aimed to assess the performance of the work VAS work by comparing VAS work with other VAS measurements and symptom-medication scores obtained concurrently.

METHODS

All consecutive MASK-air users in 23 countries from 1 June 2016 to 31 October 2018 were included (14 189 users; 205 904 days). Geolocalized users self-assessed daily symptom control using the touchscreen functionality on their smart phone to click on VAS scores (ranging from 0 to 100) for overall symptoms (global), nose, eyes, asthma and work. Two symptom-medication scores were used: the modified EAACI CSMS score and the MASK control score for rhinitis. To assess data quality, the intra-individual response variability (IRV) index was calculated.

RESULTS

A strong correlation was observed between VAS work and other VAS. The highest levels for correlation with VAS work and variance explained in VAS work were found with VAS global, followed by VAS nose, eye and asthma. In comparison with VAS global, the mCSMS and MASK control score showed a lower correlation with VAS work. Results are unlikely to be explained by a low quality of data arising from repeated VAS measures.

CONCLUSIONS

VAS work correlates with other outcomes (VAS global, nose, eye and asthma) but less well with a symptom-medication score. VAS work should be considered as a potentially useful AR outcome in intervention studies.

Cypress pollen allergy in Milan: the story of an ongoing growth

Summary

Cypress pollen allergy was virtually absent in Lombardy about 30 years ago. A 15-year clinical survey on cypress pollen sensitization and allergy in the area north of Milan reveals that both cypress pollen sensitization and allergy increased steadily from 2003 to 2017 along with the prevalence of clinical allergy over sensitization. The pollen concentration data, recorded up from 1995 showed a dramatic increase in cypress Annual Pollen Index up from the beginning of the new millennium. Cypress pollen represents now a relevant allergen source in this area.

Liquid Crystal-Induced Myoblast Alignment

The ability to control cell alignment represents a fundamental requirement toward the production of tissue in vitro but also to create biohybrid materials presenting the functional properties of human organs. However, cell cultures on standard commercial supports do not provide a selective control on the cell organization morphology, and different techniques, such as the use of patterned or stimulated substrates, are developed to induce cellular alignment. In this work, a new approach toward in vitro muscular tissue morphogenesis is presented exploiting liquid crystalline networks. By using smooth polymeric films with planar homogeneous alignment, a certain degree of cellular order is observed in myoblast cultures with direction of higher cell alignment corresponding to the nematic director. The molecular organization inside the polymer determines such effects since no cell organization is observed using homeotropic or isotropic samples. These findings represent the first example of cellular alignment induced by the interaction with a nematic polymeric scaffold, setting the stage for new applications of liquid crystal polymers as active matter to control tissue growth.

Molecule-Graphene Hybrid Materials with Tunable Mechanoresponse: Highly Sensitive Pressure Sensors for Health Monitoring

The development of pressure sensors is crucial for the implementation of electronic skins and for health monitoring integrated into novel wearable devices. Tremendous effort is devoted toward improving their sensitivity, e.g., by employing microstructured electrodes or active materials through cumbersome processes. Here, a radically new type of piezoresistive pressure sensor based on a millefeuille-like architecture of reduced graphene oxide (rGO) intercalated by covalently tethered molecular pillars holding on-demand mechanical properties are fabricated. By applying a tiny pressure to the multilayer structure, the electron tunnelling ruling the charge transport between successive rGO sheets yields a colossal decrease in the material's electrical resistance. Significantly, the intrinsic rigidity of the molecular pillars employed enables the fine-tuning of the sensor's sensitivity, reaching sensitivities as high as 0.82 kPa^-1 in the low pressure region (0-0.6 kPa), with short response times (≈24 ms) and detection limit (7 Pa). The pressure sensors enable efficient heartbeat monitoring and can be easily transformed into a matrix capable of providing a 3D map of the pressure exerted by different objects.

