Drug-Induced Urolithiasis in Pediatric Patients

Drug-induced nephrolithiasis is a rare condition in children. The involved drugs may be divided into two different categories according to the mechanism involved in calculi formation. The first one includes poorly soluble drugs that favor the crystallization and calculi formation. The second category includes drugs that enhance calculi formation through their metabolic effects. The diagnosis of these specific calculi depends on a detailed medical history, associated comorbidities and the patient's history of drug consumption. There are several risk factors associated with drug-induced stones, such as high dose of consumed drugs and long duration of treatment. Moreover, there are some specific risk factors, including urinary pH and the amount of fluid consumed by children. There are limited data regarding pediatric lithogenic drugs, and hence, our aim was to perform a comprehensive review of the literature to summarize these drugs and identify the possible mechanisms involved in calculi formation and discuss the management and preventive measures for these calculi

Association between Staphylococcus aureus nasal carriage and disease phenotype in patients affected by systemic lupus erythematosus

Staphylococcus aureus (SA) is a commensal bacterium representing one of the most important components of the skin microbiome, mostly isolated in the anterior nares. A higher rate of SA nasal colonization in patients affected by Wegener's granulomatosis and rheumatoid arthritis compared with healthy subjects (HS) has been described. No studies focusing on systemic lupus erythematosus (SLE) are available. We aimed at analyzing the prevalence of SA nasal carriers in an SLE cohort and evaluating correlation between nasal colonization and clinical, laboratory and therapeutic features. METHODS: We enrolled 84 patients with SLE (number of male/female patients 6/78; mean age 41.3 ± 12.2 years, mean disease duration 142.1 ± 103.8 months) and 154 HS blood donors. Patients with SLE underwent a physical examination and the clinical/laboratory data were collected. All the patients with SLE and the HS received a nasal swab for SA isolation and identification. RESULTS: SA nasal colonization prevalence was 21.4 % in patients with SLE and 28.6 % in HS (P not significant). We analyzed patients with SLE according to the presence (n = 18, SA-positive SLE) or the absence (n = 66, SA-negative SLE) of nasal colonization. Renal involvement was significantly more frequent in SA-positive SLE (11.6 % vs 3.0 %; P = 0.0009). Moreover, the presence of anti-dsDNA, anti-Sm, anti-SSA, anti-SSB, anti-RNP antibodies was significantly higher in SA-positive SLE (P < 0.0001, P = 0.01, P = 0.008, P = 0.03, P = 0.03, respectively). CONCLUSION: SA colonization is a relatively frequent condition in patients with SLE, with a frequency similar to HS. The presence of SA seems associated with a peculiar SLE phenotype characterized by renal manifestations and autoantibody positivity, confirming the role of the microbiome in disease phenotype

Efectos del cambio climático en la distribución de 20 especies de aves de la región amazónica del Perú

OBJETIVO El objetivo del estudio es evaluar los efectos del cambio climático en la distribución de las poblaciones silvestres de 20 especies de aves. ÁREA DE ESTUDIO El área de estudio es el bosque de las regiones Amazónicas de Huánuco, Amazonas, Junín, Loreto, Madre de Dios, Pasco, San Martín y Ucayali. SELECCIÓN DE LAS 20 ESPECIES Inicialmente, se colectaron los puntos de presencia de todas las especies de aves en la Amazonía peruana según eBird/Clements Checklist (Clements et al., 2019). Los puntos de presencia fueron obtenidos de las siguientes bases de datos: GBIF (Global Biodiversity Information Facility; www.gbif.org), e Inventario Nacional Forestal y de Fauna Silvestre del SERFOR. Luego de colectar los datos, se procedió con la selección de las especies para el modelamiento de acuerdo a los siguientes criterios: (i) que las especies estén amenazadas según el Libro Rojo de la Fauna Silvestre Amenazada del Perú (SERFOR, 2018), (ii) que existan como mínimo 15 puntos de presencia, y (iii) que por lo menos la mitad de los puntos de presencia se encuentren ubicados en la Amazonía. Las siguientes 20 especies cumplieron los criterios y fueron utilizadas para el modelamiento

