The high-pathogenicity island (HPI) promotes flagellum-mediated motility in extraintestinal pathogenic Escherichia coli

The key of success of extraintestinal pathogenic Escherichia coli (ExPEC) to colonize niches outside the intestinal tract and to establish infection is the coordinated action of numerous virulence and fitness factors. The so-called high-pathogenicity island (HPI), responsible for synthesis, secretion and uptake of the siderophore yersiniabactin, proved to be an important virulence determinant. In this study we investigated the interaction of the flagellum-mediated motility and the HPI. The impairment of yersiniabactin production by deletion of irp2 or ybtA affected significantly motility. The gain of yersiniabactin production improved motility in both pathogenic and non-pathogenic E. coli strains. The loss of flagella expression had no adverse effect on the HPI. Strikingly, external iron abundance was not able to suppress activation of the HPI during motility. The HPI activity of swarming bacteria was comparable to iron deplete conditions, and could even be maximized by supplementing excessive iron. This fact is the first description of a regulatory mechanism, which does not follow the known hierarchical regulation of siderophore systems. Transcriptional reporter fusions of the ybtA promoter demonstrated that the entire promoter region with all YbtA binding sites is necessary for complete induction in both HPI-positive and HPI-negative strains. Altogether, these results suggest that the HPI is part of a complex regulatory network, which orchestrates various virulence mechanisms to optimize the overall fitness of ExPEC

Real and perceived physical functioning in Italian elderly population: associations with BADL and IADL

This study aimed to identify the key physical abilities (aerobic endurance, gait speed, balance, strength) and psychological variables associated with the level of basic (BADL) and instrumental (IADL) activities of daily living in an autonomous community-dwelling elderly population in Italy. 135 elderly people (63% women; mean age = 73.3, SD = 5.5) were included in the study. Stepwise regression was performed to verify the association between these variables and the level of BADL and IADL in the elderly participants. Results showed that balance (β = −0.21, p < 0.01) and perception of physical functioning (β = 0.32, p < 0.0001) were the key individual variables related to BADL scores, and IADL score was associated with perception of physical functioning (β = 0.30, p < 0.0001) and upper limb strength (β = 0.21, p < 0.05). The results demonstrate a relationship between physical functioning and ADL, both real physical functioning and perceived physical functioning

Visceral adiposity index and DHEAS are useful markers of diabetes risk in women with polycystic ovary syndrome

Objective: On the basis of the known diabetes risk in polycystic ovary syndrome (PCOS), recent guidelines of the Endocrine Society recommend the use of an oral glucose tolerance test (OGTT) to screen for impaired glucose tolerance (IGT) and type 2 diabetes (T2DM) in all women with PCOS. However, given the high prevalence of PCOS, OGTTwould have ahigh cost-benefit ratio. In this study, we identified, through a receiver operating characteristic analysis, simple predictive markers of the composite endpoint (impaired fasting glucose (IFG) or IGT or IFGCIGT or T2DM) in women with PCOS according to the Rotterdam criteria.Design: We conducted a cross-sectional study of 241 women with PCOS in a university hospital setting.Methods: Clinical, anthropometric, and metabolic (including OGTT) parameters were evaluated. The homeostasis model assessment of insulin resistance (HOMA2-IR), the Matsuda index of insulin sensitivity, and the oral dispositional index and visceral adiposity index (VAI) were determined.Results: Out of 241 women included in this study, 28 (11.6%) had an IFG, 13 (5.4%) had IGT, four (1.7%) had IFGCIGT, and four (1.7%) had T2DM. Among the anthropometric variables examined, the VAI had a significantly higher C-statistic compared with BMI (0.760 (95% CI: 0.70-0.81) vs 0.613 (95% CI: 0.54-0.67); PZ0.014) and waist circumference (0.760 (95% CI: 0.70-0.81) vs 0.619 (95% CI: 0.55-0.68); PZ0.028). Among all the hormonal and metabolic serum variables examined, DHEAS showed the highest C-statistic (0.720 (95% CI: 0.65-0.77); P<0.001).Conclusions: In addition to fasting glucose, the VAI and DHEAS may be considered useful tools for prescreening in all women with PCOS without the classical risk factors for diabetes

