Diagnostic factors for recurrent pregnancy loss: an expanded workup

Purpose: There is limited information on the risk factors for recurrent pregnancy loss (RPL). Methods: In this study, a patient-based approach was used to investigate the possible involvement and relative relevance of a large number of diagnostic factors in 843 women with RPL who underwent an extensive diagnostic workup including 44 diagnostic factors divided into 7 major categories. Results: The rates of abnormalities found were: (1) genital infections: 11.74%; (2) uterine anatomic defects: 23.72%; (3) endocrine disorders: 29.42%; (4) thrombophilias: 62%; (5) autoimmune abnormalities: 39.2%; (6) parental karyotype abnormalities 2.25%; (7) clinical factors: 87.78%. Six hundred and fifty-nine out of eight hundred and forty-three women (78.17%) had more than one abnormality. The mean number of pregnancy losses increased by increasing the number of the abnormalities found (r = 0.86949, P < 0.02). The factors associated with the highest mean number of pregnancy losses were cervical isthmic incompetence, anti-beta-2-glycoprotein-1 antibodies, unicornuate uterus, anti-prothrombin A antibodies, protein C deficiency, and lupus anticoagulant. The majority of the considered abnormalities had similar, non-significant prevalence between women with 2 versus ≥ 3 pregnancy losses with the exception of age ≥ 35 years and MTHFR A1298C heterozygote mutation. No difference was found between women with primary and secondary RPL stratified according to the number of abnormalities detected (Chi-square: 8.55, P = 0.07). In these women, the only factors found to be present with statistically different rates were age ≥ 35 years, cigarette smoking, and genital infection by Ureaplasma. Conclusion: A patient-based diagnostic approach in women with RPL could be clinically useful and could represent a basis for future research

Sliding Mode Control of Quadratic Boost Converters Based on Min-Type Control Strategy

The paper deals with the control of a quadratic boost converter supplied by low-voltage energy sources, such as photovoltaic panels, fuel cells, or batteries. The control scheme consists of two control loops. A min-type controller governs the inner loop to force the current state of the nominal model to converge in a neighborhood of the equilibrium state. The external loop processes the output tracking error using an integrator, and it allows reconfiguring the converter's working point by changing the equilibrium state given in the input to the internal loop. This configuration assures both zero tracking error of the output voltage and robustness against load and input voltage variations and converter parameter uncertainties. The stability of the whole system is investigated using the hybrid system framework. The proposed control technique has been tested experimentally in a suitably developed (low-cost) setup, and the results show the effectiveness of the proposed approach

Indications for flexible fiberoptic bronchoscopy and its safety in the very elderly

Aim. To evaluate the indications and the safety of fiberoptic bronchoscopy (FOB) with bronchoalveolar lavage (BAL), protected specimen brushing (PSB), endobronchial biopsy (EBB), and transbronchial biopsy (TBB) in a population of very elderly patients. Methods. We performed a retrospective study of all adult patients, aged 50 years or older, who underwent FOB in the Bronchology Unit of the University of Parma Hospital between 1 January, 2003 and 31 April, 2005. Bronchoscopy records of 436 consecutive patients, including 191 patients, 75 yrs of age and older ("very elderly"; =>75 yrs), were reviewed. Results. Patients aged 75 years were no different with regard to gender, BMI, baseline FEV1/FVC ratio, baseline SaO2, and blood pressure. The primary indication in patients aged <75 years, was to assist in the diagnosis of a pulmonary mass of unknown aetiology (33%) and to remove secretions in the very elderly patients (31%). Indications for FOB and sampling procedures in the two groups were similar. Approximately 30% of patients in each group required supplemental oxygen during the procedure and fever occurred in 9.2% and 10.3% of patients, respectively.Hypertension and bleeding were relatively rare and did not occur more often in the very elderly. Conclusions. Indication for FOB did not vary with age and adverse events in both groups were uncommon and generally not severe

Autotrophic vs. Heterotrophic cultivation of the marine diatom cyclotella cryptica for epa production

Recently, the marketable value of ω-3 fatty acid, particularly eicosapentaenoic acid (EPA), increased considering their health effects for human consumption. Microalgae are considered a valuable and “green” source of EPA alternative to fish oils, but considerable efforts are necessary for their exploitation at an industrial level. Due to the high operation costs of photoautotrophic microalgae cultivation, heterotrophic growth represents a promising economic solution. Marine diatoms are the major ecological producers of ω-3 fatty acids. Few species of diatoms are capable to grow in the dark using organic carbon sources. The marine diatom Cyclotella cryptica was cultivated for 14 days under photoautotrophic and heterotrophic conditions to define the effects on growth parameters, lipid production, total fatty acids and EPA content. Photoautotrophic conditions led to a total EPA production of 1.6% of dry weight, 12.2 mg L−1 culture and productivity of 0.9 mg L−1 day−1 . The heterotrophy cultures reported a total EPA production of 2.7% of dry cell weight, 18 mg L−1 culture, a productivity of 1.3 mg L−1 day−1, which are promising values in the prospective of improving culture parameters for the biotechnological exploitation of dark cultivation. C. cryptica could be a potential candidate for the heterotrophic production of EPA, also considering its robustness, capacity to resist to bacterial contaminations and plasticity of lipid metabolism

The impact of clean sky technology on future 3500 lb single engine light rotorcraft

