Physiological adaptations of active postmenopausal women and matched men to the multi-day Sardinia Selvaggio Blu wild trek: a gender-comparative pilot study

PURPOSE

To evaluate the effects of wild trekking by examining, in postmenopausal women, the physiological adaptations to an intensive 5-day wild trek and comparing their responses to those displayed by a group of men of comparable age, training status and mountaineering skills.

METHODS

Six healthy, active postmenopausal women in their sixth decade of life participated in the study. Six men of comparable age and training status were also enrolled for gender-based comparisons. The participants traversed the Selvaggio Blu wild trek (Sardinia, Italy) completing a total of 56 km, for an overall height differential of 14,301 m. During all 5-day trek, subjects were supervised by two alpine guides. Changes in body composition, cardiorespiratory fitness, and metabolic patterns of energy expenditure were evaluated before and after the intervention.

RESULTS

Total energy expenditure during the trek was significantly higher (p = 0.03) in women (12.88 ± 3.37 kcal/h/kg) than men (9.27 ± 0.89 kcal/h/kg). Extracellular (ECW) and intracellular water (ICW) increased significantly following the trek only in women (ECW: - 3.8%; p = 0.01; ICW: + 3.4%; p = 0.01). The same applied to fat-free mass (+ 5.6%; p = 0.006), fat mass (- 20.4%; p = 0.006), skeletal muscle mass (+ 9.5%; p = 0.007), and appendicular muscle mass (+ 7.3%; p = 0.002). Peak VO2/kg (+ 9.4%; p = 0.05) and fat oxidation (at 80 W: + 26.96%; p = 0.04; at 100 W: + 40.95%; p = 0.02; at 120 W: + 83.02%; p = 0.01) were found increased only in women, although no concurrent changes in partial pressure of end-tidal CO2 (PETCO2) was observed.

CONCLUSIONS

In postmenopausal women, a 5-day, intensive and physically/technically demanding outdoor trekking activity led to significant and potentially relevant changes in body composition, energy balance and metabolism that are generally attained following quite longer periods of training.

A novel estimate of biological aging by multiple fitness tests is associated with risk scores for age-related diseases

Introduction: Recent research highlights the need for a correct instrument for monitoring the individual health status, especially in the elderly. Different definitions of biological aging have been proposed, with a consistent positive association of physical activity and physical fitness with decelerated aging trajectories. The six-minute walking test is considered the current gold standard for estimating the individual fitness status in the elderly. Methods: In this study, we investigated the possibility of overcoming the main limitations of assessing fitness status based on a single measure. As a result, we developed a novel measure of fitness status based on multiple fitness tests. In 176 Sardinian individuals aged 51-80 years we collected the results of eight fitness tests to measure participants' functional mobility, gait, aerobic condition, endurance, upper and lower limb strength, and static and dynamic balance. In addition, the participants' state of health was estimated through validated risk scores for cardiovascular diseases, diabetes, mortality, and a comorbidity index. Results: Six measures contributing to fitness age were extracted, with TUG showing the largest contribution (beta = 2.23 SDs), followed by handgrip strength (beta = -1.98 SDs) and 6MWT distance (beta = -1.11 SDs). Based on fitness age estimates, we developed a biological aging measure using an elastic net model regression as a linear combination of the results of the fitness tests described above. Our newly developed biomarker was significantly associated with risk scores for cardiovascular events (ACC-AHA: r = 0.61; p = 0.0006; MESA: r = 0.21; p = 0.002) and mortality (Levine mortality score: r = 0.90; p = 0.0002) and outperformed the previous definition of fitness status based on the six-minute walking test in predicting an individual health status. Discussion: Our results indicate that a composite measure of biological age based on multiple fitness tests may be helpful for screening and monitoring strategies in clinical practice. However, additional studies are needed to test standardisation and to calibrate and validate the present results.

The use of biomimetic tools for water quality monitoring: passive samplers versus sentinel organisms

