Italian Children Exposure to Bisphenol A: Biomonitoring Data from the LIFE PERSUADED Project

A human biomonitoring (HBM) study on bisphenol A (BPA) in Italian children and adolescents was performed within the LIFE PERSUADED project, considering the residing areas, sex and age. The median urinary BPA level was 7.02 mu g/L, with children living in the South of Italy or in urban areas having higher levels than those residing in the North or in rural areas. Children aged 4-6 years had higher BPA levels than those aged 7-10 and 11-14 years, but no differences were detected between sexes. The exposure in Italian children was higher compared to children from other countries, but lower than the HBM guidance value (135 mu g/L). The estimated daily intake was 0.17 mu g/kg body weight (bw) per day, about 24-fold below the temporary Tolerable Daily Intake of 4 mu g/kg bw per day established by the European Food Safety Authority. However, this threshold was exceeded in 1.44% of the enrolled children, raising concern about the overall exposure of Italian young population

A within-sibling pair analysis of lifestyle behaviours and BMI z-score in the multi-centre I.Family study

Background and aims: By investigating differences in lifestyle behaviours and BMI in sibling pairs, family-level confounding is minimized and causal inference is improved, compared to cross-sectional studies of unrelated children. Thus, we aimed to investigate within-sibling pair differences in different lifestyle behaviours and differences in BMI z-scores in children and adolesents. Methods and results: We examined three groups of sibling pairs 1) all same-sex sibling pairs with maximum 4 years age difference (n = 1209 pairs from 1072 families in 8 countries, mean age 10.7 years, standard deviation 2.4 years), 2) sibling pairs discordant for overweight (n = 262) and 3) twin pairs (n = 85). Usual dietary intake was estimated by 24-h recalls and time spent in light (LPA) and moderate-to-vigorous physical activity (MVPA) was measured by accelerometers. Screen time, sleep and dieting for weight loss were assessed by questionnaires. Within all 3 groups of sibling pairs, more time in MVPA was associated with lower BMI z-score. Higher energy intake was associated with higher BMI z-score within twin pairs and within all sibling pairs who were not currently dieting for weight loss. Regarding LPA, screen time or sleep duration, no or inconsistent associations were observed for the three groups of sibling pairs. Conclusions: MVPA and energy intake were associated with BMI differences within sibling and twin pairs growing up in the same home, thus independent of family-level confounding factors. Future studies should explore whether genetic variants regulating appetite or energy expenditure behaviours account for weight differences in sibling pairs. (C) 2019 The Italian Society of Diabetology, the Italian Society for the Study of Atherosclerosis, the Italian Society of Human Nutrition, and the Department of Clinical Medicine and Surgery, Federico II University. Published by Elsevier B.V. All rights reserved.Peer reviewe

Genetic loci linked to Type 1 Diabetes and Multiple Sclerosis families in Sardinia

<p>Abstract</p> <p>Background</p> <p>The Mediterranean island of Sardinia has a strikingly high incidence of the autoimmune disorders Type 1 Diabetes (T1D) and Multiple Sclerosis (MS). Furthermore, the two diseases tend to be co-inherited in the same individuals and in the same families. These observations suggest that some unknown autoimmunity variant with relevant effect size could be fairly common in this founder population and could be detected using linkage analysis.</p> <p>Methods</p> <p>To search for T1D and MS loci as well as any that predispose to both diseases, we performed a whole genome linkage scan, sequentially genotyping 593 microsatellite marker loci in 954 individuals distributed in 175 Sardinian families. In total, 413 patients were studied; 285 with T1D, 116 with MS and 12 with both disorders. Model-free linkage analysis was performed on the genotyped samples using the Kong and Cox logarithm of odds (LOD) score statistic.</p> <p>Results</p> <p>In T1D, aside from the HLA locus, we found four regions showing a lod-score ≥1; 1p31.1, 6q26, 10q21.2 and 22q11.22. In MS we found three regions showing a lod-score ≥1; 1q42.2, 18p11.21 and 20p12.3. In the combined T1D-MS scan for shared autoimmunity loci, four regions showed a LOD >1, including 6q26, 10q21.2, 20p12.3 and 22q11.22. When we typed more markers in these intervals we obtained suggestive evidence of linkage in the T1D scan at 10q21.2 (LOD = 2.1), in the MS scan at 1q42.2 (LOD = 2.5) and at 18p11.22 (LOD = 2.6). When all T1D and MS families were analysed jointly we obtained suggestive evidence in two regions: at 10q21.1 (LOD score = 2.3) and at 20p12.3 (LOD score = 2.5).</p> <p>Conclusion</p> <p>This suggestive evidence of linkage with T1D, MS and both diseases indicates critical chromosome intervals to be followed up in downstream association studies.</p

