Milk metagenomics and cheese-making properties as affected by indoor farming and summer highland grazing

The study of the complex relationships between milk metagenomics and milk composition and cheese-making efficiency as affected by indoor farming and summer highland grazing was the aim of the present work. The experimental design considered monthly sampling (over 5 mo) of the milk produced by 12 Brown Swiss cows divided into 2 groups: the first remained on a lowland indoor farm from June to October, and the second was moved to highland pastures in July and then returned to the lowland farm in September. The resulting 60 milk samples (2 kg each) were used to analyze milk composition, milk coagulation, curd firming, and syneresis processes, and to make individual model cheeses to measure cheese yields and nutrient recoveries in the cheese. After DNA extraction and Illumina Miseq sequencing, milk microbiota amplicons were also processed by means of an open-source pipeline called Quantitative Insights Into Microbial Ecology (Qiime2, version 2018.2; https://qiime2.org). Out of a total of 44 taxa analyzed, 13 bacterial taxa were considered important for the dairy industry (lactic acid bacteria, LAB, 5 taxa; and spoilage bacteria, 4) and for human (other probiotics, 2) and animal health (pathogenic bacteria, 2). The results revealed the transhumant group of cows transferred to summer highland pastures showed an increase in almost all the LAB taxa, bifidobacteria, and propionibacteria, and a reduction in spoilage taxa. All the metagenomic changes disappeared when the transhumant cows were moved back to the permanent indoor farm. The relationships between 17 microbial traits and 30 compositional and technological milk traits were investigated through analysis of correlation and latent explanatory factor analysis. Eight latent factors were identified, explaining 75.3% of the total variance, 2 of which were mainly based on microbial traits: pro-dairy bacteria (14% of total variance, improving during summer pasturing) and pathogenic bacteria (6.0% of total variance). Some bacterial traits contributed to other compositional-technological latent factors (gelation, udder health, and caseins)

The ISTH DIC-score predicts early mortality in patients with non-promyelocitic acute myeloid leukemia

coagulation disorders frequently complicate the clinical course of acute myeloid leukemia (AML) patients. this study examined the frequency and prognostic significance, with regards of early mortality, of the presence of overt disseminated intravascular coagulation (DIC) at AML diagnosis and its correlation with clinical and biological characteristics. a retrospective analysis of 351 newly diagnosed non-promyelocytic AML patients was conducted, utilizing the 2018 ISTH DIC-Score criteria to evaluate the presence of overt DIC at AML onset. the study cohort had a median age of 65 years with a predominance of male gender (59%). overt DIC was present in 21% of cases and was associated with advanced age, comorbidities, poor performance status, hyperleukocytosis, LDH levels, NPM1 mutations, expression of CD33 and CD4, and lack of expression of CD34. With a median follow-up of 72 months (3–147 months), the 6-year overall survival (OS) was 17.4%, with patients having overt DIC showing significantly poorer outcomes (7.2% compared to 20.3 % of those without DIC, p < 0.001). patients with overt DIC showed markedly high early mortality rates at 30 (42.5% vs 8 %), 60 (49.3% vs 16.9%), and 120 days (64.4% vs 25.6%) from disease onset. In multivariate analysis overt DIC retained its independent prognostic value for early mortality. In conclusion, the prevalence and clinical relevance of DIC in non-promyelocytic AML is not negligible, underlining its potential as an unfavorable prognostic marker. In newly diagnosed patients with AML, early recognition and measure to counteract coagulation disturbances might help mitigate the elevated mortality risk associated with DIC

