Milk quality of Italian Mediterranean Buffalo as affected by Temperature-Humidity Index during late spring and summer

Eighteen Italian Mediterranean buffalo cows were subjected to fortnightly milk sampling from May to July 2022. Air temperature and relative humidity were monitored throughout the trial; temperature-humidity index (THI) was calculated and ranged from 69 to 79 so that 3 classes were set to study the effect of different THI on milk quality: THI less than 72 - THI < 72; THI ranging from 72 to 76 THI72-76, and THI over 76 - THI > 76. Individual milk samples from buffalo cows were analyzed for milk composition and coagulation traits, fatty acid and amino-acid composition, enzymatic and mineral profile. The THI > 76 class registered the highest lactose content and poorer milk clot characteristics in comparison with THI < 72. Exposure to THI over 76 resulted in increased contents of saturated and short- chain fatty acids in milk as well as in the highest values of atherogenic and thrombogenic indexes and the lowest essential amino-acid content. Moreover, the lowest value of Calcium, Copper and Selenium contents were found in the milk of buffalo cows exposed to THI over 72. Results confirm that Italian Mediterranean buffalo expresses a good level of thermo-tolerance, even though exposure to daily THI over 76 has a deleterious effect on some nutritional and technological properties of milk.

A novel cell-permeable peptide prevents protein SUMOylation and supports the mislocalization and aggregation of TDP-43

SUMOylation is a post-translational modification (PTM) that exerts a regulatory role in different cellular processes, including protein localization, aggregation, and biological activities. It consists of the dynamic formation of covalent isopeptide bonds between a family member of the Small Ubiquitin Like Modifiers (SUMOs) and the target proteins. Interestingly, it is a cellular mechanism implicated in several neurodegenerative pathologies and potentially it could become a new therapeutic target; however, there are very few pharmacological tools to modulate the SUMOylation process. In this study, we have designed and tested the activity of a novel small cell-permeable peptide, COV-1, in a neuroblastoma cell line that specifically prevents protein SUMOylation. COV-1 inhibits UBC9-protein target interaction and efficiently decreases global SUMO-1ylation. Moreover, it can perturb RanGAP-1 perinuclear localization by inducing the downregulation of UBC9. In parallel, we found that COV-1 causes an increase in the ubiquitin degradation system up to its engulfment while enhancing the autophagic flux. Surprisingly, COV-1 modifies protein aggregation, and specifically it mislocalizes TDP-43 within cells, inducing its aggregation and co-localization with SUMO-1. These data suggest that COV-1 could be taken into future consideration as an interesting pharmacological tool to study the cellular cascade effects of SUMOylation prevention.

Decision making in bone conduction and active middle ear implants - hearing outcomes and experiences over a 10-year period

OBJECTIVES

To review the decision-making paradigm in the recommendations of BCI and aMEI overlapping candidacy for patients with conductive or mixed HL, and to determine if there are differences in hearing and quality of life outcomes between these implantable hearing devices.

METHODS

Retrospective data from patients receiving BCI or aMEI in the past decade were analysed. Patients were grouped into: 1. BCI candidates, 2. BCI or aMEI candidates, and 3. aMEI candidates. We compared outcomes and examined the impact of BC threshold, age at implantation, and duration of hearing loss on candidacy.

RESULTS

89 participants were included: 30 BCI, 37 aMEI, and 22 BCI or aMEI candidates. All groups performed similarly in aided sound field threshold testing. BCI group had lower speech scores in quiet compared to 'BCI or aMEI.' No significant differences were found in APHAB global scores. BC threshold, duration of hearing loss, and age at implantation had no significant effects.

DISCUSSION

Outcomes were generally similar across groups, except for higher effective gain in the aMEI group.

CONCLUSION

Our proposed patient pathway and decision-making approach facilitate candidate selection for aMEI and BCI, aiming to optimise outcomes.

Results of a Novel, Nonsurgical Bone-Conduction Hearing Aid for the Treatment of Conductive Hearing Loss in Australian Children

OBJECTIVE

To determine and compare the benefits a novel adhesive bone-conduction system and a conventional bone-conduction hearing aid (BCHA) on a softband for children with conductive hearing loss.

STUDY DESIGN

Prospective, single-subject randomized, crossover trial.

SETTING

Tertiary referral center in Australia.

PARTICIPANTS

Eight children aged from 4 to 17 years with conductive hearing loss.

INTERVENTION

Rehabilitative with participants using the novel adhesive bone-conduction aid and a BCHA.

MAIN OUTCOME MEASURES

Aided thresholds, as well as speech perception in quiet, unaided and aided with the novel adhesive bone-conduction aid and BCHA on a softband. For the six older children, speech in noise testing was also conducted.