Cabbage and fermented vegetables : From death rate heterogeneity in countries to candidates for mitigation strategies of severe COVID-19

Large differences in COVID-19 death rates exist between countries and between regions of the same country. Some very low death rate countries such as Eastern Asia, Central Europe, or the Balkans have a common feature of eating large quantities of fermented foods. Although biases exist when examining ecological studies, fermented vegetables or cabbage have been associated with low death rates in European countries. SARS-CoV-2 binds to its receptor, the angiotensin-converting enzyme 2 (ACE2). As a result of SARS-CoV-2 binding, ACE2 downregulation enhances the angiotensin II receptor type 1 (AT(1)R) axis associated with oxidative stress. This leads to insulin resistance as well as lung and endothelial damage, two severe outcomes of COVID-19. The nuclear factor (erythroid-derived 2)-like 2 (Nrf2) is the most potent antioxidant in humans and can block in particular the AT(1)R axis. Cabbage contains precursors of sulforaphane, the most active natural activator of Nrf2. Fermented vegetables contain many lactobacilli, which are also potent Nrf2 activators. Three examples are: kimchi in Korea, westernized foods, and the slum paradox. It is proposed that fermented cabbage is a proof-of-concept of dietary manipulations that may enhance Nrf2-associated antioxidant effects, helpful in mitigating COVID-19 severity.Peer reviewe

Nrf2-interacting nutrients and COVID-19 : time for research to develop adaptation strategies

There are large between- and within-country variations in COVID-19 death rates. Some very low death rate settings such as Eastern Asia, Central Europe, the Balkans and Africa have a common feature of eating large quantities of fermented foods whose intake is associated with the activation of the Nrf2 (Nuclear factor (erythroid-derived 2)-like 2) anti-oxidant transcription factor. There are many Nrf2-interacting nutrients (berberine, curcumin, epigallocatechin gallate, genistein, quercetin, resveratrol, sulforaphane) that all act similarly to reduce insulin resistance, endothelial damage, lung injury and cytokine storm. They also act on the same mechanisms (mTOR: Mammalian target of rapamycin, PPAR gamma:Peroxisome proliferator-activated receptor, NF kappa B: Nuclear factor kappa B, ERK: Extracellular signal-regulated kinases and eIF2 alpha:Elongation initiation factor 2 alpha). They may as a result be important in mitigating the severity of COVID-19, acting through the endoplasmic reticulum stress or ACE-Angiotensin-II-AT(1)R axis (AT(1)R) pathway. Many Nrf2-interacting nutrients are also interacting with TRPA1 and/or TRPV1. Interestingly, geographical areas with very low COVID-19 mortality are those with the lowest prevalence of obesity (Sub-Saharan Africa and Asia). It is tempting to propose that Nrf2-interacting foods and nutrients can re-balance insulin resistance and have a significant effect on COVID-19 severity. It is therefore possible that the intake of these foods may restore an optimal natural balance for the Nrf2 pathway and may be of interest in the mitigation of COVID-19 severity

Privacy-by-Design and Minimization within a Small Electronic Health Record: The Health360 Case Study

Electronic health records are playing an important role in todays&rsquo; clinical research, with the possibility to collect a wide amount of data from different sources, not only within a structured clinical setting, but also making best use of new portable technologies, such as smartphones, sensors and Internet-of-Things, as an unprecedented spring of data. In this way, even in small clinical centers, often featuring limited financial availabilities, not only clinicians can have a complete, timely outlook on patients&rsquo; health, but also data scientists could use such information to build and train tailored models in the broader perspective of &ldquo;p4 medicine&rdquo;. However, all this should align with the strict regulations and needs concerning data privacy and security, safeguarding the rights of the individual and the confidentiality of information related to their healthcare status. Here, we present a case study dealing with Health360, a platform designed to fill in this gap, representing the ideal solution for small clinical centers, where usability and cost-affordability are key characteristics for such a system, to collect multimodal data from various sources actually employed in the framework of neuromuscular conditions. The platform, designed under the Software-as-a-Service paradigm, actually collects data from different clinical centers active in the field of neuromuscular diseases, and therefore was designed to grant access to the data to specific professionals depending on their roles. At the same time, to the benefit of data scientists, Health360 enables joint data processing, with the management of authorization principles for various health professionals from different clinical centers, which is regulated by the data minimization principle, based on the accessing profile. Under such premises, we present here the approach followed for the implementation of the platform, managing the trade-off between the need from various professionals for accessing the complete dataset and the privacy requirements, as well as confidentiality maintenance for sensitive data of patients enrolled on the project