ACUTE LEUKEMIA AND LATENT TUBERCULOSIS INFECTION IN ITALY: QUANTIFERON-TB TEST SCREENING IN A LOW TUBERCULOSIS INCIDENCE COUNTRY

background: identification of latent tuberculosis infection (LTBI) is a critical step of tuberculosis surveillance, especially in low-incidence countries. however, it is limited to situations with a higher probability of developing active disease, e.g., patients with hematological malignancies. according to guidelines, in TB non-endemic countries, no clear screening program is established at diagnosis for patients with acute leukemia (AL). the primary endpoint of this study was to establish the prevalence of LTBI in patients with a diagnosis of AL using quanti FERON (QFT)-TB. Secondarily, radiological and clinical features driving the increased risk of LTBI were evaluated. methods: QFT-TB screening was performed before induction or consolidation in all patients with AL (myeloid and lymphoid) treated at our Institution between october 2019 and august 2023. results: we accrued 62 patients, of whom 7 (11,3%) tested positive, without any symptoms or signs of active TB, and 2 (3,2%) resulted as indeterminate. all positive patients started prophylaxis with isoniazid 300 mg daily, while patients whose test was indeterminate did not receive any prophylaxis. active TB was excluded by imaging, as well as microscopic, cultural, and molecular examination on bronchoalveolar lavage if signs of any infection were detected. during the 46 months of observation, no patients developed TB reactivation. conclusions: despite the low sample size, 1/10 of our patients had prior TB exposure, hinting that LTBI could be more common than expected in italy. this finding suggests implementing TB screening in the pre-treatment setting, particularly at a time when more active treatments are becoming available also for patients ineligible for intensive chemotherapy

PRÓTESES ARTICULARES: UMA REVISÃO INTEGRATIVA ACERCA DAS COMPLICAÇÕES E RISCOS

Joint replacement surgery is a significant milestone in orthopedic medicine, offering a valuable solution for patients suffering from chronic pain and loss of mobility due to debilitating joint conditions. These prostheses, designed to replace damaged or compromised joints, represent an effective approach to restoring function, relieving discomfort and improving quality of life. This article consists of an integrative review, in which it aims to discuss the complications and risks of joint prostheses, through considerations about them and their recovery and rehabilitation, in order to expand the knowledge of students and professionals in the area on the subject. in question. The work consists of an integrative literature review, in which a search was carried out in the databases. The use of joint prostheses is a notable achievement in orthopedic medicine, providing pain relief and restoration of mobility for countless patients. However, as with any medical procedure, there are complications and risks associated with these medical devices that must be fully understood and considered. In short, joint prostheses are a remarkable achievement in orthopedic medicine, offering pain relief and restoration of mobility for patients with debilitating joint conditions. However, the success of these medical devices depends on understanding the indications, choosing appropriate types and materials, performing an accurate surgical procedure, effective rehabilitation, and careful management of the associated risks and complications.A cirurgia de implantação de próteses articulares é um marco significativo na medicina ortopédica, oferecendo uma solução valiosa para pacientes que sofrem de dor crônica e perda de mobilidade devido a condições articulares debilitantes. Essas próteses, projetadas para substituir articulações danificadas ou comprometidas, representam uma abordagem eficaz para restaurar a função, aliviar o desconforto e melhorar a qualidade de vida. O presente artigo consiste em uma revisão integrativa, no qual tem como objetivo discorrer acerca das complicações e riscos das próteses articulares, mediante considerações sobre as mesmas e sua recuperação e reabilitação, no intuito de ampliar os conhecimentos de estudantes e profissionais da área acerca do tema em questão. O trabalho consiste em uma revisão de literatura do tipo integrativa, na qual foi realizada uma pesquisa nas bases de dados. A utilização de próteses articulares é uma notável conquista da medicina ortopédica, proporcionando alívio da dor e restauração da mobilidade para inúmeros pacientes. No entanto, como em qualquer procedimento médico, existem complicações e riscos associados a esses dispositivos médicos que devem ser compreendidos e considerados de forma abrangente. Em suma, as próteses articulares são uma notável conquista da medicina ortopédica, oferecendo alívio da dor e restauração da mobilidade para pacientes com condições articulares debilitantes. No entanto, o sucesso desses dispositivos médicos depende da compreensão das indicações, da escolha adequada dos tipos e materiais, da realização de um procedimento cirúrgico preciso, de uma reabilitação eficaz e da gestão cuidadosa dos riscos e complicações associados

Outcomes of pregnancies after kidney transplantation: lessons learned from CKD. A comparison of transplanted, nontransplanted chronic kidney disease patients and low-risk pregnancies: a multicenter nationwide analysis.