RESULTS

The mean unaided four frequency average hearing levels was 48 dB HL for air conduction, 10.5 dB HL for bone conduction, with a mean air-bone gap in the aided ear of 37.5 dB HL.Four-frequency average hearing level aided thresholds were 20.2 dB for the novel device and 19.8 dB for the BCHA, with no significant difference between the devices. Aided monosyllabic word scores improved from an average of 45% in the unaided condition to 81.6 and 85% for the novel adhesive and BCHA devices, respectively. Aided speech in noise performance improved, on average, by 1.6 dB SNR when wearing the BCHA and the novel adhesive device, with no significant difference in performance between the two devices.

CONCLUSIONS

The novel device provided equivalent performance to the BCHA on all measures and can be considered as an alternative device for pediatric patients with conductive hearing loss.

Cortical auditory evoked potential in cochlear implant users: An objective method to improve speech perception

OBJECTIVE

To investigate if cortical auditory evoked potential (CAEP) measures can be used to verify the cochlear implant (CI) map and consequently improve CI outcomes in adults with bilateral hearing loss.

DESIGN

CAEPs were measured in CI recipients using the speech tokens /m/, /g/, /t/ and /s/. If CAEP responses were present for all speech tokens, the participant's map was considered "satisfactory". If CAEP responses were absent, the CI map was considered "unsatisfactory" and therefore adjusted and CAEP measures repeated. This was repeated until auditory potentials were seen in response to all four speech tokens. Speech testing was conducted pre-CI, as well as before and after CAEP-guided map adjustments.

RESULTS

108 adult unilateral CI users participated, whose sound processors were previously programmed using subjective methods. 42 CI users elicited a CAEP response to all four speech tokens and therefore no further mapping adjustments were made. 66 subjected lacked a CAEP response to at least one speech token and had their CI map adjusted accordingly. Of those, 31 showed a CAEP response to all four speech tokens, and the average speech score significantly improved after CI map adjustments based on CAEP responses.

CONCLUSION

CAEP's are an objective tool that can be used to guide and verify CI mapping in adults CI users. Significant improvement in speech scores was observed in participants who had their CI map adjusted based on CAEP responses.

The humanistic burden of vitiligo: a systematic literature review of quality-of-life outcomes

Despite historical mischaracterization as a cosmetic condition, patients with the autoimmune disorder vitiligo experience substantial quality-of-life (QoL) burden. This systematic literature review of peer-reviewed observational and interventional studies describes comprehensive evidence for humanistic burden in patients with vitiligo. PubMed, EMBASE, Scopus and the Cochrane databases were searched through February 10, 2021, to qualitatively assess QoL in vitiligo. Two independent reviewers assessed articles for inclusion and extracted data for qualitative synthesis. A total of 130 included studies were published between 1996 and 2021. Geographical regions with the most studies were Europe (32.3%) and the Middle East (26.9%). Dermatology-specific instruments, including the Dermatology Life Quality Index (DLQI; 80 studies) and its variants for children (CDLQI; 10 studies) and families (FDLQI; 4 studies), as well as Skindex instruments (Skindex-29, 15 studies; Skindex-16, 4 studies), were most commonly used to measure humanistic burden. Vitiligo-specific instruments, including the Vitiligo-specific QoL (VitiQoL; 11 studies) instrument and 22-item Vitiligo Impact Scale (VIS-22; 4 studies), were administered in fewer studies. Among studies that reported total scores for the overall population, a majority revealed moderate or worse effects of vitiligo on patient QoL (DLQI, 35/54 studies; Skindex, 8/8 studies; VitiQoL, 6/6 studies; VIS-22, 3/3 studies). Vitiligo also had a significant impact on the QoL of families and caregivers; 4/4 studies reporting FDLQI scores indicated moderate or worse effects on QoL. In general, treatment significantly (P < 0.05) improved QoL, but there were no trends for types or duration of treatment. Among studies that reported factors significantly (P ≤ 0.05) associated with reduced QoL, female sex and visible lesions and/or lesions in sensitive areas were most common. In summary, vitiligo has clinically meaningful effects on the QoL of patients, highlighting that greater attention should be dedicated to QoL decrement awareness and improvement in patients with vitiligo.

Growth in height and body proportion from birth to adulthood in hereditary hypophosphatemic rickets: a retrospective cohort study

PURPOSE

Patients with hereditary hypophosphatemic rickets are short and disproportionate and very little information is available on segmental growth, but the body disproportion at adulthood leads us to think that the growth velocity of legs is slower.

METHODS

A total of 96 children were included and molecular testing was carried out in 42. Children who reached adult height were classified into two groups according to their compliance to conventional treatment (phosphate supplement and calcitriol). Individual growth records of height and sitting height/height were plotted using Argentine reference data in 96 children and growth curves were estimated by fitting Preece-Baines Model 1 in 19 of the children.

