Understanding how environmental degradation, microclimate, and management shape honey production across different spatial scales

Although the abundance, survival, and pollination performance of honeybees are sensitive to changes in habitat and climate conditions, the processes by which these effects are transmitted to honey production and interact with beekeeping management are not completely understood. Climate change, habitat degradation, and beekeeping management affect honey yields, and may also interact among themselves resulting in indirect effects across spatial scales. We conducted a 2-year, multi-scale study on Chiloe Island (northern Patagonia), where we evaluated the most relevant environmental and management drivers of honey produced by stationary beekeepers. We found that the effects of microclimate, habitat, and management variables changed with the spatial scale. Among the environmental variables, minimum temperature, and cover of the invasive shrub, gorse (Ulex europaeus) had the strongest detrimental impacts on honey production at spatial scales finer than 4 km. Specialized beekeepers who adopted conventional beekeeping and had more mother colonies were more productive. Mean and minimum temperatures interacted with the percentage of mother colonies, urban cover, and beekeeping income. The gorse cover increased by the combination of high temperatures and the expansion of urban lands, while landscape attributes, such as Eucalyptus plantation cover, influenced beekeeping management. Results suggest that higher temperatures change the available forage or cause thermal stress to honeybees, while invasive shrubs are indicators of degraded habitats. Climate change and habitat degradation are two interrelated environmental phenomena whose effects on beekeeping can be mitigated through adaptive management and habitat restoration.

Nanoscale Dynamics of Streptococcal Adhesion to AGE-Modified Collagen

The adhesion of initial colonizers such as Streptococcus mutans to collagen is critical for dentinal and root caries progression. One of the most described pathological and aging-associated changes in collagen-including dentinal collagen-is the generation of advanced glycation end-products (AGEs) such as methylglyoxal (MGO)-derived AGEs. Despite previous reports suggesting that AGEs alter bacterial adhesion to collagen, the biophysics driving oral streptococcal attachment to MGO-modified collagen remains largely understudied. Thus, the aim of this work was to unravel the dynamics of the initial adhesion of S. mutans to type I collagen in the presence and absence of MGO-derived AGEs by employing bacterial cell force spectroscopy with atomic force microscopy (AFM). Type I collagen gels were treated with 10 mM MGO to induce AGE formation, which was characterized with microscopy and enzyme-linked immunosorbent assay. Subsequently, AFM cantilevers were functionalized with living S. mutans UA 159 or Streptococcus sanguinis SK 36 cells and probed against collagen surfaces to obtain force curves displaying bacterial attachment in real time, from which the adhesion force, number of events, Poisson analysis, and contour and rupture lengths for each individual detachment event were computed. Furthermore, in silico computer simulation docking studies between the relevant S. mutans UA 159 collagen-binding protein SpaP and collagen were computed, in the presence and absence of MGO. Overall, results showed that MGO modification increased both the number and adhesion force of single-unbinding events between S. mutans and collagen, without altering the contour or rupture lengths. Both experimental and in silico simulations suggest that this effect is due to increased specific and nonspecific forces and interactions between S. mutans UA 159 and MGO-modified collagen substrates. In summary, these results suggest that collagen alterations due to aging and glycation may play a role in early bacterial adherence to oral tissues, associated with conditions such as aging or chronic hyperglycemia, among others.

Multiple environmental drivers for the Patagonian forest-dwelling beetles: Contrasting functional and taxonomic responses across strata and trophic guilds

Forest disturbances modify microhabitats along the different vertical strata, triggering structural and functional changes in forest-dwelling beetle communities. However, the effects of multiple environmental factors can be complex to detect in ecosystems that offer a broad variety of microhabitats for a great variety of beetle species. This is the case in Patagonian temperate forests, where the use of remote sensing provides an opportunity to evaluate the sensitivity of beetle species to environmental changes. Here, we identified the environmental drivers of forest-dwelling beetle communities in the ground and canopy of 34 north Patagonian-forest landscapes. We analyzed the associations of the taxonomic and functional diversity of five trophic guilds with 30 remote-sensing variables of landscape structure, composition, and disturbances; vegetation and soil properties; and climate and physical variables. Hierarchical clustering analysis was used to identify trophic guilds responding similarly to predictors. Segmented regression analysis was used to evaluate functional redundancy from taxonomic-functional richness relationships. A total of 583 species (23,848 individuals) of beetles were recorded for both strata. The effects of environmental variables were heterogeneous across strata and guilds. Canopy beetles were especially sensitive to early successional conditions, and canopy attributes, but also benefited from the canopy openness. Forest specialists of the ground and canopy responded differently to environmental variables. Ground-dwelling beetles were mostly affected by fires, human modifications, edge closeness, high temperatures, and soil properties, responding weakly to canopy properties. Functional redundancy varied weakly along environmental gradients, being more likely in local communities of ground-dwelling beetles mostly composed of species with overlapping functional roles. Contrasting environmental responses between ground and canopy beetles, as well as among beetles of different trophic guilds, should arise from microhabitats that vary across strata and interact differently with response traits.

