Comparison of anogenital distance and correlation with vulvo-vaginal atrophy: a pilot study on premenopausal and postmenopausal women

OBJECTIVES: Anogenital distance (AGD) represents the space between labia posterior commissure and anus. This was pilot study to investigate how menopause and so lack of oestrogens affects AGD. METHODS: A total of 109 patients were enrolled. AGD was measured in lithotomy position using sterile paper ruler. Anogenital index (AGI) was used to control 2 variables of height and weight (body mass index, kg/m2). Vaginal health index (VHI) was used to evaluate vaginal wellness. Female sexual function index (FSFI) questionnaire was administered to all women to evaluate the impact of menopause on their sexual function. RESULTS: AGD (30.87 ± 2.98 vs. 17.57 ± 2.18; P = 0.0001) and AGI (1.40 ± 0.21 vs. 0.70 ± 0.15; P = 0.0001) were both significantly lower in the postmenopausal group. Postmenopausal women were affected by vulvovaginal atrophy (VVA) significantly. Thus, VHI scores were dramatically worse in postmenopausal group (23.95 ± 1.28 vs. 10.75 ± 3.41; P = 0.0001) as well as FSFI results (32.68 ± 2.25 vs. 19.78 ± 5.46; P = 0.0001). CONCLUSIONS: This study confirms that AGD in post-menopausal women was significantly shorter than AGD in premenopausal women, correlating with an increase of VVA and sexual impairment. Changes of AGD and AGI demonstrated to predict hormonal changes that may occur after menopause

How Porcine Acellular Dermal Matrix Influences the Development of the Breast Capsule 1 Year after Implantation: A Histopathological Analysis

Background: In prepectoral breast reconstruction (PPBR) the acellular dermal matrix (ADM)'s integration capacity into the tissue is known. The aim of this study was to analyze the effect of the ADM on development and composition of the peri-implant breast capsule in a dynamic setting of breast tissue expansion during two-stage prepectoral breast reconstruction.Methods: This is a prospective single-center study in which 50 patients who underwent mastectomy and breast reconstruction with prepectoral tissue expander and Braxon ADM (group A) and submuscular tissue expander (group B) were enrolled. One-year post implantation hematoxylin & eosin (H&E) staining and immunohistochemistry analyses were done on capsule tissue samples.Results: The analysis conducted on H&E-stained samples showed a significant reduction of cellular density and a decrease of the cellular infiltration in capsules of ADM-covered expanders compared with naked expander capsules (P < 0.05). The immunohistochemical analyses showed that group A capsules presented significantly less M1 CD68+ macrophages (P < 0.05), lower alfa-SMA expression levels, and a lower number of myofibroblasts (P < 0.05) compared with group B capsules. Presence of lymphatic vessels was minimally detected in both groups.Conclusions: The ADM presence around the prepectoral tissue expander influences the development of the peri-implant capsule, causing a significant reduction of the number of cells and inflammatory infiltrate, especially M1 macrophages and myofibroblasts. The ADM Braxon is therefore effective in creating a noninflamed capsule around the implant and in dynamic tissue conditions, and such an environment is maintained in time

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81&nbsp;years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

Defining Kawasaki disease and pediatric inflammatory multisystem syndrome-temporally associated to SARS-CoV-2 infection during SARS-CoV-2 epidemic in Italy: results from a national, multicenter survey