Measurement invariance of TGMD-3 in children with and without mental and behavioral disorders

This study evaluated whether the Test of Gross Motor Development 3 (TGMD-3) is a reliable tool to compare children with and without mental and behavioural disorders across gross motor skill domains. A total of 1075 children (aged 3-11 years), 98 with mental and behavioural disorders and 977 without (typically developing), were included in the analyses. The TGMD-3 evaluates fundamental gross motor skills of children across two domains: locomotor skills and ball skills. Two independent testers simultaneously observed children’s performances (agreement over 95%). Each child completed one practice and then two formal trials. Scores were recorded only during the two formal trials. Multigroup Confirmatory Factor Analysis tested the assumption of TGMD-3 measurement invariance across disability groups. According to the magnitude of changes in Root Mean Square Error of Approximation and Comparative Fit Index between nested models, the assumption of measurement invariance across groups was valid. Loadings of the manifest indicators on locomotor and ball skills were significant (p < .001) in both groups. Item Response Theory analysis showed good reliability results across locomotor and the ball skills full latent traits. The present study confirmed the factorial structure of TGMD-3 and demonstrated its feasibility across normally developing children and children with mental and behavioural disorders. These findings provide new opportunities for understanding the effect of specific intervention strategies on this population

Crashworthiness of a composite bladder fuel tank for a tilt rotor aircraft

The fulfilment of the crash is a demanding requirement for a Tiltrotor. Indeed, such a kind of aircraft, being a hybrid between an airplane and a helicopter, inherits the requirements mainly from helicopters (EASA CS 29) due to its hovering ability. In particular, the fuel storage system must be designed in such a manner that it is crash resistant, under prescribed airworthiness requirements, in order to avoid the fuel leakage during such an event, preventing fire and, thus, increasing the survival chances of the crew and the passengers. The present work deals with the evaluation of crashworthiness of the fuel storage system of a Tiltrotor (bladder tank), and, in particular, it aims at describing the adopted numerical approach and some specific results. Crash resistance requirements are considered from the earliest design stages, and for this reason they are mainly addressed from a numerical point of view and by simulations that treat both single components and small/medium size assemblies. The developed numerical models include all the main parts needed for simulating the structural behavior of the investigated wing section: the tank, the structural components of the wing, the fuel sub-systems (fuel lines, probes, etc.) and the fuel itself. During the crash event there are several parts inside the tanks that can come into contact with the tank structure; therefore, it is necessary to evaluate which of these parts can be a damage source for the tank itself and could generate fuel loss. The SPH approach has been adopted to discretise fuel and to estimate the interaction forces with respect to the tank structure. Experimental data were used to calibrate the fuel tank and foam material models and to define the acceleration time-history to be applied. Thanks to the optimized foam’s configuration, the amount of dissipated impact energy is remarkable, and the evaluation of tanks/fuel system stress distribution allows estimating any undesired failure due to a survivable crash event

Diffuse post-traumatic calcification of the anterior longitudinal ligamentum of cervical and dorsal spine

Among the different conditions causing inflammation and calcification/ossification of the soft tissues of the spinal cord, single or recurrent traumatic events are included. Within the international literature, the involvement of the posterior longitudinal ligament, following spinal cord injuries is frequently reported, especially in the elders. The Authors describe here an uncommon calcification/ossification of the anterior longitudinal ligament occurred after a double traumatic event in a young man, followed clinically and radiologically for a long-term period. On the basis of clinical, laboratory and radiological findings, the differential diagnosis with other possible aetiologies, especially DISH (Diffuse idiopathic skeletal hyperostosis) and ankylosing spondylitis, is discussed

An after-school football session transiently improves cognitive function in children

