The Impact of Oxidative Stress on Pregnancy. The Neglected Role of Alcohol Misuse

Abstract

Oxygen is essential for human life. However, it could cause damaging effects on biological systems causing oxidative stress. Oxidative stress defined as "an alteration in the pro-oxidant-antioxidant balance in favor of the former that leads to potential damage" is characterized by the release of Reactive Oxygen Species (ROS). Oxidative stress is now recognized to play a central role in the pathophysiology of many different disorders, including complications of pregnancy such as placental pathology, PreEclampsia (PE), Intrauterine Growth Restriction (IUGR), gestational diabetes, and miscarriage. This narrative review aims to summarize pieces of evidence about the role of oxidative stress in the pathophysiology of the main obstetric complications with par-ticular interest in the neglected role of alcohol abuse.

Human semen quality and environmental and occupational exposure to pollutants: A systematic review

Background

The aim of the present systematic review was to evaluate the correlation between the exposure to environmental and/or occupational pollutants and possible alteration of semen quality, focalizing the attention on the studies performed using a biomonitoring approach.

Methods

The review was conducted from inception to May 11 2023, according to the PRISMA Statement 2020 and using the following databases: Scopus, Pubmed and Web of Science. The protocol was registered on PROSPERO (CRD42023405607). Studies were considered eligible if they reported data about the association between exposure to environmental pollutants and alteration of semen quality using human biomonitoring. The quality assessment was carried out by the use of the Newcastle-Ottawa Quality Assessment Scale.

Results

In total, 21 articles were included, conducted in several countries. The main matrices used for biomonitoring were urine and blood and the most sought-after contaminants were bisphenols, phthalates, pesticides, polychlorinated biphenyls, polycyclic aromatic hydrocarbons, heavy metals and other inorganic trace elements. The results of the studies demonstrated a significant positive correlation between the increase of the pollutants' levels in the biological matrices examined and some alterations of the semen quality indicators, such as a decrease in motility, concentration and morphology of the spermatozoa.

Conclusions

Male fertility can be negatively affected by the exposure to environmental and/or occupational pollutants. Human biomonitoring programs may be considered a useful tool for specific surveillance programs devoted to early highlight subjects who are more exposed to environmental pollutants in order to reduce risk exposure.

Analysing features of home-based workout during COVID-19 pandemic: a systematic review

OBJECTIVE

Since the beginning of the COVID-19 pandemic, a decrease in physical activity (PA) related to home confinement has been reported worldwide. However, some individuals were able to engage in physical activities at home. Thus, in a perspective of public health, it may be useful to analyse the available evidence regarding PA adopted during home restrictions, in order to identify possible strategies to help people stay active even during emergency situations. The aim of this review was to analyse how healthy individuals spontaneously exercised at home in the course of the pandemic, in order to detect possible factors associated with this behaviour.

STUDY DESIGN

A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines.

METHODS

The protocol was registered in PROSPERO, an international prospective register of systematic reviews, with the registration number CRD42023394673. A literature search was conducted in PubMed, Scopus, and Web of Science. Cross-sectional studies published in English from the inception of each database to February 06th 2023 and focused on healthy individuals practicing spontaneous PA/exercise at home during the pandemic were considered eligible. The quality assessment was performed using the adapted Newcastle-Ottawa Quality Assessment Scale. Bibliographic information, sample size, study paricipant/population with age, gender, ethnicity, socioeconomic status, education, smart workers or not, anthropometric parameters, characteristics of at home exercises, athletic status and sedentariness, associated health-related effects, and main findings were synthetised.

RESULTS

From 504 articles, 19 were included. Notwithstanding the differences in the studies examined, the majority of them reported that previous PA level was associated with exercise in such challenging conditions. Furthermore, technologies aimed at supporting exercise were shown to be a useful resource.

CONCLUSIONS

Being habitually active and using digital supports may be associated with a positive attitude towards exercise at home during isolation. This suggests that in emergency situations, exercise should be promoted, also through digital media, especially among those groups who are usually less engaged in PA. Further analyses of longitudinal studies are needed to confirm these findings.

Welfare of ducks, geese and quail on farm

This Scientific Opinion concerns the welfare of Domestic ducks (Anas platyrhynchos domesticus), Muscovy ducks (Cairina moschata domesticus) and their hybrids (Mule ducks), Domestic geese (Anser anser f. domesticus) and Japanese quail (Coturnix japonica) in relation to the rearing of breeders, birds for meat, Muscovy and Mule ducks and Domestic geese for foie gras and layer Japanese quail for egg production. The most common husbandry systems (HSs) in the European Union are described for each animal species and category. The following welfare consequences are described and assessed for each species: restriction of movement, injuries (bone lesions including fractures and dislocations, soft tissue lesions and integument damage and locomotory disorders including lameness), group stress, inability to perform comfort behaviour, inability to perform exploratory or foraging behaviour and inability to express maternal behaviour (related to prelaying and nesting behaviours). Animal-based measures relevant for the assessment of these welfare consequences were identified and described. The relevant hazards leading to the welfare consequences in the different HSs were identified. Specific factors such as space allowance (including minimum enclosure area and height) per bird, group size, floor quality, characteristics of nesting facilities and enrichment provided (including access to water to fulfil biological needs) were assessed in relation to the welfare consequences and, recommendations on how to prevent the welfare consequences were provided in a quantitative or qualitative way.

Welfare of calves

This Scientific Opinion addresses a European Commission request on the welfare of calves as part of the Farm to Fork strategy. EFSA was asked to provide a description of common husbandry systems and related welfare consequences, as well as measures to prevent or mitigate the hazards leading to them. In addition, recommendations on three specific issues were requested: welfare of calves reared for white veal (space, group housing, requirements of iron and fibre); risk of limited cow–calf contact; and animal‐based measures (ABMs) to monitor on‐farm welfare in slaughterhouses. The methodology developed by EFSA to address similar requests was followed. Fifteen highly relevant welfare consequences were identified, with respiratory disorders, inability to perform exploratory or foraging behaviour, gastroenteric disorders and group stress being the most frequent across husbandry systems. Recommendations to improve the welfare of calves include increasing space allowance, keeping calves in stable groups from an early age, ensuring good colostrum management and increasing the amounts of milk fed to dairy calves. In addition, calves should be provided with deformable lying surfaces, water via an open surface and long‐cut roughage in racks. Regarding specific recommendations for veal systems, calves should be kept in small groups (2–7 animals) within the first week of life, provided with ~ 20 m²/calf and fed on average 1 kg neutral detergent fibre (NDF) per day, preferably using long‐cut hay. Recommendations on cow–calf contact include keeping the calf with the dam for a minimum of 1 day post‐partum. Longer contact should progressively be implemented, but research is needed to guide this implementation in practice. The ABMs body condition, carcass condemnations, abomasal lesions, lung lesions, carcass colour and bursa swelling may be collected in slaughterhouses to monitor on‐farm welfare but should be complemented with behavioural ABMs collected on farm.

Is surgical resection predict overall survival in frail patients with glioblastoma, IDH-wildtype?

PURPOSE

We assessed the impact of frailty on surgical outcomes, survival, and functional dependency in elderly patients harboring a glioblastoma, isocitrate dehydrogenase (IDH)-wildtype.

METHODS

We retrospectively reviewed records of old and frail patients surgical treated at a single neurosurgical institution between January 2018 to May 2021. Inclusion criteria were: (1) neuropathological diagnosis of glioblastoma, IDH-wildtype; (2) patient≥65years at the time of surgery; (3) available data to assess the frailty index according to the 5-modified Frailty Index (5-mFI).

RESULTS

A total of 47 patients were included. The 5-mFI was at 0 in 11 cases (23.4%), at 1 in 30 cases (63.8%), at 2 in two cases (4.2%), at 3 in two cases (4.2%), and at 4 in two cases (4.2%). A gross total resection was performed in 26 patients (55.3%), a subtotal resection was performed in 13 patients (27.6%), and a biopsy was performed in 8 patients (17.1%). The rate of 30-day postoperative complications was higher in the biopsy subgroup and in the 5-mFI=4 subgroup. Gross total resection and age≤70years were independent predictors of a longer overall survival. Sex, 5-mFI, postoperative complications, and preoperative Karnofsky Performance Status score did not influence overall survival and functional dependency.

