Effects of Dietary Fibers on Short-Chain Fatty Acids and Gut Microbiota Composition in Healthy Adults: A Systematic Review

There is an increasing interest in investigating dietary strategies able to modulate the gut microbial ecosystem which, in turn, may play a key role in human health. Dietary fibers (DFs) are widely recognized as molecules with prebiotic effects. The main objective of this systematic review was to: (i) analyze the results available on the impact of DF intervention on short chain fatty acids (SCFAs) production; (ii) evaluate the interplay between the type of DF intervention, the gut microbiota composition and its metabolic activities, and any other health associated outcome evaluated in the host. To this aim, initially, a comprehensive database of literature on human intervention studies assessing the effect of confirmed and candidate prebiotics on the microbial ecosystem was developed. Subsequently, studies performed on DFs and analyzing at least the impact on SCFA levels were extracted from the database. A total of 44 studies from 42 manuscripts were selected for the analysis. Among the different types of fiber, inulin was the DF investigated the most (n = 11). Regarding the results obtained on the ability of fiber to modulate total SCFAs, seven studies reported a significant increase, while no significant changes were reported in five studies, depending on the analytical methodology used. A total of 26 studies did not show significant differences in individual SCFAs, while the others reported significant differences for one or more SCFAs. The effect of DF interventions on the SCFA profile seemed to be strictly dependent on the dose and the type and structure of DFs. Overall, these results underline that, although affecting microbiota composition and derived metabolites, DFs do not produce univocal significant increase in SCFA levels in apparently healthy adults. In this regard, several factors (i.e., related to the study protocols and analytical methods) have been identified that could have affected the results obtained in the studies evaluated. Future studies are needed to better elucidate the relationship between DFs and gut microbiota in terms of SCFA production and impact on health-related markers

Impact of Safety-Related Dose Reductions or Discontinuations on Sustained Virologic Response in HCV-Infected Patients: Results from the GUARD-C Cohort.

BACKGROUND: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. METHODS: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. RESULTS: SVR24 rates were 46.1% (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1, 2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced ≥1 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with ≥1 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not ≥5. CONCLUSIONS: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginterferon alfa-2a/ribavirin.This study was sponsored by F. Hoffmann-La Roche Ltd, Basel, Switzerland. Support for third-party writing assistance for this manuscript, furnished by Blair Jarvis MSc, ELS, of Health Interactions, was provided by F. Hoffmann-La Roche Ltd, Basel, Switzerland

Impact of safety-related dose reductions or discontinuations on sustained virologic response in HCV-infected patients: Results from the GUARD-C Cohort

Background: Despite the introduction of direct-acting antiviral agents for chronic hepatitis C virus (HCV) infection, peginterferon alfa/ribavirin remains relevant in many resource-constrained settings. The non-randomized GUARD-C cohort investigated baseline predictors of safety-related dose reductions or discontinuations (sr-RD) and their impact on sustained virologic response (SVR) in patients receiving peginterferon alfa/ribavirin in routine practice. Methods: A total of 3181 HCV-mono-infected treatment-naive patients were assigned to 24 or 48 weeks of peginterferon alfa/ribavirin by their physician. Patients were categorized by time-to-first sr-RD (Week 4/12). Detailed analyses of the impact of sr-RD on SVR24 (HCV RNA <50 IU/mL) were conducted in 951 Caucasian, noncirrhotic genotype (G)1 patients assigned to peginterferon alfa-2a/ribavirin for 48 weeks. The probability of SVR24 was identified by a baseline scoring system (range: 0-9 points) on which scores of 5 to 9 and <5 represent high and low probability of SVR24, respectively. Results: SVR24 rates were 46.1 % (754/1634), 77.1% (279/362), 68.0% (514/756), and 51.3% (203/396), respectively, in G1,2, 3, and 4 patients. Overall, 16.9% and 21.8% patients experienced 651 sr-RD for peginterferon alfa and ribavirin, respectively. Among Caucasian noncirrhotic G1 patients: female sex, lower body mass index, pre-existing cardiovascular/pulmonary disease, and low hematological indices were prognostic factors of sr-RD; SVR24 was lower in patients with 651 vs. no sr-RD by Week 4 (37.9% vs. 54.4%; P = 0.0046) and Week 12 (41.7% vs. 55.3%; P = 0.0016); sr-RD by Week 4/12 significantly reduced SVR24 in patients with scores <5 but not 655. Conclusions: In conclusion, sr-RD to peginterferon alfa-2a/ribavirin significantly impacts on SVR24 rates in treatment-naive G1 noncirrhotic Caucasian patients. Baseline characteristics can help select patients with a high probability of SVR24 and a low probability of sr-RD with peginter-feron alfa-2a/ribavirin