The aim of the present study was to evaluate the effect of a real-world after-school football session on subsequent cognitive function in primary school children. Following ethical approval, 100 children (aged 8–9 year) from the same after-school football club were randomly assigned to either an intervention (60 min football activity) or control (continued to rest) group. Cognitive function (selective visual attention, short term memory and long-term memory) was assessed prior to, immediately following and 45 min following the football session (and at the respective timepoints in the control group). Data were analysed via two-way (group * time) mixed methods ANOVA. The pattern of change in all domains of cognition over time, was different between the football and control groups (group * time, all p < 0.001). Specifically, performance on all cognitive tasks was greater immediately following the football session in the intervention group compared to the control group (selective visual attention, p = 0.003; short-term memory, p = 0.004; long-term memory, p < 0.001). However, there was no difference between the group 45 min following the football session (p = 0.132–0.393). These findings suggest that an after-school football session enhances cognition immediately post-activity in primary school children

Effects of 1 year of lifestyle intervention on institutionalized older adults

The socio-economic and health consequences of our ageing population are well documented, with older adults living in long-term care facilities amongst the frailest possessing specific and significant healthcare and social care needs. These needs may be exacerbated through the sedentary behaviour which is prevalent within care home settings. Reducing sedentary time can reduce the risk of many diseases and improve functional health, implying that improvements in health may be gained by simply helping older adults substitute time spent sitting with time spent standing or in light-intensity ambulation. This study identified the impact of 1 year of lifestyle intervention in a group of older adults living in a long-term care setting in Italy. One hundred and eleven older adults (mean age, 82.37 years; SD = 10.55 years) participated in the study. Sixty-nine older adults were in the intervention group (35 without severe cognitive decline and 34 with dementia) and 42 older adults were in the control group. Data on physical functioning, basic activities of daily living (BADL) and mood were collected 4 times, before, during (every four months) and after the 1 year of intervention. The lifestyle intervention focused on improving the amount of time spent every week in active behaviour and physical activity (minimum 150 min of weekly activities). All participants completed the training program and no adverse events, related to the program, occurred. The intervention group showed steady and significant improvements in physical functioning and a stable situation in BADL and mood following the intervention in older adults with and without dementia, whilst the control group exhibited a significant decline over time. These results suggest that engagement in a physical activity intervention may benefit care home residents with and without dementia both physically and mentally, leading to improved social care and a reduced burden on healthcare services

TOpic: rare and special cases, the real "Strange cases"

Introduction: The bladder hernia represents approximately 1-3% of all inguinal hernias, where patients aged more than 50 years have a higher incidence (10%). Many factors contribute to the development of a bladder hernia, including the presence of a urinary outlet obstruction causing chronic bladder distention, the loss of bladder tone, pericystitis, the perivesical bladder fat protrusion and the obesity

Modest agreement between magnetic resonance and pathological tumor regression after neoadjuvant therapy for rectal cancer in the real world.

Magnetic resonance imaging (MRI) is routinely used for preoperative tumor staging and to assess response to therapy in rectal cancer patients. The aim of our study was to evaluate the accuracy of MRI based restaging after neoadjuvant chemoradiotherapy (CRT) in predicting pathologic response. This multicenter cohort study included adult patients with histologically confirmed locally advanced rectal adenocarcinoma treated with neoadjuvant CRT followed by curative intent elective surgery between January 2014 and December 2019 at four academic high-volume institutions. Magnetic resonance tumor regression grade (mrTRG) and pathologic tumor regression grade (pTRG) were reviewed and compared for all the patients. The agreement between radiologist and pathologist was assessed with the weighted k test. Risk factors for poor agreement were investigated using logistic regression. A total of 309 patients were included. Modest agreement was found between mrTRG and pTRG when regression was classified according to standard five-tier systems (k = 0.386). When only two categories were considered for each regression system, (pTRG 0-3 vs pTRG 4; mrTRG 2-5 vs mrTRG 1) an accuracy of 78% (95% confidence interval [CI] 0.73-0.83) was found between radiologic and pathologic assessment with a k value of 0.185. The logistic regression model revealed that "T3 greater than 5 mm extent" was the only variable significantly impacting on disagreement (OR 0.33, 95% CI 0.15-0.68, P = .0034). Modest agreement exists between mrTRG and pTRG. The chances of appropriate assessment of the regression grade after neoadjuvant CRT appear to be higher in case of a T3 tumor with at least 5 mm extension in the mesorectal fat at the pretreatment MRI