Background: There is mounting evidence on the existence of a Pediatric Inflammatory Multisystem Syndrome-temporally associated to SARS-CoV-2 infection (PIMS-TS), sharing similarities with Kawasaki Disease (KD). The main outcome of the study were to better characterize the clinical features and the treatment response of PIMS-TS and to explore its relationship with KD determining whether KD and PIMS are two distinct entities. Methods: The Rheumatology Study Group of the Italian Pediatric Society launched a survey to enroll patients diagnosed with KD (Kawasaki Disease Group - KDG) or KD-like (Kawacovid Group - KCG) disease between February 1st 2020, and May 31st 2020. Demographic, clinical, laboratory data, treatment information, and patients' outcome were collected in an online anonymized database (RedCAP®). Relationship between clinical presentation and SARS-CoV-2 infection was also taken into account. Moreover, clinical characteristics of KDG during SARS-CoV-2 epidemic (KDG-CoV2) were compared to Kawasaki Disease patients (KDG-Historical) seen in three different Italian tertiary pediatric hospitals (Institute for Maternal and Child Health, IRCCS "Burlo Garofolo", Trieste; AOU Meyer, Florence; IRCCS Istituto Giannina Gaslini, Genoa) from January 1st 2000 to December 31st 2019. Chi square test or exact Fisher test and non-parametric Wilcoxon Mann-Whitney test were used to study differences between two groups. Results: One-hundred-forty-nine cases were enrolled, (96 KDG and 53 KCG). KCG children were significantly older and presented more frequently from gastrointestinal and respiratory involvement. Cardiac involvement was more common in KCG, with 60,4% of patients with myocarditis. 37,8% of patients among KCG presented hypotension/non-cardiogenic shock. Coronary artery abnormalities (CAA) were more common in the KDG. The risk of ICU admission were higher in KCG. Lymphopenia, higher CRP levels, elevated ferritin and troponin-T characterized KCG. KDG received more frequently immunoglobulins (IVIG) and acetylsalicylic acid (ASA) (81,3% vs 66%; p = 0.04 and 71,9% vs 43,4%; p = 0.001 respectively) as KCG more often received glucocorticoids (56,6% vs 14,6%; p &lt; 0.0001). SARS-CoV-2 assay more often resulted positive in KCG than in KDG (75,5% vs 20%; p &lt; 0.0001). Short-term follow data showed minor complications. Comparing KDG with a KD-Historical Italian cohort (598 patients), no statistical difference was found in terms of clinical manifestations and laboratory data. Conclusion: Our study suggests that SARS-CoV-2 infection might determine two distinct inflammatory diseases in children: KD and PIMS-TS. Older age at onset and clinical peculiarities like the occurrence of myocarditis characterize this multi-inflammatory syndrome. Our patients had an optimal response to treatments and a good outcome, with few complications and no deaths

Prolonged higher dose methylprednisolone vs. conventional dexamethasone in COVID-19 pneumonia: a randomised controlled trial (MEDEAS)

Dysregulated systemic inflammation is the primary driver of mortality in severe COVID-19 pneumonia. Current guidelines favor a 7-10-day course of any glucocorticoid equivalent to dexamethasone 6 mg·day-1. A comparative RCT with a higher dose and a longer duration of intervention was lacking

Art and the imaginary of places : 'site-specific' symbolic valorisation in Berlin