The role of mobile apps in allergic respiratory diseases: an Italian multicentre survey report

Summary

We performed a multicentre survey about the role of mobile apps in allergic respiratory diseases. The main objective was to investigate the current use and usefulness of mobile phone apps in the management of allergic respiratory disease. An original questionnaire including 12 multiple-choice questions was administered to 360 participants (153 male and 207 female subjects). Of notice, 290 subjects owned a smartphone, 120 a personal computer and 68 a tablet (multiple answers were possible). 123 subjects reported to be regular mobile-apps users, 209 were occasional users and 76 has never downloaded an app. Indeed, 259 subjects have never dealt with a medical or healthcare app, with only 8 subjects answering to often take advantage of such supportive tools. Data were even more discouraging when asking whether subjects had ever downloaded an app directly related to their own medical condition (allergy, asthma and rhinitis). 87.2% provided a negative answer. Among the few individuals who reported a previous experience with allergy/asthma apps only 2 subjects reported to regularly use the apps they had downloaded, even after months. The majority of subjects believed the apps would provide a relevant support, but only 25/360 participants found that the apps are "truly helpful", while 44 considered them of "help but not essential". Our data seem to show that the apps in the medical field, especially for allergic respiratory diseases, are welcome by patients, but their continued use and utility wane with the passage of time from the date of the download. In the future it will therefore be important to focus on the quality of the apps themselves and on the careful selection of the most suitable patients to use them. Finally, it will be important to make use of the fundamental contribution of healthcare professionals for the development of the apps.

Ambrosia pollen source inventory for Italy: a multi-purpose tool to assess the impact of the ragweed leaf beetle (Ophraella communa LeSage) on populations of its host plant

Here, we produce Ambrosia pollen source inventories for Italy that focuses on the periods before and after the accidental introduction of the Ophraella communa beetle. The inventory uses the top-down approach that combines the annual Ambrosia pollen index from a number of monitoring stations in the source region as well as Ambrosia ecology, local knowledge of Ambrosia infestation and detailed land cover information. The final inventory is gridded to a 5 × 5-km resolution using a stereographic projection. The sites with the highest European Infection levels were recorded in the north of Italy at Busto Arsizio (VA3) (European Infection level 2003-2014 = 52.1) and Magenta (MI7) (European Infection level 2003-2014 = 51.3), whereas the sites with the lowest (i.e. around 0.0) were generally located to the south of the country. Analysis showed that the European Infection level in all of Italy was significantly lower in 2013-2014 compared to 2003-2012, and this decrease was even more pronounced at the sites in the area where Ophraella communa was distributed. Cross-validations show that the sensitivity to the inclusion of stations is typically below 1% (for two thirds of the stations) and that the station Magenta (MI7) had the largest impact compared to all other stations. This is the first time that pollen source inventories from different temporal periods have been compared in this way and has implications for simulating interannual variations in pollen emission as well as evaluating the management of anemophilous plants like Ambrosia artemisiifolia.

Allergen immunotherapy for allergic asthma: A systematic review and meta-analysis

BACKGROUND

To inform the development of the European Academy of Allergy and Clinical Immunology's (EAACI) Guidelines on Allergen Immunotherapy (AIT) for allergic asthma, we assessed the evidence on the effectiveness, cost-effectiveness and safety of AIT.

METHODS

We performed a systematic review, which involved searching nine databases. Studies were screened against predefined eligibility criteria and critically appraised using established instruments. Data were synthesized using random-effects meta-analyses.

RESULTS

98 studies satisfied the inclusion criteria. Short-term symptom scores were reduced with a standardized mean difference (SMD) of -1.11 (95% CI -1.66, -0.56). This was robust to a prespecified sensitivity analyses, but there was evidence suggestive of publication bias. Short-term medication scores were reduced SMD -1.21 (95% CI -1.87, -0.54), again with evidence of potential publication bias. There was no reduction in short-term combined medication and symptom scores SMD 0.17 (95% CI -0.23, 0.58), but one study showed a beneficial long-term effect. For secondary outcomes, subcutaneous immunotherapy (SCIT) improved quality of life and decreased allergen-specific airway hyperreactivity (AHR), but this was not the case for sublingual immunotherapy (SLIT). There were no consistent effects on asthma control, exacerbations, lung function, and nonspecific AHR. AIT resulted in a modest increased risk of adverse events (AEs). Although relatively uncommon, systemic AEs were more frequent with SCIT; however no fatalities were reported. The limited evidence on cost-effectiveness was mainly available for sublingual immunotherapy (SLIT) and this suggested that SLIT is likely to be cost-effective.

