Are Linoleic Acid Supplements Beneficial in Increasing Growth in Pediatric Cystic Fibrosis Patients?

OBJECTIVE: The objective of this selective EBM review is to determine “Are linoleic acid supplements beneficial in increasing growth in pediatric cystic fibrosis patients?” STUDY DESIGN: Review of three English primary studies published between 1995 and 2000. DATA SOURCES: Two randomized control trial and one controlled clinical trial were used. Studies were found using PubMed and Cochrane Databases. OUTCOMES MEASURED: Primary outcomes measured include the taste, smell, and appearance of the supplement and the growth of the cystic fibrosis patients. RESULTS: In Steinkamp G, Demmelmair et al., the treatment group grew in its weight-for-height; whereas, there was no change in the growth/ body weight of the control group. Furthermore, the treatment group had an overall weight gain of 1.2 kg. In van Egmond et al., the participants using the supplement with more linoleic acid grew better than those using a supplement with less linoleic acid. In Rettammel AL, Marcus MS et al, fifteen of the twenty-four participants used an oral supplement before and ten of those individuals preferred this supplement. The supplement was well tolerated with fourteen participants preferring the taste of the supplement; however, seven participants thought the supplement was inconvenient and reported that the supplement was difficult to reconstitute. CONCLUSIONS: The results of the two randomized control trials and a controlled clinical trial demonstrated that linoleic acid supplements increase growth in pediatric cystic fibrosis individuals. Future study is warranted to evaluate the proper amount of linoleic acid needed to increase growth, and different techniques need to be carried out in order to improve the taste and convenience of the supplement. The trials were not double blind studies and had a small sample size, which may have limited the data formulated

Direct-acting antivirals and visceral leishmaniasis: A case report

Background: Visceral leishmaniasis is a vector-borne parasitic disease caused by protozoa belonging to the genus Leishmania. The clinical presentation of visceral leishmaniasis strictly depends on the host immunocompetency, whereas depressive conditions of the immune system impair the capability to resolve the infection and allow reactivation from sites of latency of the parasite. Case presentation: We describe a case of visceral leishmaniasis (VL) that occurred in a patient with chronic hepatitis C treated with direct-acting antiviral drugs (DAA). The hypothesized mechanism is the alteration of protective inflammation mechanisms secondary to DAA therapy. Downregulation of type II and III IFNs, their receptors, which accompany HCV clearance achieved during treatment with sofosbuvir and ribavirin might have a negative impact on a risk for reactivation of a previous Leishmania infection. We know indeed that IFN-\u3b3 is important to enhance killing mechanisms in macrophages, which are the primary target cells of Leishmania. Conclusion: Since VL is endemic in Sicily as well as in other countries of the Mediterranean basin, physicians should be aware of the possible unmasking of cryptic Leishmania infection by DAAs

New Piperidine alkaloids from fire ants are not sequestered by the green and black poison frog ( Dendrobates auratus )

Neotropical poison frogs possess alkaloid-based antipredator defenses which they sequester from a diet of arthropods such as oribatid mites and myrmicine ants. Alkaloid sequestration is still poorly understood and although several studies have examined its uptake, most experiments directly feed alkaloids to the frogs. Here, we examined the alkaloid uptake system in the poison frog species Dendrobates auratus by feeding it an alkaloid-containing prey item, the red imported fire ant Solenopsis invicta (Formicidae, Myrmicinae). Captive bred frogs were either fed live ants or fruit flies dusted with powdered ants for 4 months. Using GC–MS, we confirm that S. invicta contain previously described piperidine alkaloids known as solenopsins; however, none of these piperidine alkaloids was detected in the skin of D. auratus, suggesting the frogs are incapable of sequestering solenopsins from S. invicta. It is possible that D. auratus are unable to sequester fire ant piperidines due to their long hydrocarbon side chains, a feature that makes them structurally different than most known alkaloids in poison frogs

Regionalization of ports as a strategic leverage to improve competitiveness. A study on central italy ports and related hinterland

Nowadays, the success of a maritime port does not depend anymore on its traditional intrinsic points of strength, such as the internal capacity, but also on its ability to effectively integrate the development of its hinterland into business relations and supply chains. Mediterranean ports can get competitive, if specific "regionalization" processes are launched and supported. Key point for this strategy is the hinterland involvement: logistics and transports integration, railways, realization and development of dryports, terminals, distribution centres. All these are core elements for this purpose. The overall focus has changed from port performances to performance of the entire supply chain in the port-hinterland relationship. This is what it is going to do the Port of Civitavecchia, the most important port in Lazio Region, would like to become the central point into commercial, industrial and infrastructural development of central Italy. The development of railway terminal and of regional road network for the developing of intermodal logistics chain, of the industrial port activities (shipbuilding sector and oil bunkering), of trade relations with Fiumicino Airport and with the roman agroindustrial sector, of logistics relations with the dryport of Orte and with the intermodal terminal (road-railway) of Pomezia Santa Palomba, are some of the activities planned and undertaken by the port for improving the regionalization of Civitavecchia. Aim of this paper is to show and underline how these regionalization processes can increase the development, and so benefit the entire regional hinterland and the competitiveness and attraction of the entire port system. A model to estimate the regionalization effect has been designed by the authors and implemented to make a comparison analysis between Civitavecchia and competing ports. © 2021 Georg Thieme Verlag. All rights reserved