RESULTS

Molecular testing revealed sequence deleterious alterations or large deletions in 36/42 patients. During childhood, 76% of children grew below - 1.88 standard deviation score (SDS) and 97% had body disproportion. During adolescence, the mean peak height velocity for the good and poor compliance to treatment groups was 7.8 (0.6) and 5.4 (0.4) cm/year in boys and 7.0 (0.7) and 5.2 (0.8) cm/year in girls, respectively. At adulthood, the median sitting height/height ratio was 2.32 and 6.21 SDS for the good and poor compliance to treatment groups, respectively. The mean pubertal growth spurt of the trunk was -0.8 (1.4) SDS, with a short pubertal growth spurt of - 1.8 (0.4) SDS for limbs in the good compliance group. Median adult height in 13/29 males and 30/67 females was -4.56 and -3.16 SDS, respectively.

CONCLUSION

For all patients the growth spurt was slower, secondary to a short growth spurt of limbs, reaching a short adult height with body disproportion that was more prominent in the poor compliance group.

SIMEU position paper on non-invasive respiratory support in COVID-19 pneumonia

The rapid worldwide spread of the Coronavirus disease (COVID-19) crisis has put health systems under pressure to a level never experienced before, putting intensive care units in a position to fail to meet an exponentially growing demand. The main clinical feature of the disease is a progressive arterial hypoxemia which rapidly leads to ARDS which makes the use of intensive care and mechanical ventilation almost inevitable. The difficulty of health systems to guarantee a corresponding supply of resources in intensive care, together with the uncertain results reported in the literature with respect to patients who undergo early conventional ventilation, make the search for alternative methods of oxygenation and ventilation and potentially preventive of the need for tracheal intubation, such as non-invasive respiratory support techniques particularly valuable. In this context, the Emergency Department, located between the area outside the hospital and hospital ward and ICU, assumes the role of a crucial junction, due to the possibility of applying these techniques at a sufficiently early stage and being able to rapidly evaluate their effectiveness. This position paper describes the indications for the use of non-invasive respiratory support techniques in respiratory failure secondary to COVID-19-related pneumonia, formulated by the Non-invasive Ventilation Faculty of the Italian Society of Emergency Medicine (SIMEU) on the base of what is available in the literature and on the authors' direct experience. Rationale, literature, tips & tricks, resources, risks and expected results, and patient interaction will be discussed for each one of the escalating non-invasive respiratory techniques: standard oxygen, HFNCO, CPAP, NIPPV, and awake self-repositioning. The final chapter describes our suggested approach to the failing patient.

Flow invariants in a channel obstructed by a line of inclined rods

An experiment is conducted in a rectangular channel obstructed by a transverse line of four inclined cylindrical rods. The pressure on the surface of a central rod and the pressure drop through the channel are measured varying the inclination angle of the rods. Three assemblies of rods with different diameters are tested. The measurements were analyzed applying momentum conservation principles and semi-empirical considerations. Several invariant dimensionless groups of parameters relating the pressure at key locations of the system with characteristic dimensions of the rods are produced. It was found that the independence principle holds for most of the Euler numbers characterizing the pressure at different locations, that is, the group is independent of the inclination angle provided that the inlet velocity projection normal to the rods is used to non-dimensionalize the pressure. The resulting semi-empirical correlations can be useful for designing similar hydraulic units.

Quarantine and Mental Health Challenges for Occupational Medicine: The Case Report of a Nurse Infected With SARS-CoV-2

This case study draws attention to the psychosocial difficulties that emerged in the context of the coronavirus disease 2019 (COVID-19) outbreak in relation to the remote management of subjects with psychiatric vulnerabilities following exposure to prolonged quarantine. The case involves a 56-year-old hospital nurse, followed by the Occupational Health Department of a major university hospital in central Italy for mood instability in the context of a cyclothymic temperament. She was quarantined for occupationally acquired COVID-19 and remained positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via swab test for more than 2 months between March and May 2020. In this case study, we discuss the challenges presented by the risk of a prolonged quarantine in a psychologically vulnerable employee, the need for occupational medicine to provide adequate health surveillance of all health care workers during the COVID-19 pandemic, the effectiveness of telepsychiatry, and the difficulties in formulating a proper treatment strategy.

Qualitative and quantitative analysis of the CTX in relation to the period of intake of bisphosphonates: A systematic review

The aim of this systematic review was to determinate the true value of C-terminal crosslinking telopeptide test (CTX) in patient who takes Bisphosphonate. A comprehensive search of studies published up to March 2020 and listed in the PubMed/MEDLINE and Cochrane Library databases, was performed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta- Analyses (PRISMA) guidelines. The search identified 99 publications; 6 studies were finally deemed eligible for inclusion according to the study criteria. These studies included a total 104 patients and was selected 101. The CTX value in the various study groups is less than 150 pg/ml. There is a difference between the age of the patient and the period of taking the drug. This systematic review indicates that the CTX test has diffent predictive value in determining the risk of osteonecrosis in patients taking bisphosphonate compared to previus standard.