CONCLUSIONS

AIT can achieve substantial reductions in short-term symptom and medication scores in allergic asthma. It was however associated with a modest increased risk of systemic and local AEs. More data are needed in relation to secondary outcomes, longer-term effectiveness and cost-effectiveness.

Enhanced formation of hydroxyapatites in gelatin/imogolite macroporous hydrogels

HYPOTHESIS

Gelatin is widely investigated for the fabrication of synthetic scaffolds in bone tissue engineering. Practical limitations to its use are mainly due to the fast dissolution rate in physiological conditions and to the lack of pores with suitable dimensions for cell permeation. The aim of this work is to exploit imogolite clays as nucleation sites for the growth of calcium phosphates in gelatin-based hydrogels and to take advantage of a cryogenic treatment to obtain pores of ∼100µm.

EXPERIMENTS

We evaluated the effect of imogolites and a biocompatible cross-linker on the gelatin network in terms of morphology, thermal and rheological behavior. The hydrogels were cryogenically-treated and characterized to investigate the modification of the polymer network, both at the micro- and nano-scale. The samples were mineralized to investigate the effect of imogolites on the formation of calcium phosphates.

FINDINGS

The interaction between gelatin, imogolite and cross-linker leads to the modification of the hydrogel structure at the micro-scale, while minor effects are detected at the nano-scale. The cryogenic procedure is successful in generating pores with the desired size, while the presence of imogolites in the hydrogel promotes hydroxyapatites formation. These results demonstrate that imogolites can be effectively employed as functional fillers in polymer-based scaffolds.

Poly(N-isopropylacrylamide)-hydroxyapatite nanocomposites as thermoresponsive filling materials on dentinal surface and tubules

HYPOTHESIS

Dental decay, asa consequence of exposure to acidic foods and drinks, represents one of the most important tooth pathologies. Recently, enamel and dentinal surface remineralization using hydroxyapatite nano- and microparticles has been proposed; however, commercial remineralizing toothpastes are quite expensive, mostly due to the high costs of hydroxyapatite. Hence, we propose a thermoresponsive hybrid nanocomposite material as filler for tooth defects. The use of thermoresponsive composite particles aims at filling exposed dentinal tubules in response to a change of temperature in the oral cavity. In addition, the presence of the organic matrix contributes to the occlusion of the dentinal tubules, therefore reducing the needed amount of hydroxyapatite.

EXPERIMENTS

Poly-N-isopropylacrylamide microgels containing different amounts of hydroxyapatite nanoparticles were prepared via radical polymerization in the presence of N-N'-methylenebisacrylamide as cross-linker followed by mechanical grinding. The nano- and microstructure of the hydrogels and their thermal behavior were studied via small-angle X-ray scattering (SAXS), scanning electron microscopy (SEM) and differential scanning calorimetry (DSC). Defected teeth were treated with a dispersion of nanocomposite microparticles to simulate toothpaste action.

FINDINGS

The hydrogels maintain their structure and thermal responsiveness when loaded with an amount of hydroxyapatite nanoparticles up to 2.3%w/w. In addition, the lower critical solution temperature is not affected by the presence of the mineral particles. Exposed dentinal tubules on the surface of test tooth samples were successfully occluded after 15 cycles of treatment with a dispersion of nanocomposite microparticles alternated with washing steps.

"Metabolic and cardiovascular response to exercise in patients with type 1 diabetes"

PURPOSE

Physical activity is an effective therapeutic tool for cardiovascular risk prevention. However, exercise aerobic capacity of patients with type 1 diabetes (T1DM) has not been thoroughly investigated. Aim of the present study is to evaluate exercise aerobic capacity in patients with T1DM compared to a normal control population.

METHODS

This observational study included 17 T1DM patients and 17 matched healthy volunteers. Cardiopulmonary exercise test (CPET) was conducted on an electronically-braked cycle ergometer. Blood samples were collected for evaluation of glycemia and lactate levels.