CONCLUSION

In patients≥65years harboring a glioblastoma, IDH-wildtype, gross total resection remains an independent predictor of longer survival and good postoperative functional recovery. The frailty, assessed by the 5-mFI score, does not influence surgery and outcomes in this dataset. Further confirmatory analyses are required.

Welfare of broilers on farm

This Scientific Opinion considers the welfare of domestic fowl (Gallus gallus) related to the production of meat (broilers) and includes the keeping of day-old chicks, broiler breeders, and broiler chickens. Currently used husbandry systems in the EU are described. Overall, 19 highly relevant welfare consequences (WCs) were identified based on severity, duration and frequency of occurrence: 'bone lesions', 'cold stress', 'gastro-enteric disorders', 'group stress', 'handling stress', 'heat stress', 'isolation stress', 'inability to perform comfort behaviour', 'inability to perform exploratory or foraging behaviour', 'inability to avoid unwanted sexual behaviour', 'locomotory disorders', 'prolonged hunger', 'prolonged thirst', 'predation stress', 'restriction of movement', 'resting problems', 'sensory under- and overstimulation', 'soft tissue and integument damage' and 'umbilical disorders'. These WCs and their animal-based measures (ABMs) that can identify them are described in detail. A variety of hazards related to the different husbandry systems were identified as well as ABMs for assessing the different WCs. Measures to prevent or correct the hazards and/or mitigate each of the WCs are listed. Recommendations are provided on quantitative or qualitative criteria to answer specific questions on the welfare of broilers and related to genetic selection, temperature, feed and water restriction, use of cages, light, air quality and mutilations in breeders such as beak trimming, de-toeing and comb dubbing. In addition, minimal requirements (e.g. stocking density, group size, nests, provision of litter, perches and platforms, drinkers and feeders, of covered veranda and outdoor range) for an enclosure for keeping broiler chickens (fast-growing, slower-growing and broiler breeders) are recommended. Finally, 'total mortality', 'wounds', 'carcass condemnation' and 'footpad dermatitis' are proposed as indicators for monitoring at slaughter the welfare of broilers on-farm.

Dietary supplements intake among youth: preliminary results of a multicentric survey

Background

In the last decades, a wide spread of dietary supplements (DSs) has been observed worldwide. However, DS use is not always motivated by real nutritional needs. In this context, commercial strategies and peers’ suggestions seem to play an important role in determining this habit, with harmful effects on consumers’ health. This cross-sectional study was aimed to evaluate the DS consumption patterns among a sample of undergraduate students attending 14 Italian universities.

Methods

An anonymous web questionnaire was used to collect information about DS use and consumption habits, related motivations and possible adverse effects. The survey is still ongoing and its conclusion is expected to be on May 2022.

Results

On a total of 2019 participants enrolled so far (69.7% female, mean age 22.8±4.7), 72.6% reported the use of at least a DS in the last six months. Multivitamin and multimineral products were the most used, being reported by 35.8% of the participants, while caffeinated energy supplements were the less reported (2.0%). The main reason for DS use was to deal with a specific deficiency following a physician or nutritionist indication (47.8%). The 3.4% of participants reported the occurrence of negative outcomes, mainly gastrointestinal disorders (74%).

Conclusions

These preliminary results evidenced a wide use of DSs in the studied population. Although the main motivation was a nutritional need with a medical recommendation, a notable proportion of the sample assumed DSs without any specific prescription. Thus, it is essential to increase the knowledge about DSs and related threats deriving from their inappropriate use in the population, especially among youths. Further analysis will allow to identify possible correlations with socio-demographic and behavioural variables.

Key messages

• It is essential to increase the knowledge about dietary supplements to avoid an inappropriate use in the population.

• Youths are the most exposed to this consumption.

Welfare of pigs on farm

This scientific opinion focuses on the welfare of pigs on farm, and is based on literature and expert opinion. All pig categories were assessed: gilts and dry sows, farrowing and lactating sows, suckling piglets, weaners, rearing pigs and boars. The most relevant husbandry systems used in Europe are described. For each system, highly relevant welfare consequences were identified, as well as related animal-based measures (ABMs), and hazards leading to the welfare consequences. Moreover, measures to prevent or correct the hazards and/or mitigate the welfare consequences are recommended. Recommendations are also provided on quantitative or qualitative criteria to answer specific questions on the welfare of pigs related to tail biting and related to the European Citizen's Initiative 'End the Cage Age'. For example, the AHAW Panel recommends how to mitigate group stress when dry sows and gilts are grouped immediately after weaning or in early pregnancy. Results of a comparative qualitative assessment suggested that long-stemmed or long-cut straw, hay or haylage is the most suitable material for nest-building. A period of time will be needed for staff and animals to adapt to housing lactating sows and their piglets in farrowing pens (as opposed to crates) before achieving stable welfare outcomes. The panel recommends a minimum available space to the lactating sow to ensure piglet welfare (measured by live-born piglet mortality). Among the main risk factors for tail biting are space allowance, types of flooring, air quality, health status and diet composition, while weaning age was not associated directly with tail biting in later life. The relationship between the availability of space and growth rate, lying behaviour and tail biting in rearing pigs is quantified and presented. Finally, the panel suggests a set of ABMs to use at slaughter for monitoring on-farm welfare of cull sows and rearing pigs.

Methodological guidance for the development of animal welfare mandates in the context of the Farm to Fork Strategy

This document provides methodological guidance developed by the EFSA Panel on Animal Health and Welfare to produce Scientific Opinions in response to mandates received from the European Commission in the context of the Farm to Fork Strategy. The mandates relate to the welfare of (i) animals during transport, (ii) calves, (iii) laying hens, (iv) broilers, (v) pigs, (vi) ducks, geese and quails, and (vii) dairy cows. This guidance was developed in order to define the methods and strategy to be applied for responding to the Terms of Reference (ToRs) of the mandates. The mandates each consist of a set of General ToRs which refer to the husbandry systems used in the production of each animal species or the current transport practices for free moving animals and animals transported in cages, and a set of specific ToRs for which difficulties in ensuring animal welfare have been identified and where specific scenarios are envisaged. Part I of the guidance includes a description of welfare consequences for the animals. Part II includes a new methodology for providing quantitative recommendations regarding animal welfare. The proposed methodology follows the assumption that the effect of an exposure variable (e.g. space allowance) on animal welfare can be quantified by comparing the expression of an animal-based measure (ABM) under 'unexposed conditions' (e.g. unlimited space) and under high exposure (e.g. restrictive conditions). The level of welfare as assessed through this ABM can be quantified for different levels of the exposure variable (e.g. at increasing space allowances) and quantitative recommendations can thus be provided. The final version of the methodological guidance was endorsed for public consultation, which took place between 14 February 2022 and 31 March 2022. The comments received are integrated in this document.

O-206 The impact of oocyte central granularity (CG) on the outcomes of ICSI cycles: live birth achievement is only compromised if CG-derived embryos are transferred

Study question

Does oocyte central granularity (CG) compromise post-ICSI live birth achievement? Are morphologically normal oocytes obtained from CG cycles also affected?

Summary answer

Oocytes with CG, but not morphologically normal oocytes obtained from cycles providing CG oocytes, present lower competence to achieve a live birth.

What is known already

Ooplasm central granularity (CG) is associated with alterations in the actin cytoskeleton and meiotic spindle potentially affecting meiotic accuracy, fertilisation dynamics and embryo development. We have recently reported lower fertilisation rates and slower morphokinetics associated with CG. However, to clarify whether CG does affect oocyte developmental competence and if it is associated with endocrine alterations that may also impinge on the performance of morphologically normal oocytes obtained in the same cycle, adequately powered studies assessing the clinical outcomes of cycles transferring embryos derived from CG oocytes or from their morphologically normal companions are needed. 