This manuscript describes a collaborative research effort between members of the Clean Sky Joint Technology Initiative (JTI), within the broader area of novel rotorcraft engine technology and rotorcraft operations. The Clean Sky JTI was created as a public/private partnership between the European Commission and the aeronautical industry. The paper assesses the impact of innovative engine technologies to be integrated into the next generation of rotorcraft and evaluates their potential towards meeting the ACARE 2020 goals. The focus is on the lower segment of the light helicopter class with a particular interest in the performance of two innovative powerplants: an advanced turboshaft with Lean Premixed Prevaporised (LPP) combustor design and a supercharged diesel cycle engine. In order to evaluate their benefits alongside other Clean Sky technologies, a multi-disciplinary rotorcraft performance analysis framework (PhoeniX) is employed. Two variants of the same light helicopter platform with year 2020 technology plus Clean Sky innovations are modelled, named hereafter as Single Engine Light (SEL) Y2020 and High Compression Engine (HCE) Y2020, respectively. A turboshaft engine-powered helicopter, representative of year 2000 technology (SEL Y2000) is also modelled and used as reference. Payload-Range diagrams (PR) of the three vehicles were generated. The HCE Y2020 reached a maximum range 83% greater than the SEL counterparts. The gaseous emissions of the helicopters were also evaluated over three notional scenarios representative of light helicopter activities. The HCE Y2020 emitted 60% less carbon dioxide (CO2) and 63% less nitrogen oxides (NOx) than the SEL Y2000. The SEL Y2020 emitted on average 19% and 49% less CO2 and NOx, respectively, compared with the SEL Y2000. It was also observed that the NOx production rate of the LPP technology integrated in the SEL Y2020 combustor depends strongly on engine power setting. At certain power settings, the SEL Y2020 emitted less NOx than the HCE Y2020 even though the HCE Y2020 emitted less NOx over the complete mission. The direct comparison between SEL Y2020 and HCE Y2020 highlighted the superior performance of the HCE engine over the gas turbine for the mission types and rotorcraft class simulated

Fermentation of biodegradable organic waste by the family thermotogaceae

The abundance of organic waste generated from agro-industrial processes throughout the world has become an environmental concern that requires immediate action in order to make the global economy sustainable and circular. Great attention has been paid to convert such nutrient-rich organic waste into useful materials for sustainable agricultural practices. Instead of being an environmental hazard, biodegradable organic waste represents a promising resource for the production of high value-added products such as bioenergy, biofertilizers, and biopolymers. The ability of some hyperthermophilic bacteria, e.g., the genera Thermotoga and Pseudothermotoga, to anaerobically ferment waste with the concomitant formation of bioproducts has generated great interest in the waste management sector. These biotechnologically significant bacteria possess a complementary set of thermostable enzymes to degrade complex sugars, with high production rates of biohydrogen gas and organic molecules such as acetate and lactate. Their high growth temperatures allow not only lower contamination risks but also improve substrate solubilization. This review highlights the promises and challenges related to using Thermotoga and Pseudothermotoga spp. as sustainable systems to convert a wide range of biodegradable organic waste into high value-added products

Influence of Nutritional Status and Physical Exercise on Immune Response in Metabolic Syndrome

Metabolic Syndrome (MetS) is a cluster of metabolic alterations mostly related to visceral adiposity, which in turn promotes glucose intolerance and a chronic systemic inflammatory state, characterized by immune cell infiltration. Such immune system activation increases the risk of severe disease subsequent to viral infections. Strong correlations between elevated body mass index (BMI), type-2-diabetes and increased risk of hospitalization after pandemic influenza H1N1 infection have been described. Similarly, a correlation between elevated blood glucose level and SARS-CoV-2 infection severity and mortality has been described, indicating MetS as an important predictor of clinical outcomes in patients with COVID-19. Adipose secretome, including two of the most abundant and well-studied adipokines, leptin and interleukin-6, is involved in the regulation of energy metabolism and obesity-related low-grade inflammation. Similarly, skeletal muscle hormones—called myokines—released in response to physical exercise affect both metabolic homeostasis and immune system function. Of note, several circulating hormones originate from both adipose tissue and skeletal muscle and display different functions, depending on the metabolic context. This review aims to summarize recent data in the field of exercise immunology, investigating the acute and chronic effects of exercise on myokines release and immune system function

Struggling with COVID-19 in Adult Inborn Errors of Immunity Patients: A Case Series of Combination Therapy and Multiple Lines of Therapy for Selected Patients

Background: The SARS-CoV-2 infection is now a part of the everyday lives of immunocompromised patients, but the choice of treatment and the time of viral clearance can often be complex, exposing patients to possible complications. The role of the available antiviral and monoclonal therapies is a matter of debate, as are their effectiveness and potential related adverse effects. To date, in the literature, the amount of data on the use of combination therapies and on the multiple lines of anti-SARS-CoV-2 therapy available to the general population and especially to inborn error of immunity (IEI) patients is small. Methods: Here, we report a case series of five adult IEI patients managed as inpatients at three Italian IEI referral centers (Rome, Treviso, and Cagliari) treated with combination therapy or multiple therapeutic lines for SARS-CoV-2 infection, such as monoclonal antibodies (mAbs), antivirals, convalescent plasma (CP), mAbs plus antiviral, and CP combined with antiviral. Results: This study may support the use of combination therapy against SARS-CoV-2 in complicated IEI patients with predominant antibody deficiency and impaired vaccine response