BACKGROUND: Kidney transplantation (KT) may restore fertility in CKD. The reasons why materno-foetal outcomes are still inferior to the overall population are only partially known. Comparison with the CKD population may offer some useful insights for management and counselling.Aim of this study was to analyse the outcomes of pregnancy after KT, compared with a large population of non-transplanted CKD patients and with low-risk control pregnancies, observed in Italy the new millennium. METHODS: We selected 121 live-born singletons after KT (Italian study group of kidney in pregnancy, national coverage about 75%), 610 live-born singletons in CKD and 1418 low-risk controls recruited in 2 large Italian Units, in the same period (2000-2014). The following outcomes were considered: maternal and foetal death; malformations; preterm delivery; small for gestational age baby (SGA); need for the neonatal intensive care unit (NICU); doubling of serum creatinine or increase in CKD stage. Data were analysed according to kidney diseases, renal function (staging according to CKD-EPI), hypertension, maternal age, partity, ethnicity. RESULTS: Materno-foetal outcomes are less favourable in CKD and KT as compared with the low-risk population. CKD stage and hypertension are important determinants of results. KT patients with e-GFR >90 have worse outcomes compared with CKD stage 1 patients; the differences level off when only CKD patients affected by glomerulonephritis or systemic diseases ('progressive CKD') are compared with KT. In the multivariate analysis, risk for preterm and early-preterm delivery was linked to CKD stage (2-5 versus 1: RR 3.42 and 3.78) and hypertension (RR 3.68 and 3.16) while no difference was associated with being a KT or a CKD patient. CONCLUSIONS: The materno-foetal outcomes in patients with kidney transplantation are comparable with those of nontransplanted CKD patients with similar levels of kidney function impairment and progressive and/or immunologic kidney diseas

Metagenomic approach to rumen, intestine and milk in relation to the environment and quality of products: the summer alpine transhumance: a case study

Transhumance is an ancient practice of pastoralism that consists of the seasonal migration of herds and shepherds in the Mediterranean and the Alps, usually in the mountainous regions there is a vertical transhumance of livestock as there is a change in altitude. It begins with the ascent to high altitude, between late May and mid-June, and ends with the moving back to the valley floor or plains in midSeptember. This herding practice shapes the relationships between people, animals, and ecosystems; it has played a key role in proper landscape management, biodiversity conservation, soil protection, and maintenance of traditions. Transhumant herders have an in-depth knowledge of the environment, ecological balance and climate change, as well as the types of handicrafts and food production that result from them; in fact, it is one of the most efficient farming methods, while coping with lower average temperature, shorter growing season, greater soil slopes, lower soil fertility and the need for longer working time. By itself, mountain animal husbandry is defined as multifunctional and multidisciplinary, it is able in addition to integrating the environmental aspect also the economic aspect that reflects on tourism and social culture of the place, still ensuring the maintenance and vitality of the mountain. The analysis of the inter-relationships among environment, pastures, animals, and food obtained is fundamental for improving our knowledge on this complex mountain farming system. Metagenomic is a recent approach, with an increasing interest, used to study the complexity of microbial populations in different sectors. Metagenomics is combined with culture-dependent methods for providing a better characterization and understanding of the microbial communities in a lot of biological samples. In dairy cows, metagenomics has been used in several studies on the microbiota of rumen, and intestinal content, and of milk and cheese. Often these studies are sectorial, analysing only one of the matrices and without identifying the relationships between the matrix studied and the others or the quality traits of food products. Therefore, the present dissertation as a general objective aims to study the metagenomics of rumen and intestinal contents on one side and metagenomics and quality of milk produced on the other side in relation to transhumance to highland pasture (and return to lowlands) as a case study. Specifically, the first two contributions (Juribello project) aim to study in detail the ruminal microbiota, the first, and the milk microbiota, the second sampled contemporarily on the same cows. In these two groups of cows from the same lowland farm were compared: a group that was moved to highland summer pastures and again to lowland, and a second (control) group that remains in indoor housing for the entire duration of the trial (June to October with monthly samplings). In the first contribution, the complex relationships among the end products of rumen fermentation, the predicted methane production, the microbiological count and the rumen metagenomics traits were investigated. While in the second contribution, the possible relationships between milk microbiota and milk quality and technological properties were studied. Special focus was reserved to bacterial taxa related to specific activities, such as cheese-making, health maintenance, milk spoilage and pathogenesis. The third and fourth contributions (Vezzena Project), on the other hand, concerns the comparison of milk from 26 cows from 4 herds during summer highland pasture and then later during indoor housing in valley floor farms. In the third contribution, individual milk metagenomics was associated with milk composition and quality, udder health, milk B vitamin content and microbiological counts. Finally, the fourth and last contribution aimed at evaluating the relationship between intestinal metagenomics and milk quality and metagenomics on the same herds and cows during the summer Alpine transhumance, and after returning to the lowland permanent valley farm. In all the 4 contributions, the microbiological, chemical and technological traits analyzed were studied one at a time, but also all together with a multivariate approach. Firstly, the heat-maps of the correlations among the analysed traits were obtained and discussed. But the large number of traits considered in each of the 4 contributions suggested the need of identifying few independent latent explanatory factors responsible of the complex relationships among the many traits analysed. Overall, the results of the thesis offer interesting point of view on the evolution of the microbiome of dairy cattle in 3 mountain areas, starting from the practice of summer transhumance, the different changes of pastures, animals’ physiology and behaviour and getting to the final products such as milk and cheese, passing through the microbial evolutions of rumen an intestinal contents. The use of this innovative approach that compares livestock data with microbiology has highlighted even more the various possible connections and interactions between the surrounding farming environment, animals and consequently the final products. The various future perspectives merit in-depth analysis and interpretations of new possible interconnections between the microorganisms (bacteria) and the other animal compartment (rumen content, intestinal content and milk) considered within this thesis and microorganisms (yeasts) and products (cheese) not included here (but under analysis

