Determination of the main bioaerosol components using chemical markers by liquid chromatography–tandem mass spectrometry

This work is part of an extensive research project aimed at the determination and characterization of bioaerosol with a multidisciplinary approach. In this context, one of the main objectives of the project has been the development of a comprehensive analytical method for the determination of different chemical biomarkers of the bioaerosol, by liquid chromatography coupled with tandem mass spectrometry. The following biomarkers have been considered, and correlated to specific components of bioaerosol as unambiguous indicators: • ergosterol fungal components • chlorophylls, phytosterols (stigmasterol and b-sitosterol), -tocoferol vegetable cells and algae • cholesterol animal cells, vegetable cells and algae. • dipicolinic acid bacterial spores • muramic and meso-2,6-diaminopimelic acid bacterial cells To verify the method, to find diagnostic ratios and to calculate the appropriate conversion factors, fungal spores, bacterial cells and spores, and algae of known species, commonly airborne, were analysed. The material was subjected to freezing and de-freezing cycles, followed by extraction, hydrolysis and purification of the biomarkers. The chromatographic separation of the bacterial biomarkers was achieved by using a polymeric column, based on Hydrophilic Liquid Interaction with the electrospray ionization mass spectrometric detection, whereas sterols and chlorophylls were separated by a reversed phase column, coupled to atmospheric pressure chemical ionization – tandem mass spectrometer. The optimized method was applied to environmental particulate matter sampled in an outdoor site. Bacterial and fungal content was compared to the results obtained from the classical direct viable counting method in the sampled particulate matte

A systematic review on the impact of commercially available hybrid closed loop systems on psychological outcomes in youths with type 1 diabetes and their parents

Aim: To systematically assess the impact of commercially available hybrid closed loop (HCL) systems on psychological outcomes in youths with type 1 diabetes and their parents. Methods: We performed a systematic review including studies published in the last 10 years. PICOS framework was used in the selection process, and evidence was assessed using the GRADE system. Results: A total of 215 studies were identified after duplicate removal, and 31 studies were included in this systematic review: 20 on first-generation HCL and 11 on second-generation HCL systems. According to studies with moderate- to high-level quality of evidence, HCL systems led to better, or in some studies, unchanged psychological outcomes such as distress and burden related to diabetes management, fear of hypoglycemia, quality of life, satisfaction; instead, quality of sleep was perceived as improved, although results were not confirmed in studies using actigraphy. From semi-structured interviews, answers were more homogeneous, and participants reported a positive experience and attitude towards HCL technology, which was felt to be easy to use and apt to achieve glycemic targets. Conclusions: Evidence confirms the importance of evaluating the psychosocial needs of youths with diabetes and their families when starting HCL systems and during follow-up, and to set realistic expectations of what can be achieved along with awareness of the limitations of the systems, and educate and motivate families to overcome barriers

Thymic Epithelium Abnormalities in DiGeorge and Down Syndrome Patients Contribute to Dysregulation in T Cell Development

The thymus plays a fundamental role in establishing and maintaining central and peripheral tolerance and defects in thymic architecture or AIRE expression result in the development of autoreactive lymphocytes. Patients with partial DiGeorge Syndrome (pDGS) and Down Syndrome (DS) present alterations in size and architecture of the thymus and higher risk to develop autoimmunity. We sought to evaluate thymic architecture and thymocyte development in DGS and DS patients and to determine the extent to which thymic defects result in immune dysregulation and T cell homeostasis perturbation in these patients. Thymi from pediatric patients and age-matched controls were obtained to evaluate cortex and medullary compartments, AIRE expression and thymocyte development. In the same patients we also characterized immunophenotype of peripheral T cells. Phenotypic and functional characterization of thymic and peripheral regulatory T (Treg) cells was finally assessed. Histologic analysis revealed peculiar alterations in thymic medulla size and maturation in DGS and DS patients. Perturbed distribution of thymocytes and altered thymic output was also observed. DGS patients showed lower mature CD4+ and CD8+ T cell frequency, associated with reduced proportion and function of Tregs both in thymus and peripheral blood. DS patients showed increased frequency of single positive (SP) thymocytes and thymic Treg cells. However, Tregs isolated both from thymus and peripheral blood of DS patients showed reduced suppressive ability. Our results provide novel insights on thymic defects associated with DGS and DS and their impact on peripheral immune dysregulation. Indeed, thymic abnormalities and defect in thymocyte development, in particular in Treg cell number and function could contribute in the pathogenesis of the immunodysregulation present in pDGS and in DS patients

Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

The Italian Consensus Position Statement on Diagnosis, Treatment and Prevention of Obesity in Children and Adolescents integrates and updates the previous guidelines to deliver an evidence based approach to the disease. The following areas were reviewed: (1) obesity definition and causes of secondary obesity; (2) physical and psychosocial comorbidities; (3) treatment and care settings; (4) prevention.The main novelties deriving from the Italian experience lie in the definition, screening of the cardiometabolic and hepatic risk factors and the endorsement of a staged approach to treatment. The evidence based efficacy of behavioral intervention versus pharmacological or surgical treatments is reported. Lastly, the prevention by promoting healthful diet, physical activity, sleep pattern, and environment is strongly recommended since the intrauterine phase

Particulate matter concentration and chemical composition in the metro system of Rome, Italy

Air quality at the main station of the metro system of Rome (Termini hub) has been characterized by the point of view of particulate matter (PM) concentration and chemical composition. Indoor air in different environments (underground train platform and shopping center, metro carriages with and without air conditioning system) has been studied and compared with outdoor air at a nearby urban site. Air quality at the railway station, located outdoor at surface level, has been also considered for comparison. PM chemical characterization included ions, elemental carbon, organic carbon, macro-elements, and the bio-accessible and residual fractions of micro- and trace elements. Train platform and carriages without air conditioning resulted to be the most polluted environments, with indoor/outdoor ratio up to two orders of magnitude for many components. PM mass concentration was determined on filter membranes by the gravimetric procedure as well as from the optical particle counter (OPC) number concentration measurements. The OPC results, taken with the original calibration factor, were below 40 % of the value obtained by the gravimetric measurements. Only a chemical and morphological characterization of the collected dust could lead to a reconciliation of the results yielded by the two methods. Macro-components were used to estimate the strength of the main macro-sources. The most significant contribution is confirmed to derive from wheels, rails, and brakes abrasion; from soil re-suspension (over 50 % at the subway platform); and from organics (about 25 %). The increase in the concentration of elements was mostly due to the residual fraction, but also the bio-accessible fraction showed a remarkable enrichment, particularly in the case of Ba, Zn, Cd, and Ni

Traccianti chimici del fumo da tabacco in ambienti indoor

Il fumo di tabacco è una delle principali sorgenti di PM negli ambienti interni, attualmente regolamentata solo negli ambienti pubblici. Negli ambienti residenziali, invece, coloro che convivono con un fumatore sono soggetti al cosiddetto “fumo passivo”, che può essere “di seconda mano” (esalato dal fumatore e rilasciato dall’estremità della sigaretta) o di “terza mano” (adsorbito e successivamente rilasciato dalle superfici presenti nell’ambiente). Risulta quindi di interesse, anche ai fini della protezione della salute dei soggetti esposti, chiarire il ruolo del fumo di sigaretta nel determinare la qualità dell’aria degli ambienti residenziali. La rivelazione dei prodotti del fumo negli ambienti confinati e la determinazione del loro contributo alla concentrazione del PM può trarre vantaggio dall’identificazione di appropriati traccianti chimici. In uno studio precedente sono stati identificati Cd, Tl, La e Ce come traccianti affidabili del fumo di sigaretta. Vengono qui riportati i risultati di un nuovo studio sperimentale indirizzato a determinare i rapporti indoor-outdoor (I/O) di questi traccianti ed a chiarire il legame fra la loro concentrazione ed il numero di sigarette fumate nell’ambiente. Lo studio, della durata di 8 settimane, è stato effettuato in una stanza occupata da 2-3 fumatori durante le ore lavorative e vuota durante le ore notturne ed il week-end. L’analisi delle frazioni solubile e residua degli elementi, effettuata secondo un metodo di frazionamento chimico ben consolidato, ha premesso di identificare nelle frazioni residue di Cerio e Lantanio i migliori traccianti del fumo di sigaretta. Durante il periodo diurno, le concentrazioni di Ce residuo e di La residuo hanno mostrato un incremento fino a 15 volte rispetto al periodo del fine-settimana. Gli andamenti temporali dei due traccianti sono risultati sovrapponibili, con un coefficiente di correlazione R2 = 0.99. Durante le ore lavorative sono stati misurati rapporti I/O nell’intervallo 2-85 per Ce residuo e 2-60 per La residuo, mentre durante i fine-settimana sono stati determinati, in entrambi i casi, rapporti inferiori a 1.5. La variabilità delle concentrazioni e dei rapporti I/O è risultata legata al numero di sigarette fumate. Inoltre, misure di potenziale ossidativo effettuati sui filtri campionati durante le ore diurne hanno mostrato le capacità ossidanti del fumo di sigaretta