Criticality and conformality in the random dimer model

In critical systems, the effect of a localized perturbation affects points that are arbitrarily far from the perturbation location. In this paper, we study the effect of localized perturbations on the solution of the random dimer problem in two dimensions. By means of an accurate numerical analysis, we show that a local perturbation of the optimal covering induces an excitation whose size is extensive with finite probability. We compute the fractal dimension of the excitations and scaling exponents. In particular, excitations in random dimer problems on nonbipartite lattices have the same statistical properties of domain walls in spin glass. Excitations produced in bipartite lattices, instead, are compatible with a loop-erased self-avoiding random walk process. In both cases, we find evidence of conformal invariance of the excitations that is compatible with SLE_{κ} with parameter κ depending on the bipartiteness of the underlying lattice only.

Evaluation of the auricular surface method for subadult sex estimation on Italian modern (19th to 20th century) identified skeletal collections

OBJECTIVES

Sex estimation in subadult skeletal remains is still considered highly problematic. The aim of this research is to test the reliability of the method of subadult sex assessment proposed by Luna and co-workers in 2017, based on the analysis of the auricular surface of the ilium.

MATERIALS AND METHODS

Seven ratios and three morphological traits were recorded for 127 subadult individuals (63 males and 64 females), aged between 0 and 17 years, from several Identified Skeletal Collections of the University of Bologna. Nonparametric Mann Whitney test, Kolmogorov Smirnov test, and the Pearson correlation coefficient were used for continuous variables, whereas the Cramer Coefficient was calculated for qualitative variable. A principal component analysis was also performed on ratio values. The statistic ƞ was taken into account for both types of variables.

RESULTS

None of the ratios presented significant dimorphic results. Two qualitative variables show statistically significant differences between sexes. The overall morphology proved to be an accurate sex predictor among children aged ≥4 years (78%-86%) and meets the minimum accuracy standard (75%) for subadult sex estimation for individuals between 1 and 17 years of age. The morphology of the retroauricular end of the superior demiface (MRS) can be used with a high level of accuracy for sexing individuals from 1 to 12 years (77%-81%).

CONCLUSIONS

The metric variables did not replicate the accuracy values originally obtained by Luna and co-workers. Otherwise, the evaluation of the morphological variables proposed by the authors yielded promising results as a reliable sexing technique for individuals who died before puberty.

Clinical outcome and olanzapine plasma levels in acute schizophrenia

Purpose

This open label study was performed to evaluate the relationship between the plasma concentration of olanzapine and the response in acute schizophrenic inpatients.

Material and methods

A total of 54 inpatients, 38 males and 16 females, age ranging from 18 to 75 years, affected by Schizophrenia (DSM IV criteria) during an exacerbation phase were included in the study. Olanzapine (OLZ) was started at a dose of 5–20 mg/day and was increased to a mean dose of 15.27 mg ±5.53 S.D. Patients were evaluated at baseline, and after 2 weeks, by using BPRS, PANNS, HRS-D, EPSE, and ACS.

Results

BPRS and total PANSS showed a statistically significant improvement at the end of the study. Olanzapine plasma levels (PL) ranged from 5 to 120 ng/ml (mean 33.15 ng/ml ± 28.28 S.D.) and showed a positive correlation with OLZ dosage. A significant curvilinear correlation between OLZ PL and clinical improvement (BPRS, PANSS and HRS-D percent of amelioration) was observed.

Conclusion

Olanzapine plasma level determination seems to be a useful tool in optimizing acute treatment particularly for more problematic cases.

Complications and early mortality in percutaneous endoscopic gastrostomy placement in lombardy: A multicenter prospective cohort study

BACKGROUND

Percutaneous endoscopic gastrostomy (PEG) is the most common endoscopic procedure used to provide nutritional support.

AIM

To prospectively evaluate the mortality and complication incidences after PEG insertion or replacement.

METHODS

All patients who underwent PEG insertion or replacement were included. Details on patient characteristics, ongoing therapies, comorbidities, and indication for PEG placement/replacement were collected, along with informed consent form signatures. Early and late (30-day) complications and mortality were assessed.