Climate-induced tree senescence leads to a transient increase in reproductive success of a large woodpecker species

Climate change-induced mortality of trees is a concerning phenomenon for global forest ecosystems. The rapid decay and death of long-lived trees can significantly impact forest dynamics, with effects that transmit through ecological networks, becoming more evident in organisms occupying high trophic levels, such as large and specialized woodpecker species. However, understanding how populations of high trophic level species respond to climate change is still a challenge. In this study it was analyzed 32-year data of social groups of the Magellanic Woodpecker (Campephilus magellanicus) in North Patagonia, a region facing increasingly frequent droughts and increased temperatures. A positive trend in the size of woodpecker social groups as a response to climate-induced tree senescence was tested. A causal structural equation model examining climate- tree senescence- woodpecker relationships was used. Increasing nonlinear trends and positive interannual growth rates (>10%) for tree senescence and group size were found. Lowland forest sites had higher levels of tree senescence and more numerous social groups. The causal model supported the positive effect of mean temperature on tree senescence and the positive association of woodpeckers with tree senescence. These results provide evidence of a climate-induced increase in tree senescence that causes an increase in the size of woodpecker social groups. It is suggested that accelerated decay and mortality of trees in the northern Patagonian forests will decrease the stocks of deadwood in the long term, threatening the persistence of this large woodpecker species.

Management of Hypothyroidism in Internal Medicine: Patient Profile and Effects of an Educational Programme in the Cluster-Randomized FADOI TIAMO Study

BACKGROUND AND AIMS

There is still limited knowledge regarding the clinical profile and appropriateness of treatment in patients with hypothyroidism hospitalized in Internal Medicine (IM) Departments in Italy. The aim of this study is to evaluate: 1) the characteristics of patients and possible deviations from national and international clinical practice recommendations (CPRs) in evidence-based guidelines (EBGs); 2) the improvement of patient management by means of a standardized educational programme (EP).

METHODS

A nationwide multicentre study, comprising two replications of a retrospective survey (phases 1 and 3) with an intervening EP (phase 2) in half of the centres and no EP in the other half, was conducted. The EP was based on outreach visits. Centres were assigned to the two arms of the study, labelled the training group (TG) and control group (CG) respectively, by cluster randomization. Four EBGs and 39 CPRs provided the basis on which 22 treatment management indicators were identified (7 referring to the time of hospital admission, 15 to post-admission).

RESULTS

The 21 participating centres recruited 587 hospitalized patients with hypothyroidism, 421 of which were females (71.7%, mean age 74.1 + 14.4 yrs): 318 in phase 1 and 269 in phase 3. The cause of hypothyroidism was unknown in 282 patients (48%). Evaluation at the time of admission identified satisfactory adherence to CPRs (>50%) for 63.6% of the indicators. In the phase 3, TG centres showed significant improvement vs CG in 4 of the 15 post-admission indicators, while 1 out of 15 was significantly worse.

CONCLUSIONS

The EP based on outreach visits significantly improved some indicators in the management of patients with hypothyroidism, with specific reference to appropriateness of TSH dosage and levothyroxine (LT4) treatment modality.

CLINICAL TRIAL REGISTRATION

ClinicalTrials.gov, identifier NCT05314790.

Tree decay modulates the functional response of lichen communities in Patagonian temperate forests

Epiphytic and epixylic lichens respond negatively to forest degradation, climate change and pollution, but those effects may depend on functional traits or interact with the stage of tree decay. Disentangling the main drivers of lichen communities remains a challenge in regions where lichens are diverse and poorly known, as the case of Patagonian temperate forests. We used a multi-scale approach to evaluate the relationship between environmental variables, tree decay stage and lichens. We sampled lichens across three increasing scales (tree ≪ site ≪ landscape) by selecting 19 landscape units, where trees in four decay stages (snags, logs, cavity trees and healthy trees) were selected within sampling plots. A total of 35 predictors were measured over different scales, including 25 remote sensing indices of forest conditions, climate and air pollutants. Structural Equation Models were used to test the causal linkages of predictors with lichens, distinguishing functional categories (size, growth and reproductive strategy). A total of 69 lichen species were recorded. Cavity trees and logs supported the largest diversity, while snags and healthy trees had the lowest diversity. Functional lichen groups responded differently to fine-scale variables, including the diameter, height, density and pH of trees. Air pollutants affected species with sexual and mixed strategies. Lichens were sensitive to precipitation, temperature and wind speed, with foliose and sexual species responding positively to the latter. The abundance of all species and macrolichens increased with tree senescence and decreased with canopy continuity. Lichens occupying snags and logs responded negatively to primary productivity and tree senescence, but positively to soil organic matter. Our findings suggest: i) the functional structure of lichen communities varies non-linearly with the wood decay process; ii) the reproductive strategy influences the sensitivity to air pollutants, iii) climate variables influence dispersal and colonization of woody substrates; and iv) forest structure/succession interacts with tree decay.

Headache as main reason for consultation to a hospital Emergency Department in Spain: a prospective study

INTRODUCTION

Headache is common in the general population and a frequent reason for medical consultation.

OBJECTIVES

To describe the characteristics of patients attending the Emergency Department (ED) for headache.

METHODS

A descriptive study with prospective collection of 100 consecutive patients over 15 years old who attended our ED due to headache as the main complaint.

RESULTS

Headache accounted for 1,4% of ED visits. The most common age range is between 31 and 45 years and the majority of the patients are females (61%). We diagnosed 67 primary and 33 secondary headaches. The most frequent diagnosis was migraine, with 36% of cases. One out of 3 patients had a history of headache and 4 out of 5 consulted by their own decision. Only a small percentage of patients were admitted as inpatients (12%), and 3 out of 5 were referred to Primary Care. Complementary tests were performed on 84% of the patients. One CT scan was performed for every 3 patients. A total of 80% patients was correctly diagnosed by the ED physicians.