Climate change impact on cultivated and wild cacao in Peru and the search of climate change-tolerant genotypes

Aim: Cacao (Theobroma cacao L.) is expected to be vulnerable to climate change. The objectives of this study were to (a) assess the future impact of climate change on cacao in Peru and (b) identify areas where climate change-tolerant genotypes are potentially present. Location: Peru Methods: Drawing on 19,700 and 1,200 presence points of cultivated and wild cacao, respectively, we modelled their suitability distributions using multiple en semble models constructed based on both random and target group selection of pseudo-absence points and different resolutions of spatial filtering. To estimate the uncertainty of future predictions, we generated future projections for all the ensem ble models. We investigated the potential emergence of novel climates, determined expected changes in ecogeographical zones (zones representative for particular sets of growth conditions) and carried out an outlier analysis based on the environmental variables most relevant for climate change adaptation to identify areas where climate change-tolerant genotypes are potentially present. Results: We found that the best modelling approaches differed between cultivated and wild cacao and that the resolution of spatial filtering had a strong impact on future suitability predictions, calling for careful evaluation of the effect of model selection on modelling results. Overall, our models foresee a contraction of suitable area for cultivated cacao while predicting a more positive future for wild cacao in Peru. Ecogeographical zones are expected to change in 8%–16% of the distribution of cultivated and wild cacao. We identified several areas where climate change-tolerant genotypes may be present in Peru. Main conclusions: Our results indicate that tolerant genotypes will be required to facilitate the adaptation of cacao cultivation under climate change. The identified cacao populations will be target of collection missions

The Role of Disease Activity Score 28 in the Evaluation of Articular Involvement in Systemic Lupus Erythematosus

Objectives. To evaluate the application of Disease Activity Score 28 (DAS28) to assess joint involvement in Systemic Lupus Erythematosus (SLE). Methods. Sixty-nine SLE patients, complaining of joint symptoms, and 44 rheumatoid arthritis (RA) patients were enrolled. In SLE patients disease activity was assessed with SLEDAI-2K. DAS28 was calculated in all the patients. Results. Thirty SLE patients (43.5%) showed clinical signs of arthritis. Mean DAS28 was 4.0±1.4, 22 patients (31.9%) had low disease activity, 29 (42.0%) moderate, and 18 (26.1%) high. We dichotomized SLE patients according to the presence (Group 1) or absence (Group 2) of articular involvement according to SLEDAI-2K: 56.3% of the patients of the second group had a moderate/high activity according to DAS28. We compared SLE patients with 44 RA patients (M/F 9/35, mean age 55.6±14.5 years; mean disease duration 140.4±105.6 months). No significant differences were found regarding the values of DAS28 between SLE and RA patients. On the contrary, the values of tender and swollen joint count were significantly higher in RA compared to SLE patients (P=0.0002 and P=0.0001, resp.). Conclusions. We suggest the use of the DAS28 in the assessment of joint involvement in SLE patients

Efectos del cambio climático en la distribución de 20 especies forestales maderables de la región amazónica del Perú

OBJETIVO: El objetivo del estudio es evaluar los efectos del cambio climático en la distribución de las poblaciones silvestres de 20 especies de árboles. ÁREA DE ESTUDIO: El área de estudio es el bosque de las regiones amazónicas de Huánuco, Amazonas, Junín, Loreto, Madre de Dios, Pasco, San Martín y Ucayali. SELECCIÓN DE LAS 20 ESPECIES : Inicialmente, se colectaron los puntos de presencia de todas las especies de árboles en la Amazonía peruana, según la lista nacional de Perú (Brako & Zarucchi, 1993). Los puntos de presencia fueron obtenidos de las siguientes bases de datos: GBIF (Global Biodiversity Information Facility; www.gbif.org), BIEN (Botanical Information and Ecology Network; http://biendata.org/), Inventario Nacional Forestal y de Fauna Silvestre del SERFOR, y la Base de Datos Espaciales del Organismo de Supervisión de los Recursos Forestales y de Fauna Silvestre (OSINFOR). Luego de colectar los datos, se procedió con la selección de las especies para el modelamiento de acuerdo a los siguientes criterios: (i) que las especies tengan un grado de amenaza según el Decreto Supremo Nº 043-2006-AG AG o estén identificadas como especies forestales de acuerdo a la Resolución Ejecutiva N°118-2019-MINAGRI-SERFOR-DE, (ii) que existan como mínimo 15 puntos de presencia, y (iii) que por lo menos la mitad se encuentren ubicados en la Amazonía. Las siguientes 20 especies cumplieron los criterios y fueron utilizadas para el modelamiento

