The evolutionary history of hepaciviruses

In the search for natural reservoirs of hepatitis C virus (HCV), a broad diversity of non-human viruses within the Hepacivirus genus has been uncovered. However, the evolutionary dynamics that shaped the diversity and timescale of hepaciviruses evolution remain elusive. To gain further insights into the origins and evolution of this genus, we screened a large dataset of wild mammal samples (n = 1,672) from Africa and Asia, and generated 34 full-length hepacivirus genomes. Phylogenetic analysis of these data together with publicly available genomes emphasizes the importance of rodents as hepacivirus hosts and we identify 13 rodent species and 3 rodent genera (in Cricetidae and Muridae families) as novel hosts of hepaciviruses. Through co-phylogenetic analyses, we demonstrate that hepacivirus diversity has been affected by cross-species transmission events against the backdrop of detectable signal of virus-host co-divergence in the deep evolutionary history. Using a Bayesian phylogenetic multidimensional scaling approach, we explore the extent to which host relatedness and geographic distances have structured present-day hepacivirus diversity. Our results provide evidence for a substantial structuring of mammalian hepacivirus diversity by host as well as geography, with a somewhat more irregular diffusion process in geographic space. Finally, using a mechanistic model that accounts for substitution saturation, we provide the first formal estimates of the timescale of hepacivirus evolution and estimate the origin of the genus to be about 22 million years ago. Our results offer a comprehensive overview of the micro- and macroevolutionary processes that have shaped hepacivirus diversity and enhance our understanding of the long-term evolution of the Hepacivirus genus.

Organizational design: the case of SARS-CoV-2 vaccination in a healthcare centre

Background

Only recently Anti-Covid-19 strategies have been applied through specific vaccines, that are a decisive support to modify the evolution of the disease and to reduce the contagion curve. Along vaccination campaigns, the necessity to guarantee rapidity and effectiveness is a critical challenge for all health organizations; their operative capability is applied to carry out govern plans, to ensure safety of the procedures, to adopt good clinical practices, to help with adhesion to vaccine administration and to monitor adverse effects.

Study design

The "Centro Clinico Morgagni" is a private accredited diagnosis and treatment Centre with high specialty departments and several hospital beds. The challenge for its administration was to complete the vaccination of all the staff, so a COVID19 crisis unit was established to assure the control of all activities in the center throughout the pandemic. The goal was to complete the vaccination plan following the guidelines with no risks or harm.

Methods

An original organizational model, based on different planning methodologies was developed, its task was to define a standard procedure and to give operational instructions based on ISO 9001 for monitoring the entire vaccination process. Also, the model had to define every responsibility role and it had to follow Joint Commission International's methodologies as far as error barriers, drug conservation risks, drug transport and drug administration were concerned.Furthermore, in agreement with the HACCP system, critical control points were highlighted during all the process. The results have been processed in the form of quick references and illustrative panels based on relevant process aspects, which were given to the staff involved in the operations as reference tools for prompt consultation.

Results

The vaccination operations at the Centro Clinico Morgagni took place quickly in only four days: 800 staff units were vaccinated - first and second doses with Covid19 mRNA BNT162b2 (Cominraty) - in three different vaccination centers without highlighting significant events that did not comply with the guidelines, nor deviations from the established goals. More precisely, starting from 277 bottles corresponding to six doses each, only 0.2% was wasted, while ADR monitoring reported a prevalence of adverse effects in females (78%) compared to males (22%). Adhesion for vaccination of qualified personnel, thanks to the activities of the Medical College set up for this purpose, reached 100% of the candidate staff through repeated personalized interviews with only one opposition, compared to the 30 communicated at the beginning.

Conclusions

It was necessary to ensure the efficiency of the entire process and the model was tested positively. This model can also provide a security control of all the vaccinated personnel; its schematization allows an easy application and flexibility, thus making it an organizational tool that could be reproduced and transferred to other contexts.