Study design, size, duration

Retrospective analysis including 866 control ICSI cycles/patients providing only morphologically normal oocytes (NO) and 211 CG cycles/patients providing NO and CG oocytes, from July 2014 to August 2021. Clinical outcomes were compared (1) between cycles providing CG oocytes (CG) or not (Control 1), and (2) among cycles achieving a fresh transfer in which only NO were obtained (Control-T), CG oocytes were obtained but NO-derived embryos were transferred (NOT), and CG-derived embryos were transferred (CGT).

Participants/materials, setting, methods

Patients undergoing their first ICSI cycle (n = 866; Control) or their first ICSI cycle providing CG oocytes (n = 211; Treatment-groups) were included. Cycle characteristics and outcomes were compared using the Fisher’s exact test and the Wilcoxon sum rank test. Multivariate analyses were performed to assess the potential interference of maternal age, infertility cause, number of embryos transferred and day of embryo transfer on the relationship between CG and live birth.

Main results and the role of chance

Patients providing CG oocytes (n = 211) presented higher maternal age (37.6± 4.5 vs. 36.5± 4.3; p= p < 0.001), higher basal FSH (8.5± 3.8 vs. 7.9± 4.1 IU/L; p = 0.03), lower AMH (2.2± 2.2 vs. 3.2± 3.5 ng/mL; p < 0.001), higher incidence of ovarian infertility (17.5% vs. 4.9%; p < 0.001) and higher FSH total dose (2255.3± 866.4 vs. 1825.6± 752.3 IU; p < 0.0001), compared to controls (n = 866). Implantation, abortion and live birth rates did not differ between cycles providing (CG) or not (Control) CG oocytes (22.7% vs. 24.9%, 17.1% vs. 27.7%, 25.8% vs. 22.9%, respectively). Nevertheless, implantation and live birth rates were lower in cycles in which CG-derived embryos were transferred (CGT; n = 87) compared to cycles in which CG oocytes were obtained but only NO-derived embryos were transferred (NOT; n = 57), or to cycles in which CG oocytes were not obtained (Control-T; n = 595). Implantation rates were 11.4%, 30.9% and 24.9%, while live birth rates were 10.5%, 30.2% and 22.9% for CGT, NOT and Control-T, respectively (p < 0.001 for implantation rates in CGT vs. NOT and CGT vs. Control-T; p < 0.04 for live birth rates in CGT vs. NOT and CGT vs. Control-T). No significant differences were observed between NOT and Control-T.

Limitations, reasons for caution

Our study is subjected to the limitations of a retrospective analysis and thus the data may be affected by other variables that were not controlled for. Moreover, the intrinsic difficulty in obtaining a higher number of cycles in which only CG-derived embryos are transferred, limits the power of the analysis.

Wider implications of the findings

Our findings shed light on a still unsolved question in ICSI practice. The present data indicate that CG is associated with markedly reduced oocyte developmental competence, while the presence of CG oocytes in a cycle does not affect the quality of the companion normal oocytes. 

Trial registration number

not applicable

P-261 Morphokinetics-oriented embryo selection for day 2 transfers: adapting transfer strategy to the times of Covid-19

Study question

Can embryo selection oriented by a morphokinetic algorithm developed for day 2 transfers provide pregnancy rates similar to those achieved by elective frozen blastocyst transfers?

Summary answer

Transfers on day 2 of embryos selected by a morphokinetic algorithm can provide pregnancy rates similar to those achieved with elective frozen blastocyst transfers.

What is known already

The comparative efficacy of cleavage stage fresh transfers in relation to blastocyst fresh transfers remains controversial. On the other hand, elective transfers of frozen blastocysts have been found to provide satisfactory implantation and delivery rates, which may result from favourable embryo quality and/or endometrial receptivity associated with freeze-all cycles. The covid-19 pandemic has imposed changes to the ICSI laboratorial routine, particularly pushing for a reduction in embryo culture time. In this context, we developed an algorithm based on fertilization and cleavage morphokinetic parameters, aiming to optimize embryo selection for day 2 transfers.

Study design, size, duration

This study aimed to assess the performance of a morphokinetic algorithm to select cleavage stage embryos for day 2 transfers, using as a parameter the outcomes from elective frozen blastocyst transfers. A retrospective analysis of data generated in our clinic during pandemia was performed, comparing patient profiles and clinical outcomes of day 2 transfers following algorithm-oriented embryo selection (n = 128), with those of contemporary elective transfers of frozen blastocysts (n = 230) from freeze-all patients with OHSS risk.

Participants/materials, setting, methods

Patients were in their first ICSI cycle, 128 of which underwent a day 2 transfer of a single embryo selected by an algorithm based on fertilization (tPNf) and cleavage (T2 e T4) parameters. The remaining 230 patients had a elective frozen blastocyst selected by morphology transferred after endometrial preparation. Cycle characteristics and outcomes were compared using Fisher’s and Wilcoxon sum rank tests. A multivariate analysis tested the association of treatment and cycle variables with pregnancy.

Main results and the role of chance

Patients providing embryos transferred on day 2 after algorithm-oriented selection presented lower maternal age (35.5 ± 4.1 vs. 36.4 ± 4.4; p = 0.02), higher basal FSH (8.3 ± 3.6 vs. 6.9 ± 2.1 IU/L; p < 0.001) lower AMH (2.3 ± 2.0 vs. 5.7 ± 6.3 ng/mL; p < 0.0001), different distribution of infertility factors (p < 0.001; male factor: 64.1% vs. 39.6%, tubal: 3.1% vs. 11.3%, unexplained: 15.6% vs. 29.1%, for day 2 and frozen blastocyst transfers, respectively) and lower oocyte yield (6.9 ± 4.0 vs. 17.2 ± 6.5) as compared to patients providing frozen blastocysts.

Beta-hCG, clinical pregnancy, ongoing pregnancy and miscarriage rates (assessed until the 12th week of pregnancy) did not differ between algorithm-oriented day 2 and frozen blastocyst transfers (53.1% vs. 50.9%, 40.6% vs. 45.7%, 33.6% vs. 36.5% and 17.3% vs. 20.0%, respectively).

The multivariate analysis indicated maternal age as the only variable significantly and independently associated with ongoing pregnancy achievement [OR = 0.89 (0.84-0.94); p,0.001)].

Limitations, reasons for caution

Our study is subjected to the limitations of a retrospective analysis and the data may be affected by variables not controlled for that are heterogeneous between groups such as different endometrial conditions and the use embryo cryopreservation.

Wider implications of the findings

Our findings indicate that morphokinetic algorithms can be successfully applied to improve outcomes of day 2 transfers to a level similar of that achieved with elective frozen blastocyst transfers. Our data represent a valuable parameter for the improvement or adaptation of ICSI practice in the face of logistic constraints.

Trial registration number

not applicable

Pharmacists' mental health during the SARS-CoV-2 pandemic in Italy

OBJECTIVE

The year 2020 was characterized by the outbreak of a new pandemic caused by a novel coronavirus named SARS-CoV-2. To face the pandemic, many countries worldwide imposed general lockdowns, closing all non-essential businesses. As primary care services, pharmacies had to remain open, thus putting pharmacy staff at significant risk of viral infection and overwork. This study aimed to assess the mental health of Italian Pharmacists, considering demographic and occupational characteristics, lifestyle, and habits, during the SARS-CoV-2 outbreak and the subsequent lockdown period (March-May 2020).

MATERIALS AND METHODS

A web-based survey was created using Google® Forms to collect data from March 30, 2020, to June 1, 2020. The questionnaire consisted of three sections investigating: (1) demographic and occupational variables, (2) lifestyle and habits variables, (3) psychological distress and perceived well-being.

RESULTS

A total of 401 participants completed the questionnaire. Older workers and those with more work experience reported more psychological stress. Older and female workers, who felt lonely at home and reported psychological stress, perceived poor well-being.