Efficient Consumer Response nell'area logistica

Questo lavoro vuole offrire un contributo su attualit\ue0, risultati, vantaggi, limiti e vincoli dell\u2019applicazione dell\u2019approccio Efficient Consumer Response (ECR) nell\u2019area logistica del settore dei beni di largo consumo in Italia, attraverso l\u2019analisi della recente esperienza del Gruppo PAM. Richiamati i principali motivi che hanno spinto alla costituzione di ECR Italia, il lavoro presenta cinque progetti realizzati presso il Gruppo PAM, il cui filo conduttore \ue8 la riduzione dei costi logistici e il miglioramento del servizio offerto, tramite l\u2019ottimizzazione dei processi in un\u2019ottica supply chain mangement. Dallo studio emerge come far proprio e cercare di realizzare lo \u201cspirito ECR\u201d comporti non solo importanti recuperi di efficienza nella logistica d\u2019interfaccia fra Produttore e Distributore, riduzione dei lead time, e diminuzione delle rotture di stock, ma, soprattutto, una nuova mentalit\ue0 collaborativa per ripensare la logistica dell\u2019intero canale distributivo

Global competitiveness in the textile industry: Any strategy beyond lowering costs?

The European textile-apparel industry has recently undergone major changes, due to increased competition from low cost, emerging countries and changes in the international division of labour. Most companies have globalised their supply chains, either sourcing components from around the world, or moving manufacturing to East Europe or East Asia. This paper analyzes how the Italian textile industry has been trying to contain the effects of globalisation. Using a variety of data sources and on the basis of extensive field work, the paper offers some insights on possible strategies to remain competitive in such a global and mature industry: a) high qualifying product and service offer, guaranteeing quality, reactivity and innovation; b) outsourcing and global supply chain re-designing. The paper argues that only companies able to couple lean and agile supply chain structures, thus solving the trade-offs between the corresponding design and management principles, are likely to remain competitive in the futur

Comparison of chairs based on HDsEMG of back muscles, biomechanical and comfort indices, for violin and viola players: A short-term study

This work investigates the effect of different seats on violin and viola players sitting postures using High-Density-surface-Electromyography techniques (HDsEMG), biomechanical and comfort indices. Five types of chairs were assessed on 18 violin and three viola players by comparing: (a) pelvic tilt and kyphosis and lordosis angles, (b) subjective comfort indices, and (c) EMG amplitude of erector spinae and trapezius. Sitting “as you like” on a standard orchestra chair is the condition with the highest subjective comfort (but not significantly different from other chairs). A saddle chair with low back support is associated to the lowest EMG of the erector spinae (p < 0.05) and a saddle stool is associated to the spinal angles closest to those of the standing posture. In 12 out of 21 (57%) musicians, the erector spinae was activated in an intermittent manner, regardless of the chair used. These findings justify further research on the selected chairs, on muscle fatigue and on the intermittent postural control strategy

Stroke non emorragico, di possibile origine aortoembolica, in corso di infarto miocardico acuto trattato con trombolisi

Stroke non emorragico, di possibile origine aortoembolica, in corso di infarto miocardico acuto trattato con trombolis