RESULTS

Mean oxygen uptake at peak exercise (V'O_2,peak) was significantly lower in T1DM subjects (V'O_2,peak T1DM 2200 ± 132ml/min vs V'O_2,peak Healthy subjects of 2659 ± 120 ml/min p = 0.035). Cardiovascular response analysis did not show statistically significant differences. Respiratory exchange ratio (RER) was significantly higher in healthy subjects at peak exercise and at the first minute of recovery (p = 0.022, p = 0.024). Peak exercise lactate levels were significantly higher in healthy subjects. There was no statistical correlation between CPET results and diabetes-related parameters.

CONCLUSIONS

Patients affected by T1DM have a worse exercise tolerance than normal subjects. The two groups differed by RER which can be greatly influenced by the substrate type utilized to produce energy. Because of the impaired carbohydrate utilization, T1DM subjects may use a larger amount of lipid substrates, such hypothesis could be strengthened by the lower lactate levels found in T1DM group at peak exercise. The lack of correlation between exercise tolerance and disease-related variables suggests that the alterations found could be independent from the glycemic levels.

Functional calcium phosphate composites in nanomedicine

Calcium phosphate (CaP) materials have many peculiar and intriguing properties. In nature, CaP is found in nanostructured form embedded in a soft proteic matrix as the main mineral component of bones and teeth. The extraordinary stoichiometric flexibility, the different stabilities exhibited by its different forms as a function of pH and the highly dynamic nature of its surface ions, render CaP one of the most versatile materials for nanomedicine. This review summarizes some of the guidelines so far emerged for the synthesis of CaP composites in aqueous media that endow the material with tailored crystallinity, morphology, size, and functional properties. First, we introduce very briefly the areas of application of CaP within the nanomedicine field. Then through some selected examples, we review some synthetic routes where the presence of functional units (small templating molecules like surfactants, or oligomers and polymers) assists the synthesis and at the same time impart the functionality or the responsiveness desired for the end-application of the material. Finally, we illustrate two examples from our laboratory, where CaP is decorated by biologically active polymers or prepared within a thermo- and magneto-responsive hydrogel, respectively.

Adsorption of Amino Acids and Glutamic Acid-Based Surfactants on Imogolite Clays

Aluminum oxide surfaces are of utmost interest in different biotech applications, in particular for their use as adjuvants (i.e., booster of the immune response against infectious agents in vaccines production). In this framework, imogolite clays combine the chemical flexibility of an exposed alumina surface with 1D nanostructure. This work reports on the interaction between amino acids and imogolite, using turbidimetry, ζ-potential measurements, and Fourier transform infrared spectroscopy as main characterization tools. Amino acids with different side chain functional groups were investigated, showing that glutamic acid (Glu) has the strongest affinity for the imogolite surface. This was exploited to prepare a composite material made of a synthetic surfactant bearing a Glu polar head and a hydrophobic C₁₂ alkyl tail, adsorbed onto the surface of imogolite. The adsorption of a model drug (rhodamine B isothiocyanate) by the hybrid was evaluated both in water and in physiological saline conditions. The findings of this paper suggest that the combination between the glutamate headgroup and imogolite represents a promising platform for the fabrication of hybrid nanostructures with tailored functionalities.

Spatial and temporal variations in airborne Ambrosia pollen in Europe

The European Commission Cooperation in Science and Technology (COST) Action FA1203 "SMARTER" aims to make recommendations for the sustainable management of Ambrosia across Europe and for monitoring its efficiency and cost-effectiveness. The goal of the present study is to provide a baseline for spatial and temporal variations in airborne Ambrosia pollen in Europe that can be used for the management and evaluation of this noxious plant. The study covers the full range of Ambrosia artemisiifolia L. distribution over Europe (39°N-60°N; 2°W-45°E). Airborne Ambrosia pollen data for the principal flowering period of Ambrosia (August-September) recorded during a 10-year period (2004-2013) were obtained from 242 monitoring sites. The mean sum of daily average airborne Ambrosia pollen and the number of days that Ambrosia pollen was recorded in the air were analysed. The mean and standard deviation (SD) were calculated regardless of the number of years included in the study period, while trends are based on those time series with 8 or more years of data. Trends were considered significant at p < 0.05. There were few significant trends in the magnitude and frequency of atmospheric Ambrosia pollen (only 8% for the mean sum of daily average Ambrosia pollen concentrations and 14% for the mean number of days Ambrosia pollen were recorded in the air). The direction of any trends varied locally and reflected changes in sources of the pollen, either in size or in distance from the monitoring station. Pollen monitoring is important for providing an early warning of the expansion of this invasive and noxious plant.