RESULTS

950 patients (47.1% male) were enrolled in 25 centers in Lombardy, a region of Northern Italy. Patient mean age was 73 years. 69.5% of patients had ASA status 3 or 4. First PEG placement was performed in 594 patients. Complication and mortality incidences were 4.8% and 5.2%, respectively. The most frequent complication was infection (50%), followed by bleeding (32.1%), tube dislodgment (14.3%), and buried bumper syndrome (3.6%). At multivariable analysis, age (OR 1.08 per 1-year increase, 95% CI, 1.0-1.16, p = 0.010) and BMI (OR 0.86 per 1-point increase, 95% CI, 0.77-0.96, p = 0.014) were factors associated with mortality. PEG replacement was carried out in 356 patients. Thirty-day mortality was 1.8%, while complications occurred in 1.7% of patients.

CONCLUSIONS

Our data confirm that PEG placement is a safe procedure. Mortality was not related to the procedure itself, confirming that careful patient selection is warranted.

Bcl-2 Is a Therapeutic Target for Hypodiploid B-Lineage Acute Lymphoblastic Leukemia

Acute lymphoblastic leukemia (ALL) is the most common cancer in children. The highest rates of treatment failure occur in specific genetic subsets of ALL, including hypodiploid B-cell ALL (B-ALL), for which effective alternative therapies to current intensive chemotherapy treatments have yet to be developed. Here, we integrated biochemical and genomic profiling with functional drug assays to select effective agents with therapeutic potential against hypodiploid B-ALL. ABT-199, a selective Bcl-2 inhibitor, was effective in reducing leukemic burden in vitro and in vivo in patient-derived xenograft models of hypodiploid B-ALL. Daily oral treatment with ABT-199 significantly increased survival in xenografted mice. The unexpected efficacy of ABT-199 observed in hypodiploid leukemias lacking BIM expression (the major reported mediator of ABT-199-induced apoptosis) led us to investigate the mechanism of action of ABT-199 in the absence of BIM. Treatment with ABT-199 elicited responses in a dose-dependent manner, from cell-cycle arrest at low nanomolar concentrations to cell death at concentrations above 100 nmol/L. Collectively, these results demonstrate the efficacy of Bcl-2 inhibition and potential therapeutic strategy in hypodiploid B-ALL. SIGNIFICANCE: These results demonstrate the efficacy of ABT-199 in vivo and provide encouraging preclinical data of Bcl-2 as a potential target for the treatment of hypodiploid B-ALL.

Using aided cortical assessment as an objective tool to evaluate cochlear implant fitting in users with single-sided deafness

OBJECTIVES

To assess the use of cortical auditory evoked potentials (CAEPs) to verify, and if necessary, optimize the cochlear implant (CI) fitting of adult CI users with postlingual single-sided deafness (SSD).

METHODS

Sound field cortical responses to the speech tokens /m/, /g/, /t/, and /s/ were recorded from input to the CI while the normal hearing ear was masked. Responses were evaluated by visual inspection and classified as presence or absence of the CAEPs components P1, N1, P2. In case of an absence fitting was adjusted accordingly. After fitting, subjects were asked to use their new setting for 2-3 weeks for acclimatization purposes and then return for retesting. At retesting, new CAEP recordings were performed to objectively ensure that the new fitting maps effectively activated the auditory cortex.

RESULTS

In 14/19 subjects, as per visual inspection, clear CAEPs were recorded by each speech token and were, therefore, not refit. In the other 5 subjects, CAEPs could not be evoked for at least one speech token. The fitting maps in these subjects were adjusted until clear CAEPs were evoked for all 4 speech tokens.

CONCLUSIONS

CAEP can be used to quickly and objectively verify the suitability of CI fitting in experienced adult CI users with SSD. If used in the early post-implantation stage, this method could help CI users derive greater benefit for CI use and, therefore, be more committed to auditory training.

Correction to: Variations of characteristic time scales in rotating stratified turbulence using a large parametric numerical study

After publication of the paper, an error in computing the ratio γ of kinetic to potential energy transfer times has been detected, which has led the authors to amend two figures, as explained in the main text.

Martina Franca donkey meat quality: Influence of slaughter age and suckling technique

This work aimed to evaluate the effect of suckling technique and slaughter age on Martina Franca donkey meat quality. Twenty Martina Franca male foals were involved in the trial. Foals naturally assumed colostrum within 4h from birth. Afterwards, 10 foals were partially artificially suckled (AS), and 10 foals were naturally suckled (NS). All the foals were weaned at 180d, then housed indoors and fed the same diet. Ten donkeys were slaughtered at 12months and the other 10 at the age of 18months. Samples of Longissimus thoracis et lumborum (LTL) were taken from each foal for chemical analysis, then rheological parameters, oxidative profile, colorimetric parameters and fatty acid profile were assessed. Older donkeys (18months) fed with natural milk presented the highest intramuscular fat (IMF) and meat protein content. From a dietary view point, IMF acid composition showed a more favourable profile in meat from artificially-reared donkeys compared to naturally-suckled ones.

