High Proportions of People With Nonceliac Wheat Sensitivity Have Autoimmune Disease or Antinuclear Antibodies.

BACKGROUND & AIMS: There is much interest in wheat sensitivity among people without celiac disease (CD), but little is known about any risks associated with the condition. We evaluated the prevalence of autoimmune diseases (ADs) among patients with nonceliac wheat sensitivity (NCWS), and investigated whether they carry antinuclear antibodies (ANA). METHODS: We performed a retrospective study of 131 patients diagnosed with NCWS (121 female; mean age, 29.1 years) at 2 hospitals in Italy from January 2001 through June 2011. Data were also collected from 151 patients with CD or irritable bowel syndrome (IBS) (controls). Patient medical records were reviewed to identify those with ADs. We also performed a prospective study of 42 patients (38 female; mean age, 34 years) diagnosed with NCWS from July 2011 through March 2014 at 3 hospitals in Italy. One hundred age- and sex-matched subjects with CD or IBS served as controls. Serum samples were collected from all subjects and ANA levels were measured by immunofluorescence analysis. Participants completed a questionnaire and their medical records were reviewed to identify those with ADs. RESULTS: In the retrospective analysis, similar portions of subjects with NCWS (29%) and CD (29%) developed ADs (mainly Hashimoto's thyroiditis, 29 cases), compared with a smaller proportion of subjects with IBS (4%) (P < .001). In the prospective study, 24% of subjects with NCWS, 20% of subjects with CD, and 2% of subjects with IBS developed ADs (P < .001). In the retrospective study, serum samples tested positive for ANA in 46% of subjects with NCWS (median titer, 1:80), 24% of subjects with CD (P < .001), and 2% of subjects IBS (P < .001); in the prospective study, serum samples were positive for ANA in 28% of subjects with NCWS, 7.5% of subjects with CD (P = .02), and 6% of subjects with IBS (P = .005 vs patients with NCWS). ANA positivity was associated with the presence of the HLA DQ2/DQ8 haplotypes (P < .001). CONCLUSIONS: Higher proportions of patients with NCWS or CD develop autoimmune disorders, are ANA positive, and showed DQ2/DQ8 haplotypes compared with patients with IBS

Persistence of Nonceliac Wheat Sensitivity, Based on Long-term Follow-up

We investigated how many patients with a diagnosis of nonceliac wheat sensitivity (NCWS) still experienced wheat sensitivity after a median follow-up time of 99 months. We collected data from 200 participants from a previous study of NCWS, performed between July and December 2016 in Italy; 148 of these individuals were still on a strict wheat- free diet. In total, 175 patients (88%) improved (had fewer symptoms) after a diagnosis of NCWS; 145 of 148 patients who adhered strictly to a gluten-free diet (98%) had reduced symptoms, compared with 30 of 52 patients who did not adhere to a gluten-free diet (58%) (P < .0001). Of the 22 patients who repeated the double-blind, placebo- controlled challenge, 20 reacted to wheat. We conclude that NCWS is a persistent condition. Clinicaltrials.gov registration number: NCT02823522

COMEPA (COVID-19 Medicina Policlinico Palermo): a study in hospitalized patients.

Coronavirus disease 2019 (COVID-19) has dramatically changed our lives. In the past months, hospitals were saturated of patients; therefore, it is still important to have simple and standardized prognostic factors and to evaluate the efficacy and safety of medications commonly used for COVID-19. We aimed to collect data of the patients hospitalized in Internal Medicine and Geriatrics Wards at the University Hospital (Policlinico) ‘P. Giaccone’ in Palermo, Italy (COMEPA, COVID-19 Medicina Policlinico Palermo), with the main purpose of finding prognostic tools that can be easily used in clinical practice in order to identify patients hospitalized for/with COVID-19 at higher risk of negative outcomes, such as mortality, transfer to Intensive Care Unit (ICU) and institutionalization, as well as evaluating the efficacy/safety of medications commonly used for COVID-19. For reaching these aims, the medical records of approximately 600 patients will be recorded, having data on several parameters and including as outcomes mortality, ICU placement, institutionalization. With the COMEPA study, we therefore plan to update current literature, giving new data on prognostic factors and on the efficacy/safety of some medications used for COVID-19

