The future of road transport

A perfect storm of new technologies and new business models is transforming not only our vehicles, but everything about how we get around, and how we live our lives. The JRC report “The future of road transport - Implications of automated, connected, low-carbon and shared mobility” looks at some main enablers of the transformation of road transport, such as data governance, infrastructures, communication technologies and cybersecurity, and legislation. It discusses the potential impacts on the economy, employment and skills, energy use and emissions, the sustainability of raw materials, democracy, privacy and social fairness, as well as on the urban context. It shows how the massive changes on the horizon represent an opportunity to move towards a transport system that is more efficient, safer, less polluting and more accessible to larger parts of society than the current one centred on car ownership. However, new transport technologies, on their own, won't spontaneously make our lives better without upgrading our transport systems and policies to the 21st century. The improvement of governance and the development of innovative mobility solutions will be crucial to ensure that the future of transport is cleaner and more equitable than its car-centred present.JRC.C.4-Sustainable Transpor

Noninvasive quantification of blood potassium concentration from ECG in hemodialysis patients

Blood potassium concentration ([K+]) influences the electrocardiogram (ECG), particularly T-wave morphology. We developed a new method to quantify [K+] from T-wave analysis and tested its clinical applicability on data from dialysis patients, in whom [K+] varies significantly during the therapy. To elucidate the mechanism linking [K+] and T-wave, we also analysed data from long QT syndrome type 2 (LQT2) patients, testing the hypothesis that our method would have underestimated [K+] in these patients. Moreover, a computational model was used to explore the physiological processes underlying our estimator at the cellular level. We analysed 12-lead ECGs from 45 haemodialysis and 12 LQT2 patients. T-wave amplitude and downslope were calculated from the first two eigenleads. The T-wave slope-to-amplitude ratio (TS/A) was used as starting point for an ECG-based [K+] estimate (KECG). Leave-one-out cross-validation was performed. Agreement between KECG and reference [K+] from blood samples was promising (error: -0.09 \ub1 0.59 mM, absolute error: 0.46 \ub1 0.39 mM). The analysis on LQT2 patients, also supported by the outcome of computational analysis, reinforces our interpretation that, at the cellular level, delayed-rectifier potassium current is a main contributor of KECG correlation to blood [K+]. Following a comprehensive validation, this method could be effectively applied to monitor patients at risk for hyper/hypokalemia

Prevalence of Chlamydia trachomatis infections in young women attending to Family Planning Clinics of Turin

Background. Chlamydia trachomatis (C.t.) is one of the most common STD spread in Europe and in developed Countries. According to international studies, the highest prevalence is observed among asymptomatic, sexually active, young women, 15-24 aged. Objectives. The aim of the present study was to determine the prevalence and risk factors for genital infection with C.t. in young women under 25 aged attending to family planning clinics of Turin to active screening programs to be cost-effective in reducing the spread of C.t. infection. Study design. All the unrolled women between June 2008-December 2010, were tested for C.t. infection, using Real time PCR, on a vaginal specimen. A kit and a socio-demographic, behavioral and clinical-gynaecological questionnaire were provided to the participating clinics. Results. The study included 1831 women, of whom 31% 19 aged. The prevalence was 7.3% and was significantly associated being non Italian, having had more lifetime sexual partners and more than 1 partner in the previous six months. Conclusion. Our results are representative of general young female population of Turin. Data are comparable with those of other international studies. The high rate of infection provides information useful to plan health care interventions, like to extend the C.t. free test, not only to young women attending to STD centers but also to those one attending to family planning clinics and to promote prevention interventions to sensitize, not only youth population, on the spread of C.t. and other STD, but also family doctors and gynaecologists in order to reduce the diffusion of infections and relate complications

Tumor-infiltrating (TINKs) and tumor-associated (TANKs) natural killer cells: a new player in the inflammatory orchestration of tumor angiogenesis in colon cancer

Natural Killer (NK) cells are lymphocytes of innate immunity that can potentially control tumors by their cytotoxic activity. The NK cells of patients with NSCLC, both tumor infiltrating (TINKs) and tumor associated (TANKs, from peripheral blood), are poorly cytotoxic, CD56brightCD16-, producing substantial levels of VEGF, PlGF, IL-8 and induce angiogenesis in vitro. In the present study we extended our analysis on colorectal cancer (CRC) TINKs and TANKs. NK cell were isolated from blood and tissue (adjacent-normal and tumor tissues) from patients with CRC then phenotypically and functionally characterized for surface antigen expression and cytokine profiling by multiparametric flow cytometry. Functional angiogenesis assays were performed on human umbilical vein cells, using conditioned media derived from isolated NK cells. We found that the CD56brightCD16- NK cells predominate in both the tumors and adjacent tissues derived from CRC samples. The CRC TINKs are poorly cytotoxic and express markers of decidual NK cells (CD9 and CD49a). TINKs produce pro-angiogenic factors, including VEGF, PlGF and IL-8, associated with induction of migration and capillary-like structure formation of endothelial cells in vitro. TANKS also produced VEGF. The \u201cswitched\u201d phenotype and function of tumor infiltrating NK cells acquire a broad implications in the role of immune response against tumors and this places NK cells as a new playe r in the inflammatory promotion of tumor angiogenesis

