Alcohol and older people from a public health perspective

OBJECTIVES AND METHODS: As part of the European project VINTAGE, a systematic review of scientific literature was undertaken to document the evidence base on the impact of alcohol on the health and well-being of older people, and on effective policies and preventive approaches to face the problem in this steadily increasing segment of the population. RESULTS: 369 references were identified, from which 78 papers were selected. CONCLUSIONS: The review confirms the paucity of data on this topic and the need for more specific research. Although there is scarce evidence, the elderly seems to respond equally well to alcohol policy, screening instruments and brief interventions as do younger adults. According to a lifecycle approach, a future focus on the middle aged is also recommended

Epidemiology, surveillance and population screening of frailty. Results from the systematic reviews of the European Joint Action ADVANTAGE. Preface

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Walking with a Posterior Cruciate Ligament Injury: A Musculoskeletal Model Study

The understanding of the changes induced in the knee’s kinematics by a Posterior Cruciate Ligament (PCL) injury is still rather incomplete. This computational study aimed to analyze how the internal loads are redistributed among the remaining ligaments when the PCL is lesioned at different degrees and to understand if there is a possibility to compensate for a PCL lesion by changing the hamstring’s contraction in the second half of the swing phase. A musculoskeletal model of the knee joint was used for simulating a progressive PCL injury by gradually reducing the ligament stiffness. Then, in the model with a PCL residual stiffness at 15%, further dynamic simulations of walking were performed by progressively reducing the hamstring’s force. In each condition, the ligaments tension, contact force and knee kinematics were analyzed. In the simulated PCL-injured knee, the Medial Collateral Ligament (MCL) became the main passive stabilizer of the tibial posterior translation, with synergistic recruitment of the Lateral Collateral Ligament. This resulted in an enhancement of the tibial–femoral contact force with respect to the intact knee. The reduction in the hamstring’s force limited the tibial posterior sliding and, consequently, the tension of the ligaments compensating for PCL injury decreased, as did the tibiofemoral contact force. This study does not pretend to represent any specific population, since our musculoskeletal model represents a single subject. However, the implemented model could allow the non-invasive estimation of load redistribution in cases of PCL injury. Understanding the changes in the knee joint biomechanics could help clinicians to restore patients’ joint stability and prevent joint degeneration

Microbial translocation and T cell activation are modified by direct-acting antiviral therapy in HCV-infected patients

BACKGROUND: Microbial translocation from the gut lumen has been involved in the pathogenesis of liver damage in hepatitis C virus (HCV) infection. AIM: To investigate the impact of direct-acting antiviral treatment on microbial translocation and T-cell activation, in patients with hepatitis C-related liver disease. METHODS: We enrolled two groups of HCV-infected patients undergoing direct-acting antiviral treatment: patients with fibrosis ≥F3 according to Metavir (Group ≥F3); patients with hepatitis C recurrence after liver transplantation and Metavir ≥F2 (Group Liver Transplantation + ≥F2). All patients were treated with direct-acting antivirals based on ongoing guidelines. Surrogate biomarkers of microbial translocation (plasma concentrations of soluble-CD14, lipopolysaccharide-binding protein and intestinal fatty acid-binding protein) were evaluated at baseline, at first month, at the end of treatment and 3 months later. T-cell activation was measured by expression of CD38+ HLA-DR at the same time points, only in Group ≥F3. RESULTS: There were 32 patients in Group ≥F3 and 13 in Group LT + ≥F2. At baseline, levels of soluble-CD14 and lipopolysaccharide-binding protein were significantly higher in both groups vs healthy controls. Baseline soluble-CD14 correlated with glutamic-oxalacetic transaminase (r = 0.384, P = 0.009) and glutamic-pyruvic transaminase (r = 0.293, P = 0.05). A significant decrease in plasma levels of surrogate microbial translocation biomarkers was observed during and after treatment in the two groups although values were not normalised. In Group ≥F3, CD38+ HLADR+ T-cell expression was significantly decreased by direct-acting antiviral treatment. Relapsers (9%) showed higher soluble-CD14 levels at baseline. CONCLUSION: Surrogate microbial translocation markers and T cell activation are increased in HCV-infected patients with liver fibrosis and decrease during direct-acting antiviral treatment

Alcohol and older people: the European project VINTAGE: good health into older age; design, methods and major results

Consum d'alcohol; Persones grans; Disseny de recercaConsumo de alcohol; Personas mayores; Diseño de investigaciónAlcohol drinking; Aged; Research designObjectives: The European project VINTAGE – Good Health Into Older Age aims at filling the knowledge gap and building capacity on alcohol and the elderly, encouraging evidence- and experience-based interventions. Methods: Systematic review of scientific literature on the impact of alcohol on older people; ad hoc survey and review of grey literature to collect EU examples of good practices for prevention; dissemination of findings to stakeholders involved in the field of alcohol, aging or public health in general. Results: Design and procedures of the VINTAGE project are described, providing also an outline of major results, with particular attention to those related to the dissemination activity. Conclusions: Much more information and research is needed. This issue should be part of both alcohol and healthy ageing policies.The VINTAGE project “Good Health into Older Age” is a project funded by the Executive Agency for Health and Consumers, under the European Commission Second Programme of Community Action in the Field of Health 2008-2013 (Grant Agreement no. 20081203)