ARIA 2016: Care pathways implementing emerging technologies for predictive medicine in rhinitis and asthma across the life cycle

The Allergic Rhinitis and its Impact on Asthma (ARIA) initiative commenced during a World Health Organization workshop in 1999. The initial goals were (1) to propose a new allergic rhinitis classification, (2) to promote the concept of multi-morbidity in asthma and rhinitis and (3) to develop guidelines with all stakeholders that could be used globally for all countries and populations. ARIA—disseminated and implemented in over 70 countries globally—is now focusing on the implementation of emerging technologies for individualized and predictive medicine. MASK [MACVIA (Contre les Maladies Chroniques pour un Vieillissement Actif)-ARIA Sentinel NetworK] uses mobile technology to develop care pathways for the management of rhinitis and asthma by a multi-disciplinary group and by patients themselves. An app (Android and iOS) is available in 20 countries and 15 languages. It uses a visual analogue scale to assess symptom control and work productivity as well as a clinical decision support system. It is associated with an inter-operable tablet for physicians and other health care professionals. The scaling up strategy uses the recommendations of the European Innovation Partnership on Active and Healthy Ageing. The aim of the novel ARIA approach is to provide an active and healthy life to rhinitis sufferers, whatever their age, sex or socio-economic status, in order to reduce health and social inequalities incurred by the disease.

Scaling up strategies of the chronic respiratory disease programme of the European Innovation Partnership on Active and Healthy Ageing (Action Plan B3: Area 5)

Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) focuses on the integrated care of chronic diseases. Area 5 (Care Pathways) was initiated using chronic respiratory diseases as a model. The chronic respiratory disease action plan includes (1) AIRWAYS integrated care pathways (ICPs), (2) the joint initiative between the Reference site MACVIA-LR (Contre les MAladies Chroniques pour un VIeillissement Actif) and ARIA (Allergic Rhinitis and its Impact on Asthma), (3) Commitments for Action to the European Innovation Partnership on Active and Healthy Ageing and the AIRWAYS ICPs network. It is deployed in collaboration with the World Health Organization Global Alliance against Chronic Respiratory Diseases (GARD). The European Innovation Partnership on Active and Healthy Ageing has proposed a 5-step framework for developing an individual scaling up strategy: (1) what to scale up: (1-a) databases of good practices, (1-b) assessment of viability of the scaling up of good practices, (1-c) classification of good practices for local replication and (2) how to scale up: (2-a) facilitating partnerships for scaling up, (2-b) implementation of key success factors and lessons learnt, including emerging technologies for individualised and predictive medicine. This strategy has already been applied to the chronic respiratory disease action plan of the European Innovation Partnership on Active and Healthy Ageing.

Biphasic Anaphylactic Reaction to Ketorolac Tromethamine

Ketorolac tromethamine is a recent injectable non-steroidal anti-inflammatory drug (NSAID) with analgesic properties approved for short-term pain management. In spite of its increasing use both in adults and children (1-2), relatively few allergic-like reactions have been reported (3–5). Reactions are often severe, and a death occurred following an intramuscular injection of ketorolac (6).

Asthma and dietary intake: an overview of systematic reviews

Epidemiological research on the relationship between diet and asthma has increased in the last decade. Several components found in foods have been proposed to have a series of antioxidant, anti-allergic and anti-inflammatory properties, which can have a protective effect against asthma risk. Several literature reviews and critical appraisals have been published to summarize the existing evidence in this field. In the context of this EAACI Lifestyle and asthma Task Force, we summarize the evidence from existing systematic reviews on dietary intake and asthma, using the PRISMA guidelines. We therefore report the quality of eligible systematic reviews and summarize the results of those with an AMSTAR score ≥32. The GRADE approach is used to assess the overall quality of the existing evidence. This overview is centred on systematic reviews of nutritional components provided in the diet only, as a way to establish what type of advice can be given in clinical practice and to the general population on dietary habits and asthma.