Diversity for Restoration (D4R): guiding the selection of tree species and seed sources for climate-resilient restoration of tropical forest landscapes

1. At the start of the UN Decade of Ecosystem Restoration (2021–2030), the restoration of degraded ecosystems is more than ever a global priority. Tree planting will make up a large share of the ambitious restoration commitments made by countries around the world, but careful planning is needed to select species and seed sources that are suitably adapted to present and future restoration site conditions and that meet the restoration objectives. 2. Here we present a scalable and freely available online tool, Diversity for Restoration (D4R), to identify suitable tree species and seed sources for climate-resilient tropical forest landscape restoration. 3. The D4R tool integrates (a) species habitat suitability maps under current and future climatic conditions; (b) analysis of functional trait data, local ecological knowledge and other species characteristics to score how well species match the restoration site conditions and restoration objectives; (c) optimization of species combinations and abundances considering functional trait diversity or phylogenetic diversity, to foster complementarity between species and to ensure ecosystem multifunctionality and stability; and (d) development of seed zone maps to guide sourcing of planting material adapted to present and predicted future environmental conditions. We outline the various elements behind the tool and discuss how it fits within the broader restoration planning process, including a review of other existing tools. 4. Synthesis and applications. The Diversity for Restoration tool enables non-expert users to combine species traits, environmental data and climate change models to select tree species and seed sources that best match restoration site conditions and restoration objectives. Originally developed for the tropical dry forests of Colombia, the tool has now been expanded to the tropical dry forests of northwestern Peru–southern Ecuador and the countries of Burkina Faso and Cameroon, and further expansion is underway. Acknowledging that restoration has a wide range of meanings and goals, our tool is intended to support decision making of anyone interested in tree planting and seed sourcing in tropical forest landscapes, regardless of the purpose or restoration approachISSN:0021-8901ISSN:1365-266

COVID-19 in rheumatic diseases in Italy: first results from the Italian registry of the Italian Society for Rheumatology (CONTROL-19)

OBJECTIVES: Italy was one of the first countries significantly affected by the coronavirus disease 2019 (COVID-19) epidemic. The Italian Society for Rheumatology promptly launched a retrospective and anonymised data collection to monitor COVID-19 in patients with rheumatic and musculoskeletal diseases (RMDs), the CONTROL-19 surveillance database, which is part of the COVID-19 Global Rheumatology Alliance. METHODS: CONTROL-19 includes patients with RMDs and proven severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) updated until May 3rd 2020. In this analysis, only molecular diagnoses were included. The data collection covered demographic data, medical history (general and RMD-related), treatments and COVID-19 related features, treatments, and outcome. In this paper, we report the first descriptive data from the CONTROL-19 registry. RESULTS: The population of the first 232 patients (36% males) consisted mainly of elderly patients (mean age 62.2 years), who used corticosteroids (51.7%), and suffered from multi-morbidity (median comorbidities 2). Rheumatoid arthritis was the most frequent disease (34.1%), followed by spondyloarthritis (26.3%), connective tissue disease (21.1%) and vasculitis (11.2%). Most cases had an active disease (69.4%). Clinical presentation of COVID-19 was typical, with systemic symptoms (fever and asthenia) and respiratory symptoms. The overall outcome was severe, with high frequencies of hospitalisation (69.8%), respiratory support oxygen (55.7%), non-invasive ventilation (20.9%) or mechanical ventilation (7.5%), and 19% of deaths. Male patients typically manifested a worse prognosis. Immunomodulatory treatments were not significantly associated with an increased risk of intensive care unit admission/mechanical ventilation/death. CONCLUSIONS: Although the report mainly includes the most severe cases, its temporal and spatial trend supports the validity of the national surveillance system. More complete data are being acquired in order to both test the hypothesis that RMD patients may have a different outcome from that of the general population and determine the safety of immunomodulatory treatments