To evaluate the performance of artificial and biological integrative sampling strategies, dissolved concentrations of polychlorinated biphenyl (PCBs) and metals (Cu and Mn) were measured with passive sampler devices (PSD) enclosing hydrophobic and chelating phases, and Asiatic clams were transplanted to a polluted area in the Rio de la Plata. Water concentrations based on PSD were compared with spot water samples collected at 0, 15, 32, and 63 days of exposition. PCBs and metals displayed linear accumulation kinetics both in PSDs and bivalves, but with different slopes. PCBs slopes were 2-27 times higher in bivalves (0.3-7.9 vs. 0.1-2.6 ng g^-1 d^-1 in PSDs) reflecting active filtration and uptake from particles, colloids, and dissolved phase, whereas metal slopes were 2.5-11 times lower in bivalves (0.04-0.18 vs. 0.10-2.00 μg g^-1 d^-1 in PSDs) suggesting metal bioregulation. Truly dissolved PCB concentrations from PSD (4.0-6.9 ng.l^-1) represented average 13±4 % of PCB concentrations from filtered spot water samples reflecting the operational discrimination of the PSD diffusion membrane on competing dissolved and colloidal organic phases. In contrast, PSD dissolved Cu concentrations (2.3-8.2 μg l^-1) were equivalent to the spot water values (3.2-3.8 μg l^-1) suggesting that Cu speciation was adequately integrated by passive sampling. On the other hand, PSD-dissolved Mn concentrations (49±38 μg l^-1) were higher (p<0.05) than those from spot water samples (7±11μg l^-1) possibly due to phase changes of Mn distribution related to variable redox conditions in the water. Results evidenced that the PSDs are efficient accumulators of metals and organic compounds from the truly dissolved fraction.

THE EFFECTIVENESS OF EXTRACORPOREAL SHOCK WAVE THERAPY ON BREAST CANCER-RELATED LYMPHEDEMA: A LITERATURE REVIEW

Lymphedema is one of the most dreaded complications related to breast cancer surgery, commonly resulting in upper limb functional, esthetic, and psychological impairment. The necessity to improve the efficacy of conventional treatments and the promising effect of extracorporeal shock wave therapy (ESWT) on lymphangiogenesis in vitro and animal models, has prompted studies involving women affected by breast-cancer related lymphedema. Since intervention modalities and treatment protocols used are different, a review is necessary to verify the effectiveness of ESWT, evaluating the quality of existing studies and the eventual need for further research. Data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library and PEDro, including articles published until January 2019. Five studies met the inclusion criteria. Evident heterogeneity emerged among selected studies permitting only a purely descriptive analysis of their data and strongly limiting their comparison. When compared to other treatment modalities, ESWT showed a significant effect on measured outcomes. It is clear that further high quality research is necessary to assert with confidence the effects and possible superiority of ESWT over other conservative therapies in the management of breast-cancer related lymphedema.

Robotic hand treatment of patients affected by chronic stroke: a monocentric longitudinal pilot study

Few studies investigated the effects of a robotic treatment in hand motor recovery after stroke. Aim of the present study was to evaluate the efficacy of treatment by means of Gloreha Sinfonia® robotic glove in hand motor recovery of a chronic stroke sample of patients with different impairment severity. Thirteen chronic stroke subjects were assigned to either active-assisted robotic treatment or passive robotic treatment according to their ability to actively extend wrist for at least 20 degrees. All subjects underwent 20 sessions of treatment with Gloreha Sinfonia® and were evaluated before (T0), after treatment (T1) and after one month (T2) with clinical scales testing motor performance [Motor Power (MP); Fugl Meyer Upper-Extremity (FMUE)] and spasticity [Modified Ashworth Scale (MAS)]. Both groups showed significant motor recovery and spasticity reduction. Further randomized controlled trials with larger samples are needed to confirm our results.

COVID-19: Off-label therapies based on mechanism of action while waiting for evidence-based medicine recommendations

The world pandemic due to coronavirus disease 2019, known as COVID-19, embodies a high rate of disease transmission that causes a critical hospitalization overload. As of May 15, 2020, the disease has been the cause of more than 4 million infections and more than 280000 deaths all over the world. At the beginning, we underestimated the disease; now, we have sufficient information and it is clear that it is not just a respiratory disease. In fact, if a prompt treatment is not initiated, the disease may evolve towards an abnormal immune response and cytokine storm with an important thrombophilic pattern. Therefore, we think that while waiting for certainties to be established by evidence-based medicine, it is not ethical to not try off-label therapies for some of the well-known drugs, as they could have some efficacy based on their mechanisms of action.