CONCLUSIONS

Headache is a frequent complaint in the ED, where primary headaches are the most common with migraine being the most frequent reason for consultation. In our setting, there is a good screening and diagnosis of headaches, as well as an adequate use of the available resources in the ED for their diagnosis and management.

0249 Effects of Alcohol Consumption on Sleep-Wake Pattern of a Rat Model of Anxiety

Introduction

Anxiety is an important factor for self-administered alcohol as a tool to reduce its symptoms. However, alcohol is capable to disrupt sleep-wake patterns in subjects with medium- to high-alcohol consumption. We have selectively bred two sublines from Sprague-Dawley rats that differ on its yawning frequency. High-yawning (HY) rats have a mean of 20 yawns/h, whereas the Low-yawning (LY) rats have only 2 yawns/hour. LY rats also showed anxious responses when evaluated on standardized tests. The aim of this study was to assess the changes on sleep-wake patterns after chronic alcohol consumption.

Methods

We used 8 males from HY and LY sublines at 3 months of age, they lived in acrylic cages with water and food pellets available ad libitum under a 12:12 light-dark cycle (lights on at 0700) and temperature of 21±1 °C. All subjects were implanted to record EEG, EMG and EOG to characterize sleep-wake phases. A baseline sleep-wake recording was obtained for 24 h. A solution of 9.6% alcohol was administered as a single source of hydration for seven days and then a second sleep-wake recording was obtained. After that period, an additional bottle containing purified water was available. Position of the bottles was randomly changed daily. Water and alcohol consumption were measured daily for a period of 3 weeks and then a third sleep-wake recording was obtained.

Results

LY rats consumed more alcohol than HY rats (P<0.05), and they had an increase of bouts and duration of slow wave sleep and REM sleep on their active phase after alcohol administration (P<0.05).

Conclusion

LY rats display an anxious behavior and therefore consumed more alcohol compared to HY rats, and only LY rats were susceptible to alcohol effects on sleep on their active phase.

Support

Partially supported by CONACYT grants 243333 and 243247 to CC and JRE, respectively. Grants from VIEP-BUAP 2018 and CA in Neuroendocrinología BUAP-CA-288.

Parochodaeus bituberculatus (Erichson) (Coleoptera: Ochodaeidae) and Faargia gentilii (Martínez) (Coleoptera: Scarabaeidae), two species newly discovered in Chile

The presence in Chile of scarab beetles (Coleoptera: Scarabaeoidea) described originally from Peru and Argentina have been reported previously, as a result of the distributional corridors through passes in the Andes Mountains (Gutiérrez 1947, 1950; Roig-Juñent et al. 2005; Ruiz-Manzanos 2006; Mondaca 2011). The purpose of this paper is to report the presence of Parochodaeus bituberculatus (Erichson, 1847) (Coleoptera: Ochodaeidae: Ochodaeinae: Ochodaeini) and Faargia gentilii (Martínez, 1975) (Coleoptera: Scarabaeidae: Melolonthinae: Tanyproctini) in Chile, expanding the distribution of the second species to the west of the Andes Mountain range. The presence of both species in Chile is not surprising, due to the similarity of habitats in the collection areas with neighboring localities in Peru and Argentina.

Comparative life cycle assessment study on environmental impact of oil production from micro-algae and terrestrial oilseed crops

In this study the LCA methodology is applied in order to satisfy two goals: i) to evaluate the hot spots in site-specific production chain of biodiesel from terrestrial and micro-algae feedstock; ii) to compare quantitatively, utilizing primary data, the impacts of the first generation in respect to the third generation bio-fuels. Results show that micro-algae are neither competitive yet with traditional oil crops nor with fossil fuel. The use of renewable technologies as photovoltaics and biogas self production might increase the competitiveness of micro-algae oil. Further investigations are however necessary to optimize their production chain and to increase the added value of co-products.

Crossover from super- to subdiffusive motion and memory effects in crystalline organic semiconductors

The transport properties at finite temperature of crystalline organic semiconductors are investigated, within the Su-Schrieffer-Heeger model, by combining an exact diagonalization technique, Monte Carlo approaches, and a maximum entropy method. The temperature-dependent mobility data measured in single crystals of rubrene are successfully reproduced: a crossover from super- to subdiffusive motion occurs in the range 150≤T≤200  K, where the mean free path becomes of the order of the lattice parameter and strong memory effects start to appear. We provide an effective model, which can successfully explain features of the absorption spectra at low frequencies. The observed response to slowly varying electric field is interpreted by means of a simple model where the interaction between the charge carrier and lattice polarization modes is simulated by a harmonic interaction between a fictitious particle and an electron embedded in a viscous fluid.

System for time-discretized vacuum ultraviolet spectroscopy of spark breakdown in air

A system for time-discretized spectroscopic measurements of the vacuum ultraviolet (VUV) emission from spark discharges in the 60-160 nm range has been developed for the study of early plasma-forming phenomena. The system induces a spark discharge in an environment close to atmospheric conditions created using a high speed puff value, but is otherwise kept at high vacuum to allow for the propagation of VUV light. Using a vertical slit placed 1.5 mm from the discharge the emission from a small cross section of the discharge is allowed to pass into the selection chamber consisting of a spherical grating, with 1200 grooves/mm, and an exit slit set to 100 μm. Following the exit slit is a photomultiplier tube with a sodium salicylate scintillator that is used for the time discretized measurement of the VUV signal with a temporal resolution limit of 10 ns. Results from discharges studied in dry air, Nitrogen, SF6, and Argon indicate the emission of light with wavelengths shorter than 120 nm where the photon energy begins to approach the regime of direct photoionization.

