A comprehensive study for the validation of a LC/MS/MS method for the determination of free and total forms of urinary cortisol and its metabolites

Several pathological conditions can be related to the alteration of the urinary levels of cortisol (F) and itsmetabolites. The determination of each of them in the free and free plus conjugated form can provide adeeper insight into the impaired activity of the cortisol metabolism enzymes, thus improving the diag-nosis protocol currently based only on the determination of total amount of urinary cortisol metabolites.In that view, an LC–MS/MS method for the determination of the free and total amount of urinary F, cor-tisone (E), tetrahydrocortisol (THF), allo-tetrahydrocortisol (A-THF) and tetrahydrocortisone (THE) wasthus developed and validated. Deconjugation of glucocorticoids was carried out by enzymatic hydroly-sis. Analytes were extracted by solid phase extraction, separated by liquid chromatography and analyzedvia electro-spray ionization (negative ion mode) triple-quadrupole mass spectrometry in the selectedreaction monitoring mode using a stable isotope-labeled internal standard.Baseline separation for all compounds, in particular the two stereoisomers A-THF and THF, wasobtained. Matrix effects, not reported so far, were observed and minimized for the determination ofurinary free E and THE. Validated range was 0.5–1000 ng/mL for A-THF and THF, 5–800 ng/mL for E andTHE and 1–1000 ng/mL for F, with R2values greater than 0.9981. The LOD and LOQ of the describedmethod ranged from 0.1 to 3.0 ng/mL, while the extraction recoveries resulted close to 100% for all theglucocorticoids determined. Precision and accuracy were well within ±10%. As suggested by the resultsobtained in the preliminary study on polycystic ovary syndrome (PCOS) urine samples, the method canbe used to support clinical diagnosis of pathologies related to cortisol metabolism. In fact, levels of freeand total glucocorticoids in control subjects were in agreement with previously reported data, as well asfree and total A-THF/THF ratio in PCOS patients. Conversely, in the latter free F/E and A-THF + THF/THEratios were lower than in control subjects (P < 0.01), suggesting a possible alteration of 11-HSD1 and11-HSD2 activity, to be further investigated

Nylon 6 and nylon 6,6 micro- and nanoplastics: a first example of their accurate quantification, along with polyester (PET), in wastewater treatment plant sludges

A novel procedure for nylon 6 and nylon 6,6 polyamide (PAs) microplastics (MPs) quantification is described for the first time. The overall procedure, including quantification of poly(ethylene terephthalate) (PET), was tested on wastewater treatment plant (WWTP) sludges. The three polymers account for the largest global share of synthetic textile microfibers, being possibly the most common MPs released upon laundering in urban wastewaters. Therefore, measuring their content in WWTP sludges may provide an accurate picture of the potential risks associated with both the inflow of these MPs in natural water bodies and the practice of using WWTP sludges as agricultural soil amendment. The novel procedure involves PAs depolymerization by acid hydrolysis followed by derivatization of the monomers 6-aminohexanoic acid (AHA) and hexamethylene diamine (HMDA) with a fluorophore. Reversed-phase HPLC analysis with fluorescence detection results in high sensitivities for both AHA (LOD = 8.85·10–4 mg/L, LOQ = 3.73·10–3 mg/L) and HMDA (LOD = 2.12·10–4, LOQ = 7.04·10–4 mg/L). PET quantification involves depolymerization, in this case by alkaline hydrolysis, followed by HPLC analysis of its comonomer terephthalic acid. Eight sludge samples from four WWTPs in Italy showed contamination in the 29.3–215.3 ppm and 10.6–134.6 ppm range for nylon 6 and nylon 6,6, respectively, and in the 520–1470 ppm range for PET

AVP deficiency (central diabetes insipidus) following immunization with anti-COVID-19 BNT162b2 Comirnaty vaccine in adolescents: A case report