CONCLUSIONS

Our findings demonstrate that the Sars-CoV-2 outbreak and subsequent lockdown rules affected pharmacists' mental health and that it is important to put in place preventive measures against the occurrence of mental disorders among them.

Acute alcohol intoxication: a clinical overview

Abstract

Alcohol is a legal and yet detrimental psychoactive substance, capable of establishing addiction and impacting the physical, mental, social, and economic health of people. Alcohol intake causes a large variety of tissue damages severely impacting the nervous system, digestive and cardiovascular systems and causing oral cavity, oropharyngeal, hypopharyngeal, esophageal, colon-rectal, laryngeal, liver and intrahepatic bile duct, and breast cancers. Alcohol can also play a role in the pathogenesis of diabetes mellitus, cardiomyopathy and hemorrhagic strokes. When drunk during pregnancy it is proved to be responsible for serious damage to fetuses causing a wide range of pathological conditions from miscarriage to Fetal Alcoholic Spectrum Disorder (FASD). Acute ethanol intoxication happens when the amount of alcohol consumed is greater than the disposal capacity of the liver, causing an accumulation of its metabolites displayed by initial dysphoria and disinhibition. Nausea, vomiting, memory loss could happen. Although, it can lead to more serious conditions like impaired speaking, impaired coordination, unstable gait, nystagmus, stupor, or coma. Respiratory depression and death could also happen in such cases. Unfortunately, diagnosis of acute alcohol intoxication is difficult because most of the drinkers deny or minimize their assumption. It is dramatically important to assess when the last intake happened to avoid withdrawal syndrome. Alcohol acute intoxication can be considered a serious harm to health and a relevant issue for healthcare provid-ers working in emergency rooms. Differential diagnosis is crucial to avoid serious outcomes. There is no consensus about therapies for acute intoxication, but supportive and symptomatic treatments were proved effective. The repercussions of alcohol misuse over drinkers' social, familiar, economical and working life enhance the importance of a multidisciplinary approach in such cases.

A molecular insight into the lipid changes of pig Longissimus thoracis muscle following dietary supplementation with functional ingredients

In this work, the Longissimus thoracis pig skeletal muscle was used as a model to investigate the impact of two different diets, supplemented with n-3 polyunsaturated fatty acids from extruded linseed (L) and polyphenols from grape skin and oregano extracts (L+P), on the lipidomic profile of meat. A standard diet for growing-finishing pigs (CTRL) was used as a control. Changes in lipids profile were investigated through an untargeted lipidomics and transcriptomics combined investigation. The lipidomics identified 1507 compounds, with 195 compounds fitting with the MS/MS spectra of LipidBlast database. When compared with the CTRL group, the L+P diet significantly increased 15 glycerophospholipids and 8 sphingolipids, while the L diet determined a marked up-accumulation of glycerolipids. According to the correlations outlined between discriminant lipids and genes, the L diet may act preventing adipogenesis and the related inflammation processes, while the L+P diet promoted the expression of genes involved in lipids' biosynthesis and adipogenic extracellular matrix formation and functioning.

Health risks for body pierced community: a systematic review

OBJECTIVE

Body piercing is defined as the penetration of jewellery into openings made in different body areas. In the last decades, it has become increasingly common in the general population. The aim is to analyse the available literature about complications from body piercing for contributing to raise the awareness towards this issue and to plan and perform appropriate prevention interventions.

STUDY DESIGN

This is a systematic review.

METHODS

The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to perform this systematic review; the protocol was registered with PROSPERO [CRD42020177972]. PubMed, Scopus and Web of Science were searched from database inception to April 2020, and articles in English language reporting a proven association between piercings and health risks were included, and their quality were assessed by adequate quality assessment tools.

RESULTS

A total of 4748 studies were found, and after duplicates removal and screening, 84 articles were included. Studies dealing with microbiological effects reported these complications both locally and at distant sites as a result of the spreading of the primary site infection: mastitis, endocarditis, glomerulonephritis, cephalic tetanus, viral hepatitis, HIV, cerebellar brain abscess and toxic shock syndrome. In addition, bleeding, gingival recession, dental injuries, contact dermatitis, granulomatous dermatitis, keloid, fibroma and basal cell carcinoma were reported.

CONCLUSIONS

Health authorities should promote educational campaigns to spread the knowledge on health risks related to piercings. Besides, piercers are often not adequately aware of all the possible adverse effects due to piercings because their professional training differs among countries. It is therefore advisable to provide periodical upgrade of their education in this field.

Undergraduates' perception of health risk of body arts: results of an Italian multicentre study

Background

In the last decades, body art practices such as tattooing and piercing have known an increasing popularity, mainly in young people. These procedures are associated with infectious and non-infectious health risks. The aim of this multicenter study was to evaluate the knowledge of health risks related to body art procedures among undergraduate students from ten Italian universities.

Methods

A cross-sectional study was performed on undergraduate students attending universities in northern, central and southern Italy. An anonymous questionnaire was administered to the participants for collecting their socio-demographic characteristics and for assessing their knowledge about health risks associated with tattoos and piercing.

Results

A total of 2985 students (mean age 23.15 ± 3.99, 73.9% females) completed the questionnaire. 775 (25.9%) of them were from northern Italy, 906 (30.3%) from the Centre and 1324 (44.4%) from the South. More than 90% of the sample were aware that tattoo/piercing procedures can cause health problems. However, the mean values of correct answers about the health risks associated to body art practices were low (5.38 ± 2.39 on a total of 11 correct answers for tattooing and 5.93 ± 3.12 on a total of 14 for piercing). Higher knowledge of the health risks related to tattooing was found among those attending university since more than four years (p &lt; 0.001), life science courses (p &lt; 0.001) and residing/living in the university area (p = 0.023). Those attending North/Centre universities (p &lt; 0.001), since more than 4 years (p &lt; 0.001), life science courses (p &lt; 0.001), and those with graduated father (p = 0.013) had better knowledge of the health risks related to piercing.

Conclusions

These results show a lack of knowledge about health risks related to body art practices in the sample. Educational interventions on this issue targeted to youth are needed in Italy.

Key messages

Undergraduates do not show a good knowledge of health risks related to tattooing and piercing. Educational interventions are needed to raise youth awareness and knowledge of health risks of body art.

Behavior and Welfare of Undocked Heavy Pigs Raised in Buildings with Different Ventilation Systems

The present study aimed to evaluate animal welfare of pigs from the same farm, raised with two ventilation systems. The study involved 60 pens of fattening pigs, raised in two buildings: one naturally ventilated (NV) and the other mechanically ventilated (MV). Pigs were assessed on three observation days: at 40 kg (T1), 100 kg (T2), and 160 kg (T3) of live weight. Animal-based measures were used such as qualitative behavioral analysis (QBA), behavioral measures (BMs), and lesion and health measures (LHMs). Housing conditions (HCs) measured at each observation day were the number of pigs per pen, space allowance, temperature, light, and CO₂. The association study was performed using a general linear model and analysis of variance. Ventilation effect was analyzed by performing computational fluid dynamics. Results showed that overall pigs raised in the MV were in a more positive affective state. Despite that, with hot temperatures, the higher occurrence of pig soiling indicated heat stress in pigs and consequent welfare impairment. The higher frequency of pigs showing dog sitting behavior at T2 and T3 suggest welfare worsening in the last phases of fattening. The study concludes that ventilation system influences animal behavior and overall animal welfare, especially during the warmer season.

P–024 Health and lifestyle detrimental conditions may impact the association between patient age and semen parameters in male populations

Study question

Can health and lifestyle detrimental conditions impact the relationship between paternal age and semen quality parameters in a male population?

Summary answer

Health and lifestyle detrimental conditions can attenuate the negative relationship between age and sperm concentration in a male population.

