Assessment of circadian rhythm in pain and stiffness in rheumatic diseases according the EMA (Ecologic Momentary Assessment) method: patient compliance with an electronic diary

Background: Many researchers have used paper diaries in an attempt to capture patient experience. However, patient non-compliance with written diary protocols is a serious problem for researchers. Electronic patient experience diaries (eDiary) facilitate Ecologic Momentary Assessment (EMA) study designs by allowing the researcher to administer flexible, programmable assessments and mark each record with a time and date stamp. Objectives: The objectives of the current study were to evaluate methodological issues associated with real-time pain reports (EMA) using electronic patient experience diaries, to quantify compliance (percentage of the total number of diary reports scheduled that were actually completed), and to examine the circadian rhythm in pain and stiffness of patients with rheumatic diseases in an ecologically valid manner. Methods: In this cross-sectional study we examined 49 patients with rheumatic diseases (14 patients with rheumatoid arthritis, 18 with fibromyalgia and 17 with osteoarthritis of the knee), attending the care facilities of the Department of Rheumatology of Universita Politecnica delle Marche. All patients fulfilling the American College of Rheumatology (ACR) criteria. The assessment of pain and stiffness in all patients were repeated seven times a day (8 A.M., 10 A.M., 12 A.M., 2 P.M., 4 P.M., 6 P.M. and 8 P.M.) on seven consecutive days using an electronic diary (DataLoggerO - Pain Level Recorder). A datalogger is newly developed electronic instrument that records measurements of pain and stiffness over time. Dataloggers are small, battery-powered devices that are equipped with a microprocessor. Specific software is then used to select logging parameters (sampling intervals, start time, etc.) and view/analyse the collected data. Compliance is based on the time and date record that was automatically recorded by the devices. Results: Using the data from the electronic diary, we determined that the average verified compliance rate for pain and stiffness were 93.8 and 93.6%, respectively. The two highest compliance rates were observed in patients with rheumatoid arthritis (95.6 and 95.2%, respectively). There were no statistically significant difference in compliance between females and males or patients above or below 60 years old. Significant circadian rhytms in patients with RA and OA of the knee were detected in pain and stiffness. No rhythm in pain or stiffness was observed in subjects with fibromyalgia. Conclusions: We conclude that collection of subjective data using electronic diary in rheumatologic setting is a feasible method than can be adopted with high compliance rates across a range of patient demographic subgroups. The identification of diurnal cycles of self-reported pain and stiffness, using EMA method, has important implications for patients with respect to planning their daily activities and in developing individual therapeutic programs with respect to diurnal variability, which therefore may be more effective

Temporal correlation of population composition and environmental variables in the marine invader Ciona robusta

The capacity for ascidians to inhabit coastal sea floor worldwide relies on their peculiar tolerance to environmental variables and pollution, which is considered, together with high levels of genetic diversity, among the main drivers of their invasive potential. In spite of the continued interest in the genetics of invasive species, little attention has been paid toward the microevolutionary processes that drive structure and fate of ascidian populations over time under chemically polluted conditions. Understanding the interplay between environmental and population dynamics is critical to predict the biodiversity of marine coastal ecosystems. In the present study, a local population of the ascidian Ciona robusta living in the Fusaro Lagoon has been monitored over a 13-month period of sampling. Physico-chemical parameters (temperature, salinity, turbidity, dissolved oxygen, heavy metals), genetic composition (microsatellites, ITS-2), abundance and biomass (wet and dry weight) were assessed with the aim to infer fine-scale temporal variation of population structure with respect to rapid environmental change. Analysis of biomass showed that C. robusta is highly sensitive to salinity and oxygen concentrations. Further, genetic analysis suggested a highly dynamic population structure, likely due to the strong clustering of temporal samples and distinct responses to environmental conditions, including bioaccumulation of heavy metals. Here, we hypothesize that rapid variation in allele frequencies of neutral markers in C. robusta populations may increase the ability of the species to colonize habitats that are subject to strong variation and are under heavy human pressure

Gene body DNA methylation in seagrasses: inter- and intraspecific differences and interaction with transcriptome plasticity under heat stress

The role of DNA methylation and its interaction with gene expression and transcriptome plasticity is poorly understood, and current insight comes mainly from studies in very few model plant species. Here, we study gene body DNA methylation (gbM) and gene expression patterns in ecotypes from contrasting thermal environments of two marine plants with contrasting life history strategies in order to explore the potential role epigenetic mechanisms could play in gene plasticity and responsiveness to heat stress. In silico transcriptome analysis of CpG(O/E) ratios suggested that the bulk of Posidonia oceanica and Cymodocea nodosa genes possess high levels of intragenic methylation. We also observed a correlation between gbM and gene expression flexibility: genes with low DNA methylation tend to show flexible gene expression and plasticity under changing conditions. Furthermore, the empirical determination of global DNA methylation (5-mC) showed patterns of intra and inter-specific divergence that suggests a link between methylation level and the plants' latitude of origin and life history. Although we cannot discern whether gbM regulates gene expression or vice versa, or if other molecular mechanisms play a role in facilitating transcriptome responsiveness, our findings point to the existence of a relationship between gene responsiveness and gbM patterns in marine plants