New Minimally Invasive Intraoral Procedure for Condylar Fractures: Clinical Presentation and Considerations on Current Techniques

ABSTRACT

Mandibular fractures are the third most prevalent maxillofacial traumatic events. Surgical approaches to the condyle are a debated topic. This study describes a mini-invasive technique for condylar fracture reduction. The patient of this study suffered multiple traumatic injuries including a carotid artery dissecting aneurysm, which contraindicated the standard open reduction and internal fixation technique. The novel minimally invasive technique involves intraoral access and fracture fragment realignment using a periosteal elevator, a molar occlusal splint, and intermaxillary fixation after intraoperative radiologic imaging confirmation of condyle reposition.The approach avoids skin incisions and tissue dissection, with good aesthetic outcomes and facial nerve preservation. This technique proved to be safe and simple to be less demanding for the patient, with a shorter recovery time than experienced with other techniques.The results suggest this technique is a good option for the surgical treatment of condylar neck fractures showing favorable rim morphology with primary stability after reduction.

Clinical Experience With Machine Learning-Based Automated Treatment Planning for Whole Breast Radiation Therapy

PURPOSE

The machine learning-based automated treatment planning (MLAP) tool has been developed and evaluated for breast radiation therapy planning at our institution. We implemented MLAP for patient treatment and assessed our clinical experience for its performance.

METHODS AND MATERIALS

A total of 102 patients of breast or chest wall treatment plans were prospectively evaluated with institutional review board approval. A human planner executed MLAP to create an auto-plan via automation of fluence maps generation. If judged necessary, a planner further fine-tuned the fluence maps to reach a final plan. Planners recorded the time required for auto-planning and manual modification. Target (ie, breast or chest wall and nodes) coverage and dose homogeneity were compared between the auto-plan and final plan.

RESULTS

Cases without nodes (n = 71) showed negligible (<1%) differences for target coverage and dose homogeneity between the auto-plan and final plan. Cases with nodes (n = 31) also showed negligible difference for target coverage. However, mean ± standard deviation of volume receiving 105% of the prescribed dose and maximum dose were reduced from 43.0% ± 26.3% to 39.4% ± 23.7% and 119.7% ± 9.5% to 114.4% ± 8.8% from auto-plan to final plan, respectively, all with P ≤ .01 for cases with nodes (n = 31). Mean ± standard deviation time spent for auto-plans and additional fluence modification for final plans were 12.1 ± 9.3 and 13.1 ± 12.9 minutes, respectively, for cases without nodes, and 16.4 ± 9.7 and 26.4 ± 16.4 minutes, respectively, for cases with nodes.

CONCLUSIONS

The MLAP tool has been successfully implemented for routine clinical practice and has significantly improved planning efficiency. Clinical experience indicates that auto-plans are sufficient for target coverage, but improvement is warranted to reduce high dose volume for cases with nodal irradiation. This study demonstrates the clinical implementation of auto-planning for patient treatment and the significant importance of integrating human experience and feedback to improve MLAP for better clinical translation.

Abstract P4-12-10: Clinical implementation of the machine learning-based automated treatment planning tool for whole breast radiotherapy

Objectives: The machine learning (ML)-based automated treatment planning tool has been developed and evaluated for whole breast radiotherapy. This study implemented the tool in clinic and compared plan quality and planning efficiency with the manual treatment process for whole breast radiotherapy using irregular surface compensator technique.

Methods: This study involved two phases. The 1st phase was to evaluate and the 2nd phase was to implement in the clinic. In the 1st phase, thirty whole breast or chest wall cases were planned by using the irregular surface compensator technique with fluence maps manually and iteratively edited to achieve uniform dose distribution to the target by planners. Patients were treated with these manual plans after physician’s approval. The evaluation phase thus compared our in-house ML-based automated treatment planning tool implemented in Eclipse Scripting Application Programming Interface (ESAPI) to these manual plans. The ML-based planning tool generated the fluence maps with the same beam parameters such as beam energy, gantry angle, collimator angle, and aperture shape as manual plans. Breast or chest wall clinical target volume (CTV) coverage based on the percentage CTV volume receiving 95% of the prescribed dose (V95%) and high-dose volume based on V105% were compared to evaluate the plan quality as well as the planning efficiency. Two-tailed Wilcoxon Signed-Rank test was performed to test the null hypothesis that the two planning schemes yield equivalent plan quality.

In the 2nd phase, the planners used the automated planning tool for fourteen plans (twelve patients) followed by manual fluence modification as needed. Physicians reviewed and approved the plans, and patients were treated.