Magnetic field responsive drug release from magnetoliposomes in biological fluids

The magnetically triggered drug release properties of magnetoliposomes are strongly affected by the presence of serum proteins.

Effect of acetazolamide on post-NIV metabolic alkalosis in acute exacerbated COPD patients

OBJECTIVE

Non-invasive ventilation (NIV) is an effective treatment in patients with acute exacerbation of COPD (AECOPD). However, it may induce post-hypercapnic metabolic alkalosis (MA). This study aims to evaluate the effect of acetazolamide (ACET) in AECOPD patients treated with NIV.

PATIENTS AND METHODS

Eleven AECOPD patients, with hypercapnic respiratory failure and MA following NIV, were treated with ACET 500 mg for two consecutive days and compared to a matched control group. Patients and controls were non invasively ventilated in a bilevel positive airway pressure (BiPAP) mode to a standard maximal pressure target of 15-20 cmH2O.

RESULTS

ACET intra-group analysis showed a significant improvement for PaCO2 (63.9 ± 9.8 vs. 54.9 ± 8.3 mmHg), HCO3- (43.5 ± 5.9 vs. 36.1 ± 5.4 mmol/L) and both arterial pH (7.46 ± 0.06 vs. 7.41 ± 0.06) and urinary pH (6.94 ± 0.77 vs 5.80 ± 0.82), already at day 1. No significant changes in endpoints considered were observed in the control group at any time-point. Inter-group analysis showed significant differences between changes in PaCO2 and HCO3- (delta), both at day 1 and 2. Furthermore, the length of NIV treatment was significantly reduced in the ACET group compared to controls (6 ± 8 vs. 19 ± 19 days). No adverse events were recorded in the ACET and control groups.

CONCLUSIONS

ACET appears to be effective and safe in AECOPD patients with post-NIV MA.

Pathophysiological mechanisms of exercise-induced anaphylaxis: an EAACI position statement

This document is the result of a consensus on the mechanisms of exercise-induced anaphylaxis (EIAn), an unpredictable and potentially fatal syndrome. A multidisciplinary panel of experts including exercise physiologists, allergists, lung physicians, paediatricians and a biostatistician reached the given consensus. Exercise-induced anaphylaxis (EIAn) describes a rare and potentially fatal syndrome in which anaphylaxis occurs in conjunction with exercise. The pathophysiological mechanisms underlying EIAn have not yet been elucidated although a number of hypotheses have been proposed. This review evaluates the validity of each of the popular theories in relation to exercise physiology and immunology. On the basis of this evidence, it is concluded that proposed mechanisms lack validity, and it is recommended that a global research network is developed with a common approach to the diagnosis and treatment of EIAn in order to gain sufficient power for scientific evaluation.

MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation

Several unmet needs have been identified in allergic rhinitis: identification of the time of onset of the pollen season, optimal control of rhinitis and comorbidities, patient stratification, multidisciplinary team for integrated care pathways, innovation in clinical trials and, above all, patient empowerment. MASK-rhinitis (MACVIA-ARIA Sentinel NetworK for allergic rhinitis) is a simple system centred around the patient which was devised to fill many of these gaps using Information and Communications Technology (ICT) tools and a clinical decision support system (CDSS) based on the most widely used guideline in allergic rhinitis and its asthma comorbidity (ARIA 2015 revision). It is one of the implementation systems of Action Plan B3 of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA). Three tools are used for the electronic monitoring of allergic diseases: a cell phone-based daily visual analogue scale (VAS) assessment of disease control, CARAT (Control of Allergic Rhinitis and Asthma Test) and e-Allergy screening (premedical system of early diagnosis of allergy and asthma based on online tools). These tools are combined with a clinical decision support system (CDSS) and are available in many languages. An e-CRF and an e-learning tool complete MASK. MASK is flexible and other tools can be added. It appears to be an advanced, global and integrated ICT answer for many unmet needs in allergic diseases which will improve policies and standards.