What is known already

Paternal age has increased in parallel with maternal age but its contribution in couple subfertility deserves further investigation. Previous studies suggest that paternal ageing is associated with reduced semen volume and impaired sperm morphology and motility, but not with reduced sperm concentration. Several health and lifestyle conditions such as diabetes, hypertension and smoking can negatively affect semen quality. Since the distribution of these conditions is not homogeneous throughout men’s reproductive life, one can hypothesize that their presence may confound the association between paternal age and semen quality parameters in male populations.

Study design, size, duration

This is a retrospective study with data from 5565 men examined in a single fertility clinic between 2015 and 2020. The impact of health and lifestyle conditions was assessed by comparing the effects of age on semen parameters in two different patient populations: the overall patient population and a subpopulation excluding patients with detrimental health or lifestyle characteristics, both divided in 4 age groups (A: 25–34, B: 35–39, C: 40–44 and D: ≥45 years).

Participants/materials, setting, methods

The study includes 5565 men aged 24 to 72 years providing semen samples to assess volume, progressive motility and concentration (WHO) in a single fertility clinic. Patients presenting diabetes, heart/circulatory diseases, andrological disorders, genital neoplasms, cystic fibrosis, Y microdeletions, abusive alcohol intake, smoking and/or recreational use of drugs were excluded from the healthy subpopulation. The effect of age on semen parameters was assessed by ANOVA (motility and volume) or Kruskal-Wallis one-way ANOVA (concentration). Main results and the role of chance: Of 5565 men included in the study, 2150 (38.6%) did not present any of the detrimental health and lifestyle conditions described above. In the overall patient population, semen volume [Mean±SD (mL); A: 3.14 ± 1.55, B: 3.01 ± 1.53, C: 2.83 ± 1.52, D: 2.65 ± 1.58; p &lt; 0.001] and sperm progressive motility [Mean±SD (%); A: 33.1 ± 18.0, B: 31.7 ± 17.7, C: 31.4 ± 17.5, D: 28.4 ± 17.5; p &lt; 0.001] gradually and significantly decreased with paternal age. The same effect was observed in the patient subpopulation excluding detrimental health and lifestyle conditions [(mL; A: 3.21 ± 1.58, B: 3.05 ± 1.51, C: 2.89 ± 1.59, D: 2.78 ± 1.50; p &lt; 0.001); (%; A: 35.85 ± 17.4, B: 33.7 ± 17.4, C: 32.2 ± 17.1, D: 30.3 ± 16.5; p &lt; 0.001)]. However, sperm concentration significantly decreased with paternal age in the subpopulation excluding detrimental health and lifestyle conditions [(Mean±SD) million/mL; A: 43.19 ± 41.0, B: 38.8 ± 38.6, C: 38.4 ± 34.6, D: 36.6 ± 33.9; p &lt; 0.001], but not in the overall population (million/mL; A: 38.17 ± 40.9, B: 36.7 ± 34.7, C: 35.3 ± 35.1, D: 35. 1± 37.5; p = 0.088).

Limitations, reasons for caution

This study is limited by its retrospective nature and by the accuracy of data on health and lifestyle conditions provided by the patients. Differences between age groups not controlled for in the study could also impact the results.

Wider implications of the findings: Ours findings suggest that health and lifestyle conditions may confound the effects of age on semen and sperm quality. Therefore, these data constitute a useful reference for the accurate assessment of the impact of male age on fertility.

Trial registration number

Not applicable

Levels of Polychlorinated Dibenzo-p-Dioxins/Furans and Polychlorinated Biphenyls in Free-Range Hen Eggs in Central Italy and Estimated Human Dietary Exposure

ABSTRACT

The aim of the present study was to evaluate the contamination levels of some classes of persistent organic pollutants in free-range hen eggs and to estimate the related human dietary exposure in a site of national interest, characterized by a serious state of environmental pollution in the Bussi sul Tirino area in central Italy. For these purposes, 17 samples of free-range hen eggs collected in home-producing farms located in the site of national interest territory were analyzed for 17 polychlorinated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs), 12 dioxin-like polychlorinated biphenyls (dl-PCBs), and 6 non-dioxin-like PCBs (ndl-PCBs). Dietary exposure was assessed assuming a standard consumption of eggs per week. The concentration of ∑PCDD/Fs plus dl-PCBs ranged from 0.463 to 8.028 pg toxic equivalent g-1 fat, whereas the mean contamination level of the ∑ndl-PCBs ranged from 0.234 to 7.741 ng toxic equivalent g-1 fat. PCDD/Fs and PCBs contamination levels were lower than maximum values established by the Commission Regulation (European Union) 1259/2011, except for one sample. The estimated weekly intake, calculated to evaluate the contribution in terms of the monitored pollutants of the locally produced eggs to the diet, was lower than the tolerable weekly intake established by the European Food Safety Authority.

HIGHLIGHTS

Knowledge and Perspectives on the Welfare of Italian Heavy Pigs on Farms

Simple Summary

Italian heavy pigs are characterized by much higher body weights and age at slaughter (approximately 160–170 kg, and over 9 months of age) than the majority of pigs reared in Europe. This results in peculiar behavioral and rearing-related needs compared to smaller pigs. However, there is a limited body of research dealing with the welfare of this productive category. The aim of this review is to collect the most significant available information on welfare issues of heavy pigs on farms and to highlight recent findings and areas needing additional research. It is hoped that these findings will, in the future, serve as a basis for the development of specific policies aimed at enhancing the ethical attributes of this renowned production.

Abstract

This review aims to give an overview of the most significant available information on welfare issues of Italian heavy pigs on farms. These animals, whose meat is used to produce typical products, are characterized by much higher body weights and age at slaughter (approximately 160–170 kg, and 9 months of age) than most pigs reared in Europe, resulting in peculiar behavioral and rearing-related needs. To highlight the main findings and the areas in which additional research is needed, the paper was organized by allocating the studies on the basis of the Welfare Quality four principles framework, i.e., good feeding, good housing, good health, and appropriate behavior. The results indicate the possibility of improvement with regard to the management of feeding, watering, and some environmental parameters (light, thermal comfort, enrichments) and a lack of knowledge on the actual space requirements (and a corresponding regulatory gap). Moreover, deficiencies concerning the prevalence of injuries and disease and the relationship between lesions observed post-mortem and rearing conditions needs to be addressed. Lastly, the absence of research concerning the evaluation of the emotional state of animals has been highlighted. It is hoped that these findings will, in the future, serve as a basis for the development of specific policies for these animals in order to increase the ethical value of the entire production chain, in accordance with consumers’ demand and expectation for high animal welfare standards.

The multivariate approach identifies relationships between pre-slaughter factors, body lesions, ham defects and carcass traits in pigs

Abattoir meat inspection has been proposed for the collection of welfare outcomes. The identification of suitable animal-based measures (ABM) is still a critical point that needs to be implemented to avoid collinearity among measures. The present study aims to benchmark the presence of ABM such as skin and tail lesions and ham defects in carcasses from 79 batches of Italian Heavy pigs and to identify possible relationships between the assessed ABM and pre-slaughter factors such as the season and the overnight lairage. Furthermore, the study also considers the effect of pre-slaughter conditions and ABM on carcass traits parameters (cold carcass weight and lean meat percentage). Skin and tail lesions were recorded at the slaughter line. The presence of abscesses, muscle tears and veining defects were assessed in the hams at trimming, according to the Parma Ham Consortium. A multivariate analysis was performed to identify relationships between ABM and pre-slaughter factor; therefore, a linear model was built to assess the effect on carcass weight and lean meat percentage. Main welfare issues were represented by skin and tail lesions and muscle tears (prevalence above 10%). Multivariate analysis evidenced that skin lesions and veining defects were mostly associated with the warm season. Abscesses and muscle tears in the hams were more likely related to overnight lairage, while tail lesions contributed equally to both season and lairage. Moreover, lairage related factors showed to affect lean meat percentage. The findings of the present study suggest that ham defects might be useful indicators of pre-slaughter stress. The validation of these findings with physiological parameters could be of interest for further studies.