Frequency and clinical aspects of neurological and psychiatric symptoms in patients with non-celiac wheat sensitivity

Background: Non-Celiac Wheat Sensitivity (NCWS) is characterized by both intestinal and extra-intestinal symptoms. The study aims to investigate the frequency of neuropsychiatric manifestations in NCWS patients and identify their clinical and demographic characteristics. Methods: 278 clinical records of NCWS patients, diagnosed by a double-blind placebo-controlled wheat challenge between 2006 and 2020, were retrospectively revised. Fifty-two patients with Celiac Disease (CD) and 54 patients with Irritable Bowel Syndrome (IBS) served as controls. Results: 87% of the NCWS patients had an IBS-like clinical presentation. The NCWS group showed a longer duration of symptoms, a higher frequency of positive serum anti-nuclear antibodies than CD and IBS patients, and a higher frequency of DQ2/DQ8 haplotypes and duodenal mucosa lymphocytosis than IBS controls. In addition, 50% of NCWS patients showed neuropsychiatric manifestations, while lower percentages were observed in CD (25%) and IBS (28%) controls. Neuropsychiatric symptoms in NCWS were more frequently associated with the male sex, longer duration of symptoms, and IBS-diarrhea-like clinical presentation. Conclusions: Our data suggest that in patients with IBS-like symptoms and neuropsychiatric manifestations of unknown cause, it could be useful to investigate a correlation of these symptoms with wheat ingestion to identify NCWS patients with this ‘atypical’ manifestation

Photo Thermal Effect Graphene Detector Featuring 105 Gbit s-1 NRZ and 120 Gbit s-1 PAM4 Direct Detection

The challenge of next generation datacom and telecom communication is to increase the available bandwidth while reducing the size, cost and power consumption of photonic integrated circuits. Silicon (Si) photonics has emerged as a viable solution to reach these objectives. Graphene, a single-atom thick layer of carbon5, has been recently proposed to be integrated with Si photonics because of its very high mobility, fast carrier dynamics and ultra-broadband optical properties. Here, we focus on graphene photodetectors for high speed datacom and telecom applications. High speed graphene photodetectors have been demonstrated so far, however the most are based on the photo-bolometric (PB) or photo-conductive (PC) effect. These devices are characterized by large dark current, in the order of milli-Amperes , which is an impairment in photo-receivers design, Photo-thermo-electric (PTE) effect has been identified as an alternative phenomenon for light detection. The main advantages of PTE-based photodetectors are the optical power to voltage conversion, zero-bias operation and ultra-fast response. Graphene PTE-based photodetectors have been reported in literature, however high-speed optical signal detection has not been shown. Here, we report on an optimized graphene PTE-based photodetector with flat frequency response up to 65 GHz. Thanks to the optimized design we demonstrate a system test leading to direct detection of 105 Gbit s-1 non-return to zero (NRZ) and 120 Gbit s-1 4-level pulse amplitude modulation (PAM) optical signal

Osteoporosis risk factors in HIV positive women with osteoporosis: A retrospective analysis

