Representation of Landscape and Ecological Vision in Miyazaki’s Filmography

This study analyzes the central role of landscape in Hayao Miyazaki’s films. The depiction of landscape in Miyazaki’s films goes beyond mere visual backdrops in order to convey deep symbolic meanings and to foster an empathic connection between the viewer and the world depicted. The renowned Japanese animator, filmmaker, screenwriter, draftsman, manga artist and film director has strongly promoted environmental awareness in his productions by paying close attention to the depiction and visualization of landscape dynamics, using details, and real and invented elements to create an engaging visual experience. The landscapes also take on emotional, metaphorical dimensions, reflecting the emotions and inner thoughts of the characters. Through an in-depth critical analysis of eleven selected films, the proposed research identifies the character-defining elements adopted by Miyazaki to stimulate reflection on a sustainable combination between urban development and the preservation of natural elements, as well as increasing focus on the beauty of the landscape, thereby highlighting the importance of its preservation. The relevance of this research is to understand Miyazaki’s approach to creating representations of natural elements and how he has managed to combine them with the plots of his various films, indirectly stimulating environmental awareness and fascination with nature in its different forms. https://www.mdpi.com/2071-1050/15/20/1513

Hyaluronic acid alone versus hyaluronic acid associated with adelmidrol for intra-articular treatment of knee osteoarthritis: a long-term follow-up

Background: Hyaluronic acid (HA) has been used for many years for intra-articular treatment of knee osteoarthritis with satisfactory results. HA associated with Adelmidrol – an anti-neuroinflammatory compound – have been only recently introduced in orthopedic clinical practice with good preliminary results. Objective: To investigate whether HA associated with Adelmidrol provides better results than HA alone. Methods: Two cohorts of patients with moderate knee osteoarthritis were treated. Cohort 1 received 5 weekly intra-articular injections of HA during 2017 while Cohort 2, 4 weekly intra-articular injections of HA associated with Adelmidrol during 2018. The patients of the two Cohorts were assessed by WOMAC scale, SF-12 questionnaire and PGIC scale at 1 week (T0), 6 months (T1), 1 year (T2), and 2 years (T3) after the end of treatment. All the data were statistically analyzed. A p-value of <0.05 was considered statistically significant. Results: According to the WOMAC Scale Cohort 1 had higher mean scores than Cohort 2 at each follow-up time, with a statistically significant difference between the two cohorts at T3 (p<0.03) for all the WOMAC components, except for Stiffness. WOMAC Total mean score worsened statistically significantly only in Cohort 1, from T1 to T3 (T2 vs T1: p=0.0033; T3 vs T2: p=0.0007). The same happened for WOMAC Physical Function (T2 vs T1: p=0.0146; T3 vs T2: p=0.0046) and WOMAC Pain (T2 vs T1: p=0.0004; T3 vs T2: p=0.0002). WOMAC Stiffness worsened statistically significantly in Cohort 1 from T2 to T3 (T3 vs T2: p=0.0041), while in Cohort 2 no change on WOMAC scale was statistically significant at any time-point, for any components. The mean scores of the SF-12 questionnaire were better in Cohort 2 than in Cohort 1 at each follow-up time for both the Physical and the Mental components, with a statistically significant difference between the two groups for the latter, at T0 (p=0.0001). In both cohorts the mean score of the Physical component decreased from T0 to T3, but the difference was not statistically significant between the two groups (p=0.25). The mean score of the Mental component slightly increased in Cohort 1 and decreased in Cohort 2, without statistically significant differences between the two groups at any time-point. PGIC showed that Cohort 2 scored significantly better than Cohort 1 at T3 (p=0.0336). Conclusions: Overall, HA associated with Adelmidrol gave better long-term results than HA alone

Longitudinal landscapes of serum antibody repertoires after influenza infection and vaccination

