From soil remediation to biofuel. Process simulation of bioethanol production from Arundo donax

A range of energy crops can be grown on marginal land (i.e. land that is not suitable for food crop production or contaminated site) to provide feedstocks for bioenergy, non-food products and biofuels. The food versus fuel debate had a significant negative impact in Europe on first generation biofuels production from food crops (i.e. wheat, rapeseed, etc). A new approach involving the use of marginal land for the production of lignocellulosic species for the production of bioethanol is now pursued in Italy and in many other countries, where the demand for high quality water resources, arable land, food and fossil fuels is rapidly growing. With an emerging “feed versus fuel debate” there is a pressing need to find options for the use of marginal lands and wastewaters or saline ground waters to produce second generation biofuel or bio paper crops. Arundo donax was selected as a potential crop for use in these areas, since it produces more cellulosic biomass and sequesters more contaminants, using less land and pesticides than any other alternative crops reported in the literature. The objective of this paper is to evaluate economically a simplified process for the production of second generation bioethanol from A. donax. Process calculations and economic analyses are performed using the software SuperPro Designer®

Can Alzheimer disease be a form of type 3 diabetes?

Alzheimer disease (AD) and metabolic syndrome are two highly prevalent pathological conditions of Western society due to incorrect diet, lifestyle, and vascular risk factors. Recent data have suggested metabolic syndrome as an independent risk factor for AD and pre-AD syndrome. Furthermore, biological plausibility for this relationship has been framed within the “metabolic cognitive syndrome” concept. Due to the increasing aging of populations, prevalence of AD in Western industrialized countries will rise in the near future. Thus, new knowledge in the area of molecular biology and epigenetics will probably help to make an early molecular diagnosis of dementia. An association between metabolic syndrome and specific single-nucleotide polylmorphisms (SNPs) in the gene INPPL1, encoding for SHIP2, a SH2 domain-containing inositol 5-phosphatase involved in insulin signaling, has been described. According to recent data suggesting that Type 2 diabetes represents an independent risk factor for AD and pre-AD, preliminary results of a case–control study performed to test the putative association between three SNPs in the SHIP2 gene and AD show a trend toward association of these SNPs with AD

Cardiotoxicity related to long-term trastuzumab therapy in metastatic breast cancer: the potential role of treatment duration and cardiac risk factors.

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A point prevalence study of catheter associated urinary tract infections among patients admitted in an university hospital

Background: Urinary tract infections (UTIs) are the most common type of healthcare associated infection in acute care hospitals. Most involve urinary drainage devices, such as urinary catheter. The objective of this study was to investigate the prevalence of catheter-associated urinary tract infections in adult patients of a tertiary level university hospital.Methods: The point prevalence study was conducted in one single day and included all adult patients admitted in medical, surgical wards and intensive care units. The Centre for Disease Control (CDC) criteria were adopted to classify the different type of UTIs.Results: Out of a total of 497 adult inpatients, 94 patients had a urinary catheter for at least 48 hours. The prevalence of symptomatic urinary tract infection (SUTI) in this sample is 17%. Escherichia coli (31.2%), Enterococcus faecium (25.0%) and Enterococcus faecalis (12.5%) are the most common pathogens found.Conclusions: The main isolated uropathogens in this study are Gram-negative and Escherichia coli remains one of the most frequent cause of UTIs in human. Gram-negative pathogens have multiple virulent factors responsible for their adherence to uroepithelium and urinary catheter positioning facilitates the transmission of these pathogens to urinary tract. Urinary catheterization is frequently used as solution to facilitate continence and maintain skin integrity in elderly patients. Urinary incontinence frequently is an example of inappropriate use of urinary catheter: for that reason, urinary catheter should be considered as the last option if other solution, like incontinence pads, are not indicated

Prevalence of frailty in surgical older patients and its impact on assisted discharge

Background & aim. An increasing number of older persons is today undergoing emergency and elective surgical procedures. Frailty is a highly prevalent condition and a predictor of postoperative adverse outcomes. This study is aimed at measuring the prevalence of frailty among older persons awaiting for surgical procedures, and the activation of services supporting protected discharge from the hospital in individuals with high vulnerability to stressors. Methods. A prospective observational study was conducted in patients aged 65 years and older waiting for surgery. Frailty was measured using the criteria proposed by Robinson and colleagues. Length of stay and care services activated at the discharge recorded. Results. A total of 1,144 patients were recruited. Two-hundred and seventeen (19%) patients were defined as frail, and 395 (34.5%) were pre-frail. The average length of post-operative stay was 5 days. Only 39 (3.4%) patients received care plan assuring a protected discharge. Among these, 35 (89.7%) were frail, 4 (10.3%) pre-frail. The variable most strongly correlated with the activation of services supporting an assisted discharge was the dependence in activities of daily living (ρ = 0.27, p < 0.001). Conclusions. Frailty is a highly prevalent condition among persons undergoing emergency and elected surgery procedures. Nevertheless, services supporting assisted discharge on the territory are quite infrequently activated. An improved integration of care services bridging hospital and community is necessary and therefore a lack of continuity of health and social care. Further research should focus on the postoperative management of the frail elderly patient