The effectiveness of extracorporeal shock wave therapy on breast cancer-related lymphedema: A literature review

Lymphedema is one of the most dreaded complications related to breast cancer surgery, commonly resulting in upper limb functional, esthetic, and psychological impairment. The necessity to improve the efficacy of conventional treatments and the promising effect of extracorporeal shock wave therapy (ESWT) on lymphangiogenesis in vitro and animal models, has prompted studies involving women affected by breast cancer-related lymphedema. Since intervention modalities and treatment protocols used are different, a review is necessary to verify the effectiveness of ESWT, evaluating the quality of existing studies and the eventual need for further research. Data were obtained from PubMed, Scopus, Google Scholar, Cochrane Library and PEDro, including articles published until January 2019. Five studies met the inclusion criteria. Evident heterogeneity emerged among selected studies permitting only a purely descriptive analysis of their data and strongly limiting their comparison. When compared to other treatment modalities, ESWT showed a significant effect on measured outcomes. It is clear that further high quality research is necessary to assert with confidence the effects and possible superiority of ESWT over other conservative therapies in the management of breast cancer-related lymphedema.

Urban geochemistry and potential human health risks in the Metropolitan Area of Buenos Aires: PAHs and PCBs in soil, street dust, and bulk deposition

Soil, street dust, and bulk deposition (dry and wet deposition) were collected in the Metropolitan Area of Buenos Aires (MABA), Argentina, to assess the polycyclic aromatic hydrocarbons (PAHs) and polychlorinated biphenyls (PCBs) pollution and the potential risks to human health. Compared with other countries, the mean concentration of PAHs and PCBs in surface soils, street dust and bulk deposition of MABA were at a low or moderate level. Average PAHs and PCBs concentrations in bulk deposition (5.7 ± 5.1 and 0.41 ± 0.25 µg g^-1, respectively) were five and ten times higher than those of soil (1.08 ± 0.98 and 0.02 ± 0.01 µg g^-1) and street dust (1.2 ± 0.95 and 0.04 ± 0.03 µg g^-1), respectively. Different compositional profiles, observed in the three matrices for both groups of contaminants, could be attributed to dissimilar source contribution, partition processes between gas and particulate phases, and transformation. The most contaminated bulk deposition presented higher values for cancer and non-cancer risks relative to soil and street dust. In all matrices, non-carcinogenic risks were below the safety threshold (HI < 1). Regarding carcinogenic risks, exposure to both bulk deposition and soil indicated a moderated potential for cancerous development (Incremental lifetime cancer risk ~ 3.0 × 10^-6).

Interactions between Proteins and the Membrane Surface in Multiscale Modeling of Organic Fouling

In the present paper, an improved multiscale modeling aimed at describing membrane fouling in the UltraFiltration (UF) process was proposed. Some of the authors of this work previously published a multiscale approach to simulate ultrafiltration of Bovine Serum Albumin (BSA) aqueous solutions. However, the noncovalent interactions between proteins and the membrane surface were not taken into account in the previous formulation. Herein, the proteins-surface interactions were accurately computed by first-principle-based calculations considering also the effect of pH. Both the effective surface of polysulfone (PSU) and the first layer of proteins adsorbed on the membrane surface were accurately modeled. Different from the previous work, the equilibrium distance between proteins was calculated and imposed as lower bound to the protein-protein distances in the compact deposit accumulated on the membrane surface. The computed BSA surface charges were used to estimate the protein potential and the charge density, both necessary to formulate a forces balance at microscopic scale. The protein surface potential was compared with Z-potential measurements of BSA aqueous solution, and a remarkable agreement was found. Finally, the overall additional resistance, as due to both the compact and loose layers of the deposit, was computed, thus allowing the final transition to a macroscopic scale, where an unsteady-state mass transfer model was formulated to describe the behavior of a typical dead-end UF process. A good agreement between simulated and experimental permeate flux decays was observed.

Evaluation of optoelectronic Plethysmography accuracy and precision in recording displacements during quiet breathing simulation

Opto-electronic Plethysmography (OEP) is a motion analysis system used to measure chest wall kinematics and to indirectly evaluate respiratory volumes during breathing. Its working principle is based on the computation of marker displacements placed on the chest wall. This work aims at evaluating the accuracy and precision of OEP in measuring displacement in the range of human chest wall displacement during quiet breathing. OEP performances were investigated by the use of a fully programmable chest wall simulator (CWS). CWS was programmed to move 10 times its eight shafts in the range of physiological displacement (i.e., between 1 mm and 8 mm) at three different frequencies (i.e., 0.17 Hz, 0.25 Hz, 0.33 Hz). Experiments were performed with the aim to: (i) evaluate OEP accuracy and precision error in recording displacement in the overall calibrated volume and in three sub-volumes, (ii) evaluate the OEP volume measurement accuracy due to the measurement accuracy of linear displacements. OEP showed an accuracy better than 0.08 mm in all trials, considering the whole 2m(3) calibrated volume. The mean measurement discrepancy was 0.017 mm. The precision error, expressed as the ratio between measurement uncertainty and the recorded displacement by OEP, was always lower than 0.55%. Volume overestimation due to OEP linear measurement accuracy was always <; 12 mL (<; 3.2% of total volume), considering all settings.