The influence of soft acidic drinks in exposing dentinal tubules after non-surgical periodontal treatment: : a SEM investigation on the protective effects of oxalate-containing phytocomplex

Objective: The aim of this study was to investigate the different smear layer morphologies produced by instrumentation with a hand curette and a periodontal sonic scaler for potential removal by soft acidic solution. The effect of a new oxalate-containing phytocomplex spray in preventing tubules exposure after citric acid solution application was also evaluated. Methods: Thirty recently extracted human teeth were used to obtain root dentinal fragments and divided in two groups: Curette treatment (CRT) root planed applying 30 working strokes to each surface using a Gracey?s curette 5-6 and Ultrasonic scaler (USC) treated using a periodontal scaler mounted on an ultrasonic hand-piece for 30 seconds. Each principal group was further divided in three sub-groups (Control, Acid challenge and Acid/Phyto-oxalate). The control group samples were immersed in distilled water buffered to pH 7.4 using NH4 OH solution. The samples of the acid challenge group were immersed in a solution of citric acid 0,02M; [pH 2.5] for 3 minutes. The samples of the Acid/Phyto-oxalate group were sprayed for 15 sec with a 1.5% phytocomplex spray prior to immersion. Samples were examined using SEM. Results: Ultrasonic instrumentation created a very thin smear layer whereas curettes produced a multilayered smear layer. The acidic solution was able to remove the smear layer from root surfaces treated with ultrasonic instrumentation exposing the dentinal tubules. The smear layer on the root surfaces treated with hand instruments was not completely removed. The phytocomplex solution was able to prevent dentinal tubule exposure. Conclusions: Acidic soft drinks are able to remove the smear layer created on root surfaces during different non-surgical periodontally treatments. The smear plugs created by hand instrumentation appeared to be more resistant to acid attack. The tested phytocomplex solution protected the dentine from demineralization and it might prevent post-treatment dentinal hypersensitivity induced by acidic soft drinks

Frailty assessment in an unselected population admitted to an intensive cardiac care unit

Abstract Background Although interest in frailty has expanded among cardiology experts over the past 2 decades, its integration, as part of cardiovascular disease management, is still lacking, above all in the acute cardiac care setting. The Clinical Frailty Scale (CFS) is a brief guided tool to assess frailty in hospital settings without specialist equipment. Purpose Our objective was to test the performance of the CFS in an older, unselected population, admitted to an Intensive Cardiac Care Unit (ICCU) during the year 2019. Methods The study sample included 431 patients ≥65 years old, admitted to an ICCU of a tertiary cardiac center in Italy. The CFS ranged from "very fit: 1" to "terminally ill: 9", but it was considered present at a score ≥5. Our primary endpoint was defined by a combination of severe complications requiring critical care and in-hospital death. The data were collected from the hospital discharge summary and the electronic chart records. Results 158 patients (36.7%) were frail. These individuals had greater comorbidity and higher in-hospital mortality (Table 1). After a multivariable logistic regression analysis, 4 predictors were identified: signs of congestive heart failure (OR: 8.51, 95% Confidence Interval-CI: 4.63–14.6; p<0,001), systolic blood pressure (OR per 1 mmHg increasing: 0.98, 95% CI: 0.97–0.99; p<0,001), smoking habit (OR: 0.49, 95% CI: 0.22–1.11; p=0.09) and the CFS ≥5 (OR: 1.86, 95% CI: 1.08–3.23: p=0,026). Conclusions The CFS is a simple guided frailty tool that may enhance outcome prediction in the acute cardiac care setting. These findings merit evaluation in larger cohorts of unselected patients. Funding Acknowledgement Type of funding sources: None

Photo-physiology and morphology reveal divergent warming responses in northern and southern hemisphere seagrasses

En prensa2,01

Effects of Current and Future Summer Marine Heat Waves on Posidonia oceanica: Plant Origin Matters?