Transfer of silica-coated magnetic (Fe3O4) nanoparticles through food: a molecular and morphological study in zebrafish

The increasing use of magnetic iron oxide nanoparticles (NPs) in biomedical applications has prompted extensive investigation of their interactions with biological systems also through animal models. A variety of toxic effects have been detected in NP-exposed fish and fish embryos, including oxidative stress and associated changes, such as lipid oxidation, apoptosis, and gene expression alterations. The main exposure route for fish is through food and the food web. This study was devised to investigate the effects of silica-coated NP administration through food in zebrafish (ZF, Danio rerio). Silica-coated magnetic NPs were administered to ZF through feed (zooplankton) from day 1 to 15 posthatching (ph). Larvae were examined 6 and 15 days ph and adults 3 and 6 months ph. A multidisciplinary approach, including morphometric examination; light, transmission electron, and confocal microscopy; inductively coupled plasma emission spectrometry; and real-time polymerase chain reaction, was applied to detect NP accumulation, structural and ultrastructural damage, and activation of detoxification processes in larvae and adults. Our findings document that the silica-coated NPs: (1) do not induce toxicity in ZF, (2) are excreted through feces, and (3) do not activate detoxification processes or promote tissue/cell injury.

Polymer films removed from solid surfaces by nanostructured fluids: microscopic mechanism and implications for the conservation of cultural heritage

Complex fluids based on amphiphilic formulations are emerging, particularly in the field of conservation of works of art, as effective and safe liquid media for the removal of hydrophobic polymeric coatings. The comprehension of the cleaning mechanism is key to designing tailored fluids for this purpose. However, the interaction between nanostructured fluids and hydrophobic polymer films is still poorly understood. In this study, we show how the combination of confocal laser scanning microscopy (CLSM) and atomic force microscopy (AFM) provides interesting and complementary insight into this process. We focused on the interaction between an ethyl methacrylate/methyl acrylate 70:30 copolymer film deposited onto a glass surface and a water/nonionic surfactant/2-butanone (MEK) ternary system, with MEK being a good solvent and water being a nonsolvent for the polymer. Our results indicate a synergy between the organic solvent and the surfactant assemblies: MEK rapidly swells the outer layers of the polymer film allowing for the subsequent diffusion of solvent molecules, while the amphiphile decreases the interfacial energy between the polymeric coating and the liquid phase, favoring dewetting and dispersion of swollen polymer droplets in the aqueous phase. The chemical nature of the surfactant and the microstructure of the assemblies determine both the kinetics and the overall efficiency of polymer removal, as assessed by comparing the behavior of similar formulations containing an anionic surfactant (sodium dodecyl sulfate, SDS).

Design and characterization of a composite material based on Sr(II)-loaded clay nanotubes included within a biopolymer matrix

This paper reports on the preparation, characterization, and cytotoxicity of a hybrid nanocomposite material made of Sr(II)-loaded Halloysite nanotubes included within a biopolymer (3-polyhydroxybutyrate-co-3-hydroxyvalerate) matrix. The Sr(II)-loaded inorganic scaffold is intended to provide mechanical resistance, multi-scale porosity, and to favor the in-situ regeneration of bone tissue thanks to its biocompatibility and bioactivity. The interaction of the hybrid system with the physiological environment is mediated by the biopolymer coating, which acts as a binder, as well as a diffusional barrier to the Sr(II) release. The degradation of the polymer progressively leads to the exposure of the Sr(II)-loaded Halloysite scaffold, tuning its interaction with osteogenic cells. The in vitro biocompatibility of the composite was demonstrated by cytotoxicity tests on L929 fibroblast cells. The results indicate that this composite material could be of interest for multiple strategies in the field of bone tissue engineering.

Investigating nanoparticle properties in plasmonic nanoarchitectures with DNA by surface plasmon resonance imaging

The optimal optical coupling conditions between SPWs and nanoparticle LSPs can be achieved by overlapping the source wavelength with the wavelength of excitation of LSPs.

