Creation of a specific and separated pediatric intra-hospital pathway in primary level hospitals during the era of COVID-19

Every new pandemic forces us to start new specific behaviors both in the civil life and within the hospitals trying to contain the spreading of the infection and preserve the more fragile people. In this regard, at the debut of Severe Acute Respiratory Syndrome-CoronaVirus-2 (SARS-CoV-2) pandemic, our Local Health Agency had drastically modified every clinical and organizational pathways in order to limit the diffusion of the infection as well as to maintain a good quality of care and preserve healthcare workers. We report how we have modified the usual pediatric intra-hospital pathways in our primary level hospital to avoid mixing children with suspected and non-suspected symptoms of SARS-CoV-2 infection. Before every hospitalization, regardless of symptoms, each child and him/her parent/caregiver are undergone to rapid antigenic and molecular swab to rule out a SARS-CoV-2 infection; hence, positive patients are transferred to Pediatric Unit of third level hospital equipped by a Pediatric COVID Intensive Unit. We think the healthcare behaviors described in this manuscript can help to reduce the intra-hospital spreading of SARS-CoV-2, although children seem to have a minimal role in the dissemination, but we cannot let down your guard. Simultaneously we observed that the overall children requiring inpatient pediatric evaluation and hospitalization have dramatically decreased from the beginning of pandemic

Aortic septotomy with scissor-technique

Viene descritta tecnica innovativa per il ridurre le complicanze legate alla dissezione aorta toracic

The management of water resources between traditions and sustainability: the qanats of Shahrood Province (North-eastern Iran)

Qanats, Iran, multidisciplinary study, water supply

Osmotic dehydration of organic kiwifruit pre-treated by pulsed electric fields and monitored by NMR

[EN] Osmotic dehydration (OD) is a widely used preservation technique that consists in the reduction in food water activity by the immersion of the biological tissue in hypertonic solutions. The aim of this work was to analyze the effect of pulsed electric fields (PEF) in mass transfer as a pre-treatment of the OD using NMR. In this sense, PEF pre-treatments were done using three different voltages (100, 250 and 400 V/cm) and 60 number of pulse. The OD of kiwifruit was carried out in 61.5% of sucrose solution at 25 °C, for a contact period from 0 to 120 min. The water distribution into the cellular tissue was studied by NMR relaxometry. In conclusion, NMR is an excellent technique for quantifying water molecules according to their interactions in the fruit tissue, obtaining the adsorbed water and opening the possibility to apply the BET model to fit the adsorbed isotherm over the whole range of water activity.The authors Urszula Tylewicz and Marco Dalla Rosa want to thank for the financial support provided by funding bodies within the FP7 ERA-Net CORE Organic Plus, and with cofounds from the European Commission. The author Maria Victoria Traffano Schiffo wants to thank the FPI Predoctoral Program of the Universidad Politecnica de Valencia for support her PhD studies, ERASMUS PRACTICAS program to finance her mobility to Italy. The authors Pedro J. Fito, Marta Castro-Giraldez and M. Victoria Traffano-Schiffo acknowledge the financial support from the Spanish Ministerio de Economia, Industria y Competitividad, Programa Estatal de I+D+i orientada a los Retos de la Sociedad AGL2016-80643-R.Traffano-Schiffo, MV.; Laghi, L.; Castro Giráldez, M.; Tylewicz, U.; Rocculi, P.; Ragni, L.; Dalla Rosa, M.... (2017). Osmotic dehydration of organic kiwifruit pre-treated by pulsed electric fields and monitored by NMR. Food Chemistry. 236:87-93. https://doi.org/10.1016/j.foodchem.2017.02.046S879323

Effect of pulsed electric field pre-treatment on microstructure and internal transport throughout osmotic treatment of organic kiwifruit.