Statistical moments of power spectrum: a fast tool for the classification of seismic events recorded on volcanoes

Abstract. Spectral analysis has been applied to almost thousand seismic events recorded at Vesuvius volcano (Naples, southern Italy) in 2018 with the aim to test a new tool for a fast event classification. We computed two spectral parameters, central frequency and shape factor, from the spectral moments of order 0, 1, and 2, for each event at seven seismic stations taking the mean among the three components of ground motion. The analyzed events consist of volcano-tectonic earthquakes, low frequency events and unclassified events (landslides, rockfall, thunders, quarry blasts, etc.). Most of them are of low magnitude, and/or low maximum signal amplitude, therefore the signal to noise ratio is very different between the low noise summit stations and the higher noise stations installed at low elevation around the volcano. The results of our analysis show that volcano-tectonic earthquakes and low frequency events are easily distinguishable through the spectral moments values, particularly at seismic stations closer to the epicenter. On the contrary, unclassified events show the spectral parameters values distributed in a broad range which overlap both the volcano-tectonic earthquakes and the low frequency events. Since the computation of spectral parameters is extremely easy and fast for a detected event, it may become an effective tool for event classification in observatory practice

Reduced Plasma Levels of sCD14 and I-FABP in HIV-infected Patients with Mesalazine-treated Ulcerative Colitis

BACKGROUND: Microbial translocation (MT) is a shared feature of HIV infection and inflammatory bowel disease (IBD). AIMS: This study was conducted to assess the impact of IBD (and particularly ulcerative colitis, UC) on plasma markers of MT and immune activation in HIV+ subjects. METHODS: A cross-sectional study was conducted in 3 groups of patients: HIV+/UC+(group HIV/UC); HIV+/UC- (group HIV); HIV-/UC+(group UC). Plasma levels of soluble CD14 (sCD14), intestinal fatty acid-binding protein (I-FABP), and endotoxin core antibodies (endoCAB) were measured as plasma markers of MT. Inflammation and immune activation were evaluated by measuring plasma levels of IL-6, IL-21, TNF-alpha, and high-sensitivity C-reactive protein (hs-CRP). T- and B-cells subpopulations were characterized by FACS analysis. RESULTS: Seven patients were enrolled in group HIV/UC, 9 in HIV, and 10 in UC. All HIV-positive patients had plasma values of HIV-1 RNA < 37 copies/mL for at least 12 months and good immunological recovery. All patients with UC were treated with oral mesalazine. Markers of MT, immune activation, and inflammation were not increased in subjects with HIV/UC. In fact, they had lower levels of I-FABP (p = 0.001) and sCD14 (p = 0.007) when compared to other patients groups. Positive correlations were found between I-FABP and sCD14 (r = .355, p = 0.076). Frequency of T- and B-cell subsets did not differ among groups. CONCLUSIONS: Our results suggest that UC does not worsen MT, inflammation, or immune activation in HIV-infected subjects. The anti-inflammatory activity of chronic mesalazine administration on intestinal mucosa may contribute to this finding

Array and spectral ratio techniques applied to seismic noise to investigate the Campi Flegrei (Italy) subsoil structure at different scales

Abstract. The purpose of this work is to study the subsoil structure of the Campi Flegrei area using both spectral ratios and array techniques applied to seismic noise. We have estimated the dispersion curves of Rayleigh waves by applying the Frequency–Wavenumber (f–k hereinafter) and Modified Spatial Autocorrelation (MSPAC) techniques to the seismic noise recorded by the underground short period seismic Array "ARF", by the broadband stations of the UNREST experiment and by the broadband stations of the seismic monitoring network of INGV – Osservatorio Vesuviano. We have performed the inversion of a dispersion curve (obtained averaging the f–k and MSPAC dispersion curves of seismic noise and single phase velocity values of coherent transient signals) jointly with the H∕V spectral ratio of the broadband station CELG, to obtain a shear wave velocity model up to 2000 m depth. The best-fit model obtained is in a good agreement with the stratigraphic information available in the area coming from shallow boreholes and deep wells drilled for geothermal exploration. In active volcanic areas, such as Campi Flegrei, the definition of the velocity model is a crucial issue to characterize the physical parameters of the medium. Generally, a high quality characterization of the medium properties helps to separate the contributions of the volcanic source, path and site in the geophysical observables. Therefore, monitoring possible variations in time of such properties in general can help to recognize anomalies due to the volcano dynamics, i.e. fluid migration connected to the volcanic activity