Increasing appropriateness of hospital admissions in the Emilia-Romagna region of Italy.

OBJECTIVES: The Emilia-Romagna region of Italy has reduced the number of available hospital beds and introduced financial incentives to curb hospital use. The goal of this study was to assess the impact of these policies on changes over time in the number of acute hospital admissions classified in diagnosis related groups (DRGs) that could be treated safely and effectively in alternative, less costly settings. METHODS: The assessment of the appropriate site of care was based on analysis of hospital discharge data for all hospitals for the selected diagnosis related groups in the Emilia-Romagna region for 2001 to 2005. The necessity for acute hospital admission was based on the severity of a patient\u27s principal diagnosis, co-morbid diseases and, for surgical admissions, procedure performed. RESULTS: From 2001 to 2005, potentially inappropriate medical admissions of more than one day decreased from 20,076 to 11,580, a 42% decrease. Inappropriate admissions decreased in both public and private hospitals but there remained a higher rate of inappropriate admissions to private hospitals. Potentially inappropriate medical admissions accounted for 128,319 bed-days in 2001 and 68,968 bed-days in 2005, a reduction of 59,351 bed-days. Potentially inappropriate surgical admissions decreased from 7383 in 2001 to 4349 in 2005, a 41% decrease. Bed-days consumed by inappropriate surgical admissions decreased from 23,181 in 2001 to 13,660 in 2005. CONCLUSIONS: The Emilia-Romagna region has succeeded in reducing the use of acute hospital beds for patients in selected diagnosis related groups. However, there are still substantial numbers of admissions that could potentially be treated in less costly settings

R&D experiences on FPGAs and astronomical applications at IASF Milano

The paper describes R&D activities that were or are currently developed at the INAF - IASF Milano and that involve the usage of FPGAs for astrophysical applications. They span from the emulation of radiation induced faults in SRAM-based FPGAs to the development of a backend unit for the SKA low frequency antennas and astronomical detectors

Discrete Changes in Glucose Metabolism Define Aging

Aging is a physiological process in which multifactorial processes determine a progressive decline. Several alterations contribute to the aging process, including telomere shortening, oxidative stress, deregulated autophagy and epigenetic modifications. In some cases, these alterations are so linked with the aging process that it is possible predict the age of a person on the basis of the modification of one specific pathway, as proposed by Horwath and his aging clock based on DNA methylation. Because the energy metabolism changes are involved in the aging process, in this work, we propose a new aging clock based on the modifications of glucose catabolism. The biochemical analyses were performed on mononuclear cells isolated from peripheral blood, obtained from a healthy population with an age between 5 and 106 years. In particular, we have evaluated the oxidative phosphorylation function and efficiency, the ATP/AMP ratio, the lactate dehydrogenase activity and the malondialdehyde content. Further, based on these biochemical markers, we developed a machine learning-based mathematical model able to predict the age of an individual with a mean absolute error of approximately 9.7 years. This mathematical model represents a new non-invasive tool to evaluate and define the age of individuals and could be used to evaluate the effects of drugs or other treatments on the early aging or the rejuvenation

Spent espresso coffee grounds as a source of anti-proliferative and antioxidant compounds

Disposal of spent espresso coffee grounds (SCG) is costly and leads to the loss of bioactive compounds that could be fractionated, in several applications. This work aimed to investigate phenolic profile, tocopherols, and antioxidant and anti-proliferative activities of SCGs ethanolic extracts from coffee powders differing in coffee provenience and composition (arabica/robusta). Tyrosol, detected for the first time in SCGs, was the most abundant phenolic measured (121-1,084 mg/kg in the extract), along with 4-hydroxybenzoic acid and vanillin (885-1813 and 340-1103 mg/kg, respectively). Extract derived from 100% robusta from Guatemala (S7-R) showed the highest α- to ß-tocopherol ratio of 1.2 and the highest antioxidant potential as evidenced by RACI and GAS values of -0.43 and 0.20, respectively. Moreover, S7-R showed a promising anti-proliferative activity toward human lung carcinoma cells (A549), with IC50 value of 61.2 ug/mL comparable to that given by the positive control vinblastine (IC50 value of 67.3 ug/mL)

Adhesion of Immature and Mature T Cells Induces in Human Thymic Epithelial Cells (TEC) Activation of IL-6 Gene Trascription Factors (NF-κB And NF-IL6) and IL-6 Gene Expression : Role of αtβ1 and α6β4 Integrins