Disordered eating in three different age groups in Cyprus : a comparative cross-sectional study

Objective: The objective of this study was to evaluate disordered eating behaviours (DEBs) in different age groups in a Cypriot non-clinical population sample. Study design: Comparative cross-sectional study. Method: A total of 1716 participants from the Cyprus component of the I.Family study completed the Eating Attitudes Test-26 (EAT-26). The EAT-26 score >= 20 was used to define participants at risk for DEBs. Participants were divided according to age: adolescence (12-18 years old), young adulthood (25-45 years old) and middle adulthood (46-60 years old). Results: Mean EAT-26 total scores were higher for middle adulthood men and women compared with the two younger age groups. Young adulthood women had the highest percentage of behavioural symptoms of DEBs: binge eating (35%) and laxatives/diet pills/ diuretics (12%) compared with the other age groups. Men and women in young adulthood had the highest percentage of participants with EAT-26 scores >= 20. In logistic regression analysis, age group did not prove a significant predictor of DEB risk in a model adjusting for sex, body mass index and physical activity. Conclusion: DEB can present at any age and was not confined to adolescence. (C) 2018 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.Peer reviewe

Blockade of A2A receptors plus L-DOPA after nigrostriatal lesion results in GAD67 mRNA changes different from L-DOPA alone in the rat globus pallidus and substantia nigra reticulata.

Studies in animal models of Parkinson’s disease (PD) suggest the potential utility of adenosine A2A antagonists in the treatment of this disease. In the present study, unilaterally 6-hydroxydopamine (6-OHDA)-lesioned rats received chronic intermittent treatment with the adenosine A2A antagonist SCH58261 (5 mg/kg) plus L-DOPA (3 mg/kg) or L-DOPA (6 mg/kg) alone, at doses producing the same intensity of contralateral turning on first administration. Three days after discontinuation of treatments, GABA synthesizing enzyme glutamic acid decarboxylase (GAD67) mRNA was evaluated at cellular level in the globus pallidus (GP) and substantia nigra pars reticulata (SNr) by in situ hybridization. 6-OHDA lesion significantly increased GAD67 mRNA levels in both the GP and SNr ipsilateral to the lesion. Chronic LDOPA (6 mg/kg), in contrast to SCH58261 plus L-DOPA (3 mg/kg), produced a sensitized contralateral turning indicative of dyskinetic potential and further increased GAD67 mRNA in the GP. In the SNr, a significant decrease in GAD67 mRNA was observed after either treatments. However, while L-DOPA (6 mg/kg) decreased SNr GAD67 mRNA below the intact side, SCH58261 plus L-DOPA (3 mg/kg) brought GAD67 mRNA to the same level of the intact SNr. L-DOPA (3 mg/kg) or SCH58261 (5 mg/kg) alone failed to modify GAD67 mRNA. Results suggest that an increase in GAD67 mRNA in GP and a decrease in SNr might underlie dyskinetic movements induced by chronic L-DOPA. In contrast, the lack of GAD67 mRNA changes in the GP and a less marked inhibition of SNr might correlate with the absence of dyskinetic potential observed after SCH58261 plus L-DOPA

The complex link between severity of asthma and rhinitis in mite allergic patients

AIM: The aim of the study was to evaluate the link between the severity of upper and lower airways diseases in mite allergic patients with respiratory allergy. PATIENTS AND METHOD: A multicentre, observational, cross-sectional study was carried out in 556 consecutively enrolled mite allergic patients with rhinitis and asthma comorbidity attending a specialist unit. Severity assessment of rhinitis and asthma was evaluated in accordance with ARIA and GINA guidelines. RESULTS: Reliable data were available for 518 patients. The distribution of rhinitis severity was: 15.6% mild intermittent rhinitis, 4.4% moderate-severe intermittent rhinitis, 30.3% mild persistent rhinitis and 49.6% moderate persistent rhinitis. The distribution of asthma severity was: 41.3% mild intermittent asthma, 14.3% mild persistent asthma, 19.1% moderate persistent asthma and 25.3% severe persistent asthma. In patients with moderate-severe persistent rhinitis (49.5%) a significant trend (p = 0.005) was found pointing to an increased link with asthma severity. CONCLUSION: A link between respective severities of rhinitis and asthma was found in only half of mite allergic patients with rhinitis and asthma