IntroductionThe coronavirus disease 19 (COVID-19) pandemic has prompted the development of new vaccines to reduce the morbidity and mortality associated with this disease. Recognition and report of potential adverse effects of these novel vaccines (especially the urgent and life-threatening ones) is therefore essential. Case presentationA 16-year-old boy presented to the Paediatric Emergency Department with polyuria, polydipsia and weight loss over the last four months. His past medical history was unremarkable. Onset of symptoms was referred to be few days after first dose of anti-COVID-19 BNT162b2 Comirnaty vaccine and then worsened after the second dose. The physical exam was normal, without neurological abnormalities. Auxological parameters were within normal limits. Daily fluid balance monitoring confirmed polyuria and polydipsia. Biochemistry laboratory analysis and urine culture were normal. Serum osmolality was 297 mOsm/Kg H2O (285-305), whereas urine osmolality was 80 mOsm/Kg H2O (100-1100), suggesting diabetes insipidus. Anterior pituitary function was preserved. Since parents refused to give consent to water deprivation test, treatment with Desmopressin was administered and confirmed ex juvantibus diagnosis of AVP deficiency (or central diabetes insipidus). Brain MRI revealed pituitary stalk thickening (4 mm) with contrast enhancement, and loss of posterior pituitary bright spot on T1 weighted imaging. Those signs were consistent with neuroinfundibulohypophysitis. Immunoglobulin levels were normal. Low doses of oral Desmopressin were sufficient to control patient's symptoms, normalizing serum and urinary osmolality values and daily fluid balance at discharge. Brain MRI after 2 months showed stable thicken pituitary stalk and still undetectable posterior pituitary. Due to persistence of polyuria and polydipsia, therapy with Desmopressin was adjusted by increasing dosage and number of daily administrations. Clinical and neuroradiological follow-up is still ongoing. ConclusionHypophysitis is a rare disorder characterized by lymphocytic, granulomatous, plasmacytic, or xanthomatous infiltration of the pituitary gland and stalk. Common manifestations are headache, hypopituitarism, and diabetes insipidus. To date, only time correlation between SARS-CoV-2 infection and development of hypophysitis and subsequent hypopituitarism has been reported. Further studies will be needed to deepen a possible causal link between anti-COVID-19 vaccine and AVP deficiency

Cast Away in the Adriatic: Low Degree of Parallel Genetic Differentiation in Three-Spined Sticklebacks

The three-spined stickleback (Gasterosteus aculeatus) has repeatedly and independently adapted to freshwater habitats from standing genetic variation (SGV) following colonization from the sea. However, in the Mediterranean Sea G. aculeatus is believed to have gone extinct, and thus the spread of locally adapted alleles between different freshwater populations via the sea since then has been highly unlikely. This is expected to limit parallel evolution, that is the extent to which phylogenetically related alleles can be shared among independently colonized freshwater populations. Using whole genome and 2b-RAD sequencing data, we compared levels of genetic differentiation and genetic parallelism of 15 Adriatic stickleback populations to 19 Pacific, Atlantic and Caspian populations, where gene flow between freshwater populations across extant marine populations is still possible. Our findings support previous studies suggesting that Adriatic populations are highly differentiated (average F-ST approximate to 0.45), of low genetic diversity and connectivity, and likely to stem from multiple independent colonizations during the Pleistocene. Linkage disequilibrium network analyses in combination with linear mixed models nevertheless revealed several parallel marine-freshwater differentiated genomic regions, although still not to the extent observed elsewhere in the world. We hypothesize that current levels of genetic parallelism in the Adriatic lineages are a relic of freshwater adaptation from SGV prior to the extinction of marine sticklebacks in the Mediterranean that has persisted despite substantial genetic drift experienced by the Adriatic stickleback isolates.Peer reviewe

Microplastic pollution in the sediments of interconnected lakebed, seabed, and seashore aquatic environments: polymer-specific total mass through the multianalytical “PISA” procedure

The total mass of individual synthetic polymers present as microplastic (MP &lt; 2 mm) pollutants in the sediments of interconnected aquatic environments was determined adopting the Polymer Identification and Specific Analysis (PISA) procedure. The investigated area includes a coastal lakebed (Massaciuccoli), a coastal seabed (Serchio River estuarine), and a sandy beach (Lecciona), all within a natural park area in Tuscany (Italy). Polyolefins, poly(styrene) (PS), poly(vinyl chloride) (PVC), polycarbonate (PC), poly(ethylene terephthalate) (PET), and the polyamides poly(caprolactame) (Nylon 6) and poly(hexamethylene adipamide) (Nylon 6,6) were fractionated and quantified through a sequence of selective solvent extractions followed by either analytical pyrolysis or reversed-phase HPLC analysis of the products of hydrolytic depolymerizations under acidic and alkaline conditions. The highest concentrations of polyolefins (highly degraded, up to 864 μg/kg of dry sediment) and PS (up to 1138 μg/kg) MPs were found in the beach dune sector, where larger plastic debris are not removed by the cyclic swash action and are thus prone to further aging and fragmentation. Surprisingly, low concentrations of less degraded polyolefins (around 30 μg/kg) were found throughout the transect zones of the beach. Positive correlation was found between polar polymers (PVC, PC) and phthalates, most likely absorbed from polluted environments. PET and nylons above their respective LOQ values were found in the lakebed and estuarine seabed hot spots. The pollution levels suggest a significant contribution from riverine and canalized surface waters collecting urban (treated) wastewaters and waters from Serchio River and the much larger Arno River aquifers, characterized by a high anthropogenic pressur

Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study

Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores. Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs. Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients

Beta-Blocker Use in Older Hospitalized Patients Affected by Heart Failure and Chronic Obstructive Pulmonary Disease: An Italian Survey From the REPOSI Register

Beta (β)-blockers (BB) are useful in reducing morbidity and mortality in patients with heart failure (HF) and concomitant chronic obstructive pulmonary disease (COPD). Nevertheless, the use of BBs could induce bronchoconstriction due to β2-blockade. For this reason, both the ESC and GOLD guidelines strongly suggest the use of selective β1-BB in patients with HF and COPD. However, low adherence to guidelines was observed in multiple clinical settings. The aim of the study was to investigate the BBs use in older patients affected by HF and COPD, recorded in the REPOSI register. Of 942 patients affected by HF, 47.1% were treated with BBs. The use of BBs was significantly lower in patients with HF and COPD than in patients affected by HF alone, both at admission and at discharge (admission, 36.9% vs. 51.3%; discharge, 38.0% vs. 51.7%). In addition, no further BB users were found at discharge. The probability to being treated with a BB was significantly lower in patients with HF also affected by COPD (adj. OR, 95% CI: 0.50, 0.37-0.67), while the diagnosis of COPD was not associated with the choice of selective β1-BB (adj. OR, 95% CI: 1.33, 0.76-2.34). Despite clear recommendations by clinical guidelines, a significant underuse of BBs was also observed after hospital discharge. In COPD affected patients, physicians unreasonably reject BBs use, rather than choosing a β1-BB. The expected improvement of the BB prescriptions after hospitalization was not observed. A multidisciplinary approach among hospital physicians, general practitioners, and pharmacologists should be carried out for better drug management and adherence to guideline recommendations

Global burden of 288 causes of death and life expectancy decomposition in 204 countries and territories and 811 subnational locations, 1990–2021: a systematic analysis for the Global Burden of Disease Study 2021