T cell precursors homed to thymus develop in close contact with stromal cells. Among them, thymic epithelial cells (TEC) are known to exert dominant roles in their survival and functional shaping. Key molecules mediating TEC/thymocytes interactions include cytokines and growth factors secreted by the two cell types and adhesion receptors mediating cell contact. Signaling events triggered in thymocytes by adhesion to epithelial cells have been extensively investigated, whereas little is known on the opposite phenomenon. We have previously investigated this issue in a co-culture system composed of TEC cultures derived from human normal thymus and heterologous thymocytes. We demonstrated that thymocytes adhere to TEC involving β1 and β4 integrins and induce the clustering of (α3β1 and α6β4 heterodimers at the TEC surface. In addition thymocyte adhesion was followed by activation of NF-κB and NF-IL6 gene transciption factors and enhanced IL-6 production. The two latter phenomena were reproduced by the cross-linking of the α3, α6, β1 and β4 integrins, thus implying that the α3β1 and α6β4 heterodimers can signal during thymocyte adhesion. We have extended our previous work investigating in the same experimental setting the inducing activity of non stimulated or activated policlonal or clonal mature T cells as representative of the more mature thymocyte subset. We found that adhesion of unstimulated T cell i) involved β1, but not β4 integrin functions at the surface ii) induced the clustering of α3β1 , but not α2β1 heterodimers at the TEC surface and iii) up-regulated the nuclear binding activity of NF-κB transcription factor and the IL-6 secretion. We propose that α3β1 and α6β4 heterodimers are induced to cluster at the TEC surface recognizing yet unknown cellular ligands differentially expressed during T cell development

How to improve the sensitivity of future neutrino mass experiments with thermal calorimeters

Abstract In this paper we discuss the perspectives for a new generation of neutrino mass experiments using thermal detectors to reach interesting sensitivities before and after the KATRIN experiment. By scaling the performance of the present Milano neutrino mass experiment with Monte Carlo simulations, we show how a new experiment can validate the present limit of few eV set by spectrometers before the KATRIN experiment starts. We also show how such a result can be used to design a very large thermal detector experiment to reach sensitivities beyond the KATRIN expected one

Nutritional counseling in childhood and adolescence: a systematic review

Healthy eating habits are the basis for good health status, especially for children and adolescents, when growth and development are still ongoing. Nutrition educational programs are essential to prevent and treat chronic diseases. Nutritional counseling (NC), as a collaborative process between the counselor and the client process, could help to achieve better outcomes. This review aims to collect information about the utilization of NC during childhood and adolescence and to highlight its possible impact on adherence/compliance rates, nutrition knowledge, status and dietary intake. The methods applied in this systematic review followed the instruction of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The search in PubMed/Medline, Scopus, Web of Science, LILACS, and Science Direct included observational or randomized studies. RoB 2.0 and Robins-I tools was used for the risk of bias assessment in randomized and non-randomized studies, respectively. The quality of evidence was checked by the Mixed Methods Appraisal Tool system. A total of 21 articles were selected, computing 4,345 individuals. 11 achieved at least 4 stars quality level. The highest risk of bias for randomized studies was related to the randomization process. 42.9% of non-randomized studies had some concerns of bias, mainly because of a lack of control of all confounding factors. Different strategies of NC were used in children and adolescents with positive results for health or diseases. NC strategies can be effectively used in children and adolescents. In general, NC showed benefits in pediatrics age for anthropometric or body composition parameters, dietary intake, nutrition knowledge and physical activity improvement. Performing NC in pediatrics is challenging due to the counseling strategies that must be adapted in their contents to the cognitive ability of each age. More structured research must be done focused on this population. Investments in healthy eating behaviors in pediatrics can lead to better health outcomes in the future population with substantial benefits to society.Systematic review registration[https://www.crd.york.ac.uk/prospero/#recordDetails], identifier [CRD42022374177]

Rapamycin rescues mitochondrial dysfunction in cells carrying the m.8344A > G mutation in the mitochondrial tRNALys

