Which Are the Best Regimens of Broad-Spectrum Beta-Lactam Antibiotics in Burn Patients? A Systematic Review of Evidence from Pharmacology Studies

Background: Burn injury causes profound pathophysiological changes in the pharmacokinetic/pharmacodynamic (PK/PD) properties of antibiotics. Infections are among the principal complications after burn injuries, and broad-spectrum beta-lactams are the cornerstone of treatment. The aim of this study was to review the evidence for the best regimens of these antibiotics in the burn patient population. Methods: We performed a systematic review of evidence available on MEDLINE (from its inception to 2023) of pharmacology studies that focused on the use of 13 broad-spectrum beta-lactams in burn patients. We extracted and synthetized data on drug regimens and their ability to attain adequate PK/PD targets. Results: We selected 35 studies for analysis. Overall, studies showed that both high doses and the continuous infusion (CI) of broad-spectrum beta-lactams were needed to achieve internationally-recognized PK/PD targets, ideally with therapeutic drug monitoring guidance. The most extensive evidence concerned meropenem, but similar conclusions could be drawn about piperacillin-tazobactam, ceftazidime, cefepime, imipenem-clinastatin and aztreonam. Insufficient data were available about new beta-lactam-beta-lactamase inhibitor combinations, ceftaroline, ceftobiprole and cefiderocol. Conclusions: Both high doses and CI of broad-spectrum beta-lactams are needed when treating burn patients due to the peculiar changes in the PK/PD of antibiotics in this population. Further studies are needed, particularly about newer antibiotics

HIV Infection among Illegal Migrants, Italy, 2004–2007

To determine HIV prevalence and place of exposure for illegal migrants in Italy, we tested 3,003 illegal adult migrants for HIV; 29 (0.97%) were HIV positive. Antibody avidity index results (indicators of time of infection) were available for 27 of those persons and showed that 6 (22.2%) presumably acquired their infection after migration

Decellularized silk fibroin scaffold primed with adipose mesenchymal stromal cells improves wound healing in diabetic mice

Introduction: Silk fibroin (SF) scaffolds have been shown to be a suitable substrate for tissue engineering and to improve tissue regeneration when cellularized with mesenchymal stromal cells (MSCs). We here demonstrate, for the first time, that electrospun nanofibrous SF patches, cellularized with human adipose-derived MSCs (Ad-MSCs-SF) or decellularized (D-Ad- MSCs-SF) are effective in the treatment of skin wounds, improving skin regeneration in db/db diabetic mice. Methods: The conformational and structural analyses of SF and D-Ad-MSCs-SF patches were performed by scanning electron microscopy, confocal microscopy, Fourier transform infrared spectroscopy and differential scanning calorimetry. Wounds were performed by a 5mm punch biopsy tool on the mouse\u2019s back. Ad-MSCs-SF and D-Ad-MSCs-SF patches were transplanted and the efficacy of treatments was assessed by measuring the wound closure area, by histological examination and by gene expression profile. We further investigated the in vitro angiogenic properties of Ad-MSCs-SF and D-Ad-MSCs-SF patches by affecting migration of human umbilical vein endothelial cells (HUVECs), keratinocytes (KCs) and dermal fibroblasts (DFs), through the aortic ring assay and, finally, by evaluating the release of angiogenic factors. Results: We found that Ad-MSCs adhere and grow on SF, maintaining their phenotypic mesenchymal profile and differentiation capacity. Conformational and structural analyses on SF and D-Ad- MSCs-SF samples, showed that sterilization, decellularization, freezing and storing did not affect the SF structure. When grafted in wounds of diabetic mice, both Ad-MSCs-SF and DAd- MSCs-SF significantly improved tissue regeneration, reducing the wound area respectively by 40% and 35%, within three days, completing the process in around 10 days compared to 15-17 days of controls. RT2 gene profile analysis of the wounds treated with Ad- MSCs-SF and D-Ad-MSCs-SF showed an increment of genes involved in angiogenesis and matrix remodelling. Finally, Ad-MSCs-SF and D-Ad-MSCs-SF co-cultured with HUVECs, DFs and KCs, preferentially enhanced the HUVECs\u2019 migration and the release of angiogenic factors stimulating microvessel outgrowth in the aortic ring assay. Conclusions: Our results highlight for the first time that D-Ad-MSCs-SF patches are almost as effective as Ad-MSCs-SF patches in the treatment of diabetic wounds, acting through a complex mechanism that involves stimulation of angiogenesis. Our data suggest a potential use of DAd- MSCs-SF patches in chronic diabetic ulcers in humans

Association of kidney disease measures with risk of renal function worsening in patients with type 1 diabetes