Results: For the 1st phase, the mean planning time was 110.2 min with standard deviation (SD) of 62.8 min for the manual planning with the range from 25 to 270 min, and 6.4 min with SD of 2.1 min for the automated planning with the range from 4 to 12 min (p&lt;0.01). CTV mean V95% was 96.7% (SD: 5.0%) for the manual planning and 96.7% (SD: 4.8%) for the automated planning (p=0.89). CTV mean V105% was 21.6% (SD: 29.8%) for the manual planning and 20.4% (SD: 30.5%) for the automated planning (p=0.22). Differences in doses to heart and lungs were negligible between the paired plans as the two planning schemes used the same beam parameters.

For the 2nd phase, the mean planning time was 16.4 min (SD: 9.1 min) and the mean time for additional manual editing was 12.7 min (SD: 12.5 min). The mean total treatment planning time was 29.1 min (SD: 14.8 min).). CTV mean V95% was 97.2% (SD: 4.2%) and mean V105% was 8.2 % (SD: 3.6%). The manual post modifications were added by the planners with intention to improve the target coverage or to reduce high doses, yet, the difference between the plans without and without the manual post modification was negligible.

Conclusion: The ML-based automated treatment planning tool through Varian ESAPI has been successfully implemented for clinical use going through two phases of study. Abiding to the same plan quality as manual process, the automated tool significantly reduced the planning time as the ML-based tool automate the iterative fluence editing process.

Citation Format: Sua Yoo, Yang Sheng, Rachel Blitzblau, Suzanne Catalano, Jay Morrison, Leigh O'Neill, Fangfang Yin, Q. Jackie Wu. Clinical implementation of the machine learning-based automated treatment planning tool for whole breast radiotherapy [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P4-12-10.

Impact of Esophageal Motion on Dosimetry and Toxicity With Thoracic Radiation Therapy

Purpose:

To investigate the impact of intra- and inter-fractional esophageal motion on dosimetry and observed toxicity in a phase I dose escalation study of accelerated radiotherapy with concurrent chemotherapy for locally advanced lung cancer.

Methods and Materials:

Patients underwent computed tomography imaging for radiotherapy treatment planning (CT1 and 4DCT1) and at 2 weeks (CT2 and 4DCT2) and 5 weeks (CT3 and 4DCT3) after initiating treatment. Each computed tomography scan consisted of 10-phase 4DCTs in addition to a static free-breathing or breath-hold computed tomography. The esophagus was independently contoured on all computed tomographies and 4DCTs. Both CT2 and CT3 were rigidly registered with CT1 and doses were recalculated using the original intensity-modulated radiation therapy plan based on CT1 to assess the impact of interfractional motion on esophageal dosimetry. Similarly, 4DCT1 data sets were rigidly registered with CT1 to assess the impact of intrafractional motion. The motion was characterized based on the statistical analysis of slice-by-slice center shifts (after registration) for the upper, middle, and lower esophageal regions, respectively. For the dosimetric analysis, the following quantities were calculated and assessed for correlation with toxicity grade: the percent volumes of esophagus that received at least 20 Gy (V20) and 60 Gy (V60), maximum esophageal dose, equivalent uniform dose, and normal tissue complication probability.

Results:

The interfractional center shifts were 4.4 ± 1.7 mm, 5.5 ± 2.0 mm and 4.9 ± 2.1 mm for the upper, middle, and lower esophageal regions, respectively, while the intrafractional center shifts were 0.6 ± 0.4 mm, 0.7 ± 0.7 mm, and 0.9 ± 0.7 mm, respectively. The mean V60 (and corresponding normal tissue complication probability) values estimated from the interfractional motion analysis were 7.8% (10%), 4.6% (7.5%), 7.5% (8.6%), and 31% (26%) for grade 0, grade 1, grade 2, and grade 3 toxicities, respectively.

Conclusions:

Interfractional esophageal motion is significantly larger than intrafractional motion. The mean values of V60 and corresponding normal tissue complication probability, incorporating interfractional esophageal motion, correlated positively with esophageal toxicity grade.