S'il est désormais acquis que les communautés d'artistes et plus généralement le système de l'art contemporain jouent un rôle majeur dans le changement urbain, il reste encore plusieurs aspects à éclaircir en ce qui concerne la spécificité de cette contribution. Dans le contexte des quartiers en voie de régénération en particulier, les artistes ont un impact sur le capital symbolique qui se transmet des communautés qui y habitent ou y travaillent, à l'espace ; un processus que l'on pourrait qualifier de « spatialisation du capital symbolique ». Ces hypothèses ont été développées à travers l'exploration d'un ensemble d'éléments artistiques ayant agi dans le processus de régénération urbaine, au sein du cadre spécifique du Berlin des années 1990.Afin de donner des réponses nouvelles à ces questions, il a fallu élargir le champ de l'analyse en associant aux dimensions sociologiques, géographiques, économiques et urbaines la considération des activités artistiques qui appartiennent à la sphère plus proprement esthétique. L'hypothèse étant que les œuvres d'art – qui ne sont pas nécessairement des objets – sont des « configurations signifiantes à partir desquelles il est possible d'exercer un jugement rationnel » parce que dans l'expérience esthétique qu'elles engendrent, se produisent des effets d'ordre « normatif, cognitif et pragmatique ». Le rôle crucial de l'espace urbain dans l'évolution de l'art depuis la fin du XIXe siècle étaye l'hypothèse d'un ensemble d'interactions spécifiques, sur le plan esthétique, entre expression artistique et espace urbain. On ne se réfère pas aux recherches artistiques qui trouvent dans la ville un sujet à représenter, mais à des expériences plus radicales qui ont pu choisir l'urbain comme espace d'intervention, substrat des œuvres et lieu où établir des relations plus directes avec le public et le monde réel. La compréhension de l'émergence d'une approche site-specific dans l'art du XXe siècle peut servir à comprendre les racines symboliques du rôle croissant du système artistique dans le changement urbain. Pour aborder une question intrinsèquement transdisciplinaire nous avons dû avoir recours à des instruments variés et hétérogènes. Ainsi cette recherche s'appuie sur une variété de sources : des fonds d'archives concernant les programmes publics et les initiatives institutionnelles ; des recherches anthropologiques visant à reconstruire des histoires de vie et des expériences racontées par leurs protagonistes ; des sources bibliographiques importantes sur le cadre historique et théorique. Le degré d'indépendance des acteurs artistiques dans la détermination de ces changements démontre une profonde ambivalence qu'on ne peut réduire à des formules synthétiques. Les résultats des actions artistiques peuvent être analysés soit comme une exploitation de la valeur symbolique produite par les acteurs institutionnels de la ville, soit au contraire comme la préservation et le développement d'une alternative urbaine et politique. Par rapport aux exemples observés à Berlin, nous avons essayé de retracer les liens qui unissent ces expériences à des phénomènes antérieurs similaires – et à d'autres encore en évolution dans le présent – cela nous a permis de les considérer ceux-ci comme l'expression d'une tradition constamment renouvelée. En ce sens, les acteurs artistiques dont nous nous sommes occupés peuvent être considérés comme les interprètes de besoins et de désirs latents du corps social et urbain qui reviendraient de façon cyclique et qui pourraient jouer un rôle dans le développement de la ville dans le future aussi. L'analyse approfondie des deux cas d'étude, au-delà de leur intérêt individuel, s'offre comme une exploration à l'intérieur d'un champ dans lequel les études sont encore limitées et souvent très circonscrites. Notre recherche se veut comme la tentative de formuler des concepts, des instruments et des stratégies d'analyse qui pourront par la suite être appliqués à d'autres contextesThe key role played in urban change by artist communities, and more generally the art system has been widely recognized, yet the specific characteristics of this contribution are still to be explored. In the context of regenerating neighborhoods in particular, artist communities are able to produce a symbolic value that is subsequently transferred to the space they inhabit and work into, in a process that we could define as a ‘spatialisation of symbolic value'. Our thesis is focused on a series of artistic elements and events that were able to interact with the urban regeneration process that took place in post-wall Berlin in the 1990s.To fully understand such process, it is necessary to broaden the scope of the analysis in order to associate to sociological, geographical, economic and urban aspects the consideration of those artistic activities that belong to the aesthetic sphere. Our hypothesis being that works of art – which are not necessarily objects – may be regarded as significant configurations whose consideration allows a rational judgment as the aesthetic experience they determine encompasses prescriptive, cognitive and pragmatic effects. The crucial role of urban space in the evolution of art since the end of the XIX century supports the hypothesis of the existence of specific interactions between artistic expressions and the urban environment. We are not referring to those art works that find in the city an object to represent, but to more radical researches that choose the urban dimension as a site of intervention, the foundation of the work of art and the place where a more direct relationship with the public and the real world may be established. The consideration of the ‘site-specific' approach that appeared in the art of the XX century has helped us to understand the symbolic nature of the role increasingly played by the art system in urban change. In order to deal with a question that pertains to urban and cultural geography, urbanism, history as well as art history, we had to rely on a set of heterogeneous tools and sources: archival material concerning public programs and institutional initiatives; anthropological enquiries concerned with ‘life histories' and experiences reconstructed through the direct testimony of their protagonists; extensive bibliographic sources used to analyze the broader context of more specific case studies. As a result of our analysis, the degree of independence of artistic actors in the determination of such changes is marked by deep ambiguity that cannot be reduced to synthetic formulas. At times the symbolic value produced may be subsequently commodified and exploited by the institutional players of the city, in other cases art interventions prove as the expression of an alternative vision for urban development and its politics. In the specific context of Post-wall Berlin, we have tried to explore the relationship that connects specific experiences of the time to similar ones occurring in the past – as well as others currently taking place. This effort has brought us to consider the events of the 1990s as the expression of needs and desires periodically reappearing at the surface of the urban and social body, forces that may still play an important role in the future development of the city. Besides its intrinsic interest, in depth analysis of two case studies appears as a further inquiry in a field where research is still lacking and often focused on specific perspectives. Our contribution is intended as an attempt to develop concepts, tools and analytical strategies that may in the future be applied to other context