Background: Albuminuria has been classically considered a marker of kidney damage progression in diabetic patients and it is routinely assessed to monitor kidney function. However, the role of a mild GFR reduction on the development of stage 653 CKD has been less explored in type 1 diabetes mellitus (T1DM) patients. Aim of the present study was to evaluate the prognostic role of kidney disease measures, namely albuminuria and reduced GFR, on the development of stage 653 CKD in a large cohort of patients affected by T1DM. Methods: A total of 4284 patients affected by T1DM followed-up at 76 diabetes centers participating to the Italian Association of Clinical Diabetologists (Associazione Medici Diabetologi, AMD) initiative constitutes the study population. Urinary albumin excretion (ACR) and estimated GFR (eGFR) were retrieved and analyzed. The incidence of stage 653 CKD (eGFR < 60 mL/min/1.73 m2) or eGFR reduction > 30% from baseline was evaluated. Results: The mean estimated GFR was 98 \ub1 17 mL/min/1.73m2 and the proportion of patients with albuminuria was 15.3% (n = 654) at baseline. About 8% (n = 337) of patients developed one of the two renal endpoints during the 4-year follow-up period. Age, albuminuria (micro or macro) and baseline eGFR < 90 ml/min/m2 were independent risk factors for stage 653 CKD and renal function worsening. When compared to patients with eGFR > 90 ml/min/1.73m2 and normoalbuminuria, those with albuminuria at baseline had a 1.69 greater risk of reaching stage 3 CKD, while patients with mild eGFR reduction (i.e. eGFR between 90 and 60 mL/min/1.73 m2) show a 3.81 greater risk that rose to 8.24 for those patients with albuminuria and mild eGFR reduction at baseline. Conclusions: Albuminuria and eGFR reduction represent independent risk factors for incident stage 653 CKD in T1DM patients. The simultaneous occurrence of reduced eGFR and albuminuria have a synergistic effect on renal function worsening

Análisis tafonómico de moluscos por debajo de la interfase agua-sedimento en una laguna del sudeste bonaerense, Argentina

Se analizó la preservación de los restos de moluscos por debajo de la interfase agua-sedimento en la laguna Nahuel Rucá (37°37'S, 57°25'O). El objetivo fue determinar el grado de alteración tafonómica y estimar la extensión de la zona tafonómicamente activa (TAZ), que es donde se produce la mayor destrucción de los restos. Para ello se realizó una descripción de los patrones de preservación observados y se midieron las principales variables físico-químicas, en cinco testigos de entre 25 y 72cm de longitud, extraídos de la zona litoral. Además se evaluó por medio de un experimento de campo el efecto de la disolución de los restos a diferentes profundidades y en presencia o ausencia de periostraco. En todos los testigos los restos recuperados estuvieron dominados por fragmentos. La riqueza máxima fue de siete: Biomphalaria peregrina (d'Orbigny), Drepanotrema kermatoides (d'Orbigny), Heleobia australis (d'Orbigny), H. parchappii (d'Orbigny), Pomacea canaliculata (Lamarck), Uncancylus concentricus (d'Orbigny) y Musculium argentinum (d'Orbigny). En los testigos se definieron tres secciones según diferencias en las variables físico-químicas medidas. Las dos primeras (primeros 25cm) corresponderían a la TAZ, dado que allí se observó la mayor destrucción de los restos y un decrecimiento en la diversidad, quedando solamente H. parchappii y fragmentos indeterminables hacia el final de la misma. Además se registró el mayor contenido de humedad, materia orgánica y carbonatos totales y el menor pH de toda la secuencia. La tercera sección se ubica en la base de los testigos, y presentó una homogeneidad en las variables físico-químicas con mejor estado de preservación de los restos fósiles. Respecto de la disolución de los restos, las observaciones de campo indican que fue mayor en aquellas conchillas que carecían de periostraco y a su vez fue mayor en la especie de mayor tamaño, mientras que no se registraron diferencias en profundidad.Simposio IX: El presente es la clave del pasado: importancia de los estudios actualistas en paleontologíaFacultad de Ciencias Naturales y Muse

Molluscan taphonomic patterns below the sediment-water interface in freshwater shallow lakes from the Southeastern Pampa plain, Argentina

Molluscan taphonomic patterns below the sediment-water interface in three freshwater shallow lakes from the Southeastern Pampa Plain, Argentina (Nahuel Ruca´, Las Mostazas, and Los Carpinchos), were analyzed in order to explore the taphonomic alteration suffered by mollusks with depth and determine if this taphonomic alteration varied locally within lakes or between them. Short cores (approximately 30 cm) from littoral environment as well as open water were sampled in each lake. Nine mollusk species were identified: Heleobia parchappii, H. australis, Biomphalaria peregrina, Uncancylus concentricus, Musculium argentinum, Drepanotrema kermatoides, Succinea meridionalis, Antillorbis nordestensis, and Pomacea canaliculata. The highest percentage of moisture, organic matter and carbonates as well as less alkaline pH were recorded at the top of the cores and in littoral environments, indicating less favorable conditions for preservation. Results suggest that the taphonomically active zone occupies the first 10 cm below the sediment-water interface.Fil: Cristini, Paula Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencia Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: de Francesco, Claudio German. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencia Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; Argentin