Environmental analysis of sunflower production with different forms of mineral nitrogen fertilizers

Environmental profiles of mineral nitrogen fertilizers were used to evaluate the environmental disturbances related to their use in cultivation systems in Europe. Since the production of mineral fertilizers requires a large amount of energy, the present study of bioenergy systems is relevant in order to achieve crop yields less dependent on fossil fuels and to reduce the environmental impact due to fertilization. In this study, the suitability of the LCA methodology to analyze the environmental impact of sunflower cultivation systems with different forms of mineral nitrogen fertilizers urea and ammonium nitrate was investigated. Effects on climate change were estimated by the use of Ecoinvent 2.2 database default value for soil N2O emission factor (1%) and local emission data (0.8%) of mineral nitrogen applied to soils. LCA analysis showed a higher impact on environmental categories (human health and ecosystem quality) for the system in which urea was used as a nitrogen source. Use of urea fertilizer showed a higher impact on resource consumption due to fossil fuel consumption. Use of mineral nitrogen fertilizers showed a higher environmental burden than other inputs required for sunflower cultivation systems under study. Urea and ammonium nitrate showed, respectively, a 7.8% and 4.9% reduced impact of N2O as greenhouse gas by using direct field data of soil N2O emission factor compared to the default soil emission factor of 2006 IPCC Guidelines. Use of ammonium nitrate as mineral nitrogen fertilizer in sunflower cultivation would have a lower impact on environmental categories considered. Further environmental analysis of available technologies for fertilizer production might be also evaluated in order to reduce the environmental impacts of each fertilizer.

Differential regulation of Notch ligands in dendritic cells upon interaction with T helper cells

The Notch signalling pathway has recently been linked to T helper 1 (Th1)/T helper 2 (Th2) cell polarization via a mechanism involving differential expression of Notch ligands, Delta-like and Jagged, in antigen-presenting cells. However, whether stimuli other than pathogen-derived factors are involved in the regulation of Notch ligand expression in dendritic cells (DCs) remains unknown. Here, we address the effect of T helper cells (Th1 and Th2) on Delta-like 4 and Jagged 2 expression in bone marrow-derived DCs. We demonstrate that both Th1 and Th2 cells induce Delta-like 4 mRNA expression in DCs, in a process that is, in part, mediated by CD40 signalling. In contrast, only Th2 cells induce a significant increase in Jagged 2 mRNA levels in DCs. Additionally, we show that IL-4, a hallmark Th2 cytokine, plays a role in Jagged 2 expression, as evidenced by the fact that cholera toxin, a Th2-promoting stimulus, induces Jagged 2 mRNA expression in DCs only in the presence of IL-4. Finally, we demonstrate that DCs also express Notch 1 and that this expression is downregulated by IL-4. These data suggest that Notch ligands are differentially regulated in DCs: Delta-like 4 is regulated by T helper cells and by pathogen-derived Th1 stimuli, whereas Jagged 2 is regulated by Th2 cells and pathogen-derived Th2-promoting stimuli. Based on our results, we propose that the positive feedback loop that Th2 cells exert on T cell polarization may involve the induction of Jagged 2 expression in DCs.

A simple stochastic lattice gas model for H1N1 pandemic. Application to the Italian epidemiological data

We construct a very simple epidemic model for influenza spreading in an age-class-distributed population, by coupling a lattice gas model for the population dynamics with a SIR stochastic model for susceptible, infected and removed/immune individuals. We use as a test case the age-distributed Italian epidemiological data for the novel influenza A(H1N1). The most valuable features of this model are its country-independent and virus-independent structure (few demographic, social and virological data are used to fix some parameters), its large statistic due to a very short run-time machine, and its easy generalizability to include mitigation strategies. In spite of its simplicity, the model presented reproduces the epidemiological Italian data, with sensible predictions for the reproduction number and theoretically interesting results for the generation time distribution.

Evaluation of late immunologic parameters among renal transplant recipients induced with Campath-1H

Organ transplantation success depends principally on avoiding rejection, a purpose almost accomplished with immunosuppressant therapy. Nevertheless, drug side effects have promoted the search for other mechanisms to restrain alloresponses. T-regulatory cells (Treg) might exert that function. Campath 1H (C1H) induces Treg proliferation in the period subsequent to T-cell depletion following C1H administration. In the present study, the status of Treg and de novo HLA antibody production was determined posttransplantation when T-cell repopulation had been completed. In 14 patients, the following parameters were analyzed: renal function, rejection, Treg, panel-reactive antibody (PRA), and HLA antibodies. Patient and graft survivals were 100%. At the moment of Treg determination (20 months following transplant) the mean tacrolimus level was 8.4 ng/mL. One patient experienced an antibody-mediated rejection at 15 months after transplantation while having 3.2% Treg, with excellent treatment responses. Mean leukocyte and lymphocyte counts were 5752 and 1183 cells/mm(3); the mean peripheral blood percentage of Treg of 7.1% +/- 5.9% was not different from that observed in subjects without induction (mean 5.5% +/- 2.5%). Three patients (21%) showed Treg greater than 8.0%. In seven patients, we compared Treg at 4 and 20 months posttransplant, observing a decline from a mean of 19.9% to 5.9% (P = .05). In seven recipients, posttransplant PRA was determined; five of them became "de novo" sensitized, three with a mean class I PRA of 16% and two with a mean class II PRA of 37%. In conclusion, patient and graft survivals were excellent, mean Treg percentage was not elevated with results lower than in the early posttransplant period. Rejection incidence was negligible. Late "de novo" sensitization occurred in 70% showing that B cell-mediated alloresponses were only partially controlled among recipients induced with C1H even when associated with sustained anticalcineurin treatment.