Comparative analysis and quantitative evaluation of ankle-foot orthoses for foot drop in chronic hemiparetic patients

BACKGROUND

Ankle-foot-orthoses (AFOs) are frequently prescribed for hemiparetic patients to compensate for the foot drop syndrome. However, there is not a systematic study either on the effectiveness of AFOs in the gait recovery process or pointing out the therapeutic differences among the various types of AFOs available on the market.

AIM

To perform a comparative evaluation of solid and dynamic Ankle-Foot-Orthoses (AFOs) on hemiparetic patients affected by foot drop syndrome by means of spatio-temporal, kinematic and electromyographic indicators.

DESIGN

Crossover design with randomization for the interventions.

SETTING

A rehabilitation center for adults with neurologic disorders.

POPULATION

Ten chronic hemiparetic patients with foot drop syndrome met inclusion criteria and volunteered to participate.

METHODS

Biomechanical gait analysis was carried out on hemiparetic subjects with foot drop syndrome under 3 conditions with randomized sequences: 1) without AFO; 2) wearing a solid AFO; 3) wearing a dynamic AFO. Significant changes in spatio-temporal, kinematic and electromyographic features of gait were investigated.

RESULTS

Gait analysis outcomes showed that there were no significant differences among the solid and the dynamic AFO on the spatio-temporal parameters. Both AFOs led to a reduction of the range of motion of the ankle dorsi-plantar-flexion during stance with respect to the ambulation without AFO. They also had the effect of reducing the asymmetry between the paretic and the contralateral limb in terms of ankle angle at initial contact and hip flexion. The solid AFO generally led to an increase of the co-contraction of the couples of muscles involved in the gait.

CONCLUSION

The proposed set of indicators showed that the AFOs were capable of limiting the effect of the foot-drop in hemiparetic patients and balancing the two limbs. Main differences between the two orthoses were related to muscular activity, being the level of co-contraction of the two couples of analysed muscles typically lower when the dynamic AFO was worn and closer to a normal pattern.

CLINICAL REHABILITATION IMPACT

A more extensive use of the proposed indicators in the clinical practice is expected in order to enable the definition of clinical guidelines for the prescription of the two devices.

Low temperature laser scanning microscopy of a superconducting radio-frequency cavity

An apparatus was developed to obtain, for the first time, 2D maps of the surface resistance of the inner surface of an operating superconducting radio-frequency niobium cavity by a low-temperature laser scanning microscopy technique. This allows identifying non-uniformities of the surface resistance with a spatial resolution of about 2.4 mm and surface resistance resolution of ~1 μΩ at 3.3 GHz. A signal-to-noise ratio of about 10 dB was obtained with 240 mW laser power and 1 Hz modulation frequency. The various components of the apparatus, the experimental procedure and results are discussed in detail in this contribution.

Evaluation of natural reductants protecting red blood cell membranes against oxidative damage in psoriatic patients

OBJECTIVE

Psoriasis is a chronic skin disease and one of its main causes could be the oxidative stress. The use of natural reductants, in the treatment of several diseases, is well known but the effects of such treatments on the chronic psoriasis are not clear. The aim of this study is to evaluate the efficacy of the treatment with organic matrix, deriving from micro-flora, grown in shallow hyper thermal water tubs at Guardia Piemontese-Acquappesa (CS) Italy, in patients affected by moderate psoriasis.

MATERIALS AND METHODS

The study has been performed on 10 subjects with plaque psoriasis and on 10 healthy control subjects. Clinical severity of psoriasis was determined according to Psoriasis and Severity Index (PASI). The treatment efficacy was observed trough the evaluation of membrane fluidity, by fluorescence polarization, lipid peroxidation, anion permeability and haemolysis in red blood cells.

RESULTS

After 12 days of patients' treatment, a significant reduction of PASI score was observed, this result is supported by a significant improvement of all studied parameters.

CONCLUSIONS

The results, obtained by the evaluation of all studied parameters in patients treated with the organic matrix, are evidence of the efficacy of this treatment, according to PASI evaluation. Thus our results, suggest that this therapeutic line may be useful in the treatment of moderate psoriatic lesions and also in improving the life quality of psoriatic patients.