LO STILE DI VITA COME FATTORE DI RISCHIO E DI PREVENZIONE DEL CANCRO AL COLON-RETTO

L'elaborato si propone di esaminare diversi aspetti del cancro al colon-retto (CRC) quindi tratta inizialmente l’epidemiologia: l’incidenza, la mortalità e la prevalenza del CRC a livello globale. Sono stimati 1,93 milioni di nuovi casi di CRC nel 2020 in tutto il mondo, rappresentando il 10.7% dell'incidenza globale del cancro (18,09 milioni di nuovi casi): è il secondo tumore al mondo per incidenza. Il CRC è la terza causa di decessi per cancro in entrambi i sessi nel mondo, stimati a 935.173 decessi totali nel 2020 e oggi più di 5,25 milioni (prevalenza a 5 anni) di persone in tutto il mondo convivono con il CRC. La relazione analizza successivamente come si sviluppa la patologia e quali sono i relativi fattori di rischio: genetici come la poliposi adenomatosa familiare (FAP) e il cancro colorettale ereditario non poliposico (HNPCC, anche detto sindrome di Lynch), ambientali come la sedentarietà, il sovrappeso e l’obesità, il fumo e l’alcol, l’alimentazione e altri fattori come le malattie infiammatorie croniche intestinali (IBD) e la presenza di polipi adenomatosi. L'analisi si focalizza sulla carne rossa e lavorata: l'Agenzia internazionale per la ricerca sul cancro (IARC) ha classificato la carne lavorata come cancerogena per l'uomo (Gruppo 1) e il consumo di carne rossa come probabilmente cancerogeno per l'uomo (Gruppo 2A). La trattazione si concentra infine sulla prevenzione primaria della patologia incentrata sullo stile di vita che comprende una regolare attività fisica e un mantenimento del corretto peso corporeo, un’aderenza alla dieta mediterranea ricca di fibre, acidi grassi polinsaturi e micronutrienti come calcio e vitamina D. In particolare, secondo il World Cancer Research Fund (WCRF), il consumo di cereali integrali, di cibi contenenti fibre alimentari (frutta, verdura, legumi) quindi alimenti alla base della dieta mediterranea e di latticini quindi alimenti il cui consumo consigliato è giornaliero, riduce il rischio di cancro al colon-retto mentre il consumo di pesce e di cibi contenenti vitamina D potrebbe ridurre il rischio di cancro al colon-retto. Gli obiettivi degli studi futuri sono la ricerca di nuove vie coinvolte nella carcinogenesi e di nuovi modi per aumentare l'efficacia della prevenzione e ridurre quindi al minimo la tossicità del tumore. L'esame per la ricerca del sangue occulto nelle feci (SOF) per tutti gli individui tra i 50 e i 70 anni di età resta comunque uno dei metodi primari per la prevenzione del cancro al colon-retto: un programma di screening permette di tenere sotto controllo la salute del colon e del retto e aumenta in modo esponenziale le possibilità di arrivare a una diagnosi precoce del tumore, migliorando di conseguenza anche le possibilità di cura. L’adesione a questi programmi di screening, tuttavia, va sempre affiancata a uno stile di vita sano