L'abuso sessuale nei bambini prepuberi Requisiti e raccomandazioni per una valutazione appropriata

L\u2019abuso sessuale sui bambini/e non ha a tutt\u2019oggi una definizione condivisa. La complessit\ue0 del fenomeno, che coinvolge l\u2019area medica, psicologica, sociale e legale porta inoltre spesso a letture interpretative molto differenziate. Segni e sintomi fisici, psicologici e comportamentali devono essere quindi valutati da operatori con adeguata formazione e competenza tecnica. Poich\ue9 la valutazione fisica del bambino/a che \ue8 stato vittima di abuso sessuale \ue8 spesso priva di riscontri obiettivi significativi, \ue8 fondamentale che il professionista che incontra il/la minore sappia riconoscere e distinguere l\u2019obiettivit\ue0 genito - anale normale da quella caratterizzata da lesioni e/o esiti di lesioni e sia in grado di fornire una corretta interpretazione della stessa.. Un approccio da subito adeguato con corretta stesura di una relazione pu\uf2 evitare ulteriori inutili se non traumatiche visite al bambino/a. Nel 2003 ho costituito il \u201cGruppo di lavoro per l\u2019Abuso e il maltrattamento dell\u2019infanzia\u201d che ha coinvolto professionisti italiani afferenti all\u2019area ginecologica, medico-legale e pediatrica e che ha elaborato un primo documento in tema di semeiotica medica dell\u2019abuso sessuale nel prepubere. La necessit\ue0 di condividere le esperienze attraverso il confronto reciproco, la letteratura internazionale e i colleghi di molte societ\ue0 mediche che si occupano della tematica ha portato alla realizzazione di questa breve guida. L\u2019utilizzo della stessa pu\uf2 essere di aiuto sia al medico che deve affrontare per la prima volta una situazione di sospetto abuso sessuale, sia agli operatori pi\uf9 esperti che possono trovare in essa un sintetico compendio di tutti gli elementi necessari per una corretta semeiotica medica

Add-On Effect of Selenium and Vitamin D Combined Supplementation in Early Control of Graves’ Disease Hyperthyroidism During Methimazole Treatment

Prompt and stable control of hyperthyroidism is fundamental to avoid the detrimental effects of thyroid hormone excess, and antithyroid drugs, mainly methimazole (MMI), represent the first-line treatment for Graves’ disease (GD) hyperthyroidism. Decreased serum concentrations of selenium (Se) and calcifediol (25(OH)D, VitD) have been reported in newly diagnosed GD patients in observational studies. Low Se levels might exacerbate oxidative stress by compromising the antioxidant machinery’s response to reactive oxygen species, and low VitD levels might hamper the anti-inflammatory immune response. We performed a randomized controlled clinical trial (EudraCT 2017-00505011) to investigate whether Se and cholecalciferol (VitD) addition to MMI is associated with a prompter control of hyperthyroidism. Forty-two consecutive patients with newly-onset GD and marginal/insufficient Se and VitD levels were randomly assigned to treatment with either MMI monotherapy or MMI combined with Se and VitD. Se treatment was withdrawn after 180 days, while the other treatments were continued. Combination therapy resulted in a significantly greater reduction in serum FT4 concentration at 45 days (-37.9 pg/ml, CI 95%, -43.7 to -32.2 pg/ml) and 180 days (-36.5 pg/ml, CI 95%, -42 to -30.9 pg/ml) compared to MMI monotherapy (respectively: -25.7 pg/ml, CI 95%, -31.6 to -19.7 pg/ml and -22.9 pg/ml, CI 95%, -28 to -17.3 pg/ml, p 0.002). Data at 270 days confirmed this trend (-37.8 pg/ml, CI 95%, -43.6 to -32.1 pg/ml vs -24.4 pg/ml, CI 95%, -30.3 to -18.4 pg/ml). The quality of life (QoL) score was investigated by the validated “Thyroid-related Patient-Reported Outcome” questionnaire (ThyPRO). ThyPRO composite score showed a greater improvement in the intervention group at 45 days (-14.6, CI 95%, -18.8 to -10.4), 180 (-9, CI 95%, -13.9 to -4.2) and 270 days (-14.3, CI 95%, -19.5 to -9.1) compared to MMI group (respectively, -5.2, CI 95%, -9.5 to -1; -5.4, CI 95%, -10.6 to -0.2 and -3.5, CI 95%, -9 to -2.1, p 0-6 months and 6-9 months <0.05). Our results suggest that reaching optimal Se and VitD levels increases the early efficacy of MMI treatment when Se and VitD levels are suboptimal. Copyright © 2022 Gallo, Mortara, Veronesi, Cattaneo, Genoni, Gallazzi, Peruzzo, Lasalvia, Moretto, Bruno, Passi, Pini, Nauti, Lavizzari, Marinò, Lanzolla, Tanda, Bartalena and Piantanida