Vaccination is the most effective means of infectious disease prevention. Despite its success, however, we still lack a clear understanding of vaccine responses in humans. For example, influenza vaccines still leave a large fraction of population vulnerable. Over the past decade, single B-cell analysis and next-generation sequencing (NGS) technologies have become invaluable tools for studying the antibody repertoire to influenza. Such studies have led to discoveries of broadly-neutralizing antibodies (bNAbs), which can neutralize across multiple strains of influenza virus, promoting the notion of designing a universal vaccine that will elicit such antibodies. One of such isolated bNAbs, called FI6, showed remarkable ability to neutralize all of the influenza A virus strains through targeting the conserved epitope in the stem of hemagglutinin (HA). However, it remains unclear whether such bNAbs actually play a role in conferring protection against influenza since antibody proteins (not B-cells) need to circulate at physiologically relevant concentrations in serum to have implications in protection. Using high-resolution proteomics coupled with NGS, we quantitatively determined the serological antibody repertoire to CA09 HA (H1) at the individual clonotype-level in a donor (whom FI6 was isolated from) following influenza infection (in 2010 with pandemic CA09) and vaccination across five years (2010-2014 with seasonal flu vaccine). We analyzed the temporal changes of head-targeting and stem-binding antibodies, illustrating the gradual increase of stem-targeting antibodies following repeated exposures to CA09 HA. Following vaccination in 2014, \u3e60% of the repertoire consisted of one single clonotype of stem-binding antibody that was present at very low abundance in 2010. Our data demonstrate that the repetitive exposure to influenza skews the serological repertoire toward antibodies that target conserved epitopes, and these antibodies continue to be boosted every time the same epitopes are encountered. Once elicited, stem-binding antibodies displayed a tendency to persist in serum across multiple years while head-specific antibodies decayed quicker. The differential longevity of stem-binding and head-specific antibodies presented here has direct implications for the design of the future universal vaccine

Persistent antibody clonotypes dominate the serum response to influenza following repeated vaccination over multiple years

We used Ig-Seq, a liquid chromatography tandem mass spectrometry (LC-MS/MS)–based serum antibody proteomics methodology, to determine the clonal composition and dynamics of the H1N1 California/7/2009 (CA09) hemagglutinin (HA)-reactive antibody repertoire over 5 years in a well-characterized donor from whom a large number of homosubtypic and heterosubtypic neutralizing monoclonal antibodies had been previously isolated by B cell analysis. The donor was infected with the CA09 strain in 2009 and immunized annually for the next five years with seasonal influenza vaccine which contained the CA09 strain. We find that the serological repertoire in this donor was highly static, with a modest number (24) of persistent antibody clonotypes, detected in serum for at least 4 out of 5 years, accounting on average for 72.6 ± 10.0% of the repertoire to the CA09 HA. These persistent antibodies: (i) displayed a higher degree of somatic hypermutation relative to antibodies that could be detected in the serum transiently (i.e. lasted less than 1 year in serum); (ii) comprised a significant fraction that also bound to HA from a phylogenetically distant H5N1 A/Vietnam/1203/2004 (VT04) strain, a hallmark of stem-binding antibodies due to the lack of homology between CA09 and VT04 in the head region of HA and (iii) perhaps most strikingly, but consistent with the wealth of heterosubtypic neutralizing antibodies that had previously been identified from this donor, some of the most abundant persistent antibody clonotypes, including the dominant clone that accounted on average for 18.6 ± 12.3% of the serum titer across 5 years, neutralized both the CA09 and VT04 influenza strains. Our analysis highlights the magnitude of ‘serological imprinting’ in the donor’s serum response to CA09, indicates that seasonal vaccination can further reinforce a stable serological memory and finally suggests that once elicited, antibodies cross-reactive between CA09 and VT04 with heterosubtypic neutralization activity, thus likely to bind to HA-stem, can persist for many years, which is a fundamental goal of universal influenza vaccines

KNOWLEDGE AND VIEWPOINTS ON THE EFFECTS OF CORRUPTION ON HEALTHCARE: A SURVEY CONDUCTED AMONG STUDENTS OF PALERMO UNIVERSITY MEDICAL SCHOOL, ITALY

Corruption affects healthcare effectiveness and efficiency and limits equity in access to health services. Aim of the survey was to document knowledge and viewpoints on the impact of corruption on healthcare system in a sample of students attending pre-lauream healthcare professional courses at Palermo University Medical school and to evaluate any improvement in their awareness on this topic after a dedicated multidisciplinary educational intervention. An anonymous questionnaire was administered to students before and after the intervention. Absolute and relative frequency of correct and incorrect answers was computed. Chi-squared test was used to compare answers given before and after the educational intervention. Approximately less than a quarter of the respondents were able to correctly estimate impact of corruption, inappropriateness and waste in healthcare on NHS. The study documented how improving students\u2019 knowledge of the impact of corruption in the healthcare system could represent a possible strategy to prevent corruption in healthcare