[Self-injured inflicted and anxiety-depressive syndrome in patients that came to Protected Medicine of Sandro Pertini Hospital in Rome]

The aim of our study is to observe the self-injured inflicted dimension in prisoners and to estimate the presence of one correlation with the anxiety-depressive syndrome.

MATERIALS AND METHODS

From 15th of Oct 2006 till 31st Aug 2009 we have admitted to our department 150 patients that showed previous or recent evidences of self inflicted injuries and the use and abuse of tranquillizers and antidepressive drugs. The patients were classified in data base and we made an observation study.

RESULTS

Out of 150 (100%) patients admitted to hospital, 55 (37%) patients had had a recent or previous episode of self-injured inflicted, 23 (15%) patients had taken antidepressive drugs and 72 (48%) patients had been in treatment with benzodiazepines. Among 55 patients that reported on medical history evidences of self-injured inflicted only 4 (7%) had taken antidepressive drugs and 18 (33%) had been in treatment with benzodiazepines. Among 18 patients in treatment with benzodiazepines, 12 (67%) patients had begun to use it during the detention regime.

CONCLUSION

The phenomenon of self-injured inflicted among the patients that came to our department is very widespread and it resulted to be more frequent than in common people. We observed a correlation among the episodes of self-injured inflicted and the anxiety-depressive syndrome. Often the hardships is pre-existent to admittance in prison and the detention stresses that phenomenon. In fact, most of episodes of self-injured inflicted occurred during detention regime.

Dynamical heterogeneities in irreversible gels: analogy with spin glasses

We describe the sol-gel transition by introducing an order parameter, defined as the average of local variables, and its fluctuations. It can be shown that these quantities are related to percolation quantities, but in principle they can be measured without resorting to connectivity properties. In this framework it appears that the dynamical transition associated with gelation is a real thermodynamic transition, as happens in spin glasses. The strong analogies between the sol-gel transition and the spin glass transition are also discussed.

Alemtuzumab induction in kidney transplantation: clinical results and impact on T-regulatory cells

Alemtuzumab (ALT), a humanized monoclonal anti-CD52 antibody, was introduced in solid organ transplantation as an induction agent. ALT associated with anticalcineurins has provided a low incidence of acute rejection episodes (ARE) and potential tolerogenic properties. We analyzed the clinical outcomes and effects on peripheral Treg of renal transplant recipients treated with ALT. Six-month data on kidney alone or kidney combined with pancreas or liver patients treated with ALT and tacrolimus (TAC) in standard doses were compared with those on renal transplant recipients of similar demography who were not treated with ALT. We evaluated patient and graft survivals, ARE incidence, hematological parameters, renal function, adverse events, and CD4+CD25+FoxP3+ T cells in peripheral blood. Demographics of recipients, donors, and transplants were similar in both groups. Mean HLA mismatch was slightly greater among ALT-treated patients (3.5 vs 2.5). No combined transplantation was performed in the ALT-untreated group. Patient and graft survivals were 100% without rejection or serious infections in both groups. ALT-treated recipients showed anemia and leukopenia in 3 patients as well as severe lymphopenia in 5 recipients, who partially recovered on day 90. Final mean plasma creatinine was 1.4 mg/dL, while calculated creatinine clearance was approximately 65 mL/min in both groups. Mean Treg cell percentage was higher among ALT-treated recipients than the comparative group or healthy controls (P < .05). In conclusion, renal transplantation results obtained using ALT with rigorous immunosuppressive therapy were excellent; serious adverse events and acute rejection were absent. The effect of the increased proportion of Treg cells must be evaluated with longer observation.

Dynamical heterogeneity in a model for permanent gels: different behavior of dynamical susceptibilities

We present a systematic study of dynamical heterogeneity in a model for permanent gels upon approaching the gelation threshold. We find that the fluctuations of the self-intermediate scattering function are increasing functions of time, reaching a plateau whose value, at large length scales, coincides with the mean cluster size and diverges at the percolation threshold. Another measure of dynamical heterogeneities-i.e., the fluctuations of the self-overlap-displays instead a peak and decays to zero at long times. The peak, however, also scales as the mean cluster size. Arguments are given for this difference in the long-time behavior. We also find that the non-Gaussian parameter reaches a plateau in the long-time limit. The value of the plateau of the non-Gaussian parameter, which is connected to the fluctuations of diffusivity of clusters, increases with the volume fraction and remains finite at the percolation threshold.