A systematic review of the prevalence, risk factors and screening tools for autonomic and diabetic peripheral neuropathy in children, adolescents and young adults with type 1 diabetes.

AIMS: We aimed to estimate the prevalence of Diabetic peripheral neuropathy (DPN) and Cardiac autonomic neuropathy (CAN) in youth with type 1 diabetes; identify key risk factors; identify the most useful tests for the diagnostic evaluation of DPN and CAN; identify key treatment options for DPN and CAN. METHODS: A systematic search was performed including studies published in the last 15 years. PICO framework was used in the selection process and evidence was assessed using the GRADE system. RESULTS: A total of 758 studies were identified and a final number of 49 studies were included in this systematic review. According to moderate-high level quality studies, the prevalence of probable DPN, ranged between 13.5 and 62%; subclinical DPN between 22 and 88%; confirmed DPN between 2.6 and 11%. The Michigan Neuropathy Screening Instrument was the tool with higher sensitivity and specificity for detecting DPN, which needs to be confirmed by nerve conduction velocity. The prevalence of CAN was 4-39%. Specific treatment options for DPN or CAN in patients younger than 25 years are not available. Key risk factors for DPN and CAN are hyperglycemia/HbA1c, age, diabetes duration, the presence of other microvascular complications, waist/height ratio, lipid profile and blood pressure. For CAN, additional risk factors were cigarette smoking, BMI and total daily insulin. CONCLUSIONS: Prevalence of neuropathy in youth with type 1 diabetes varies depending on different screening methods and characteristics of the study populations. However, the assessed studies confirmed a relatively high prevalence of subclinical neuropathy, reiterating the importance of early identification of risk factors to prevent this complication

Optimal Prandial Timing of Insulin Bolus in Youths with Type 1 Diabetes: A Systematic Review.

The aim of this systematic review was to report the evidence on optimal prandial timing of insulin bolus in youths with type 1 diabetes. A systematic search was performed including studies published in the last 20 years (2002-2022). A PICOS framework was used in the selection process and evidence was assessed using the GRADE system. Up to one third of children and adolescents with type 1 diabetes injected rapid-acting insulin analogues after a meal. Moderate-high level quality studies showed that a pre-meal bolus compared with a bolus given at the start or after the meal was associated with a lower peak blood glucose after one to two hours, particularly after breakfast, as well as with reduced HbA1c, without any difference in the frequency of hypoglycemia. There were no differences related to the timing of bolus in total daily insulin and BMI, although these results were based on a single study. Data on individuals' treatment satisfaction were limited but did not show any effect of timing of bolus on quality of life. In addition, post-prandial administration of fast-acting analogues was superior to rapid-acting analogues on post-prandial glycemia. There was no evidence for any difference in outcomes related to the timing of insulin bolus across age groups in the two studies. In conclusion, prandial insulin injected before a meal, particularly at breakfast, provides better post-prandial glycemia and HbA1c without increasing the risk of hypoglycemia, and without affecting total daily insulin dose and BMI. For young children who often have variable eating behaviors, fast-acting analogues administered at mealtime or post-meal could provide an additional advantage