Abstract P1-05-04: Leptin modulates exosome biogenesis in breast cancer cells through an enhanced Hsp90/Tsg101 interaction

Exosomes, small membrane vesicles secreted by both normal and malignant cells upon fusion of endosomal multivesicular bodies (MVBs) with the plasma membrane,play an important role in cell-to-cell communication. Several reports have highlighted the involvement of exosomes in many aspects of breast cancer (BC) development and progression, thus mounting interest in the potential exploitation of these vesicles and their cargoes as cancer biomarkers, drug delivery systems, and for the development of novel therapies. It has been extensively demonstrated the involvement of the obesity hormone leptin in all steps of breast tumorigenesis, but up to now its role in modulating breast cancer exosome generation has not been investigated. Here, we studied the effect of leptin on exosome biogenesis and secretion in estrogen receptor a (ERa)-positive MCF-7 and triple negative MDA-MB-231 BC cells. First, we revealed by Transmission Electron Microscopy (TEM) that the number of MVBs in the cytoplasm of leptin-treated MCF-7 and MDA-MB-231 BC cells was significantly increased compared to control untreated cells. Next, we characterized size distribution, particle number and protein cargo of exosomes, isolated by ultracentrifugation method, from conditioned media (CM) of cells treated or not with leptin. Nanoparticle Tracking Analysis revealed that the concentration of exosomes in the leptin treated MCF-7- and MDA-MB-231-CM was significantly higher compared to untreated samples. Furthermore, exosomes quantification by Acetylcholinesterase activity showed that the full leptin receptor antagonist, peptide LDFI, abrogated leptin-induced exosome secretion. Exosomes from leptin treated cells showedan increased expression of the leptin target gene Heat shock protein 90 (Hsp90) and its client protein HER2, along with activated leptin signaling effectors (pJAK2, pSTAT3, and pMAPK42/44) compared to exosomes from untreated cells. Mechanistically, our results demonstrated that, among proteins involved in exosome biogenesis, leptin significantly increased protein expression of the well-known exosomal luminal marker Tumor susceptibility gene 101 (Tsg101), without affecting its mRNA levels. Thus, we aimed to analyse specific Tsg101 protein-protein interaction as a possible mechanism able to modulate its stability or half-life within the cells. To answer to this question, we performed, in MCF-7 BC cells, co-immunoprecipitation studies combined with mass spectrometry. Analysis of the spectra identified Hsp90 as a specific Tsg101 interacting protein, and concomitantly immunoblotting assays revealed a specific interaction between HSP90 and Tsg101 in basal condition that was further increased upon leptin exposure. Accordingly, leptin-induced Tsg101 protein levels were completely abrogated in the presence of specific Hsp90 inhibitor, 17-allylamino-17-demethoxygeldanamicin.

In conclusion, our results demonstrate for the first time that leptin was able to increase exosomes release in BC cells, through an up-regulation of Tsg101 expression at posttranslational level. These findings, providing additional insights into the molecular mechanism governing exosome generation in BC cells, might open new avenues for therapeutic intervention in BC.

Citation Format: Gelsomino L, Giordano C, Barone I, Panza S, Augimeri G, Bonofiglio D, Catalano S, Andò S. Leptin modulates exosome biogenesis in breast cancer cells through an enhanced Hsp90/Tsg101 interaction [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-05-04.

Rare-earth nickelates RNiO3: thin films and heterostructures

This review stands in the larger framework of functional materials by focussing on heterostructures of rare-earth nickelates, described by the chemical formula RNiO₃ where R is a trivalent rare-earth R  =  La, Pr, Nd, Sm, …, Lu. Nickelates are characterized by a rich phase diagram of structural and physical properties and serve as a benchmark for the physics of phase transitions in correlated oxides where electron-lattice coupling plays a key role. Much of the recent interest in nickelates concerns heterostructures, that is single layers of thin film, multilayers or superlattices, with the general objective of modulating their physical properties through strain control, confinement or interface effects. We will discuss the extensive studies on nickelate heterostructures as well as outline different approaches to tuning and controlling their physical properties and, finally, review application concepts for future devices.

Abstract P4-03-07: Inhibition of cancer-associated fibroblast function by farnesoid X receptor activation: Experimental basis for a novel therapeutic strategy in breast cancer

This abstract was withdrawn by the authors.

Multiple Supersonic Phase Fronts Launched at a Complex-Oxide Heterointerface

Selective optical excitation of a substrate lattice can drive phase changes across heterointerfaces. This phenomenon is a nonequilibrium analogue of static strain control in heterostructures and may lead to new applications in optically controlled phase change devices. Here, we make use of time-resolved nonresonant and resonant x-ray diffraction to clarify the underlying physics and to separate different microscopic degrees of freedom in space and time. We measure the dynamics of the lattice and that of the charge disproportionation in NdNiO_{3}, when an insulator-metal transition is driven by coherent lattice distortions in the LaAlO_{3} substrate. We find that charge redistribution propagates at supersonic speeds from the interface into the NdNiO_{3} film, followed by a sonic lattice wave. When combined with measurements of magnetic disordering and of the metal-insulator transition, these results establish a hierarchy of events for ultrafast control at complex-oxide heterointerfaces.