Antibacterial activity of silver nanoparticles grafted on stone surface

Microbial colonization has a relevant impact on the deterioration of stone materials with consequences ranging from esthetic to physical and chemical changes. Avoiding microbial growth on cultural stones therefore represents a crucial aspect for their long-term conservation. The antimicrobial properties of silver nanoparticles (AgNPs) have been extensively investigated in recent years, showing that they could be successfully applied as bactericidal coatings on surfaces of different materials. In this work, we investigated the ability of AgNPs grafted to Serena stone surfaces to inhibit bacterial viability. A silane derivative, which is commonly used for stone consolidation, and Bacillus subtilis were chosen as the grafting agent and the target bacterium, respectively. Results show that functionalized AgNPs bind to stone surface exhibiting a cluster disposition that is not affected by washing treatments. The antibacterial tests on stone samples revealed a 50 to 80 % reduction in cell viability, with the most effective AgNP concentration of 6.7 μg/cm(2). To our knowledge, this is the first report on antimicrobial activity of AgNPs applied to a stone surface. The results suggest that AgNPs could be successfully used in the inhibition of microbial colonization of stone artworks.

Exercise tolerance in systemic sclerosis patients without pulmonary impairment: correlation with clinical variables

OBJECTIVES

In systemic sclerosis (SSc) patients pulmonary vasculopathy (PV) is present in the early stage of disease and impairs dilation of affected pulmonary blood vessels, impeding pulmonary blood flow during exercise. Abnormal gas exchange findings were early investigated by cardiopulmonary exercise test (CPET).

METHODS

A total of 34 female and 6 male [median age 49 (20-63) years] SSc patients with normal chest imaging and pulmonary function tests were enrolled. Twenty healthy controls age and sex matched [16 female and 4 male; median age 51 (35-73) years] were also recruited. All subjects underwent a full clinical examination, including a nailfold video capillaros copy (NVC). An incremental symptom-limited CPET was performed with estimation of minute ventilation (VE), workload (WR), peak oxygen uptake (pVO₂2), and ventilatory efficiency (VE/VCO2 slope).

RESULTS

A reduced exercise tolerance (pVO₂<80% of predicted) was documented in 18 out of 40 subjects (45%). Six out of 18 patients with a reduced exercise tolerance showed indirect signs of ventilation perfusion mismatch (VE/ VCO2 slope >34). Patients with digital ulcers (DUs) history showed VE/VCO₂slope values significantly higher [31.4 (18-39.6)] than in patients without DUs history [26.9 (22-29.4)] (p<0.0001). VE/VCO₂slope values also significantly differed between the three capillaroscopic groups: early [26.3 (18-29.4)], active [28 (26.8-39.6)], and late [32.9 (22.4-39)] (p<0.0001). A positive correlation was found between the VE/ VCO₂slope and both Disease Activity Index (p<0.0001, r=0.59) and Disease Severity Scale (p<0.0001, r=0.73).

CONCLUSIONS

In SSc patients without evidence of pulmonary and cardiac involvement, CPET might be useful in disclosing an early PV.

Geographic and temporal variations in pollen exposure across Europe

BACKGROUND

The EC-funded EuroPrevall project examined the prevalence of food allergy across Europe. A well-established factor in the occurrence of food allergy is primary sensitization to pollen.

OBJECTIVE

To analyse geographic and temporal variations in pollen exposure, allowing the investigation of how these variations influence the prevalence and incidence of food allergies across Europe.

METHODS

Airborne pollen data for two decades (1990-2009) were obtained from 13 monitoring sites located as close as possible to the EuroPrevall survey centres. Start dates, intensity and duration of Betulaceae, Oleaceae, Poaceae and Asteraceae pollen seasons were examined. Mean, slope of the regression, probability level (P) and dominant taxa (%) were calculated. Trends were considered significant at P < 0.05.

RESULTS

On a European scale, Betulaceae, in particular Betula, is the most dominant pollen exposure, two folds higher than to Poaceae, and greater than five folds higher than to Oleaceae and Asteraceae. Only in Reykjavik, Madrid and Derby was Poaceae the dominant pollen, as was Oleaceae in Thessaloniki. Weed pollen (Asteraceae) was never dominant, exposure accounted for >10% of total pollen exposure only in Siauliai (Artemisia) and Legnano (Ambrosia). Consistent trends towards changing intensity or duration of exposure were not observed, possibly with the exception of (not significant) decreased exposure to Artemisia and increased exposure to Ambrosia.

CONCLUSIONS

This is the first comprehensive study quantifying exposure to the major allergenic pollen families Betulaceae, Oleaceae, Poaceae and Asteraceae across Europe. These data can now be used for studies into patterns of sensitization and allergy to pollen and foods.