A score that predicts aquaporin-4-IgG positivity in patients with longitudinally extensive transverse myelitis

Background: Longitudinally extensive transverse myelitis (LETM) associated with aquaporin-4 autoantibodies (AQP4-IgG) can cause severe disability. Early diagnosis and prompt treatment are critical to prevent relapses. We describe a novel score based on clinical and neuroimaging characteristics that predicts AQP4-IgG positivity in patients with LETM. Methods: Patients were enrolled both retrospectively and prospectively from multiple Italian centers. Clinical and neuroimaging characteristics of AQP4-IgG positive and negative patients were compared through univariate and multivariate analysis. Results: Sixty-six patients were included. Twenty-seven (41%) were AQP4-IgG positive and median age at onset was 45.5 years old (range 19-81, interquartile range 24). Female sex (odds ratio [OR] 17.9; 95% confidence interval [CI] 2.6-381.9; p=0.014), tonic spasms (OR 45.6; CI 3.1-2197; p=0.017) and lesion hypointensity on T1-weighted images (OR 52.9; CI 6.8-1375; p=0.002) were independently associated with AQP4-IgG positivity. The Aquaporin-4-IgG positivity in Myelitis (AIM) score predicted AQP4-IgG positivity with 85% sensitivity and 95% specificity. Positive and negative likelihood ratio were 16.6 and 0.2 respectively. The inter-rater and intra-rater agreement in the score application were both excellent. Conclusions: The AIM score predicts AQP4-IgG positivity with good sensitivity and specificity in patients with a first episode of LETM. The score may assist clinicians in early diagnosis and treatment of AQP4-IgG positive LETM

Re-use of wastewater for a sustainable forest production and climate change mitigation under arid environments

Over the last decades biotic and abiotic constrains together with human actions are determining a substantial environmental pressure, particularly in dry lands as the south of the Mediterranean region. From very long time, indeed, simultaneous drivers such as demographic growth, climate change and socio-economic factors are weakening the previous homeostasis between human needs and natural resources on the regional scale.Resulting pressures are determining environmental degradation and increase of desertification risk for the arid and semiarid lands. Water quality and availability are both crucial points limiting people well-being and livelihoods in the same context. Scarcity of fresh water and heavy and mismanaged production of wastewater are the main factors affecting water resources. Increasing pollution of soil and ground waters reduces the possibility of sustainable development of local communities with relevant social consequences. The FAO's supporting program in north Africa aims to: a) develop new and cheaper phytotechnologies (e.g. constructed wetland system; innovative treatment system for reuse of waste water for fertigation); b) treat wastewater for water quality protection; c) promote land recovery by means of sustainable multipurpose forestry; d) adopt bioengineering interventions to stop slopes erosion and protect urban, and semi-urban infrastructures; e) create pilot demonstrative areas to test multi-purpose sustainable agroforestry systems. Within this frame, an integrated approach was designed to promote innovative sustainable water management and multipurpose forestry, in order to mitigate the effects of climate change, promote land recovery, and improve the livelihoods of local population. The present paper aims to provide an overview of the FAO project GCP/RAB/013/ITA. Particularly, two pilot studies are shown and discussed

Mycobacterial and Human Ferrous Nitrobindins: Spectroscopic and Reactivity Properties

Structural and functional properties of ferrous Mycobacterium tuberculosis (Mt-Nb) and human (Hs-Nb) nitrobindins (Nbs) were investigated. At pH 7.0 and 25.0 °C, the unliganded Fe(II) species is penta-coordinated and unlike most other hemoproteins no pH-dependence of its coordination was detected over the pH range between 2.2 and 7.0. Further, despite a very open distal side of the heme pocket (as also indicated by the vanishingly small geminate recombination of CO for both Nbs), which exposes the heme pocket to the bulk solvent, their reactivity toward ligands, such as CO and NO, is significantly slower than in most hemoproteins, envisaging either a proximal barrier for ligand binding and/or crowding of H2O molecules in the distal side of the heme pocket which impairs ligand binding to the heme Fe-atom. On the other hand, liganded species display already at pH 7.0 and 25 °C a severe weakening (in the case of CO) and a cleavage (in the case of NO) of the proximal Fe-His bond, suggesting that the ligand-linked movement of the Fe(II) atom onto the heme plane brings about a marked lengthening of the proximal Fe-imidazole bond, eventually leading to its rupture. This structural evidence is accompanied by a marked enhancement of both ligands dissociation rate constants. As a whole, these data clearly indicate that structural-functional relationships in Nbs strongly differ from what observed in mammalian and truncated hemoproteins, suggesting that Nbs play a functional role clearly distinct from other eukaryotic and prokaryotic hemoproteins