Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

Objectives. Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations.Methods. SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses.Results. The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP.AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001].Conclusion. Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

The impact on the landscape, environment and society of new productive chains in a mountain area: strategies, analysis and future perspectives

Zootechnical farms enhance the preservation and valorization of the environmental value of the surroundings in marginal areas, such as the mountains of Friuli Venezia Giulia. An important tool for relaunching mountain animal husbandry can be the promotion of an appropriate policy to maintain and develop local food chains, supporting typical products, tightly related to the peculiarity of the agro-ecosystem. The aim of the chain <em>Carne della Montagna Friulana-Carne di Qualità</em> is to create a cooperation among primary producers, transformation companies, sellers and research institutes, in order to develop innovative pathways throughout the production of meat in Carnia (UD). The project was designed in 2007/08 but it was operative from 2010, with a first batch of animals. The stakeholders subscribed a chain agreement, adopting production guidelines and a commercial trademark. Since the meat is not yet ready, the present paper is, in part, an analysis of the preliminary modification of the operative context and, in part, a previsional examination of the possible effect of the activation of this production chain on the area. The results investigated economic, social, landscape, technical and technological (related to food safety) elements. It can be observed, by an introductive evaluation, that this productive circuit may valorize the resources of this mountain area and can enhance zootechnics in mountain areas. The guidelines allow a vertical integration throughout the production path, coordinating all the operators. This type of production can be considered a niche product, related to the territory, with the maximum guarantee for the consumers. The environmental worthiness is the recovering and the improving of these marginal, agricultural areas. Actually, an overall evaluation can be done only from the summer of 2011, when data such as the organoleptic and qualitative characteristics, selling prices, level of appreciation by the customers and landscape effects will be available

Tidal notches, coastal landforms and relative sea-level changes during the Late Quaternary at Ustica Island (Tyrrhenian Sea, Italy)

In this paperwe present and discuss data concerning themorphostructural evolution at Ustica Island (Tyrrhenian Sea, Italy) during Late Quaternary. New insights on the relative sea-level changes of Ustica are coming from data collected during a geomorphological field survey around the island, togetherwith the bathymetric analysis of the surrounding seabed and 14C datings on samples of speleothems, flowstones and marine shells found inside three selected sea caves. The survey was mainly accomplished on June 2015 through the first complete snorkel investigation off the about 18 km-long volcanic coast of the island, which allowed to precisely define location, relationship and morphometric features of coastal landforms associated with modern sea level. This study highlights the occurrence, for the first time in the Mediterranean, of tidal notches in correspondence of carbonate inclusions in volcanic rocks. The elevation of the modern tidal notch suggests that no significant vertical deformations occurred in the southeastern and eastern sectors of Ustica in the last 100 years. However, the presence of pillow lavas along the coast demonstrates that Ustica was affected by a regional uplift since the Late Quaternary, as also confirmed by MIS5.5 deposits located at about 30 m a.s.l., which suggests an average uplift rate of 0.23 mm/y. Radiocarbon dating of fossil barnacles collected inside the Grotta Segreta cave indicate an age of 1823 \ub1 104 cal. BP. The difference in height with respect to living barnacles in the same site suggests that their present elevation could be related to stick-slip coseismic deformations caused by the four earthquake sequences (two of which with Mw = 4.63 \ub1 0.46) that strongly struck the island between 1906 and 1924

Mesenchymal stroma: primary determinant and therapeutic target for epithelial cancer.

Multifocal and recurrent epithelial tumors, originating from either dormant or de novo cancer cells, are major causes of morbidity and mortality. The age-dependent increase of cancer incidence has long been assumed to result from the sequential accumulation of cancer-driving or -facilitating mutations with induction of cellular senescence as a protective mechanism. However, recent evidence suggests that the initiation and development of epithelial cancer results from a close interplay with its altered tissue microenvironment, with chronic inflammation, stromal senescence, autophagy, and the activation of cancer-associated fibroblasts (CAFs) playing possible primary roles. We will discuss recent progress in these areas, and highlight how this understanding may be used for devising novel preventive and therapeutic approaches to the epithelial cancer problem

Racial differences in systemic sclerosis disease presentation: a European Scleroderma Trials and Research group study

OBJECTIVES Racial factors play a significant role in SSc. We evaluated differences in SSc presentations between white patients (WP), Asian patients (AP) and black patients (BP) and analysed the effects of geographical locations. METHODS SSc characteristics of patients from the EUSTAR cohort were cross-sectionally compared across racial groups using survival and multiple logistic regression analyses. RESULTS The study included 9162 WP, 341 AP and 181 BP. AP developed the first non-RP feature faster than WP but slower than BP. AP were less frequently anti-centromere (ACA; odds ratio (OR) = 0.4, P < 0.001) and more frequently anti-topoisomerase-I autoantibodies (ATA) positive (OR = 1.2, P = 0.068), while BP were less likely to be ACA and ATA positive than were WP [OR(ACA) = 0.3, P < 0.001; OR(ATA) = 0.5, P = 0.020]. AP had less often (OR = 0.7, P = 0.06) and BP more often (OR = 2.7, P < 0.001) diffuse skin involvement than had WP. AP and BP were more likely to have pulmonary hypertension [OR(AP) = 2.6, P < 0.001; OR(BP) = 2.7, P = 0.03 vs WP] and a reduced forced vital capacity [OR(AP) = 2.5, P < 0.001; OR(BP) = 2.4, P < 0.004] than were WP. AP more often had an impaired diffusing capacity of the lung than had BP and WP [OR(AP vs BP) = 1.9, P = 0.038; OR(AP vs WP) = 2.4, P < 0.001]. After RP onset, AP and BP had a higher hazard to die than had WP [hazard ratio (HR) (AP) = 1.6, P = 0.011; HR(BP) = 2.1, P < 0.001]. CONCLUSION Compared with WP, and mostly independent of geographical location, AP have a faster and earlier disease onset with high prevalences of ATA, pulmonary hypertension and forced vital capacity impairment and higher mortality. BP had the fastest disease onset, a high prevalence of diffuse skin involvement and nominally the highest mortality

Reporting items for capillaroscopy in clinical research on musculoskeletal diseases: A systematic review and international Delphi consensus

Objectives: The level of detail included when describing nailfold videocapillaroscopy (NVC) methods varies among research studies, making interpretation and comparison of results challenging. The overarching objective of the present study was to seek consensus on the reporting standards in NVC methodology for clinical research in rheumatic diseases and to propose a pragmatic reporting checklist. Methods: Based on the items derived from a systematic review focused on this topic, a three-step web-based Delphi consensus on minimum reporting standards in NVC was performed among members of the European League against Rheumatism (EULAR) Study Group on Microcirculation in Rheumatic Diseases and the Scleroderma Clinical Trials Consortium. Results: A total of 319 articles were selected by the systematic review, and 46 items were proposed in the Delphi process. This Delphi exercise was completed by 80 participants from 31 countries, including Australia and countries within Asia, Europe, North America and South America. Agreement was reached on items covering three main areas: Patient preparation before NVC (15 items), device description (5 items) and examination details (13 items). Conclusion: Based on the available evidence, the description of NVC methods was highly heterogeneous in the identified studies and differed markedly on several items. A reporting checklist of 33 items, based on practical suggestions made (using a Delphi process) by international participants, has been developed to provide guidance to improve and standardize the NVC methodology to be applied in future clinical research studies