Integrated clinicopathologic and molecular analysis of endometrial carcinoma: Prognostic impact of the new ESGO-ESTRO-ESP endometrial cancer risk classification and proposal of histopathologic algorithm for its implementation in clinical practice

IntroductionThe European Society of Gynecologic Oncology/European Society of Radiation Therapy and Oncology/European Society of Pathology (ESGO/ESTRO/ESP) committee recently proposed a new risk stratification system for endometrial carcinoma (EC) patients that incorporates clinicopathologic and molecular features. The aim of the study is to compare the new ESGO/ESTRO/ESP risk classification system with the previous 2016 recommendations, evaluating the impact of molecular classification and defining a new algorithm for selecting cases for molecular analysis to assign the appropriate risk class.MethodsThe cohort included 211 consecutive EC patients. Immunohistochemistry and next-generation sequencing were used to assign molecular subgroups of EC: POLE mutant (POLE), mismatch repair deficient (MMRd), p53 mutant (p53abn), and no specific molecular profile (NSMP).ResultsImmuno-molecular analysis was successful in all cases, identifying the four molecular subgroups: 7.6% POLE, 32.2% MMRd, 20.9% p53abn, and 39.3% NSMP. The recent 2020 guidelines showed a 32.7% risk group change compared with the previous 2016 classification system: the reassignment is due to POLE mutations, abnormal p53 expression, and a better definition of lymphovascular space invasion. The 2020 system assigns more patients to lower-risk groups (42.2%) than the 2016 recommendation (25.6%). Considering the 2020 risk classification system that includes the difference between “unknown molecular classification” and “known,” the integration of molecular subgroups allowed 6.6% of patients to be recategorized into a different risk class. In addition, the use of the proposed algorithm based on histopathologic parameters would have resulted in a 62.6% reduction in molecular analysis, compared to applying molecular classification to all patients.ConclusionApplication of the new 2020 risk classification integrating clinicopathologic and molecular parameters provided more accurate identification of low-and high-risk patients, potentially allowing a more specific selection of patients for post-operative adjuvant therapy. The proposed histopathologic algorithm significantly decreases the number of tests needed and could be a promising tool for cost reduction without compromising prognostic stratification

Data Logger: cognitive analysis

This work is developed on the basis of data related to the driving experience of a motorcycle in its aspects. The drivers point of view is supported by the analysis of the data produced by the sensors and collected by a data logger. The two aspects, human and technical, have been standardized from a technological point of view so that they can be analysed and related to each other. The need for cognitive algorithms has led to the use of Cloud PaaS and SaaS technologies: these have allowed the rapid realization of the project without technical constraints. All of this is part of the specific requirements set up by Ducati's PQ department whose aim is to evaluate the response on the road of new models or technological improvements before the production in series. The final solution for the proposed data collection was realized using different services of IBM Cloud: a web app was built using a virtual assistant based on cognitive technology that guides the user in the collection of information and verifies its consistency. The application required backend services such as an Object Storage and a Database, to store multimedia content and data respectively. Concerning the front-end instead, the automation of the collection mode has led to the introduction of an acquisition process that was easier to use and always available in terms of reachability and flexibility. The information related to the data collected by the logger did not need to be mediated by further technological components. The technology used for the analytical part is Microsoft's Power BI. The integration with the two data sources is plug and play: the data are automatically updated. Several types of analysis have been done and range from reconstruction and correlation of measurements on a route to text analysis of driver sensations. In addition to this, a PCB has been developed to solve an issue related to the data logger itself