Conversion from a calcineurin inhibitor-based immunosuppressive regimen to everolimus in renal transplant recipients: effect on renal function and proteinuria

New immunosuppressive agents are being actively researched to avoid complications of chronic allograft nephropathy (CAN), calcineurin inhibitor (CNI) nephrotoxicity, and posttransplantation cancer. The family of mTOR inhibitors offers a unique immunosuppressive opportunity to avoid CNI toxicity and reduce the incidence of malignancy. Nevertheless, increasing data have demonstrated that sirolimus (SRL), the first mTOR introduced in the treatment of solid organ transplant recipients, induces proteinuria, an adverse event that could produce deterioration of long-term renal function. In this short-term study of patients followed for 1 to 16 months, we examined changes in renal function and proteinuria among renal transplant recipients converted from a CNI-based regimen to an everolimus (EVL)-based one, a recently introduced mTOR inhibitor. Our data showed that renal function can be optimized after conversion to EVL by up to 42% in recipients showing CAN grade 1 or 2, or CNI nephrotoxicity. Importantly, patients who improved their creatinine clearance did not show increased proteinuria measured in a voided specimen as the ratio of urinary protein and creatinine concentration (P/C). These results, if confirmed with long-term follow-up and a larger number of patients, would allow us to consider EVL as a promising agent for maintenance immunosuppressive regimens in kidney transplantation.

Conversion from a calcineurin inhibitor-based immunosuppressive regimen to everolimus in renal transplant recipients: effect on renal function and proteinuria

New immunosuppressive agents are being actively researched to avoid complications of chronic allograft nephropathy (CAN), calcineurin inhibitor (CNI) nephrotoxicity, and posttransplantation cancer. The family of mTOR inhibitors offers a unique immunosuppressive opportunity to avoid CNI toxicity and reduce the incidence of malignancy. Nevertheless, increasing data have demonstrated that sirolimus (SRL), the first mTOR introduced in the treatment of solid organ transplant recipients, induces proteinuria, an adverse event that could produce deterioration of long-term renal function. In this short-term study of patients followed for 1 to 16 months, we examined changes in renal function and proteinuria among renal transplant recipients converted from a CNI-based regimen to an everolimus (EVL)-based one, a recently introduced mTOR inhibitor. Our data showed that renal function can be optimized after conversion to EVL by up to 42% in recipients showing CAN grade 1 or 2, or CNI nephrotoxicity. Importantly, patients who improved their creatinine clearance did not show increased proteinuria measured in a voided specimen as the ratio of urinary protein and creatinine concentration (P/C). These results, if confirmed with long-term follow-up and a larger number of patients, would allow us to consider EVL as a promising agent for maintenance immunosuppressive regimens in kidney transplantation.

Diffuse abdominal hydatidosis: role of magnetic resonance imaging

Hydatid cyst disease still is a serious public-health problem in endemic areas. It is a tissue infestation caused by the larval stage of a parasite, Echinococcus granulosus. Although liver and lung are the most commonly involved organs, hydatid disease can occur in all viscera and soft tissues. In 10% of cases, hydatid disease arises in the viscera: mainly in the spleen (0.9-8%), but also in kidney, bone, heart and peritoneal cavity (0.5-5%). Other rare locations such as muscles have been described in less than 1% of cases of hydatid disease. We report magnetic resonance imaging findings of a case of diffuse abdominal hydatidosis.

[A new reality in the field of penitentiary medicine: the Complex Protected Medicine Structure of the ASL Rome B. Initial report of our working sanitary care]

BACKGROUND

The continuous demand for sanitary care from the imprisoned patients to the general public hospitals has carried to the creation of dedicated structures like the Complex Protected Medicine Structure (SCMP) at the Hospital Sandro Pertini of Rome. Aim of this study was to present the preliminary epidemiologic-clinical data gathered from July 26th 2006 to March 1st, 2006 in our SCMP.

MATERIAL AND METHODS

This study is based on an observational retrospective protocol. Patients characteristics included sex, age, alcohol, smoke and drug abuse, serology for viral hepatitis and AIDS, and treatment with benzodiazepine.

RESULTS

The records of 200 consecutive patients (18 F, 182 M; median age 46 years; range: 20-84 years), attending our Unit were analyzed retrospectively. Out of these patients, 40 (20%) were foreigners, 43 (21.5%) alcohol abusers, and 141 (70.5%) smokers. Forty-eight patients (24%) had a recent or last history of drug addiction (heroin and/or cocaine). The HIV antibodies have been assayed only on 28 patients, turning out positive in 10 (35.71%). Twenty-five patients were positive for HBsAg (12.5%) and 57 (28.5%) for HCV. A consumption of benzodiazepine (BZD) was present in 71 (35.5%) of the patients.

CONCLUSIONS

The essential elements of medical attendance of our structure are described in the article. We present the initial report of our working experience. The present data are in keeping with previous studies of the literature. We hope that our experience coul be extended to all italian Countries.

Static and dynamic heterogeneities in a model for irreversible gelation

We study the structure and the dynamics in the formation of irreversible gels by means of molecular dynamics simulation of a model system where the gelation transition is due to the random percolation of permanent bonds between neighboring particles. We analyze the heterogeneities of the dynamics in terms of the fluctuations of the self-intermediate scattering functions: in the sol phase close to the percolation threshold, we find that this dynamic susceptibility increases with the time until it reaches a plateau. At the gelation threshold this plateau scales as a function of the wave vector k as k(eta-2), with eta being related to the decay of the percolation pair connectedness function. At the lowest wave vector, approaching the gelation threshold it diverges with the same exponent gamma as the mean cluster size. These findings suggest an alternative way of measuring critical exponents in a system undergoing chemical gelation.