Striped nanoscale phase separation at the metal-insulator transition of heteroepitaxial nickelates

Nucleation processes of mixed-phase states are an intrinsic characteristic of first-order phase transitions, typically related to local symmetry breaking. Direct observation of emerging mixed-phase regions in materials showing a first-order metal–insulator transition (MIT) offers unique opportunities to uncover their driving mechanism. Using photoemission electron microscopy, we image the nanoscale formation and growth of insulating domains across the temperature-driven MIT in NdNiO₃ epitaxial thin films. Heteroepitaxy is found to strongly determine the nanoscale nature of the phase transition, inducing preferential formation of striped domains along the terraces of atomically flat stepped surfaces. We show that the distribution of transition temperatures is a local property, set by surface morphology and stable across multiple temperature cycles. Our data provide new insights into the MIT of heteroepitaxial nickelates and point to a rich, nanoscale phenomenology in this strongly correlated material.

Probing the evolution of mixed-phase states in materials offers unique insights into the microscopic mechanism of phase transitions. Here, Mattoni et al. report imaging of nanoscale formation and growth of insulating domains across the metal-insulator transition in NdNiO₃ thin films, uncovering a rich interplay between structural and electronic degrees of freedom.

Erratum to: Estrogen receptor beta binds Sp1 and recruits a corepressor complex to the estrogen receptor alpha gene promoter

Erratum to: Breast Cancer Res Treat (2012), 134:569–581, DOI 10.1007/s10549-012-2090-9. Uunfortunately, authors could not find the original film from which the figure was drawn. Therefore, as suggested by the Editor, they have repeated the relative experiment, and ask to publish this new figure as a correction. The authors apologize for any inconvenience that it may cause.

Abstract P1-03-06: Leptin as a mediator of tumor-stromal interactions promotes breast cancer stem cell activity

Breast cancer stem cells (BCSCs) play crucial roles in tumor initiation, metastasis and resistance to anticancer therapies. These cells rely for their properties on complex interactions with the tumor microenvironment through networks of cytokines and growth factors. In this study, we investigated how leptin, as a mediator of tumor-stromal interactions, may affect BCSC activity using breast cancer cell lines and patient-derived samples. We found that conditioned media (CM) from cancer associated fibroblasts and breast adipocytes significantly increase mammosphere formation in breast cancer cells. Depletion of leptin from stromal cell-CM as well as inhibition of leptin signaling by using a full leptin receptor antagonist peptide LDFI completely abrogated this effect. Accordingly, mammosphere cultures exhibited increased leptin receptor expression and leptin exposure enhanced mammosphere formation. Microarray analyses revealed a similar expression profile of genes involved in stem cell biology in mammosphere cells treated with stromal cell-CM and leptin. Interestingly, leptin is able to increase the mammosphere formation in metastatic breast cancer cells isolated from patients (n = 10) and this can be blocked by using peptide LDFI. In addition, leptin receptor (OBR) mRNA expression, analyzed in cells from metastatic fluids, directly correlated with mammosphere formation activity ex vivo (r=0.68, p= 0.05; n = 8). Finally, Kaplan–Meier survival curves indicated that OBR expression correlated with reduced overall survival in breast carcinomas (HR=1.9, p=0.022). Together, our results suggest that leptin/leptin receptor may represent a potential therapeutic target that can block the stromal-tumor interactions that drive BCSC-mediated disease progression.

Citation Format: Giordano C, Panza S, Chemi F, Barone I, Bonofiglio D, Cordella A, Hashim A, Györffy B, Simões BM, Clarke RB, Weisz A, Catalano S, Andò S. Leptin as a mediator of tumor-stromal interactions promotes breast cancer stem cell activity. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P1-03-06.