Multifactorial risk factors such as HIV/HCV co-infection and antiretroviral therapy (ARV) have been associated with osteoporosis in HIV+ women. We retrospectively analysed which known risk factors were associated with the diagnosis of osteoporosis, according to the WHO definition, in HIV positive women who were followed-up at the AIDS Centre of the University of Palermo, Italy between January 2011 and December 2014. Twenty-one HIV+ women with osteoporosis (13 HIV+ mono-infected and 8 HIV/HCV co-infected females) who underwent dual-energy X-ray absorptiometry (DXA) and liver stiffness assessment were included in the study. No significant differences between the HIV and HIV/HCV group were found regarding liver stiffness and lumbar/femoral osteoporosis scores. In a univariate analysis, we observed a positive linear correlation between LBD score (Lumbar Bone Density) with pre-fractures (p-value = 0.0082), smoke (p-value = 0.0008), alcohol (p-value < 0.0001) and ARV exposure score (p-value = 0.0039), while there were no significant negative linear correlations. In multivariate analysis, pre-fractures, smoke and alcohol were positive predictors of LBD score, while previous antiretroviral therapy (ARV) (years) score was a negative predictor compared to others. Univariate analysis showed a positive linear correlation between FDB (Femoral Bone Density) with smoke (p-value = 0.0303) and alcohol (p-value = 0.0050), while there were no significant negative linear correlations. In multivariate analysis, alcohol was a positive predictor of FDB score compared to others, while ARV score was a negative predictor compared to others. This preliminary study suggests that other factors besides ARV score and liver fibrosis may affect the skeletal system in osteoporotic women with HIV infection. Some of these factors, such as alcohol and smoking, are modifiable. Additional research into impact on osteoporosis in HIV women with osteoporosis is required

Calcineurin Orchestrates Lateral Transfer of Aspergillus fumigatus During Macrophage Cell Death.

RATIONALE: Pulmonary aspergillosis is a lethal mould infection in the immunocompromised host. Understanding initial control of infection, and how this is altered in the immunocompromised host, is a key goal for understanding the pathogenesis of pulmonary aspergillosis. OBJECTIVES: To characterise the outcome of human macrophage infection with Aspergillus fumigatus, and how this is altered in transplant recipients on calcineurin inhibitor immunosuppressants. METHODS: We defined the outcome of human macrophage infection with Aspergillus fumigatus, and the impact of calcineurin inhibitors, through a combination of single cell fluorescence imaging, transcriptomics, proteomics, and in vivo studies. MEASUREMENTS AND MAIN RESULTS: Macrophage phagocytosis of Aspergillus fumigatus enabled control of 90% of fungal germination. However fungal germination in the late phagosome led to macrophage necrosis. During programmed necroptosis, we observed frequent cell-cell transfer of Aspergillus fumigatus between macrophages which assists subsequent control of germination in recipient macrophages. Lateral transfer occurred through actin-dependent exocytosis of the late endosome in a vasodilator-stimulated phosphoprotein (VASP) envelope. Its relevance to the control of fungal germination was also shown by direct visualisation in our zebrafish aspergillosis model in vivo. The calcineurin inhibitor FK506/tacrolimus reduced cell death and lateral transfer in vitro by 50%. This resulted in uncontrolled fungal germination in macrophages and hyphal escape. CONCLUSIONS: These observations identify programmed necrosis-dependent lateral transfer of Aspergillus fumigatus between macrophages as an important host strategy for controlling fungal germination. This process is critically dependent on calcineurin. Our studies provide fundamental insights into the pathogenesis of pulmonary aspergillosis in the immunocompromised host

Dispositional optimism as a correlate of decision-making styles in adolescence

Despite the numerous psychological areas in which optimism has been studied, including career planning, only a small amount of research has been done to investigate the relationship between optimism and decision-making styles. Consequently, we have investigated the role of dispositional optimism as a correlate of different decision-making styles, in particular, positive for effective styles and negative for ineffective ones (doubtfulness, procrastination, and delegation). Data were gathered through questionnaires administered to 803 Italian adolescents in their last 2 years of high schools with different fields of study, each at the beginning stages of planning for their professional future. A paper questionnaire was completed containing measures of dispositional optimism and career-related decision styles, during a vocational guidance intervention conducted at school. Data were analyzed using stepwise multiple regression. Results supported the proposed model by showing optimism to be a strong correlate of decision-making styles, thereby offering important intervention guidelines aimed at modifying unrealistically negative expectations regarding their future and helping students learn adaptive decision-making skills