Mesenchymal stem cells cultured on a collagen scaffold: In vitro osteogenic differentiation

OBJECTIVE

Management of periodontal defects has always been a challenge in clinical periodontics. Recently mesenchymal stem cells (MSC) have been proposed for tissue regeneration in periodontal disease and repair of large bone defects. Bone regeneration has to be supported by a scaffold which has to be biocompatible, biodegradable, and able to support cell growth and differentiation. The aim of this study was to evaluate osteogenic differentiation of MSC seeded on a collagen scaffold.

DESIGN

MSC were obtained from adult rat bone marrow, expanded and cultured in plastic dishes or seeded in a collagen scaffold (Gingistat). MSC were induced towards osteogenic differentiation using osteogenic supplements. Cell differentiation and calcium deposits were evaluated by immunoblotting, immunohistochemistry, histochemical techniques, enzymatic activity assay, and SEM-EDX analysis. Biomaterial in vitro degradation was evaluated by measuring mass reduction after incubation in culture medium.

RESULTS

Rat MSC osteogenic differentiation was demonstrated by osteopontin and osteocalcin expression and an increase in alkaline phosphatase activity. MSC were distributed homogeneously in the collagen scaffold. Nodular aggregates and alizarin red stained calcium deposits were observed in MSC induced towards osteogenic differentiation cultured in dishes or seeded in the collagen scaffold. SEM-EDX analysis demonstrated that calcium co-localized with phosphorous. The biomaterial in vitro degraded in 4-5 weeks.

CONCLUSIONS

MSC from bone marrow differentiate towards osteogenic lineage, representing a suitable cell source for bone formation in periodontal regeneration. Gingistat collagen scaffold supports MSC distribution and differentiation, but its short degradation time may be a limitation for a future application in bone tissue regeneration.

[Effect of sulphurous Bioglea on psoriasis]

OBJECTIVE

The efficacy of biological sulphurous Bioglee on psoriasis was investigated using an organic matrix derived from the metabolism of microflora growing in shallow hyper thermal waters possessing high sulphur concentrations and in thermal mud at Guardia Piemontese-Acquappesa (CS). Such a matrix forms part of the "Sulphuretum" ecological matrix which is dominated by cyanobacteria and sulfobacteria. The effect of this matrix on psoriasis was evaluated through the typical symptoms such as desquamation, cutaneous erythema and itching.

METHODS

The study was carried out on 20 patients wich gave informed consent, suffering from psoriasis. Image analysis was used to monitor the intensity of psoriasic lesions prior to and at the conclusion of the therapy which consisted of topical applications of the thermal matrices twice a day for 12 days.

RESULTS

Image analysis illustrated a reduction in the intensity of psoriasic lesions at the conclusion of the therapy with significant reductions in desquamation, erythema and itching.

CONCLUSIONS

The anti-psoriasic action of the thermal matrix used in this study may be attributable to the substances such as carotene, hydro and lipo-soluble vitamins and naturally occuring phytosterols. These substances may not only be anti-inflammatory but may also work synergistically with the mineral components of the thermal matrix to attenuate the symptoms of psoriasis.

Primary- and secondary-school environmental health science education and the education crisis: a survey of science teachers in Ohio

There is a science education crisis in the United States, with studies showing that U.S. high school graduates are not as well-versed in science as graduates in other countries. Studies also suggest that students are better learners when the environment is used as an integrating theme. Therefore, the time is right to discuss opportunities for integrating environmental health science into kindergarten through 12th grade (K-12) curriculum. The research presented here takes a step toward developing the use of environmental health science as a multidisciplinary theme in the K-12 curriculum. Almost 500 K-12 science teachers in Ohio were surveyed for their opinions about the science education crisis and the role of environmental health science in their current courses of instruction. These teachers had been identified as having an interest in environmental education because of their participation in the Environmental Education Council of Ohio. Nevertheless, the results of the survey suggest that these environmentally oriented science teachers are currently not aware of existing environmental health science learning opportunities. Environmental health practitioners have work to do to educate science teachers about the field and about the ways in which studying environmental health science could alleviate the science education crisis.

Drug delivery systems for topical ophthalmic medication

Two new topical ophthalmic delivery systems are described. The modes of delivery were compared with conventionally administered eyedrops on the basis of intraocular pressure lowering effect, dependability in delivery of prescribed dosage, and patient acceptance of the system. Pilocarpine delivered by each of the systems was found to control IOP as well as conventional pilocarpine drops. Although some patients took a longer time than others to adjust to a new mode of delivery, patient acceptance of the systems was high.