Abstract P5-04-10: Phosphodiesterase type 5 promotes the invasive potential of breast cancer cells through Rho GTPase activation

The impairment of cyclic guanosine monophosphate (cGMP) signaling by overexpression of PDE5 isoform has been recently described in multiple human carcinomas. In addition, accumulating evidences indicate that PDE5 inhibitors could have direct anti-cancer activities as well as they may enhance the sensitivity of certain types of cancer to standard chemotherapeutic drugs. However, despite these studies, neither the expression of PDE5 in breast cancer subtypes nor the underlying regulatory molecular mechanisms by which PDE5 expression may contribute to breast cancer progression have been deeply studied.

We demonstrated that PDE5 was expressed in different subtypes of breast cancer cell lines at higher levels than in non tumorogenic human epithelial breast cell lines. Increased levels were detected in more aggressive endocrine non responsive basal-like breast cancer cells. Interestingly, PDE5 was expressed at very low levels in luminal A-type breast cancer cell lines, which display low ki67 expression, weak invasive behavior and endocrine responsiveness (MCF-7 and T47D cells) compared to luminal B-like cells (such as ZR-75 cells). These results well correlated with data obtained in immunohistochemistry analyses of human breast cancer tissues, showing PDE5 expression in 30 of 35 tumor entities analyzed, with the highest intensity staining in high-grade tumors. Concomitantly, no cytoplasmic PDE5 staining was observed in non neoplastic tissues examined (n=5). In addition, retrospective analyses (n=1959, median follow-up time: 25 years) showed that high PDE5 expression in breast cancer patients was correlated with a statistically significant poorer survival compared to low PDE5-expressing patients. A more relevant discrimination is achieved in lymphnode-negative patients, suggesting a role of PDE5 for identifying early patients at high risk of rapid progression.

In order to better ascertain the role of PDE5 in breast tumorogenesis, we selected a breast tumor cell line that express low levels of this enzyme, MCF-7 and engineered stable clones for overexpression studies. Both vector- and PDE5-stable MCF-7 clones demonstrated comparable proliferation rates; whereas, cell motility and invasion were dramatically increased in PDE5-overexpressing cells. RNA sequencing to compare the transcriptomes of vector- and PDE5-overexpressing MCF-7 cells identified differential expression of genes involved in cell migration and invasion. Particularly, based on pathway analysis we found marked changes in the expression of Rho GTPase family members, proteins involved in cell cytoskeleton organization, migration, and metastasis dissemination (Rho A, cdc42 and Rac signaling, activation score= 1.9, 1.342, and 0.302, respectively). Indeed, Rho and cdc42 pull-down assays revealed increased Rho GTPase activity in cells overexpressing PDE5. Moreover, the selective ROCK inhibitor Y-27632 as well as the PDE5 inhibitor sildenafil were able to significantly reduce both migration and invasion of PDE5 clones.

Our data reveal that PDE5 expression enhances motility and invasiveness of breast cancer cells through the activation of the Rho family of GTPases, and highlight, for the first time, a novel role for PDE5 as a marker of poor outcome in breast cancer patients.

Citation Format: Barone I, Campana A, Giordano C, Tarallo R, Rinaldi A, Bruno G, Gyorffy B, Lanzino M, Bonofiglio D, Catalano S, Ando' S. Phosphodiesterase type 5 promotes the invasive potential of breast cancer cells through Rho GTPase activation. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr P5-04-10.

Interfacial Control of Magnetic Properties at LaMnO3/LaNiO3 Interfaces

The functional properties of oxide heterostructures ultimately rely on how the electronic and structural mismatches occurring at interfaces are accommodated by the chosen materials combination. We discuss here LaMnO3/LaNiO3 heterostructures, which display an intrinsic interface structural asymmetry depending on the growth sequence. Using a variety of synchrotron-based techniques, we show that the degree of intermixing at the monolayer scale allows interface-driven properties such as charge transfer and the induced magnetic moment in the nickelate layer to be controlled. Further, our results demonstrate that the magnetic state of strained LaMnO3 thin films dramatically depends on interface reconstructions.

