Identification of dangerous fibers: some examples in Northern Italy

The presence of asbestiform minerals has to be foreseen in the planning of infrastructural activities: Asbestos can be a component of sedimentary rocks or of mafic and ultra mafic metamorphic rocks. Surveys and core drilling, in addition to providing important information on the quality of the rock and its geotechnical characteristics, allow for a prediction of the presence of asbestiform minerals in the areas affected by mining or infrastructural activities. During the excavation, workers can be exposed to the asbestos risk, therefore, the control of the air quality and of the excavated materials are fundamental for the safety of involved people. In this work some problems we met in the analysis of airborne filters and bulk samples from sites in northern Italy are presented. The asbestos fibers present in rocks as accessory minerals, are often different in habit and dimension from the well-known asbestos fibers used as industrial minerals and moreover can be erroneously identified as minerals morphologically and chemically similar present in the same rock or environment. In the case of tunnel muck it could be contaminated by substances used for the excavation that could modify colours and optical properties of asbestos minerals. In the PCOM (Phase Contrast Optical Microscope) analysis chrysotile, sepiolite and antigorite, due to their different refraction index, when the fibers have dimension > 0,5 micron and aren’t contaminated by lubricant can be easely identified even if the morphology of chrysotile is very similar to that of sepiolite. In Electron Scanning Microscope (SEM) the discrimination between chrysotile and antigorite on the airborne filters is not always possible because the fibers of thin dimensions show similar habit and spectrum. In the case of the tremolite amphibole, morphology changes from prismatic to fibrous depending on its origin (p.eg. Monastero, Val Grana, Verrayes, Brachiello). Both prismatic and asbestiform tremolite (Gamble and Gibbs, 2007; Addison and McConnel, 2007) may show inhalable elements with width less than 3 micron, length more than 5 micron and width length ratio 1:3, whose dangerousness (fiber coming from fibrous tremolite or the cleavage fragments coming from prismatic tremolite) could be different and it is object of epidemiologic studies

Hybrid Human-Machine Interface to Mouse Control for Severely Disabled People

This paper describes a hybrid human-machine interface, based on electro-oculogram (EOG) and electromyogram (EMG), which allows the mouse control of a personal computer using eye movement and the voluntary contraction of any facial muscle. The bioelectrical signals are sensed through adhesives electrodes, and acquired by a custom designed portable and wireless system. The mouse can be moved in any direction, vertical, horizontal and diagonal, by two EOG channels and the EMG signal is used to perform the mouse click action. Blinks are avoided by a decision algorithm and the natural reading of the screen is possible with a specially designed software. A virtual keyboard was used for the experiments with healthy people and with a severely disabled patient. The results demonstrate an intuitive and accessible control, evaluated in terms of performance, time for task execution and user´s acceptance. Besides, a quantitative index to estimate the training impact was computed with good results.Fil: López Celani, Natalia Martina. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Orosco, Eugenio Conrado. Universidad Nacional de San Juan. Facultad de Ingeniería. Instituto de Automática; ArgentinaFil: Pérez Berenguer, María Elisa. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Bajinay, Sergio. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Zanetti, Roberto. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; ArgentinaFil: Valentinuzzi, Maximo. Universidad Nacional de San Juan. Facultad de Ingeniería. Departamento de Electrónica y Automática. Gabinete de Tecnología Médica; Argentin

Breast cancer-secreted miR-939 downregulates VE-cadherin and destroys the barrier function of endothelial monolayers.

Abstract Exosomes-secreted microRNAs play an important role in metastatic spread. During this process breast cancer cells acquire the ability to transmigrate through blood vessels by inducing changes in the endothelial barrier. We focused on miR-939 that is predicted to target VE-cadherin, a component of adherens junction involved in vessel permeability. By in silico analysis miR-939 was found highly expressed in the basal-like tumor subtypes and in our cohort of 63 triple-negative breast cancers (TNBCs) its expression significantly interacted with lymph node status in predicting disease-free survival probability. We demonstrated, in vitro , that miR-939 directly targets VE-cadherin leading to an increase in HUVECs monolayer permeability. MDA-MB-231 cells transfected with a miR-939 mimic, released miR-939 in exosomes that, once internalized in endothelial cells, favored trans-endothelial migration of MDA-MB-231-GFP cells by the disruption of the endothelial barrier. Notably, when up taken in endothelial cells exosomes caused VE-cadherin down-regulation specifically through miR-939 as we demonstrated by inhibiting miR-939 expression in exosomes-releasing TNBC cells. Together, our data indentify an extracellular pro-tumorigenic role for tumor-derived, exosome-associated miR-939 that can explain its association with worse prognosis in TNBCs

Familial breast cancer: characteristics and outcome of BRCA 1–2 positive and negative cases

BACKGROUND: The clinical and pathological characteristics and the clinical course of patients with breast cancer and BRCA 1–2 mutation are poorly known. METHODS: From 1997, patients with breast cancer and a family history of breast or ovarian cancer were offered BRCA testing. The clinical and pathological features of patients with known BRCA status were retrospectively assessed and comparisons were made between cancers arising in BRCA positive and BRCA wild type (WT) patients respectively. Type of treatment, pattern of relapse, event (local relapse, contralateral breast cancer, metastases) free and overall survival were also compared in the two groups. Out of the 210 patients tested, 125 had been treated and followed-up at our Institution and were evaluated in this study. RESULTS: BRCA positive patients tended to be more often premenopausal (79% vs 65%) and to have positive lymphnodes (63% vs 49%), poorly differentiated tumours (76% vs 40% – p = 0.002 at univariate analysis, not significant at multivariate analysis) and negative estrogen receptors (43% vs 29%). Treatment was not different in the two groups. In the 86 BRCA-WT patients, the first event was a local relapse in 3 (3%), metachronous contralateral breast cancer in 7 (8%) and distant metastases in 16 (19%). In the 39 BRCA positive patients, the corresponding figures were 3 (8%), 8 (21%) and 3 (8%). There was no difference in event free survival, with a median of 180 months in both groups of patients. At 20 years, projected survival was 85% for BRCA positive patients and 55% for BRCA-WT, but this difference was not statistically significant. CONCLUSION: Although BRCA positive patients have more frequently negative prognostic factors, their prognosis appears to be equal to or better than in patients with BRCA-WT