Background: Myoclonus, Epilepsy and Ragged-Red-Fibers (MERRF) is a mitochondrial encephalomyopathy due to heteroplasmic mutations in mitochondrial DNA (mtDNA) most frequently affecting the tRNALys gene at position m.8344A > G. Defective tRNALys severely impairs mitochondrial protein synthesis and respiratory chain when a high percentage of mutant heteroplasmy crosses the threshold for full-blown clinical phenotype. Therapy is currently lim- ited to symptomatic management of myoclonic epilepsy, and supportive measures to counteract muscle weakness with co-factors/supplements. Methods: We tested two therapeutic strategies to rescue mitochondrial function in cybrids and fibroblasts carry- ing different loads of the m.8344A > G mutation. The first strategy was aimed at inducing mitochondrial biogenesis directly, over-expressing the master regulator PGC-1α, or indirectly, through the treatment with nicotinic acid, a NAD+ precursor. The second was aimed at stimulating the removal of damaged mitochondria through prolonged rapamy- cin treatment. Results: The first approach slightly increased mitochondrial protein expression and respiration in the wild type and intermediate-mutation load cells, but was ineffective in high-mutation load cell lines. This suggests that induction of mitochondrial biogenesis may not be sufficient to rescue mitochondrial dysfunction in MERRF cells with high-muta- tion load. The second approach, when administered chronically (4 weeks), induced a slight increase of mitochondrial respiration in fibroblasts with high-mutation load, and a significant improvement in fibroblasts with intermediate- mutation load, rescuing completely the bioenergetics defect. This effect was mediated by increased mitochondrial biogenesis, possibly related to the rapamycin-induced inhibition of the Mechanistic Target of Rapamycin Complex 1 (mTORC1) and the consequent activation of the Transcription Factor EB (TFEB). Conclusions: Overall, our results point to rapamycin-based therapy as a promising therapeutic option for MERRF

When worlds collide: Invader-driven benthic habitat complexity alters predatory impacts of invasive and native predatory fishes

Interactions between multiple invasive alien species (IAS) might increase their ecological impacts, yet relatively few studies have attempted to quantify the effects of facilitative interactions on the success and impact of aquatic IAS. Further, the effect of abiotic factors, such as habitat structure, have lacked consideration in ecological impact prediction for many high-profile IAS, with most data acquired through simplified assessments that do not account for real environmental complexities. In the present study, we assessed a potential facilitative interaction between a predatory invasive fish, the Ponto-Caspian round goby (Neogobius melanostomus), and an invasive bivalve, the Asian clam (Corbicula fluminea). We compared N. melanostomus functional responses (feeding-rates under different prey densities) to a co-occurring endangered European native analogue fish, the bullhead (Cottus gobio), in the presence of increased levels of habitat complexity driven by the accumulation of dead C. fluminea biomass that persists within the environment (i.e. 0, 10, 20 empty bivalve shells). Habitat complexity significantly influenced predation, with consumption in the absence of shells being greater than where 10 or 20 shells were present. However, at the highest shell density, invasive N. melanostomus maximum feeding-rates and functional response ratios were substantially higher than those of native C. gobio. Further, the Relative Impact Potential metric, by combining per capita effects and population abundances, indicated that higher shell densities exacerbate the relative impact of the invader. It therefore appears that N. melanostomus can better tolerate higher IAS shell abundances when foraging at high prey densities, suggesting the occurrence of an important facilitative interaction. Our data are thus fully congruent with field data that link establishment success of N. melanostomus with the presence of C. fluminea. Overall, we show that invader-driven benthic habitat complexity can alter the feeding-rates and thus impacts of predatory fishes, and highlight the importance of inclusion of abiotic factors in impact prediction assessments for IAS

Is Coffee Powder Extract a Possible Functional Ingredient Useful in Food and Nutraceutical Industries?

The present study aimed to assess the phytochemical content and in vitro bioactivity of ethanolic extracts of Arabica (A) and/or Robusta (R) coffee powder having different geographical origins. For this purpose, total phenols (TPC) and flavonoids (TFC) content as well as a- and b-tocopherol were quantified. The antioxidant activity was assessed by using a multi-target approach in which the radical scavenging potential, the protection from lipid peroxidation, and the involvement of the iron-reducing mechanism were applied. The carbohydrate hydrolyzing enzymes' (a-amylase and a-glucosidase) inhibitory activities were also assessed. Arabica coffee sample (C2-A) showed the highest TPC, TFC, and a-tocopherol content with values of 63.1 mg chlorogenic acid equivalents (CAE)/g dry powder, 16.2 mg of quercetin (QE) equivalents/g dry powder, and 5.6 mg/100 g dry powder, respectively. Relative Antioxidant Capacity Index (RACI), used to statistically integrate results from 2,2′-azino-bis(3- ethylbenzothiazoline-6-sulfonic acid) diammonium salt (ABTS), 2,2-diphenyl-1-picrylhydrazyl (DPPH), ferric reducing ability power (FRAP), and protection of lipid peroxidation assays, evidenced that sample C4-R derived from Robusta from Guatemala showed the highest antioxidant potential with a value of -0.61. Arabica from Puerto Rico was the most active against a-amylase, whereas the blend Arabica/Robusta sample (C5-A60R40) showed the highest inhibitory activity against a-glucosidase with IC50 values of 120.2 and 134.6 mg/mL, respectively. The results show how the qualitative-quantitative composition of the extracts is strongly associated not only with the variety but also with the geographical origin of the samples