Ontogenetic colour change in Oreophryne ezra (Anura: Microhylidae) reflects an unusual shift from conspicuousness to crypsis but not in toxicity

Ontogenetic colour change (OCC) may signal a switch in defensive strategies across development. Commonly, juveniles use cryptic colours and transition to conspicuous coloration as adults. Extensive theoretical and empirical work suggest such a transition is more likely than the converse. Oreophryne ezra, a newly discovered frog from New Guinea, however, undergoes OCC that belies expectations. We investigated the notion juveniles are aposematic while the adults use crypsis. We quantified the extent of conspicuousness of O. ezra across life stages using spectrophotometry and models of avian vision; and analysed skin extracts for the presence of toxic alkaloids. As predicted, the juvenile colour patterns were estimated to be conspicuous to likely predators against the frogs natural viewing backgrounds, while adults consistently fell below the threshold of discriminability. However, we discovered no alkaloids in either juveniles or adults. This suggests the juveniles use alternative defensive chemicals, or the colour pattern has an alternative origin – to which we offer the hypothesis that juvenile frogs may be Batesian mimics of a synoptic species of weevil. This study highlights the potential for this system, and others like it, to inform our understanding of the adaptive significance of OCC and the selective drivers for different anti-predatory strategies

Contact between the components of a knee prosthesis: numerical and experimental study

The aim of this work is the analysis of the contact area in a knee prosthesis using two different approaches. In particular, the interface between the femoral component and the polyethylene insert has been studied both numerically and experimentally. The interest in studying the contact area is related to the fact that the wear of the polyethylene insert, due to the high contact pressures, represents one of the major causes of failure of the total knee prosthesis. The possibility to evaluate the contact area at different loads and mutual position between femur and tibia is, therefore, of fundamental importance to study the service life of a prosthesis and to improve its performance. The finite element numerical approach has required the acquisition, through reverse engineering, and CAD modelling of the prosthetic components. Then the FEM simulations have been developed considering two different load conditions. In order to compare the calculated data, the same load configurations have been used for experimental tests based on ultrasonic method. In this case, some preliminary tests were required to calibrate the system depending on the particular characteristics of materials, geometries and surface finish of the prosthesis.The results show a good correlation between the data obtained with the two different approaches and, consequently, a good level of reliability of the procedures developed for the numerical and experimental evaluation of the contact area. The numerical procedure can be used to determine the area for different angles and loads, but especially in the design phase. The ultrasonic technique can be used to validate the numerical data

Sequestered Alkaloid Defenses in the Dendrobatid Poison Frog Oophaga pumilio Provide Variable Protection from Microbial Pathogens

Most amphibians produce their own defensive chemicals; however, poison frogs sequester their alkaloid-based defenses from dietary arthropods. Alkaloids function as a defense against predators, and certain types appear to inhibit microbial growth. Alkaloid defenses vary considerably among populations of poison frogs, reflecting geographic differences in availability of dietary arthropods. Consequently, environmentally driven differences in frog defenses may have significant implications regarding their protection against pathogens. While natural alkaloid mixtures in dendrobatid poison frogs have recently been shown to inhibit growth of non-pathogenic microbes, no studies have examined the effectiveness of alkaloids against microbes that infect these frogs. Herein, we examined how alkaloid defenses in the dendrobatid poison frog, Oophaga pumilio, affect growth of the known anuran pathogens Aeromonas hydrophila and Klebsiella pneumoniae. Frogs were collected from five locations throughout Costa Rica that are known to vary in their alkaloid profiles. Alkaloids were isolated from individual skins, and extracts were assayed against both pathogens. Microbe subcultures were inoculated with extracted alkaloids to create dose-response curves. Subsequent spectrophotometry and cell counting assays were used to assess growth inhibition. GC-MS was used to characterize and quantify alkaloids in frog extracts, and our results suggest that variation in alkaloid defenses lead to differences in inhibition of these pathogens. The present study provides the first evidence that alkaloid variation in a dendrobatid poison frog is associated with differences in inhibition of anuran pathogens, and offers further support that alkaloid defenses in poison frogs confer protection against both pathogens and predators

Contact between the components of a knee prosthesis: numerical and experimental study