Plant cellular structure could be considered a complex organized system where flows are carried out by different solutes or solvents transports systems. Passive transports, which is based on the free energy gradients, involve symplastic, apoplastic and aquaporins transmembrane transports. During osmotic dehydration (OD) treatment the semipermeable membranes such as plasma membrane and tonoplast, are forced to separate, due to the water losses from the vacuoles, starting the process known as plasmolysis, characterized by the loss of the turgor pressure. In the last years, OD has been extensively studied for the partial dehydration of fruits and vegetables in order to obtain semi-moist products; however, it presents some limitations such as the low dehydration rate and the high solute content in the final product. Therefore, the use of pre-treatment such as Pulsed Electric Fields (PEF) has been reported to facilitate water removal and to improve the quality of the dried or osmo-dried products. PEF is a non-thermal technology which involves the application of short and repeated voltage pulses to a biological tissue placed between two electrodes; it induces changes and reorganization in the electric conformation of the cell membrane, modifying the normal fluxes during drying process when it is used as a pre-treatment. In present work PEF has been applied as a pre-treatment prior OD of organic kiwifruits (Actinidia deliciosa cv Hayward) in order to evaluate its effect on the internal structure and internal water transport. PEF pre-treatments were performed using the following parameters: E= 100, 250 and 400 V/cm, 60 near-rectangular shape pulses, pulse width of 100 ± 2 μs and a repetition time of 10.0 ± 0.1 ms. The OD was carried out by immersing the samples in 61.5% sucrose solution at 25 °C for different time period (0-120 min). The samples were analyzed in terms of microstructure by Cryo-SEM microscopy and internal water transport by Time Domain Nuclear Magnetic Resonance (TD-NMR). The results showed that the application of a PEF pre-treatment before the OD produces a process of plasmolysis proportional to the electric field strength applied. It is because the PEF removes the mobile charges of the medium, such as electrolytes, organic acids, amino acids; Ca+2 is the major culprit of the plasmolysis because it fixes some of the junctions of the microtubules between the cell wall and the membrane. In addition, the process of plasmolysis induced by the electric field changes the behavior of kiwifruit tissue during the OD process. In a standard OD without any pretratment, the main transport is the symplastic, whereas if previously treated with PEF, the apoplastic transport is as important as the symplastic, considerably increasing the rate of dehydration. Acknowledgements: Financial support for this project is provided by funding bodies within the FP7 ERA-Net CORE Organic Plus, and with cofounds from the European Commission (No 618107)

Herpes Zoster Associated Hospital Admissions in Italy: Review of the Hospital Discharge Forms

In Italy a specific surveillance system for zoster does not exist, and thus updated and complete epidemiological data are lacking. The objective of this study was to retrospectively review the national hospital discharge forms database for the period 1999–2005 using the code ICD9-CM053. In the period 1999–2005, 35,328 hospital admissions have been registered with annual means of 4,503 hospitalizations and 543 day-hospital admissions. The great part of hospitalizations (61.9%) involved subjects older than 65 years; the mean duration of stay was 8 days. These data, even if restricted to hospitalizations registered at national level, confirm the epidemiological impact of shingles and of its complications

Comparison of EV-free fraction, EVs, and total secretome of amniotic mesenchymal stromal cells for their immunomodulatory potential: a translational perspective

Amniotic mesenchymal stromal cells (hAMSCs) have unique immunomodulatory properties demonstrated in vitro and in vivo in various diseases in which the dysregulated immune system plays a major role. The immunomodulatory and pro-regenerative effects of MSCs, among which hAMSCs lie in the bioactive factors they secrete and in their paracrine activity, is well known. The mix of these factors (i.e., secretome) can be either freely secreted or conveyed by extracellular vesicles (EV), thus identifying two components in the cell secretome: EV-free and EV fractions. This study aimed to discern the relative impact of the individual components on the immunomodulatory action of the hAMSC secretome in order to obtain useful information for implementing future therapeutic approaches using immunomodulatory therapies based on the MSC secretome. To this aim, we isolated EVs from the hAMSC secretome (hAMSC-CM) by ultracentrifugation and validated the vesicular product according to the International Society for Extracellular Vesicles (ISEV) criteria. EVs were re-diluted in serum-free medium to maintain the EV concentration initially present in the original CM. We compared the effects of the EV-free and EV fractions with those exerted by hAMSC-CM in toto on the activation and differentiation of immune cell subpopulations belonging to both the innate and adaptive immune systems.We observed that the EV-free fraction, similar to hAMSC-CM in toto, a) decreases the proliferation of activated peripheral blood mononuclear cells (PBMC), b) reduces the polarization of T cells toward inflammatory Th subsets, and induces the induction of regulatory T cells; c) affects monocyte polarization to antigen-presenting cells fostering the acquisition of anti-inflammatory macrophage (M2) markers; and d) reduces the activation of B lymphocytes and their maturation to plasma cells. We observed instead that all investigated EV fractions, when used in the original concentrations, failed to exert any immunomodulatory effect, even though we show that EVs are internalized by various immune cells within PBMC. These findings suggest that the active component able to induce immune regulation, tested at original concentrations, of the hAMSC secretome resides in factors not conveyed in EVs. However, EVs isolated from hAMSC could exert actions on other cell types, as reported by others