A Naturally Occurring Antibody Fragment Neutralizes Infectivity of Diverse Infectious Agents

A phosphorylated peptide, named K40H, derived from the constant region of IgMs was detected in human serum by liquid chromatography coupled to high-resolution mass spectrometry. Synthetic K40H proved to exert a potent in vitro activity against fungal pathogens, and to inhibit HIV-1 replication in vitro and ex vivo. It also showed a therapeutic effect against an experimental infection by Candida albicans in the invertebrate model Galleria mellonella. K40H represents the proof of concept of the innate role that naturally occurring antibody fragments may exert against infectious agents, shedding a new light upon the posthumous role of antibodies and opening a new scenario on the multifaceted functionality of humoral immunity

RACCOMANDAZIONI PER L\u2019ASSISTENZA ALLA DONNA VITTIMA DI VIOLENZA SESSUALE

Di fronte ad una vittima di violenza sessuale la priorit\ue0 assistenziale dovr\ue0 essere la tutela della sua salute e del suo benessere. \uc8 importante restituire alla donna il suo valore di persona in ogni fase del percorso clinico. Trattare la donna con rispetto ed empatia pu\uf2 essere di aiuto nella successiva elaborazione del trauma. \u2022 L\u2019esame fisico e la raccolta delle prove dovrebbero avvenire nello stesso tempo per evitare visite ripetute e lo stress a queste correlato. La completezza dell\u2019esame comporta un inevitabile impegno di tempo e di risorse da parte del personale sanitario. \u2022 Sar\ue0 importante riservare una stanza predisposta per accogliere la vittima per tutto il tempo che rimane nella struttura (in caso di Ospedale la stanza dovr\ue0 essere preferibilmente nel punto di ac\u2011 cesso e cio\ue8 il Pronto Soccorso). Il personale dovr\ue0 rivolgersi alla vittima con voce calma, senza esprimere sorpresa o incredulit\ue0, con parole e atteggiamento assolutamente non giudicante. \u2022 Per aiutare il sanitario ad applicare correttamente le procedure diagnostiche e terapeutiche validate, \ue8 suggerito l\u2019impiego di una SCHEDA CLINICA GUIDATA che si applica alle ragazze di et\ue0 superiore ai 13 anni e alle donne adulte. \u2022 La scheda costituisce documentazione clinica da archiviare e da consegnare eventualmente alla donna in copia per gli usi che ritiene opportuni (per es. la denuncia) oltre al verbale di Pronto Soc\u2011 corso che viene abitualmente compilato. \uc8 inoltre uno strumento che favorisce la raccolta di dati epidemiologici per lo studio del fenomeno. \u2022 Si dovr\ue0 ottenere il consenso per tutta la procedura e per la comunicazione delle informazioni a terzi. Le domande e le scelte della donna saranno assecondate in ogni fase. Nel caso in cui il personale sanitario debba procedere con la denuncia d\u2019ufficio all\u2019Autorit\ue0 Giudiziaria, la donna deve esserne informata ma non \ue8 richiesto consenso. \u2022 La scheda clinica guidata dovr\ue0 inserirsi in una PROCEDURA di accoglienza pi\uf9 ampia sviluppata in modo MULTIDISCIPLINARE che preveda un iter specifico fin dal momento in cui la donna incontra la struttura (generalmente il pronto soccorso) per la risposta standardizzata a ogni problematica presente in caso di violenza sessuale. In particolare si dovr\ue0 definire un protocollo per il metodo di raccolta e conservazione delle prove forensi, un protocollo per la profilassi dell\u2019HIV, un protocollo per i test tossi\u2011 cologici dato che spesso la violenza \ue8 facilitata dall\u2019uso di sostanze, infine un protocollo per la presa in carico successiva della vittima che non pu\uf2 essere abbandonata dopo la prima valutazione. \u2022 La costituzione di una RETE multidisciplinare composta dalle varie competenze e risorse presenti nello specifico ambito territoriale garantir\ue0 la coerenza della presa in carico in fase iniziale e di quella nei tempi successivi, per una tutela della vittima non solo sanitaria ma anche psicologica e sociale nonch\ue9 legale. La legge prevede la denuncia a querela di parte entro dodici mesi, quando non sono presenti le condizioni per denuncia d\u2019ufficio