Taphonomic analysis of mollusks below the sediment-water interface in Nahuel Rucá lake (Buenos Aires Province, Argentina)

Se analizó la preservación de los restos de moluscos por debajo de la interfase agua-sedimento en la laguna Nahuel Rucá (37°37’S-57°25’O) con el objetivo de determinar el grado de alteración tafonómica y estimar la extensión de la zona tafonómicamente activa (TAZ). Para ello se realizó una descripción de los patrones de preservación observados en cinco testigos extraídos de la zona litoral y se evaluó el efecto de la disolución de los restos a diferentes profundidades y en presencia o ausencia de perióstraco, por medio de un experimento de campo. En todos los testigos los restos recuperados estuvieron dominados por fragmentos. En total se identificaron 7 especies: Biomphalaria peregrina (d’Orbigny, 1835), Drepanotrema kermatoides (d’Orbigny,1835), Heleobia australis (d’Orbigny, 1835), H. parchappii (d’Orbigny, 1835), Pomacea canaliculata (Lamarck, 1801), Uncancylus concentricus (d’Orbigny, 1835) y Musculium argentinum (d’Orbigny, 1835). Se concluye que la TAZ se extiende desde la superficie hasta aproximadamente 25 cm de profundidad. La mayor destrucción tiene lugar en los primeros 10 cm y disminuye gradualmente con la profundidad. De manera similar, la riqueza específica y la abundancia de los restos disminuyen a lo largo de la TAZ, preservándose solamente H. parchappii y fragmentos indeterminables. El efecto de la disolución que tiene lugar en la TAZ es mayor en aquellas conchas que carecen de perióstraco. Sin embargo, no se observaron diferencias en la disolución con la profundidad.The preservation of mollusk remains below the sediment-water interface in Nahuel Rucá lake (37°37′S–57°25′W) was analyzed in order to determine the degree of taphonomic alteration and to estimate the vertical extension of the taphonomically active zone (TAZ). To achieve that, the preservation patterns observed in five cores sampled from the litoral zone were described, and the effect of depth and presence of periostracum on shell dissolution was assessed by means of a field experiment. In all cores the recovered remains were dominated by fragments. Seven species were found: Biomphalaria peregrina (d’Orbigny, 1835), Drepanotrema kermatoides (d’Orbigny, 1835), Heleobia australis (d’Orbigny, 1835), H. parchappii (d’Orbigny, 1835), Pomacea canaliculata (Lamarck, 1801), Uncancylus concentricus (d’Orbigny, 1835) and Musculium argentinum (d’Orbigny, 1835). We concluded that the TAZ extends from the surface to a depth of approximately 25 cm. The highest destruction takes place in the first 10 cm and decreases gradually with depth. In a similar way, specific richness and abundance decrease downward through the TAZ, and only H. parchappii and unidentified fragments are found near the bottom. Dissolution was higher in shells without periostracum. No differences in dissolution were observed with depth.Fil: Cristini, Paula Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: de Francesco, Claudio German. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; Argentin

Taphonomic field experiment in a freshwater shallow lake: alteration of gastropod shells below the sediment–water interface

We conducted a taphonomic field experiment to evaluate the effects of (1) depth below the sediment-water interface (SWI) and (2) time of exposure on the accrual of damage (particularly through dissolution) to empty mollusc shells in freshwater environments. The experiment, which lasted 30 months, was carried out in the littoral area of Lake Nahuel Rucá, a shallow freshwater lake in the Pampa plain of Argentina. Bags (0.5-cm mesh) containing empty, cleaned shells of the freshwater gastropods Heleobia parchappii, Biomphalaria peregrina and Pomacea canaliculata were buried at three different depths (5, 20 and 35 cm) below the SWI. Damage was assessed every 3 months. All experimental shells exhibited fine-scale surface alteration, but the extent of this damage was relatively low, even in shells recovered after 30 months of exposure. Most of the damage consisted of minor pitting. For H. parchappii and B. peregrina, shell surface alteration varied significantly with depth, but not with time; in both species, alteration occurred mainly at the beginning of the experiment. For P. canaliculata, shell surface alteration varied significantly only with respect to time and this was the case for all three burial depths. All shells of this species exhibited a lower level of damage than what was observed for H. parchappii and B. peregrina. These differences may be related to the fact that P. canaliculata is characterized by a larger and thicker shell than the other two species. The shell attributes of larger size and greater thickness are known to confer a greater resistance to shell dissolution. In addition, the reactive surface area available for dissolution varies with shell size. Larger-sized shells have a lower potential for dissolution than smaller shells due to their lower surface-Area-To-volume ratio. In contrast, species such as H. parchappii and B. peregrina, which have smaller and thinner shells, are likely to be more rapidly destroyed because they are more vulnerable to dissolution and have less preservation potential. Our results demonstrate that dissolution is a significant taphonomic process affecting shells even during burial and that the influence of dissolution on shell alteration might be significant in cases of long persistence within the taphonomically active zone. Consequently, we suggest that when working on taphofacies in the context of aquatic environments, assessments of taphonomic alteration should include changes at and below the SWI.Fil: Cristini, Paula Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: de Francesco, Claudio German. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencias Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; Argentin