Challenges for Midwives' Healthcare Practice in the Next Decade: COVID-19 - Global Climate Changes - Aging and Pregnancy - Gestational Alcohol Abuse

Midwives are multifaceted healthcare professionals whose competence spectrum includes a large variety of knowledge and skills going from antenatal care to education and research. The aim of this review is to suggest the future challenges midwives are going to face in the upcoming decade of this Century. COVID-19 and other infections will reasonably impact healthcare workers all over the world. Midwives are frontline healthcare professionals who are constantly at risk of contagion as their job implies close contact with women, physical support and hand touch. Also, menstruation waste plays a large role in the pollution of waters, severely impacting hygiene in the developing countries and fueling climate change. Appropriate disposal of used menstrual material is still insufficient in many countries of the world especially because of lack of sanitary education on girls. As educators, midwives will be more involved into preventing inappropriate disposal of menstrual hygiene devices by educating girls around the world about the green alternatives to the commercial ones. Despite the evidences about the fertility decrement that occurs with aging, women keep postponing reproduction and increasing their chance being childless or suffering complications related to the advanced maternal age. Teen pregnancies are as well an important issue for midwives who will be called to face more age-related issues and use a tailored case to case approach, enhancing their family planning skills. Another crucial role of midwifery regards the information about the risk of drinking alcohol during gestation. Alcohol assumption during pregnancy is responsible for serious damage to the fetus causing a wide range of pathological conditions related to Fetal Alcoholic Spectrum Disorder, leading cause of mental retardation in children of western countries. On the whole, midwives have demonstrated their willingness to expand their practice through continuing professional development, and through specialist and advanced roles especially in preventive and educational positions.

Nerve growth factor serum levels in treatment-resistant schizophrenic patients following electroconvulsive therapy

BACKGROUND

Electroconvulsive Therapy (ECT) has been widely applied to treat schizophrenia (SCZ) in the presence of resistance to pharmacotherapy. The mechanism of action of ECT in schizophrenia has not been fully clarified, though its intrinsic mechanism presents analogies with some neurobiological processes mediated by nerve growth factor (NGF).

OBJECTIVES

The aim of this study was to investigate in patients with treatment-resistant schizophrenia (TRS) the effect of ECT on acute and long-term NGF serum levels and the association with the clinical outcomes.

METHODS

Twelve male inpatients with TRS underwent eight sessions of ECT. Blood samples were collected during the first and the eighth ECT at the following time points: 5 minutes before the induction of seizure and then at 0, 5, 15 and 30 minutes after seizure.

RESULTS

Following ECT treatment, a substantial clinical improvement in symptom severity was indicated by a significant reduction in the Positive and Negative Syndrome Scale (PANSS) total and subscales scores. Even though the baseline NGF levels showed an increase over time, there were no statistical differences in NGF at time 0 at the first and the eighth ECT session. Furthermore, no correlation was observed between the severity of schizophrenic symptoms and NGF levels.

CONCLUSIONS

This is the first study addressing peripheral NGF during ECT treatment in TRS, as well as the first study in which NGF has been evaluated in different ECT sessions at various time points. These findings may potentiate the knowledge about the neurotrophic effects of ECT and the role of NGF in synaptic plasticity related to possible mechanisms of schizophrenia treatment.

Potential antimicrobial effects of photocatalytic nanothecnologies in hospital settings

BACKGROUND

Recently, several advanced technologies have been considered to reduce the microbial load in hospital environments and control Healthcare Associated Infections (HAIs) incidence. New strategies for preventing HAIs have continuously evolved, including enforcement of hygiene procedures by novel liquid biocides or no-touch technologies, self-disinfecting surfaces coated by heavy metals or light-activated photosensitizers such as Titanium Dioxide (TiO2) nanoparticles.

STUDY DESIGN

Review publications concerning the use of photocatalytic systems in hospital setting, focusing on products based on TiO².

METHODS

Specific keywords combinations were analitically searched in PubMed and Scopus databases.

RESULTS

Starting 80s-90s, over 2000 papers report "in vitro" studies on antimicrobial activity of TiO2 photocatalysis on several microorganisms including bacteria, viruses, fungi, yeasts, and antibiotic resistant strains. Besides, at least 4 selected papers addressed the potentials of this approach by "in field" studies, showing a widespread pool of applications in hospital and healthcare settings. However, the low number of available experiences and their heterogeneity represent major limitations to achieve a comprehensive final overview on effectiveness and feasibility of these technologies.

CONCLUSIONS

Photocatalytic systems based on TiO2 represent a promising strategy for hospital hygiene and HAI prevention. Additional "in field" studies are desirable in a next future to further evaluate and exploit this novel and interesting health technology.

Hospital environment as a reservoir for cross transmission: cleaning and disinfection procedures

BACKGROUND

Healthcare associated infections (HAIs) represent a serious problem for public health, as they increase the morbidity and mortality rates, present a relevant financial burden, and significantly contribute to the antimicrobial resistance.

METHODS

The aim of this review was to investigate the literature about HAIs, with particular reference to hospital environments and the role of cleaning and disinfection procedures. Hospital environments are an essential reservoir for HAIs cross transmission, and the application of appropriate procedures related to hand hygiene and disinfection/sterilization of surfaces and instruments remain key strategies for controlling HAIs.

RESULTS

Different procedures, based on the risk associated with the healthcare procedure, are recommended for hand hygiene: washing with soap and water, antiseptic rubbing with alcohol-based disinfectants, antiseptic and surgical hand washing. Environmental surfaces can be treated with different products, and the mostly used are chlorine-based and polyphenolic disinfectant. The reprocessing of instruments is related to their use according to the Spaulding's classification. In addition, scientific evidence demonstrated the great relevance of the "bundles" (small set of practices performed together) in controlling HAIs.

CONCLUSIONS

Research agenda should include the improvement of well-known effective preventive procedures and the development of new bundles devoted to high-risk procedures and specific microorganisms.

Determination of 2-Ethyl-l-Hexanol as Contaminant in Drinking Water

An analytical procedure for the determination of 2-ethyl-1-hexanol (2-EH) in drinking water is presented. The method is based on volatile-compound stripping, adsorption on activated-charcoal-filled tubes, solvent elution, identification by gas chromatography/ mass spectrometry, and determination by gas chromatography with flame ionization detection. Bottled samples with undesirable organoleptic characteristics were analzyed to determine a possible correlation with the presence of 2-EH. The presence of 2-EH at 2-10 μg/L was confirmed in several samples. The presence of di-2-ethylhexyl phthalate (D2EHP) was also checked in all samples. This compound was always found at 2-30 μg/L. Hydrolysis of D2EHP was carried out for 2 weeks to evaluate its possible contribution to water contamination by 2-EH. Tests did not show measurable amounts of the alcohol. Nonetheless, the hydrolysis of phthalates in the weakly acidic conditions of the examined waters would not justify the presence of 2-EH at the observed levels, and so it is reasonable to hypothesize a direct contamination from packaging materials containing 2-EH as residue from D2EHP synthesis.

Capsulated essential oil in gel spheres for the protection of cellulosic cultural heritage

In this paper we present a possible application of cinnamon essential oil to be encapsulated into gel drops of psyllium and of psyllium-alginate mixtures and to be released by the beads. It could act as green biocide for the protection of antique books, old documents and, generally, of any cellulosic material (paper, wood, textiles) object of cultural interest from biological attack. The components of the cinnamon essential oil, released by alginate, psyllium-alginate and purified psyllium-alginate beads, were determined by GC-MS analysis. Moreover, an evaluation of the cinnamon essential oil release during the time was carried out by in time HS-SPME-GS-MS so to obtain in time semi-quantitative information about the emitted gaseous species. Last by, in order to confirm the ability of the beads to perform an antimicrobial action, respirometric tests were carried out on Saccharomyces cerevisiae yeast cells looking at the reduction of their breathing activity, when in presence of the above beads.