Random domain decompositions for object-oriented Kriging over complex domains

We propose a new methodology for the analysis of spatial fields of object data distributed over complex domains. Our approach enables to jointly handle both data and domain complexities, through a divide et impera approach. As a key element of innovation, we propose to use a random domain decomposition, whose realizations define sets of homogeneous sub-regions where to perform simple, independent, weak local analyses (divide), eventually aggregated into a final strong one (impera). In this broad framework, the complexity of the domain (e.g., strong concavities, holes or barriers) can be accounted for by defining its partitions on the basis of a suitable metric, which allows to properly represent the adjacency relationships among the complex data (such as scalar, functional or constrained data) over the domain. As an illustration of the potential of the methodology, we consider the analysis and spatial prediction (Kriging) of the probability density function of dissolved oxygen in the Chesapeake Bay

Metagenomics of milk before, during and after summer transhumance to highland pasture in relation to human health and cheese making properties

Summer transhumance is a traditional form of pastoralism to highland pasture in the dairy system of alpine regions and it is practiced all over the world. Positive influences can be obtained for the environment, society, tourism, animal health and welfare. The aim of this study was to analyze the evolution of the milk microbiota before, during, and after summer transhumance to highland pasture in relation to possible effects on animal / human health and cheese-making properties. The study involved 12 healthy, multiparous, mid-lactation Brown Swiss cows reared in a farm located in the Trento province (Northern East Italy). The cows were monitored from June to October and divided into two groups: six cows were used as a control group and kept in the lowland permanent farm (PF); the other six cows were moved to a temporary alpine farm (ALP) from July to September. From each milk, samples were collected every four weeks for genomic DNA extraction and microbiota characterization using community 16S rRNA amplicon (V3\u2013V4 region) based Illumina Miseq sequencing and QIIME2 (2018.2 version). The relative abundance was analyzed after a log10 transformation and identified species were classified into two unfavorable categories: Spoilage and Pathogenic species, and two favorable categories: Probiotics and Dairy species. For the statistical analysis, we used a linear mixed model, where the combined Month 7 Group (MG) effect was used as fixed and the cow effect as random. The results revealed a different behavior in the ALP group compared to the PF group during the 3 months of summer transhumance. The Spoilage bacteria tended to decrease in the alpine pasture (MG effect: p < .001), with significant differences in terms of Pseudomonas, Alicyclobacillus, and Clostridiales (p < .001, p < .001, p < .05 respectively). Pathogenic did not show large differences between the two groups; instead, the Probiotic category, which includes Propionibacterium and Bifidobacterium, showed a gradual increase in the ALP group (p < .001). Dairy species also had a significant increase in the ALP group (p < .001), especially Lactococcus and Lactobacillus (both p < .001). All the microbiological changes disappeared when cows were moved back from alpine pasture to the permanent indoor farm. Summer transhumance to alpine pasture, therefore, has a favorable effect on the milk microbiota, with positive implications for both the cheese-making attitude of milk produced and its possible effect on human health