Small-bowel capsule endoscopy with panoramic view: results of the first multicenter, observational study (with videos)

BACKGROUND AND AIMS

The first small-bowel video-capsule endoscopy (VCE) with 360° panoramic view has been developed recently. This new capsule has wire-free technology, 4 high-frame-rate cameras, and a long-lasting battery life. The aim of the present study was to assess the performance and safety profile of the 360° panoramic-view capsule in a large series of patients from a multicenter clinical practice setting.

METHODS

Consecutive patients undergoing a 360° panoramic-view capsule procedure in 7 European Institutions between January 2011 and November 2015 were included. Both technical (ie, technical failures, completion rate) and clinical (ie, indication, findings, retention rate) data were collected by means of a structured questionnaire. VCE findings were classified according to the likelihood of explaining the reason for referral: P0, low; P1, intermediate; P2, high.

RESULTS

Of the 172 patients (94 men; median age, 68 years; interquartile range, 53-75), 142 underwent VCE for obscure (32 overt, 110 occult) GI bleeding (OGIB), and 28 for suspected (17) or established (2) Crohn's disease (CD). Overall, 560 findings were detected; 252 were classified as P2. The overall diagnostic yield was 40.1%; 42.2% and 30.0% in patients with OGIB and CD, respectively. The rate of complete enteroscopy was 90.2%. All patients but one, who experienced capsule retention (1/172, 0.6%), excreted and retrieved the capsule. VCE failure occurred in 4 of 172 (2.3%) patients because of technical problems.

CONCLUSIONS

This multicenter study, conducted in the clinical practice setting and based on a large consecutive series of patients, showed that the diagnostic yield and safety profile of the 360° panoramic-view capsule are similar to those of forward-view VCEs.

Peripheral blood mononuclear cell proliferation and cytokine production in sheep as affected by cortisol level and duration of stress

A large number of studies recognize glucocorticoids (Gc) as suppressors of inflammation; Gc exert an important role in coordinating the magnitude and duration of host immune responses. In the present in vitro investigation, we tested incremental levels of cortisol to verify the immunosuppressive or immunopermissive role of cortisol in sheep peripheral blood mononuclear cells (PBMC) after acute and chronic stress. Phytohemagglutinin (PHA)-stimulated PBMC were cultured for 24h and 96h at 37°C with 5% of CO₂ and varying cortisol levels: 10 ng/mL (baseline), 100 ng/mL (physiological poststressor), and 1,000 ng/mL [hyperactivated hypothalamic-pituitary-adrenal (HPA) axis]. The cell-free supernatants were collected for determination of IL-6, IL-1β, and IL-10 by ELISA, and the bromodeoxyuridine assay was performed on cells. Physiological cortisol concentration negatively affected the levels of IL-6 secreted by PBMC, resulting in increased cell proliferation after acute stress (24h of incubation). However, physiological cortisol concentration exhibited a reduction in cell proliferation induced by increased levels of IL-6 secreted by PBMC during chronic stress (96h of incubation). The cortisol concentration representing a hyperactivated HPA axis led to a reduction in cell proliferation after acute stress, which was probably induced by the elevated IL-10 production. Our results demonstrate that in sheep the effect of Gc on the immune system was related to the magnitude and the duration of stress. In particular, cortisol levels higher than physiological concentrations suppressed cell proliferation soon after acute stress. Instead, the physiological poststressor concentration of cortisol affected the immune responses in a bidirectional manner depending on the duration of the stressor.

Quality of buffalo milk as affected by dietary protein level and flaxseed supplementation

The aim of the present research was to evaluate the effects of protein level and flaxseed supplementation on the yield and quality of buffalo milk. In particular, the fatty acid profile of milk from buffalo cows subjected to different diets has been investigated. A 2×3 factorial design was tested with buffalo cows receiving 2 dietary crude protein (CP) and 3 flaxseed (FS) supplementation levels. Treatments were (1) low dietary CP level [12% of dry matter (DM)] and no flaxseed supplementation (LP); (2) low dietary CP level (12% of DM) and low flaxseed supplementation (500g/d) (LPFS500); (3) low dietary CP level (12% of DM) and moderate flaxseed supplementation (1,000g/d) (LPFS1000); (4) moderate dietary CP level (15% of DM) and no flaxseed supplementation (MP); (5) moderate dietary CP level (15% of DM) and low flaxseed supplementation (500g/d) (MPFS500); and (6) moderate dietary CP level (15% of DM) and moderate flaxseed supplementation (1,000g/d) (MPFS1000). Milk protein and casein were affected by flaxseed supplementation being higher in MP, intermediate in LP, and lower in flaxseed-supplemented diets. However, the results from the present study highlighted that low protein diets sustained milk yield, protein, and casein synthesis in milk when whole flaxseed was administered. Short-chain fatty acids, in particular C8:0 and C10:0, were the lowest in milk from buffalo cows fed the highest level of flaxseed supplementation. Medium-chain fatty acids were the lowest in FS1000, intermediate in FS500, and the highest in the HP and LP groups. Long-chain fatty acids were the highest in FS1000, intermediate in FS500 groups, and the lowest in milk from buffalo receiving no flaxseed supplementation. Protein level of the diet influenced the percentage of C18:0, which was higher in MP than LP groups. Total conjugated linoleic acid content evidenced the same trend of long-chain fatty acids, with an increase of about 7% in FL500 and of 22% in FL1000 than the control. Apart from protein level of the diet, atherogenic index, thrombogenic index, and n-6/n-3 were the lowest in FS1000 groups; thrombogenic index and n-6/n-3 were intermediate in milk from animals receiving FS500. Nutritional value of the acidic profile in buffalo milk is influenced by flaxseed supplementation, and its improvement reflects the level of dietary flaxseed supplementation.