Columnar and lamellar phases in attractive colloidal systems

In colloidal suspensions, at low volume fraction and temperature, dynamical arrest occurs via the growth of elongated structures that aggregate to form a connected network at gelation. Here we show that, in the region of parameter space where gelation occurs, the stable thermodynamical phase is a crystalline columnar one. Near and above the gelation threshold, the disordered spanning network slowly evolves and finally orders to form the crystalline structure. At higher volume fractions the stable phase is a lamellar one, which seems to have a still longer ordering time.

Complex viscosity behavior and cluster formation in attractive colloidal systems

The increase in viscosity that is observed in attractive colloidal systems by varying the temperature or the volume fraction can be related to the formation of structures due to particle aggregation. In particular we have studied the nontrivial dependence of the viscosity from the temperature and the volume fraction in the copolymer-micellar system L64. The comparison of the experimental data with the results of numerical simulations in a simple model for gelation phenomena suggests that this intriguing behavior can be explained in terms of cluster formation and that this picture can be quite generally extended to other attractive colloidal systems.

Size segregation in granular media induced by phase transition

In order to study analytically the nature of the size segregation in granular mixtures, we introduce a mean field theory in the framework of a statistical mechanics approach, based on Edwards' original ideas. For simplicity we apply the theory to a lattice model for a hard sphere binary mixture under gravity, and we find a new purely thermodynamic mechanism that gives rise to the size segregation phenomenon. By varying the number of small grains and the mass ratio, we find a crossover from the Brazil nut to the reverse Brazil nut effect, which becomes a true phase transition when the number of small grains is larger then a critical value. We suggest that this transition is induced by the effective attraction between large grains due to the presence of small ones (depletion force). Finally the theoretical results are confirmed by numerical simulations of the 3d system under taps.

Jamming transition in granular media: a mean-field approximation and numerical simulations

In order to study analytically the nature of the jamming transition in granular material, we have considered a cavity method mean-field theory, in the framework of a statistical mechanics approach, based on Edwards' original idea. For simplicity, we have applied the theory to a lattice model, and a transition with exactly the same nature of the glass transition in mean-field models for usual glass formers is found. The model is also simulated in three dimensions under tap dynamics, and a jamming transition with glassy features is observed. In particular, two-step decays appear in the relaxation functions and dynamic heterogeneities resembling ones usually observed in glassy systems. These results confirm early speculations about the connection between the jamming transition in granular media and the glass transition in usual glass formers, giving moreover a precise interpretation of its nature.

Cyclosporine preconditions dendritic cells during differentiation and reduces IL-2 and IL-12 production following activation: a potential tolerogenic effect

The mode of action of cyclosporine (CsA) has been ascribed to its capacity to inhibit IL-2 and IFNgamma production by T cells, two cytokines implicated in allograft rejection. Recently, it has been reported that upon activation, dendritic cells (DCs) exhibit transient production of IL-2, a property that appears to be related to their capacity to initiate immune responses. On the other hand, DCs can generate signals determining Th1/Th2 polarizing effects, an effect that can drastically influence the outcome of organ transplant. The purpose of the present study was to investigate the effect of CsA on cytokine production by immature and mature DCs. DC precursors from mouse bone marrow were induced to differentiate by incubation with GM-CSF for 5 days followed by activation with LPS for 4 hours. CsA was added at different times during this process. Our results show that when CsA is added during the differentiation period following activation with LPS, IL-2 and IL-12 secretion are significantly reduced without affecting the evolution of the DC. Conversely, CsA had no effect when added during the LPS activation period. These results show that CsA affects DCs before they receive the final activation stimulus, preconditioning them to antigen stimulation. This preconditioning of DCs by calcineurin-inhibiting drugs conceptually integrates the mode of action of CsA with the tolerogenic and T-cell polarization function ascribed to DCs. These results may be especially meaningful for the future design of immunosuppressive protocols.

Interleukin-4 Selectively Inhibits Interleukin-2 Secretion by Lipopolysaccharide-Activated Dendritic Cells

Dendritic cells (DCs) generated in vitro from bone marrow precursors using granulocyte-macrophage colony-stimulating factor (GM-CSF) secrete interleukin-2 (IL-2) upon activation, an event probably associated to the initiation of adaptive immune responses. Additionally, they produce IL-12, a cytokine related to T-cell polarization. To analyse the effect of IL-4 on DC differentiation and function, we assessed the capacity of murine bone marrow dendritic cells (BMDCs) differentiated with GM-CSF in the presence or absence of IL-4 to produce IL-2 and IL-12 upon lipopolysaccharide (LPS) activation. We found that although IL-4 enhanced DC IL-12p70 production, it strongly impaired IL-2 secretion by BMDCs. This inhibition, which depends on the presence of IL-4 during LPS activation, is DC specific, as IL-4 did not affect IL-2 secretion by T cells. Interestingly, inhibition of DC IL-2 production did not prevent DC priming of T lymphocytes. These results illustrate a new putative role for IL-4 on the regulation of the immune response and should help clarify the controversial reports on the effect of IL-4 on DCs.