Helminths of grizzly bears (Ursus arctos) and American black bears (Ursus americanus) in Alberta and British Columbia, Canada

Between May 2011 and June 2013, we collected the carcasses and gastrointestinal tracts of 40 American black bears (Ursus americanus Pallas, 1780) and 13 grizzly bears (Ursus arctos L., 1758) from populations of Alberta and British Columbia, Canada. Specimens were examined for helminths, which were identified to the species level by applying an integrated morphological and molecular approach. Our goal was to investigate parasite biodiversity and infection parameters in the sampled grizzly and black bears. We found seven parasite taxa: Dirofilaria ursi Yamaguti, 1941, Baylisascaris transfuga (Rudolphi, 1819), Uncinaria rauschi Olsen, 1968, Uncinaria yukonensis (Wolfgang, 1956), Taenia arctos Haukisalmi, Lavikainen, Laaksonen and Meri, 2011, Diphyllobothrium dendriticum (Nitzsch, 1824), and Diphyllobothrium nihonkaiense Yamane, Kamo, Bylund and Wikgren, 1986. The statistical significance of infection prevalence, intensity, and abundance for each helminth species was assessed relative to host species, gender, age class, sampling season, and location. This is the first unequivocal report of the potentially zoonotic tapeworms D. dendriticum and D. nihonkaiense in North American bears. Furthermore, we provide insight into the biology and ecology of the nematodes B. transfuga, D. ursi, and species of Uncinaria Frölich, 1789, and enrich the information available on the recently described tapeworm T. arctos.

The impact of drug interactions and polypharmacy on antimicrobial therapy in the elderly

Infectious diseases are more prevalent in older people than in younger adults, and represent a major healthcare issue in older populations. Indeed, infections in the elderly are often associated with higher morbidity and mortality, and may present atypically. Additionally, older patients are generally treated with polypharmacy regimens, which increase the likelihood of drug-drug interactions when the prescription of an antimicrobial agent is needed. A progressive impairment in the functional reserve of multiple organs may affect either pharmacokinetics or pharmacodynamics during aging. Changes in body composition occurring with advancing age, reduced liver mass and perfusion, and reduced renal excretion may affect either pharmacokinetics or pharmacodynamics. These issues need to be taken into account when prescribing antimicrobial agents to older complex patients taking multiple drugs. Interventions aimed at improving the appropriateness and safety of antimicrobial prescriptions have been proposed. Educational interventions targeting physicians may improve antimicrobial prescriptions. Antimicrobial stewardship programmes have been found to reduce the length of hospital stay and improve safety in hospitalized patients, and their use in long-term care facilities is worth testing. Computerized prescription and decision support systems, as well as interventions aimed at improving antimicrobial agents dosage in relation to kidney function, may also help to reduce the burden of interactions and inherent costs.

Invasive species and their parasites: eastern cottontail rabbit Sylvilagus floridanus and Trichostrongylus affinis (Graybill, 1924) from Northwestern Italy

The eastern cottontail Sylvilagus floridanus is a native American lagomorph. Within the genus Sylvilagus, the eastern cottontail is the species with the widest distribution. From 1950s, the species was introduced to several European countries. A rapid territorial expansion of the introduced eastern cottontails has been observed in many areas of Italy. The eastern cottontail has been demonstrated to play a main role as carrier of exotic parasites. To date, three nematode species, exotic in Italian ecosystems, have been reported from introduced S. floridanus. However, its parasite fauna biodiversity is richer in native populations of the American continent. The aim of this work was to further investigate the gastrointestinal parasites of S. floridanus, to evaluate the potential presence of other exotic species. During 2010, 101 hosts were examined, and three nematodes were collected from their digestive tract. Two parasite species (Obeliscoides cuniculi, Trichostrongylus calcaratus) were already reported in Italy; the isolation of Trichostrongylus affinis is instead the first report of this nematode in Italy and in Europe as a whole. This study wants to highlight the great risks related to the introduction of allochthonous species. The impact of the invasion by alien animal species may be particularly severe for public and animal health, due to the potential introduction of new pathogens. The good number of exotic parasites found in introduced eastern cottontails, together with the few sanitary surveys carried out, suggests that an epidemiological survey, with specimens from multiple localities on a wider geographic range, could lead to interesting findings on parasites of native and alien lagomorphs in Europe.