Knowledge management to compete in digital era: skills evolution of enterprise systems

National Industry 4.0 Plan is contributing to introduce new digital industrial technologies within the enterprise sector. This has brought the researchers and the experts of the sector to study as the business equilibriums are evolving and what new emergent professionalisms can be. On this basis, the paper aims to identify these skills and analyze professional’s dynamics, in order to achieve a higher level of competitiveness on the national manufacturing sector 4.0 stage. National Industry 4.0 Plan provides significant incentives aimed at strengthening R&D investments and incentivizing new technologies investments, as well as developing new skills among the professionals who will play a primary role in the "new 4.0 companies". Therefore, Industry 4.0 does not only intend to promote investments in new machinery and technologies, but, in parallel, to modify both, the productive and organizational paradigms, to effectively manage the indispensable and delicate process of cultural and organizational transformation. In other words, the goal is to transform all the processes into a continuous sequence of interconnected inter-digitally phases, which will be managed by an inter-functional group that has complete responsibility for it. This target is to be considered as a result of a training process across all company levels, which, according to a bottom up approach, stimulates a process of new skills creation and increases the sense of belonging to the company. This process also accompanying the profound changes of non-technological nature, which, however, are a presupposition and consequence of technology. In this perspective, the paper intends to set up a desk analysis - where the main focus are the national SMEs - aimed at better identifying the necessary skills to achieve a higher competitiveness level in the landscape 4.0 and, consequently, analysing the evolution of the professionalism that are characterizing the evolution of the enterprise systems

Mollusk successions of holocene shallow-lake deposits from the southeastern Pampa plain, Argentina

We analyzed variations in taxonomic composition, abundance, and preservation of freshwater mollusks during the mid- to late Holocene in three shallow lakes of the southeastern Pampa plain. Mollusks were obtained from core samples (110–140 cm long) from the deepest part of the lakes, and sampled at 1 cm intervals. Six species were identified: Heleobia australis, Heleobia parchappii, Biomphalaria peregrina, Uncancylus concentricus, Succinea meridionalis, and Antillorbis nordestensis. Assemblages were dominated by H. parchappii, which displayed continuous and complete records in the three sections. With the exception of H. australis, fossil assemblages were represented by the same species that today inhabit Pampean lakes and preserved the same rank order of abundance as modern communities. A similar pattern of variation in mollusk assemblage composition was recognized in the three successions, which initiated prior to circa 6000 cal. year B.P, with assemblages composed of H. parchappii and S. meridionalis at low abundances. A broad expansion of H. parchappii occurred between circa 6000 and 5400 cal. year B.P., and the species rapidly dominated the whole malacofauna. At circa 5400 cal. year B.P., the freshwater B. peregrina was recorded for the first time, and its abundance gradually increased until circa 3600 cal. year B.P. At ∼3700 cal. year B.P., the estuarine H. australis was recorded. The arrival of the freshwater U. concentricus occurred at ∼1697 cal. year B.P. Finally, only H. parchappii and B. peregrina were represented in the topmost levels (younger than ∼736 cal. year B.P.). Changes in mollusk composition were mostly related to changes in water salinity, which brings a historical perspective to understanding the modern dominance of the euryhaline H. parchappii in these lakes. Shell preservation became favored when water bodies developed brackish conditions.Fil: de Francesco, Claudio German. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencia Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Tietze, Eleonor. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencia Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; ArgentinaFil: Cristini, Paula Andrea. Consejo Nacional de Investigaciones Científicas y Técnicas. Centro Científico Tecnológico Conicet - Mar del Plata. Instituto de Investigaciones Marinas y Costeras. Universidad Nacional de Mar del Plata. Facultad de Ciencia Exactas y Naturales. Instituto de Investigaciones Marinas y Costeras; Argentin