SHIP2: A ‘‘NEW’’ Insulin Pathway Target for Aging Research

Strong evidence suggests that systemic inflammation and central adiposity contribute to and perpetuate metabolic syndrome. All of these alterations predispose individuals to type 2 diabetes mellitus (T2DM), cardiovascular disease, as well as Alzheimer’s disease (AD), all characterized by chronic inflammatory status. On the other hand, extensive abnormalities in insulin and insulin-like growth factor I (IGF-I) and IGF-II signaling mechanisms in brains with AD have been demonstrated, suggesting that AD could be a third form of diabetes. The Src homology domain-containing inositol 5-phosphatase 2 (SHIP2) has an important role in the insulin pathway because its over-expression causes impairment of insulin/IGF-1 signaling. Because some singlenucleotide polymorphisms (SNP) of the gene encoding SHIP2 were significantly associated in T2DM patients with metabolic syndrome and some related conditions, we decided to conduct a case–control study on this gene, analyzing AD and T2DM subjects as cases and young, old, and centenarians as controls. Our results suggest a putative correlation between the the rs144989913 SNP and aging, both successful and unsuccessful, rather than age-related diseases. Because this SNP is an insertion/deletion of 28 bp, it might cause an alteration in SHIP2 expression. It is noteworthy that SHIP2 has been demonstrated to be a potent negative regulator of insulin signaling and insulin sensitivity. Many studies demonstrated the association of the insulin/IGF1 pathway with aging and longevity, so it is tempting to speculate that the found association with SHIP2 and aging might depend on its effect on the insulin/IGF-1 pathwa

Prognostic Value of T-Wave Alternans in Patients With Heart Failure Due to Nonischemic Cardiomyopathy Results of the ALPHA Study

ObjectivesThe aim of this study was to assess the prognostic value of T-wave alternans (TWA) in New York Heart Association (NYHA) functional class II/III patients with nonischemic cardiomyopathy and left ventricular ejection fraction (LVEF) ≤40%.BackgroundThere is a strong need to identify reliable risk stratifiers among heart failure candidates for implantable cardioverter-defibrillator (ICD) prophylaxis. T-wave alternans may identify low-risk subjects among post-myocardial infarction patients with depressed LVEF, but its predictive role in nonischemic cardiomyopathy is unclear.MethodsFour hundred forty-six patients were enrolled and followed up for 18 to 24 months. The primary end point was the combination of cardiac death + life-threatening arrhythmias; secondary end points were total mortality and the combination of arrhythmic death + life-threatening arrhythmias.ResultsPatients with abnormal TWA (65%) compared with normal TWA (35%) tests were older (60 ± 13 years vs. 57 ± 12 years), were more frequently in NYHA functional class III (22% vs. 19%), and had a modestly lower LVEF (29 ± 7% vs. 31 ± 7%). Primary end point rates in patients with abnormal and normal TWA tests were 6.5% (95% confidence interval [CI] 4.5% to 9.4%) and 1.6% (95% CI 0.6% to 4.4%), respectively. Unadjusted and adjusted hazard ratios were 4.0 (95% CI 1.4% to 11.4%; p = 0.002) and 3.2 (95% CI 1.1% to 9.2%; p = 0.013), respectively. Hazard ratios for total mortality and for arrhythmic death + life-threatening arrhythmias were 4.6 (p = 0.002) and 5.5 (p = 0.004), respectively; 18-month negative predictive values for the 3 end points ranged between 97.3% and 98.6%.ConclusionsAmong NYHA functional class II/III nonischemic cardiomyopathy patients, an abnormal TWA test is associated with a 4-fold higher risk of cardiac death and life-threatening arrhythmias. Patients with normal TWA tests have a very good prognosis and are likely to benefit little from ICD therapy

Open Quantum Dynamics: Complete Positivity and Entanglement

We review the standard treatment of open quantum systems in relation to quantum entanglement, analyzing, in particular, the behaviour of bipartite systems immersed in a same environment. We first focus upon the notion of complete positivity, a physically motivated algebraic constraint on the quantum dynamics, in relation to quantum entanglement, i.e. the existence of statistical correlations which can not be accounted for by classical probability. We then study the entanglement power of heat baths versus their decohering properties, a topic of increasing importance in the framework of the fast developing fields of quantum information, communication and computation. The presentation is self contained and, through several examples, it offers a detailed survey of the physics and of the most relevant and used techniques relative to both quantum open system dynamics and quantum entanglement.Comment: LaTex, 77 page

Elotuzumab plus pomalidomide and dexamethasone in relapsed/refractory multiple myeloma: a multicenter, retrospective real-world experience with 200 cases outside of controlled clinical trials

In the ELOQUENT-3 trial, the combination of elotuzumab, pomalidomide and dexamethasone (EloPd) proved a superior clinical benefit over Pd with a manageable toxicity profile, leading to its approval in relapsed/refractory multiple myeloma (RRMM), who had received at least two prior therapies, including lenalidomide and a proteasome inhibitor (PI). We report here a real-world experience of 200 RRMMs treated with EloPd in 35 Italian centers outside of clinical trials. In our dataset, the median number of prior lines of therapy was 2, with 51% of cases undergoing autologous stem cell transplant (ASCT) and 73% exposed to daratumumab. After a median follow-up of 9 months, 126 patients stopped EloPd, most of them (88.9%) because of disease progression. The overall response rate (ORR) was 55.4%, in line with the pivotal trial results. Regarding adverse events, our cohort experienced a toxicity profile similar to the ELOQUENT-3 trial, with no significant differences between younger (&lt;70 years) and older patients. The median progression-free survival (PFS) was 7 months, shorter than that observed in the ELOQUENT-3, probably due to the different clinical characteristics of the two cohorts. Interestingly, the ISS stage III (HR:2.55) was associated with worse PFS. Finally, our series's median overall survival (OS) was shorter than that observed in the ELOQUENT-3 trial (17.5 versus 29.8 months). In conclusion, our real-world study confirms EloPd as a safe and possible therapeutic choice for RRMM who received at least two prior therapies, including lenalidomide and a PI