Probability distribution of inherent states in models of granular media and glasses

The present paper develops a Statistical Mechanics approach to the inherent states of glassy systems and granular materials by following the original ideas proposed by Edwards for granular media. We consider three lattice models (a diluted spin glass, a system of hard spheres under gravity and a hard-spheres binary mixture under gravity) introduced to describe glassy and granular systems. They are evolved using a "tap dynamics" analogous to that of experiments on granular media. We show that the asymptotic states reached in such a dynamics are not dependent on the particular sample history and are characterized by a few thermodynamical parameters. We assume that under stationarity these systems are distributed in their inherent states satisfying the principle of maximum entropy. This leads to a generalized Gibbs distribution characterized by new "thermodynamical" parameters, called "configurational temperatures" (related to Edwards compactivity for granular materials). Finally, we show by Monte Carlo calculations that the average of macroscopic quantities over the tap dynamics and over such distribution indeed coincide. In particular, in the diluted spin glass and in the system of hard spheres under gravity, the asymptotic states reached by the system are found to be described by a single "configurational temperature". Whereas in the hard-spheres binary mixture under gravity the asymptotic states reached by the system are found to be described by two thermodynamic parameters, coinciding with the two configurational temperatures which characterize the distribution among the inherent states when the principle of maximum entropy is satisfied under the constraint that the energies of the two species are independently fixed.

Glass transition in the quenched and annealed version of the frustrated lattice gas model

In this paper we study the three-dimensional frustrated lattice gas model in the annealed version, where the disorder is allowed to evolve in time with a suitable kinetic constraint. Although the model does not exhibit any thermodynamic transition it shows a diverging peak at some characteristic time in the dynamical nonlinear susceptibility, similar to the results on the p-spin model in mean field and the Lennard-Jones mixture recently found by Donati et al. (e-print cond-mat/9905433). Comparing these results to those obtained in the model with quenched interactions, we conclude that the critical behavior of the dynamical susceptibility is reminiscent of the thermodynamic transition present in the quenched model, and signaled by the divergence of the static nonlinear susceptibility, suggesting therefore a similar mechanism also in supercooled glass-forming liquids.

Surgical treatment of multinodular goiter: incidence of lesions of the recurrent nerves after total thyroidectomy

The problems concerning surgical goiter treatment are discussed, particularly the morbidity of total thyroidectomy and possible injury to recurrent nerves in comparison to the partial resection of the gland. We discuss our case material and review the literature. We conclude that total thyroidectomy seems to be the most effective surgical procedure with lower morbidity than subtotal thyroidectomy.

Shortened head-up tilt testing potentiated with sublingual nitroglycerin in patients with unexplained syncope

BACKGROUND

Head-up tilt testing is extensively used to determine the vasovagal origin of syncope in patients with otherwise unexplained loss of consciousness, although issues remain regarding the method of the test. The diagnostic value of a shortened head-up tilt test potentiated with sublingual nitroglycerin was assessed in patients with unexplained syncope.

METHODS

Two hundred two patients (mean age 49+/-19 years) with syncope of unknown origin and 34 subjects in a control group (mean age 45+/-17 years) were studied. The patients and the subjects in the control group were tilted upright to 60 degrees for 20 minutes. If syncope did not occur, sublingual nitroglycerin (400 microg) was administered, and observation was continued for 25 more minutes.

RESULTS

During the unmedicated phase syncope occurred in 22 (11%) patients and in one member of the control group. After nitroglycerin was administered, syncope occurred in 119 (59%) patients and in 1 (3%) member of the control group. False-positive response (exaggerated response) was observed in eight (4%) patients and in four (12%) subjects in the control group. The total positivity rate of the test was 70% with a specificity rate of 94%.

CONCLUSIONS

Short-duration head-up tilt test potentiated with sublingual nitroglycerin provides an adequate specificity and positivity rate in patients with unexplained syncope.

[Experience at an ambulatory surgical service for thyroid diseases]

Based of a personal series of 206 patients, the authors evaluate their personal experience of an outpatient surgery ward for thyroid pathologies. The paper reports the diagnostic and therapeutic approaches both in patients undergoing surgery and those who do not. Attention is focused on the importance of the multidisciplinary team and the quality of the results of a homogeneous follow-up.

[Surgical treatment of non-toxic multinodular goitre. Retrospective evaluation of a personal case series]

The authors base their study on a retrospective evaluation of a personal series of patients and on a review of the literature on this topic. They focus their attention on surgical problems relating to the type of treatment of non-toxic multinodular goitre. On the basis of the data obtained, they underline that in this pathology total thyroidectomy is the most appropriate form of surgery and does not entail a higher morbidity in relation to more conservative resection.

ACTH 1-17 and short-term memory, anxiety, heart rate, blood pressure

The research investigated the effects of acute ACTH 1-17 administration on plasma cortisol, short-term memory, anxiety state, blood pressure and heart rate. In a double blind crossover design, healthy volunteers were serially evaluated at 5 min, 20 min, 40 min, 60 min after injection of ACTH 1-17 or placebo in separate sessions. Results show that ACTH 1-17 produced, in addition to an increase in plasma cortisol (5 min - 60 min), significant improvements in short-term memory (5 min), a reduction in anxiety (20 min and 40 min), and an increase in systolic (5 min and 20 min) and diastolic blood pressure (5 min). If confirmed by other studies, the short-term memory effect of ACTH 1-17 at 5 min after i.v. could suggest a central action of the peptide, and confirm the role of HPA axis as a modulator of performance and emotional arousal during acute environmental changes.