Lentiviral Hematopoietic Stem Cell Gene Therapy Benefits Metachromatic Leukodystrophy

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Real-Time genomic surveillance for SARS-CoV-2 variants of concern, Uruguay

We developed a genomic surveillance program for realtime monitoring of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants of concern (VOCs) in Uruguay. We report on a PCR method for SARSCoV- 2 VOCs, the surveillance workflow, and multiple independent introductions and community transmission of the SARS-CoV-2 P.1 VOC in Uruguay

Clinical features and outcomes of elderly hospitalised patients with chronic obstructive pulmonary disease, heart failure or both

Background and objective: Chronic obstructive pulmonary disease (COPD) and heart failure (HF) mutually increase the risk of being present in the same patient, especially if older. Whether or not this coexistence may be associated with a worse prognosis is debated. Therefore, employing data derived from the REPOSI register, we evaluated the clinical features and outcomes in a population of elderly patients admitted to internal medicine wards and having COPD, HF or COPD + HF. Methods: We measured socio-demographic and anthropometric characteristics, severity and prevalence of comorbidities, clinical and laboratory features during hospitalization, mood disorders, functional independence, drug prescriptions and discharge destination. The primary study outcome was the risk of death. Results: We considered 2,343 elderly hospitalized patients (median age 81 years), of whom 1,154 (49%) had COPD, 813 (35%) HF, and 376 (16%) COPD + HF. Patients with COPD + HF had different characteristics than those with COPD or HF, such as a higher prevalence of previous hospitalizations, comorbidities (especially chronic kidney disease), higher respiratory rate at admission and number of prescribed drugs. Patients with COPD + HF (hazard ratio HR 1.74, 95% confidence intervals CI 1.16-2.61) and patients with dementia (HR 1.75, 95% CI 1.06-2.90) had a higher risk of death at one year. The Kaplan-Meier curves showed a higher mortality risk in the group of patients with COPD + HF for all causes (p = 0.010), respiratory causes (p = 0.006), cardiovascular causes (p = 0.046) and respiratory plus cardiovascular causes (p = 0.009). Conclusion: In this real-life cohort of hospitalized elderly patients, the coexistence of COPD and HF significantly worsened prognosis at one year. This finding may help to better define the care needs of this population

The “Diabetes Comorbidome”: A Different Way for Health Professionals to Approach the Comorbidity Burden of Diabetes

(1) Background: The disease burden related to diabetes is increasing greatly, particularly in older subjects. A more comprehensive approach towards the assessment and management of diabetes’ comorbidities is necessary. The aim of this study was to implement our previous data identifying and representing the prevalence of the comorbidities, their association with mortality, and the strength of their relationship in hospitalized elderly patients with diabetes, developing, at the same time, a new graphic representation model of the comorbidome called “Diabetes Comorbidome”. (2) Methods: Data were collected from the RePoSi register. Comorbidities, socio-demographic data, severity and comorbidity indexes (Cumulative Illness rating Scale CIRS-SI and CIRS-CI), and functional status (Barthel Index), were recorded. Mortality rates were assessed in hospital and 3 and 12 months after discharge. (3) Results: Of the 4714 hospitalized elderly patients, 1378 had diabetes. The comorbidities distribution showed that arterial hypertension (57.1%), ischemic heart disease (31.4%), chronic renal failure (28.8%), atrial fibrillation (25.6%), and COPD (22.7%), were the more frequent in subjects with diabetes. The graphic comorbidome showed that the strongest predictors of death at in hospital and at the 3-month follow-up were dementia and cancer. At the 1-year follow-up, cancer was the first comorbidity independently associated with mortality. (4) Conclusions: The “Diabetes Comorbidome” represents the perfect instrument for determining the prevalence of comorbidities and the strength of their relationship with risk of death, as well as the need for an effective treatment for improving clinical outcomes

Antidiabetic Drug Prescription Pattern in Hospitalized Older Patients with Diabetes

Objective: To describe the prescription pattern of antidiabetic and cardiovascular drugs in a cohort of hospitalized older patients with diabetes. Methods: Patients with diabetes aged 65 years or older hospitalized in internal medicine and/or geriatric wards throughout Italy and enrolled in the REPOSI (REgistro POliterapuie SIMI—Società Italiana di Medicina Interna) registry from 2010 to 2019 and discharged alive were included. Results: Among 1703 patients with diabetes, 1433 (84.2%) were on treatment with at least one antidiabetic drug at hospital admission, mainly prescribed as monotherapy with insulin (28.3%) or metformin (19.2%). The proportion of treated patients decreased at discharge (N = 1309, 76.9%), with a significant reduction over time. Among those prescribed, the proportion of those with insulin alone increased over time (p = 0.0066), while the proportion of those prescribed sulfonylureas decreased (p < 0.0001). Among patients receiving antidiabetic therapy at discharge, 1063 (81.2%) were also prescribed cardiovascular drugs, mainly with an antihypertensive drug alone or in combination (N = 777, 73.1%). Conclusion: The management of older patients with diabetes in a hospital setting is often sub-optimal, as shown by the increasing trend in insulin at discharge, even if an overall improvement has been highlighted by the prevalent decrease in sulfonylureas prescription