Functional analysis finds differences on the muscle transcriptome of pigs fed an n-3 PUFA-enriched diet with or without antioxidant supplementations

Supplementing pig diets with n-3 polyunsaturated fatty acids (n-3 PUFA) may produce meat products with an increased n-3 fatty acid content, and the combined antioxidants addition could prevent lipid oxidation in the feed. However, to date, the effects of these bioactive compounds at the molecular level in porcine skeletal muscle are mostly unknown. This study aimed to analyse changes in the Longissimus thoracis transcriptome of 35 pigs fed three diets supplemented with: linseed (L); linseed, vitamin E and Selenium (LES) or linseed and plant-derived polyphenols (LPE). Pigs were reared from 80.8 ± 5.6 kg to 151.8 ± 9.9 kg. After slaughter, RNA-Seq was performed and 1182 differentially expressed genes (DEGs) were submitted to functional analysis. The L vs LES comparison did not show differences, while L vs LPE showed 1102 DEGs and LES vs LPE 80 DEGs. LPE compared to the other groups showed the highest number of up-regulated genes involved in preserving muscle metabolism and structure. Results enlighten that the combined supplementation of bioactive lipids (n-3 PUFA from linseed) with plant extracts as a source of polyphenols increases, compared to the only addition of linseed, the expression of genes involved in mRNA metabolic processes and transcriptional regulation, glucose uptake and, finally, in supporting muscle development and physiology. These results improve the knowledge of the biological effect of bioactive compounds in Longissimus thoracis muscle, and sustain the growing interest over their use in pig production.

Effect of diets supplemented with linseed alone or combined with vitamin E and selenium or with plant extracts, on Longissimus thoracis transcriptome in growing-finishing Italian Large White pigs

Background

Supplementing farm animals diet with functional ingredients may improve the nutritional quality of meat products. Diet composition has been also demonstrated to influence the gene expression with effect on biological processes and pathways. However, the knowledge on the effect of nutrients at the molecular level is scant. In particular, studies on the effects of antioxidants and polyphenols dietary supplementation have been investigated mainly in rodents, and only scarcely in farm animals so far. RNA-Seq with next-generation sequencing is increasingly the method of choice for studying changes in the transcriptome and it has been recently employed also in pig nutrigenomics studies to identify diet-induced changes in gene expression. The present study aimed to investigate the effect of diets enriched with functional ingredients (linseed, vitamin E and plant extracts) on the transcriptome of pig Longissimus thoracis to elucidate the role of these compounds in influencing genes involved in muscle physiology and metabolism compared to a standard diet.

Results

Eight hundred ninety-three significant differentially expressed genes (DEGs) (FDR adjusted P-value ≤ 0.05) were detected by RNA-Seq analysis in the three diet comparisons (D2-D1, D3-D1, D4-D1). The functional analysis of DEGs showed that the diet enriched with n-3 PUFA from linseed (D2) mostly downregulated genes in pathways and biological processes (BPs) related to muscle development, contraction, and glycogen metabolism compared to the standard diet. The diet supplemented with linseed and vitamin E/Selenium (D3) showed to mostly downregulate genes linked to oxidative phosphorylation. Only few genes involved in extracellular matrix (ECM) organization were upregulated by the D3. Finally, the comparison D4-D1 showed that the diet supplemented with linseed and plant extracts (D4) upregulated the majority of genes compared to D1 that were involved in a complex network of pathways and BPs all connected by hub genes. In particular, IGF2 was a hub gene connecting protein metabolism, ECM organization, immune system and lipid biosynthesis pathways.

Conclusion

The supplementation of pig diet with n-3 PUFA from linseed, antioxidants and plant-derived polyphenols can influence the expression of a relevant number of genes in Longissimus thoracis muscle that are involved in a variety of biochemical pathways linked to muscle function and metabolism.

Effect of dietary polyunsaturated fatty acid and antioxidant supplementation on the transcriptional level of genes involved in lipid and energy metabolism in swine

Porcine fat traits depend mostly on the interaction between nutritional and genetic factors. However, the pathways and biological processes influenced by this interaction are still poorly known in pigs, although they can have a huge impact on meat quality traits. The present research provides new knowledge insight into the effect of four diets (D1 = standard diet; D2 = linseed supplementation; D3 = linseed, vitamin E and selenium supplementation; D4 = linseed and plant-derived polyphenols supplementation) on the expression of 24 candidate genes selected for their role in lipid and energy metabolism. The data indicated that 10 out of 24 genes were differentially expressed among diets, namely ACACA, ADIPOQ, ADIPOR1, CHREBP (MLXPL), ELOVL6, FASN, G6PD, PLIN2, RXRA and SCD. Results from the univariate analysis displayed an increased expression of ACACA, ADIPOQ, ADIPOR1, CHREBP, ELOVL6, FASN, PLIN2, RXRA and SCD in D4 compared to D2. Similarly, ACACA, ADIPOQ, ADIPOR1, ELOVL6 and SCD were highly expressed in D4 compared to D3, while no differences were observed in D2-D3 comparison. Moreover, an increased expression of G6PD and ELOVL6 genes in D4 compared to D1 was observed. Results from the multivariate analysis confirmed that D2 was not different from D3 and that ACACA, SCD and FASN expression made D4 different from D2 and D3. Comparing D4 and D1, the expression levels of ELOVL6 and ACACA were the most influenced. This research provides evidence that the addition of both n-3 PUFA and polyphenols, derived from linseed, grape-skin and oregano supplementation in the diets, stimulates the expression of genes involved in lipogenesis and in oxidative processes. Results evidenced a greater effect on gene expression of the diet added with both plant extracts and n-3 PUFA, resulting in an increased expression of genes coding for fatty acid synthesis, desaturation and elongation in pig Longissimus thoracis muscle.

Procedures in endoscope reprocessing and monitoring: an Italian survey

BACKGROUND

The high diffusion of endoscopes worldwide and the need for effective reprocessing methods requested the development of guidelines and implementation of surveillance procedures at local level.

STUDY DESIGN

In order to collect data on everyday's practice and adherence to available guidelines, endoscopy units from different public institutions were surveyed using a dedicated questionnaire.

METHODS

Between July and November 2015 a survey was carried in 12 main hospitals from 10 different Italian regions, involving 22 endoscopy units. The state of the art of national and international guidelines was investigated to compare the protocols adopted at local level.

RESULTS

In all the surveyed hospitals, the reprocessing activity is based on pre-established protocols in adherence with principal guidelines. Enzymatic detergents, which are recommended by the international guidelines, are used in 55.6% of units and peracetic acid is currently the most widely used chemical disinfectant. Discrepancies were observed in the application of periodic quality controls.

CONCLUSION

Updated guidelines are generally applied in reprocessing practice. Quality controls may represent a critical issue to improve effectiveness and surveillance. The whole of acquired data can promote a positive trend towards the application of best practices.

Behavioral Assessment of Vision in Pigs

Swine (Sus scrofa) are often the 'gold standard' laboratory animal for ophthalmology research due to the anatomic and physiologic similarities between the porcine and human eye and retina. Despite the importance of this model, few tools for behavioral vision assessment in pigs are available. The aim of this study was to identify and validate a feasible and reproducible behavioral test to assess vision in a pig model of photoreceptor degeneration. In addition, a robust behavioral test will reduce stress and enhance enrichment by allowing animals opportunities for environmental exploration and by reducing the number of invasive experimental procedures. Two distinct behavioral approaches were tested: the obstacle-course test and temperament test. In the obstacle-course test, pigs were challenged (after an initial training period) to navigate a 10-object obstacle course; time and the number of collisions with the objects were recorded. In the temperament test, the time needed for pigs to complete 3 different tasks (human-approach, novel-object, and open-door tests) was recorded. The obstacle-course test revealed significant differences in time and number of collisions between swine with vision impairment and control animals, and the training period proved to be pivotal to avoid bias due to individual animal characteristics. In contrast, the temperament test was not altered by vision impairment but was validated to measure stress and behavioral alterations in laboratory pigs undergoing experimental procedures, thus achieving marked refinement of the study.