Marine heat waves (MHWs), prolonged discrete anomalously warm water events, have been increasing significantly in duration, intensity and frequency all over the world, and have been associated with a variety of impacts including alteration of ecosystem structure and function. This study assessed the effects of current and futureMHWs on the Mediterranean seagrass Posidonia oceanica performance, also testing the importance of the thermal environment where the plant lives. The effects of current MHWs were studied through a mensurative experiment in a cold and in a warm site (West and North-West Sardinia, Italy, respectively). Future MHWs effects were tested through a manipulative experiment using P. oceanica shoots collected fromthe cold and warmsites and transplanted in a common garden in front of a power plant (North-West Sardinia): here plants were exposed to heat longer in duration and stronger in intensity than the natural MHWs of the last 20 years, resembling the future scenario. Morphological (total # of leaves, maximum leaf length, and percentage of total necrotic leaf length per shoot) and biochemical variables (leaf proteins, carbohydrates, and lipids) were considered. Plants had similar sublethal responses in both the experiments for most of the variables, revealing that current and future MHWs had similar effect types, but different in magnitude depending on the intensity of the waves: in general, the number of leaves, the maximum leaf length and lipid content decreased, while the leaf necrosis and carbohydrates increased. However, also the origin of the plants affected the results, corroborating the hypothesis that the thermal context the plants live affects their tolerance to the heat. Overall, this study provided evidence about the importance of biochemical variations, such as carbohydrate and lipid levels, as potentially good indicators of seagrass heat stress

Effects of Current and Future Summer Marine Heat Waves on Posidonia oceanica: Plant Origin Matters?

Marine heat waves (MHWs), prolonged discrete anomalously warm water events, have been increasing significantly in duration, intensity and frequency all over the world, and have been associated with a variety of impacts including alteration of ecosystem structure and function. This study assessed the effects of current and future MHWs on the Mediterranean seagrass Posidonia oceanica performance, also testing the importance of the thermal environment where the plant lives. The effects of current MHWs were studied through a mensurative experiment in a cold and in a warm site (West and North-West Sardinia, Italy, respectively). Future MHWs effects were tested through a manipulative experiment using P. oceanica shoots collected from the cold and warm sites and transplanted in a common garden in front of a power plant (North-West Sardinia): here plants were exposed to heat longer in duration and stronger in intensity than the natural MHWs of the last 20 years, resembling the future scenario. Morphological (total # of leaves, maximum leaf length, and percentage of total necrotic leaf length per shoot) and biochemical variables (leaf proteins, carbohydrates, and lipids) were considered. Plants had similar sublethal responses in both the experiments for most of the variables, revealing that current and future MHWs had similar effect types, but different in magnitude depending on the intensity of the waves: in general, the number of leaves, the maximum leaf length and lipid content decreased, while the leaf necrosis and carbohydrates increased. However, also the origin of the plants affected the results, corroborating the hypothesis that the thermal context the plants live affects their tolerance to the heat. Overall, this study provided evidence about the importance of biochemical variations, such as carbohydrate and lipid levels, as potentially good indicators of seagrass heat stress.En prens

Comparison of relativity theories with observer-independent scales of both velocity and length/mass

We consider the two most studied proposals of relativity theories with observer-independent scales of both velocity and length/mass: the one discussed by Amelino-Camelia as illustrative example for the original proposal (gr-qc/0012051) of theories with two relativistic invariants, and an alternative more recently proposed by Magueijo and Smolin (hep-th/0112090). We show that these two relativistic theories are much more closely connected than it would appear on the basis of a naive analysis of their original formulations. In particular, in spite of adopting a rather different formal description of the deformed boost generators, they end up assigning the same dependence of momentum on rapidity, which can be described as the core feature of these relativistic theories. We show that this observation can be used to clarify the concepts of particle mass, particle velocity, and energy-momentum-conservation rules in these theories with two relativistic invariants.Comment: 21 pages, LaTex. v2: Andrea Procaccini (contributing some results from hia Laurea thesis) is added to the list of authors and the paper provides further elements of comparison between DSR1 and DSR2, including the observation that both lead to the same formula for the dependence of momentum on rapidit

Thermo-priming increases heat-stress tolerance in seedlings of the Mediterranean seagrass P. oceanica

Seawater warming and increased incidence of marine heatwaves (MHW) are threatening the integrity of coastal marine habitats including seagrasses, which are particularly vulnerable to climate changes. Novel stress tolerance-enhancing strategies, including thermo-priming, have been extensively applied in terrestrial plants for enhancing resilience capacity under the re-occurrence of a stress event. We applied, for the first time in seedlings of the Mediterranean seagrass Posidonia oceanica, a thermo-priming treatment through the exposure to a simulated warming event. We analyzed the photo-physiological and growth performance of primed and non-primed seedlings, and the gene expression responses of selected genes (i.e. stress-, photosynthesis- and epigenetic-related genes). Results revealed that during the re-occurring stress event, primed seedlings performed better than unprimed showing unaltered photo-physiology supported by high expression levels of genes related to stress response, photosynthesis, and epigenetic modifications. These findings offer new opportunities to improve conservation and restoration efforts in a future scenario of environmental changes.Versión del editor2,35