Exhibiting the New Art : 'Op losse schroeven' and 'When attitudes become form' 1969

"The 'new art' of the late 1960s was shown in two landmark exhibitions in 1969: 'Op Losse Schroeven' and 'When Attitudes Become Form'. This book reveals how each brought together Arte Povera, Anti-Form, Conceptual and Land art, whilst challenging such categories and introducing innovative curatorial strategies. Christian Rattemeyer offers a rich comparative analysis of the two exhibitions, exploring the related but differing approaches of the two curators - Wim Beeren and Harald Szeemann - in the two distinct institutional settings of the Stedelijk Museum in Amsterdam and the Kunsthalle Bern. Numerous installation photographs enable a virtual 'walk through' of each exhibition, while meticulous chronologies detail the negotiations that shaped them. Crucial texts from the time are complemented by new research and recent interviews with participating artists" p. [4] of cover

Effect of Chicken Bone Extracts on Metabolic and Mitochondrial Functions of K562 Cell Line

Background: Tetracyclines’ use in intensive animal farming has raised some concerns regarding the biosafety for humans. Increasing evidences have revealed the presence of these drugs in processed animal by-products, such as bone, throughout the food chain. A potential off-target of tetracyclines is the bacterial-like mitochondrial translational machinery, thereby causing proteostatic alterations in mitochondrial DNA-encoded components of the oxidative phosphorylation system. Methods: The Seahorse methodology, confocal microscopy imaging of mitochondrial potential and reactive oxygen species, and q-RT-PCR analysis of the expression of genes involved in mitochondrial biogenesis and mitophagy were carried out on human lymphoblast derived K562 cell line challenged with bone powder derived from chicken treated with or without oxytetracycline and pure oxytetracycline. Results: A complex dose-dependent profile was attained with a low dosage of bone powder extracts causing a metabolic adaptation hallmarked by stimulation of the mitochondrial respiration and enhanced expression of mitochondriogenic factors in particular in cells challenged with oxytetracycline-free bone extract. Conversely, a higher dosage of bone powder extracts, regardless of their source, caused a progressive inhibition of mitochondrial respiration and glycolysis, ultimately leading to cell death. No significant effects of the pure oxytetracycline were observed. Conclusion: Bone powder, regardless of chicken treatment, contains and releases factors/chemicals responsible for the observed effects on energy metabolism. Quantitative differential effects appear to depend on biochemical alterations in the bone matrix caused by antibiotics rather than antibiotics themselves

Der Umgang der Tessiner Schule mit der „ersten Welle“ der COVID-19-Pandemie – eine Onlinebefragung von Schulleitenden, Lehrpersonen, Eltern, Schülerinnen und Schülern Wie gestalteten sich Kontakte und Austausch während des Fernunterrichts?

Der Ausbruch der COVID-19-Pandemie Anfang 2020 wirkte sich massiv auch auf den Bildungsbereich aus. In Deutschland, Österreich und der Schweiz wurden die Schulen geschlossen, was zu neuen Herausforderungen und vielen offenen Fragen führte. Bildungsforschende haben sich in dieser Situation zu dem Forschungsnetzwerk „Covid-19 Education Research“ (CovER) mit dem Ziel zusammengeschlossen, jene nationale und internationale Bildungsforschung, die die Folgen der COVID-19-Pandemie für die Bildung in den Mittelpunkt stellt, zu erfassen und den Diskurs zu bündeln. Die von 84 Autorinnen und Autoren aus dem CovER-Netzwerk vorgestellten Studien beziehen sich auf die Corona-Jahre 2020 bis 2022 und decken ein thematisch breites Spektrum ab, entweder als umfassende, multiperspektivisch angelegte Studie oder mit einem bestimmten Fokus auf Personengruppen (Schülerinnen und Schüler, Eltern, Lehrkräfte, Schulaufsicht) oder Themen (wie z.B. Lernen, Wohlbefinden, Integration und Inklusion, Unterricht(-squalität) und Lehren, Bildungsbenachteiligung, soziale Medien, Zukunftsperspektiven). Sie variieren auch methodologisch und geographisch. In einem gemeinsamen Schlusskapitel leiten die Autorinnen und Autoren Implikationen für Politik, Verwaltung, Schul- und Bildungspraxis und Unterstützungssysteme sowie Desiderate für die Wissenschaft ab