Current progress of Reelin in development, inflammation and tissue remodeling: from nervous to visual systems

Reelin is a matrix glycoprotein that plays a pivotal role for the positioning of neurons throughout brain development. In the early developing cortex Reelin regulates radial migration of cortical neurons while later in development, Reelin promotes maturation of dendrites and dendritic spines. Low Reelin levels characterize healthy adult brain while increased Reelin levels have been associated with cellular events underlying response to injury. Reelin has been detected in structural and immune cells outside brain (liver, gut/colon tracts, kidney, testis, ovary, lung, retina and cornea). In the Visual system, Reelin was first described in the retina and thereafter in the cornea. Increased Reelin levels were observed during retinogenesis, low levels were found in adulthood and a significant increase was detected upon injury. Insult-driven Reelin changes occur after upregulation of adhesion molecules, cytokines, neurotrophins, growth factors, neuropeptides and other mediators as well as their receptors. These soluble factors contribute to the development of nervous and visual system and promote survival/recovery of neurons/accessory cells populating the injured visual system. Likewise, Reelin might modulate these factors by driving different multiple effects on homeostasis/plasticity, inflammation, healing and remodeling at different physiopathological levels. Very low-density lipoprotein receptor, apolipoprotein E receptor 2, integrins and the adaptor molecule Disabled 1 trigger Reelin. Recent advances highlight some Reelin activities during inflammation and tissue remodeling and point out to a crucial Reelin activity in the visual system. A better understanding of Reelin function in retinal development might open to new attractive perspective for counteracting retina degeneration.

Psychological and behavioral acculturation in a social network of Mexican Americans in the United States and use of dental services

OBJECTIVES

We used data from the TalaSurvey study to examine associations between dental health experiences, social network characteristics, and levels of behavioral and psychological acculturation in one location in the American Midwest.

METHODS

Starting in parishes and community organizations, we identified adults of Mexican origin living in Indianapolis, who were 1st- or 2nd-generation immigrants from Tala, Mexico. Using a social networks methodology and following extensive formative research, we created an egocentric social network survey and administered it via face-to-face interviews. We identified the peers (alters) in interviewees' (egos) personal networks. We asked egos about multiple oral health and dental care variables for self and for alters. Acculturation (psychological and behavioral) was measured with a validated tool. Through logistic and negative binomial regression, we examined the effects of acculturation and network composition on ego's dental insurance status, dental office visits, and the reason for most recent dental office visit.

RESULTS

A total of 332 egos (mean age 36; 63% female) were interviewed: 90% were born in Mexico; 45% had completed elementary school or lower; and most had low income. Each ego named 3.9 (SD±1.9) alters in his/her personal network, for a total of 1299 alters (mean age 39; 61% female). Both behavioral acculturation and psychological acculturation were moderately associated with dental insurance coverage, and greater behavioral acculturation predicted more frequent dental care. More psychologically acculturated egos were more likely to seek preventive care. Further, egos with more highly educated networks sought care more frequently and for preventive purposes, net of ego's own education and acculturation.

CONCLUSIONS

This study contextualizes acculturation of Mexican Americans within the personal networks in which oral health discussion takes place. The findings underscore the critical importance of acculturation and social network factors in shaping a subgroup of Latinos' orientation toward dental care.

Cochlear implantation in adults with unilateral deafness: A review of the assessment/evaluation protocols

OBJECTIVES

Cochlear implantation is becoming widely used outside the tertiary research centers for treatment of unilateral deafness (UD). No consensus exists, however, on the most suitable assessment/evaluation protocols for this group of adult patients. This paper aims to review the assessment and evaluation protocols used by various research groups and to propose a protocol for the use in the clinical setting.