BACKGROUND Regular, detailed reporting on population health by underlying cause of death is fundamental for public health decision making. Cause-specific estimates of mortality and the subsequent effects on life expectancy worldwide are valuable metrics to gauge progress in reducing mortality rates. These estimates are particularly important following large-scale mortality spikes, such as the COVID-19 pandemic. When systematically analysed, mortality rates and life expectancy allow comparisons of the consequences of causes of death globally and over time, providing a nuanced understanding of the effect of these causes on global populations. METHODS The Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) 2021 cause-of-death analysis estimated mortality and years of life lost (YLLs) from 288 causes of death by age-sex-location-year in 204 countries and territories and 811 subnational locations for each year from 1990 until 2021. The analysis used 56 604 data sources, including data from vital registration and verbal autopsy as well as surveys, censuses, surveillance systems, and cancer registries, among others. As with previous GBD rounds, cause-specific death rates for most causes were estimated using the Cause of Death Ensemble model-a modelling tool developed for GBD to assess the out-of-sample predictive validity of different statistical models and covariate permutations and combine those results to produce cause-specific mortality estimates-with alternative strategies adapted to model causes with insufficient data, substantial changes in reporting over the study period, or unusual epidemiology. YLLs were computed as the product of the number of deaths for each cause-age-sex-location-year and the standard life expectancy at each age. As part of the modelling process, uncertainty intervals (UIs) were generated using the 2·5th and 97·5th percentiles from a 1000-draw distribution for each metric. We decomposed life expectancy by cause of death, location, and year to show cause-specific effects on life expectancy from 1990 to 2021. We also used the coefficient of variation and the fraction of population affected by 90% of deaths to highlight concentrations of mortality. Findings are reported in counts and age-standardised rates. Methodological improvements for cause-of-death estimates in GBD 2021 include the expansion of under-5-years age group to include four new age groups, enhanced methods to account for stochastic variation of sparse data, and the inclusion of COVID-19 and other pandemic-related mortality-which includes excess mortality associated with the pandemic, excluding COVID-19, lower respiratory infections, measles, malaria, and pertussis. For this analysis, 199 new country-years of vital registration cause-of-death data, 5 country-years of surveillance data, 21 country-years of verbal autopsy data, and 94 country-years of other data types were added to those used in previous GBD rounds. FINDINGS The leading causes of age-standardised deaths globally were the same in 2019 as they were in 1990; in descending order, these were, ischaemic heart disease, stroke, chronic obstructive pulmonary disease, and lower respiratory infections. In 2021, however, COVID-19 replaced stroke as the second-leading age-standardised cause of death, with 94·0 deaths (95% UI 89·2-100·0) per 100 000 population. The COVID-19 pandemic shifted the rankings of the leading five causes, lowering stroke to the third-leading and chronic obstructive pulmonary disease to the fourth-leading position. In 2021, the highest age-standardised death rates from COVID-19 occurred in sub-Saharan Africa (271·0 deaths [250·1-290·7] per 100 000 population) and Latin America and the Caribbean (195·4 deaths [182·1-211·4] per 100 000 population). The lowest age-standardised death rates from COVID-19 were in the high-income super-region (48·1 deaths [47·4-48·8] per 100 000 population) and southeast Asia, east Asia, and Oceania (23·2 deaths [16·3-37·2] per 100 000 population). Globally, life expectancy steadily improved between 1990 and 2019 for 18 of the 22 investigated causes. Decomposition of global and regional life expectancy showed the positive effect that reductions in deaths from enteric infections, lower respiratory infections, stroke, and neonatal deaths, among others have contributed to improved survival over the study period. However, a net reduction of 1·6 years occurred in global life expectancy between 2019 and 2021, primarily due to increased death rates from COVID-19 and other pandemic-related mortality. Life expectancy was highly variable between super-regions over the study period, with southeast Asia, east Asia, and Oceania gaining 8·3 years (6·7-9·9) overall, while having the smallest reduction in life expectancy due to COVID-19 (0·4 years). The largest reduction in life expectancy due to COVID-19 occurred in Latin America and the Caribbean (3·6 years). Additionally, 53 of the 288 causes of death were highly concentrated in locations with less than 50% of the global population as of 2021, and these causes of death became progressively more concentrated since 1990, when only 44 causes showed this pattern. The concentration phenomenon is discussed heuristically with respect to enteric and lower respiratory infections, malaria, HIV/AIDS, neonatal disorders, tuberculosis, and measles. INTERPRETATION Long-standing gains in life expectancy and reductions in many of the leading causes of death have been disrupted by the COVID-19 pandemic, the adverse effects of which were spread unevenly among populations. Despite the pandemic, there has been continued progress in combatting several notable causes of death, leading to improved global life expectancy over the study period. Each of the seven GBD super-regions showed an overall improvement from 1990 and 2021, obscuring the negative effect in the years of the pandemic. Additionally, our findings regarding regional variation in causes of death driving increases in life expectancy hold clear policy utility. Analyses of shifting mortality trends reveal that several causes, once widespread globally, are now increasingly concentrated geographically. These changes in mortality concentration, alongside further investigation of changing risks, interventions, and relevant policy, present an important opportunity to deepen our understanding of mortality-reduction strategies. Examining patterns in mortality concentration might reveal areas where successful public health interventions have been implemented. Translating these successes to locations where certain causes of death remain entrenched can inform policies that work to improve life expectancy for people everywhere. FUNDING Bill & Melinda Gates Foundation

Palladium Supported on Bioinspired Materials as Catalysts for C–C Coupling Reactions

In recent years, the immobilization of palladium nanoparticles on solid supports to prepare active and stable catalytic systems has been deeply investigated. Compared to inorganic materials, naturally occurring organic solids are inexpensive, available and abundant. Moreover, the surface of these solids is fully covered by chelating groups which can stabilize the metal nanoparticles. In the present review, we have focused our attention on natural biomaterials-supported metal catalysts applied to the formation of C–C bonds by Mizoroki–Heck, Suzuki–Miyaura and Sonogashira reactions. A systematic approach based on the nature of the organic matrix will be followed: (i) metal catalysts supported on cellulose; (ii) metal catalysts supported on starch; (iii) metal catalysts supported on pectin; (iv) metal catalysts supported on agarose; (v) metal catalysts supported on chitosan; (vi) metal catalysts supported on proteins and enzymes. We will emphasize the effective heterogeneity and recyclability of each catalyst, specifying which studies were carried out to evaluate these aspects

Enzymes in Poly(Butylene-Succinate) Industry: An Overview on Synthesis Routes and Post-Processing Strategies

This paper will present some sectors in which enzymes can replace traditional catalysts in poly(butylene-succinate) industry, emphasizing the green chemistry aspects associated with these newer strategies