The aim of this work is the analysis of the contact area in a knee prosthesis using two different approaches. In particular, the interface between the femoral component and the polyethylene insert has been studied both numerically and experimentally. The interest in studying the contact area is related to the fact that the wear of the polyethylene insert, due to the high contact pressures, represents one of the major causes of failure of the total knee prosthesis. The possibility to evaluate the contact area at different loads and mutual position between femur and tibia is, therefore, of fundamental importance to study the service life of a prosthesis and to improve its performance. The finite element numerical approach has required the acquisition, through reverse engineering, and CAD modelling of the prosthetic components. Then the FEM simulations have been developed considering two different load conditions. In order to compare the calculated data, the same load configurations have been used for experimental tests based on ultrasonic method. In this case, some preliminary tests were required to calibrate the system depending on the particular characteristics of materials, geometries and surface finish of the prosthesis.The results show a good correlation between the data obtained with the two different approaches and, consequently, a good level of reliability of the procedures developed for the numerical and experimental evaluation of the contact area. The numerical procedure can be used to determine the area for different angles and loads, but especially in the design phase. The ultrasonic technique can be used to validate the numerical data

Improving sustainable mobility in university campuses. The case study of Sapienza University

The pursue of sustainable mobility is one of the greatest environmental challenges nowadays. It requires a people mind shift, where the use of private vehicles give way to different modes of public transport like buses, bicycles, car sharing, electric cars, and walking lanes. This new call to make mobility sustainable has already been undertaken by policymakers and public managers in many urban contexts around the world, as well as, more recently, by the managers of university systems. The paper shows the work developed in 2018 for the Sapienza Sustainable University Mobility Plan (SUMP). The study stems from the need to understand and improve, in the sustainability direction, modes of travel for the students and staff of one of the oldest universities in the world, and one of the largest in Europe (112,142 students enrolled and 23,101 between academic staff and no academic staff), with its premises located in a complex and challenging urban context such as the city of Rome. The SUMP has been developed in two phases. The first one investigated travel patterns and the reasons for the modal shift and highlighted the main issues. The second phase defined strategies and interventions to be implemented in the short, medium, and long term to make students and staff's mobility more environmentally sustainable. The methodology used in the fact-finding stage was the online survey that was carried out through the use of a diversified questionnaire for staff and students of the University. The sample of students who participated in the survey amounted to 14,719 units, while the sample of faculty and staff was 9,403. The main questionnaire outcomes showed that the attitudes recorded were largely different between faculty and staff and students. While for the first ones the choice of private vehicles is the first option (36%), for students public transport is the prevailing preference (78%). According to the critical aspects found in this first stage, the SUMP objectives were defined, leading to the identification of macro-areas of intervention and specific actions. At a policy and strategic level, the attention was focused on the guidelines issued by the United Nations, the European Commission, and the Network of Universities for Sustainable Development, of which Sapienza University is a member. For this reason, the identification of strategies and interventions results from the combination of the first phase analysis, the Sapienza Governance objectives, and the national and international context in which the SUMP was drafted. Five macro-areas of intervention have been identified: Smart Strategies, Pedestrian Mobility, Cycling, Local Public Transport, Private Transport, and for each one specific intervention to be implemented in different time frames have been defined

An update of the evolving epidemic of blaKPC carrying Klebsiella pneumoniae in Sicily, Italy, 2014: Emergence of multiple Non-ST258 Clones

Background: In Italy, Klebsiella pneumoniae carbapenemase producing K. pneumoniae (KPC-Kp) strains are highly endemic and KPC producing CC258 is reported as the widely predominating clone. In Palermo, Italy, previous reports have confirmed this pattern. However, recent preliminary findings suggest that an epidemiological change is likely ongoing towards a polyclonal KPC-Kp spread. Here we present the results of molecular typing of 94 carbapenem non susceptible K. pneumoniae isolates detected during 2014 in the three different hospitals in Palermo, Italy. Methods and Results: Ninety-four consecutive, non replicate carbapenem non susceptible isolates were identified in the three largest acute general hospitals in Palermo, Italy, in the six-month period March-August 2014. They were characterized by PCR for β-lactam, aminoglycoside and plasmid mediated fluoroquinolone resistance genetic determinants. The mgrB gene of the colistin resistant isolates was amplified and sequenced. Clonality was assessed by pulsed field gel electrophoresis and multilocus sequence typing. Eight non-CC258 sequence types (STs) were identified accounting for 60% of isolates. In particular, ST307 and ST273 accounted for 29% and 18% of isolates. CC258 isolates were more frequently susceptible to gentamicin and non-CC258 isolates to amikacin. Colistin non susceptibility was found in 42% of isolates. Modifications of mgrB were found in 32 isolates. Conclusions: Concurrent clonal expansion of some STs and lateral transmission of genetic resistance determinants are likely producing a thorough change of the KPC-Kp epidemiology in Palermo, Italy. In our setting mgrB inactivation proved to substantially contribute to colistin resistance. Our findings suggest the need to continuously monitor the KPC-Kp epidemiology and to assess by a nationwide survey the possible shifting towards a polyclonal epidemic