METHODS

The PubMed, Embase, and Cochrane Library databases were searched with the keywords 'cochlear', 'implant', 'single-sided', 'deafness', 'adults', 'unilateral', and 'deafness'. The words were either used individually, combined in pairs, or in groups of 5. All articles reporting on prospective studies, retrospective studies, or case studies were included.

RESULTS

Sixteen published studies met the inclusion criteria. Measures of hearing performance, tinnitus, subjective quality of hearing, and quality of life varied greatly among studies.

DISCUSSION

Adaptive speech in noise testing, localization, tinnitus measurement questionnaires, and self-rated hearing improvement are widely used among the research groups. These tools in conjunction assess and evaluate the main issues associated with UD.

CONCLUSION

The test battery most commonly used to assess and evaluate adult cochlea implant users with UD consists of (a) a subjective self-rating of hearing performance, (b) localization testing, and

Radiographic outcomes in the coronal plane with iASSIST™ versus optical navigation for total knee arthroplasty: A preliminary case-control study

BACKGROUND

The new navigation system iASSIST™ for total knee arthroplasty (TKA) relies on accelerometers and gyroscopes. The objective of this prospective study was to compare the accuracy of iASSIST™ to that of the conventional optical navigation system Navitrack™ by determining the rate of mechanical axis restoration (±3°), postoperative mean mechanical alignment, rate of adequate femoral and tibial component positioning, mean operative time, and occurrence of navigation-related adverse events.

HYPOTHESIS

The rate of mechanical axis restoration (±3°) is not lower with iASSIST™ than with the conventional navigation system Navitrack™.

MATERIAL AND METHODS

Of 40 patients who underwent primary TKA between October 2013 and March 2014, 20 had navigation using iASSIST™ and 20 using Navitrack™. Six months after TKA, an independent observer measured three parameters on coronal radiographs: the hip-knee-ankle angle (HKA), the mechanical lateral distal femoral angle (mLDFA), and the mechanical medial proximal tibial angle (mMPTA).

RESULTS

The two groups showed no significant differences for the rates of HKA restoration (P=0.3), adequate coronal positioning of the femoral component (P=0.12) and tibial component (P=0.12), or optimal success (P=0.09). Significant differences in favour of iASSIST™ were demonstrated for the values and angular deviations of the HKA (P=0.02) and mMPTA (P=0.01), whereas no significant difference was found for mLDFA. There were no significant differences regarding the mean operative time (P=0.06) or the occurrence of navigation-related adverse events (P=0.18).

DISCUSSION

The iASSIST™ system provides a neutral mechanical axis and optimal component position in the coronal plane in 95% of cases, indicating that it is as accurate as the optical navigation system Navitrack™.

LEVEL OF EVIDENCE

III, prospective case-control study.

Milk from different species: Relationship between protein fractions and inflammatory response in infants affected by generalized epilepsy

The present study was undertaken to evaluate the effect of protein fractions from bovine, caprine, and ovine milk on production of cytokines and reactive oxygen species (ROS) and reactive nitrogen species (RNS) by cultured peripheral blood mononuclear cells (PMBC) from infants with generalized epilepsy. Bovine, caprine, and ovine bulk milks were pasteurized and analyzed for chemical composition. Then, PBMC were isolated from 10 patients with generalized epilepsy (5 males; mean age 33.6±5.4mo). Production of tumor necrosis factor-α (TNF-α), IL-10, IL-6, and IL-1β was studied in cultured PBMC (from infants with epilepsy and controls) stimulated by bovine, caprine, and ovine milk and casein and whey protein fractions, and levels of ROS and RNS were measured in the culture supernatant. The ability of PBMC to secrete cytokines in response to milk and protein fraction stimulation may predict the secretion of soluble factor TNF-α in the bloodstream of challenged patients. Bovine, caprine, and ovine bulk milks induced low-level production of IL-10 by cultured PBMC in at least 50% of cases; the same behavior was observed in both casein and whey protein fractions for all species studied. Bovine and ovine milk and their casein fractions induced production of lower levels of IL-1β in 80% of patients, whereas caprine milk and its casein fraction induced the highest levels in 80% of patients. The amount of IL-6 detected after stimulation of PBMC by milk and its fractions for all species was lower than that of other proinflammatory cytokines. In the bovine, total free radicals were higher in bulk milk and lower in the casein fraction, whereas the whey protein fraction showed an intermediate level; in caprine, ROS/RNS levels were not different among milk fractions, whereas ovine had higher levels for bulk milk and casein than the whey protein fraction. Lower levels of ROS/RNS detected in PBMC cultured with caprine milk fraction could be responsible for the lower levels of TNF-α cytokine in the corresponding fraction. Cytokines might be useful biomarkers to discriminate the effects of foods on the inflammatory response; dietary strategies could help in alleviating the negative effects of epilepsy in infants.