Exposure to individual and multiple carcinogenic metals during paediatric age: an experience from an Italian urban scenario

BACKGROUND

Exposure to single and multiple carcinogenic metals and/or semimetals represents a major environmental risk factor for public health. In particular, children are more susceptible to environmental pollutants than adults, but specific studies are still limited. The aims of the present study were: 1) to trace the exposure and co-exposure profiles to eight known or suspected carcinogenic metals and semimetals (As, Be, Cd, Co, Cr, Ni, Pb, and Sb); and: 2) to evaluate the influence of some possible interfering/confounding factors on the exposure to these elements during childhood.

STUDY DESIGN

Cross-sectional study.

METHODS

We recruited 159 healthy Italian children attending a primary school of the urban area of Rome, Italy. Selected metals were determined by inductively coupled plasma mass spectrometry on urinary samples collected at the end of a "typical" day (one sample for each child), while information about possible confounding/interfering factors were collected via questionnaires.

RESULTS

The great part of the studied children resulted co-exposed to the monitored metals: 83.2%, 69.2%, 51.0% and 29.3% of the participants were concurrently exposed to at least two, three, four and five trace elements, respectively. Gender was the only one among the investigated variable that significantly influenced the co-exposure, with females resulting at lower risk (OR = 0.392; 95 IC = 0.156 - 0.989; p < 0.047).

CONCLUSIONS

Given the importance of protecting child's health and the risks related to the exposure to carcinogenic metals, especially when they occur simultaneously, other researches in this field are strongly recommended.

Development of the laboratory prototype "CavyPool" for assessing treatments and materials for swimming pools

BACKGROUND

Hygiene and surveillance in swimming pools are established by WHO Guidelines and national laws. Progress in water management and pool construction is revolutionizing the field, introducing new materials, systems, disinfection procedures or monitoring markers. Innovation advances challenge the upgrading of safety and quality in pools and the appropriate implementation of guidelines.

STUDY DESIGN

In order to provide a device for laboratory test, a prototype was realized and applied to study and compare swimming pool materials and treatments.

METHODS

A pool scale-model was engineered and evaluated by computational fluid dynamics algorithms. An automated real time monitoring assured steady state. Critical control points along the water circuit were made accessible to allow the placing of different biocides or water sampling. Simulations were safely performed in a standard hood. Materials for pool surfaces and pipelines were evaluated for biofilm formation under different disinfection conditions. Adherent microorganisms were assayed by mfDNA analysis using real time PCR.

RESULTS

The prototype reached the steady state within 5-25 hours under different conditions, showing chemical, physical and fluid-dynamic stability. A method was optimized for testing materials showing their different response to biofilm induction. Several innovative PVC samples displayed highest resistance to bacterial adhesion.

CONCLUSIONS

A device and method was developed for testing swimming pool hygienic parameters in laboratory. It allowed to test materials for pools hygiene and maintenance, including biofilm formation. It can be applied to simulate contaminations under different water treatments or disinfection strategies. It may support technical decisions and help policymakers in acquiring evidences for comparing or validating innovative solutions.

A Feasibility Study using Polychemotherapy (Cisplatin + Vindesine + Dacarbazine) plus Interferon-Alpha or Monochemotherapy with Dacarbazine plus Interferon-Alpha in Metastatic Melanoma

Aims and Background

This trial evaluated the feasibility and tol-erability of an immunochemotherapeutic approach that uses cisplatin, vindesine, and dacarbazine (DTIC), or only DTIC, in combination with interferon alpha-2a (IFN-a), in patients with metastatic melanoma, considering the significant toxicity of several different regimens used up to now.

Methods

Between May 1995 and September 1997, 51 melanoma patients (50 of whom were assessable) entered a multicentric trial and were randomized to receive cisplatin (30 mg/m2 daily for 3 days) + vindesine (2.5 mg/m2 only day 1) + DTIC (250 mg/m2 daily for 3 consecutive days) + IFN-α (3 MIU im 3x/wk continuously) (CVD arm) versus DTIC (800 mg/m2 day 1) + IFN-α (3 MIU im 3x/wk continuously) (DTIC arm). The chemotherapy was recycled every 21 days. Patient reevaluation was performed every two cycles, and the treatment was continued in case of objective response or stabilization of disease.

Results

We observed 3 complete responses, 2 partial responses and 5 stable diseases in the CVD arm, and 2 partial responses and 4 stabilizations of disease in the DTIC arm.

Conclusions

We conclude that these chemotherapeutic regimens are well tolerated regimens with modest toxicity. Future trials will be conducted associating the CVD regimen with biological response modifiers (IFN, IL-2) in order to improve the results.

Use of the spectrophotometric color method for the determination of the age of skin lesions on the pig carcass and its relationship with gene expression and histological and histochemical parameters

The presence of lesions on the pig carcass is an indicator of poor animal welfare and has economic impact as it downgrades the carcass value. The assessment of the age of lesions on the carcass may help identify risk factors and ultimately prevent their occurrence. The aim of this study was to assess the age of lesions on pig carcasses through spectrophotometric color evaluation and to relate the results with gene expression and histological and histochemical parameters. A total of 96 barrows were mixed 4 times over 3 d before slaughter and 80 lesions were selected after skin lesion observations to define 4 age categories: < 7 h (T1), 7-25 h (T2), 25-30 h (T3), and 49-54 h (T4). A nonlesioned skin area was used as a control. At slaughter, 3 biopsies per lesion and control skin were taken immediately after bleeding for analyses of gene expression (, , , , , , , , , ), skin histological characteristics (inflammation, erosion or ulceration, and necrosis), and enzyme activity (alkaline phosphatase and adenosine triphosphatase). The number of lesions was counted on each carcass, and the color was assessed visually by a pictorial chart and instrumentally through a spectrophotometer. Delta values (Δ) were calculated as the difference between the value of the lesion and the value of the control for all measures, except for the histological analysis. Results indicated that visual color observation was not sufficiently accurate to discriminate lesions by time of infliction ( > 0.10), while the spectrophotometer ΔL* and Δa* values variation allowed the identification of < 7 h or > 25 h old lesions ( < 0.05). Similarly, the expression of , , , , and genes was higher ( < 0.05) in < 7 h old lesions, while gene expression was higher ( < 0.05) in < 25 h old lesions. As for the histological analysis, the severity of inflammation was correlated with the age of the lesion (lower score in < 7 h old lesions and higher score in > 25 h old lesions; < 0.05). To conclude, the spectrophotometric color assessment of the carcass lesions at slaughter appears to be a reliable method to discriminate between fresh and older lesions on the carcass at the abattoir.

Cancer mortality in Rieti province (Latium Region, Italy) for the years 2006-2010: evaluation of temporal and spatial trends and comparison with the other Latium provinces

BACKGROUND

The present research aims to obtain information on cancer deaths in the five Latium provinces in the years 2006-2010 and to highlight similarities and differences between them.

METHODS

The survey was carried through statistical elaboration of cancer mortality data for the years 2006-2010 obtained from the National Institute of Statistics.

RESULTS

The mortality due to oncological diseases in Rieti province showed a decreasing temporal trend for the years investigated. Among all the Latium provinces, Rieti presented the lowest standardized mortality rates. This phenomenon could be related to specific environmental conditions and low levels of air, water and soil pollution affecting the Rieti province.

CONCLUSION

The results of the present study show that the "healthy" environment of Rieti province could be considered as a benchmark for studies in oncological diseases.

Second-hand smoke exposure generated by new electronic devices (IQOS® and e-cigs) and traditional cigarettes: submicron particle behaviour in human respiratory system

Passive exposure profiles to submicronic particles (SMPs, 5.6-560 nm) of traditional cigarettes and new electronic commercial devices (e-cig and IQOS®, a new heat-not-burn smoking device) were compared. During smoking, SMPs released by traditional cigarettes resulted four-times higher than those released by electronic and heat-not-burn devices and remained high for at least one hour, while SMPs values returned immediately similar to background for electronic and heat-not-burn devices. In all experiments, approximately half of SMPs resulted so small to reach the alveolar region.