Bergapten induces ER depletion in breast cancer cells through SMAD4-mediated ubiquitination

ERα function is crucial for the development of normal mammary gland as well as in the process of progression of breast cancer cells. Signals that target receptor levels contribute to regulate estrogens effects in the cells. An intricate cross-regulation has been documented between ERα and TGF-β down-stream molecules: SMAD2, SMAD3, and SMAD4, that can bind ERα and regulate their signaling. Thus, identification of natural anticancer drugs able to influence the latter molecule might provide alternative choices for breast cancer treatment. Taking into account our previous published data we wanted to study the effect of 5-Methoxypsoralen (bergapten) on ERα and on TGF-β pathway. We reported that bergapten, a coumarin containing compound, effectively depletes ERα in MCF-7 breast cancer sensitive cells and in tamoxifen-resistant clone. The decrease of ERα protein after bergapten treatment results from the ubiquitine-proteasome pathway as demonstrated by the use of MG-132. IP experiments with ER antibody, demonstrated that the protein has physical interaction with SMAD4 and poly-ubiquitine and the amount of ubiquitinated receptor, linked to SMAD4, is greater under bergapten. The crucial role played by SMAD4, in this process, emerges from the observation that in breast cancer cells, silencing of SMAD4, resulted in increased expression of endogenous ERα in both control and bergapten-treated cells, compared to wild- type cells. The same results were confirmed in siRNA TGF-β RII cells. The results suggest a novel negative regulation of ERα by TGF-β/SMAD4 in breast cancer cells and indicate that the SMAD4 protein is involved in the degradation of ERα induced by bergapten. We propose that bergapten may efficiently act as a natural antitumoral agent, able to deplete ERα from breast cancer tamoxifen-sensitive and resistant cells, thereby retraining the effect of membrane signals targeting ERα and in such way its mitogenic potentiality.

Gastrointestinal parasites of coyotes (Canis latrans) in the metropolitan area of Calgary, Alberta, Canada

Disease ecology is a relevant but relatively unexplored subject of research in urban coyotes ( Canis latrans Say, 1823). In fact, this carnivore may play a role in the circulation of parasites that can have implications on the health of humans and domestic dogs, but can also be affected by pathogens transmitted from domestic reservoirs. To investigate the gastrointestinal parasites of urban coyotes in Calgary, Alberta, Canada, we analyzed 61 carcasses and 247 fecal samples collected within the metropolitan area, including city parks, in 2009–2010. We found nine parasite taxa: Toxascaris leonina (Linstow, 1902), Uncinaria stenocephala (Railliet, 1884), Ancylostoma caninum (Ercolani, 1859), Pterygodermatites affinis (Jägerskiöld, 1904), Trichuris vulpis (Froelich, 1789), Echinococcus multilocularis Leuckart, 1863, Taenia crassiceps (Zeder, 1800), genus Giardia Kunstler, 1882, and genus Cystoisospora Frenkel, 1977. Factors related to coyote ecology, habitat characteristics, and dog management likely influence the community of coyote parasites in an urban environment, and need to be taken into account to assess the actual role of this carnivore in the maintenance of parasites in the city landscape. Further research is needed to assess the current risk for transmission of potentially zoonotic parasites (e.g., E. multilocularis, T. crassiceps, Giardia sp.) among coyotes, dogs, and humans.

Estrogen receptor beta binds Sp1 and recruits a corepressor complex to the estrogen receptor alpha gene promoter

Human estrogen receptors alpha and beta are crucially involved in the regulation of mammary growth and development. Normal breast tissues display a relative higher expression of ER beta than ER alpha, which drastically changes during breast tumorogenesis. Thus, it is reasonable to suggest that a dysregulation of the two estrogen receptor subtypes may induce breast cancer development. However, the molecular mechanisms underlying the potential opposing roles played by the two estrogen receptors on tumor cell growth remain to be elucidated. In the present study, we have demonstrated that ER beta overexpression in breast cancer cells decreases cell proliferation and down-regulates ER alpha mRNA and protein content, along with a concomitant repression of estrogen-regulated genes. Transient transfection experiments, using a vector containing the human ER alpha promoter region, showed that elevated levels of ER beta down-regulated basal ER alpha promoter activity. Furthermore, site-directed mutagenesis and deletion analysis revealed that the proximal GC-rich motifs at -223 and -214 are critical for the ER beta-induced ER alpha down-regulation in breast cancer cells. This occurred through ER beta-Sp1 protein-protein interactions within the ER alpha promoter region and the recruitment of a corepressor complex containing the nuclear receptor corepressor NCoR, accompanied by hypoacetylation of histone H4 and displacement of RNA-polymerase II. Silencing of NCoR gene expression by RNA interference reversed the down-regulatory effects of ER beta on ER alpha gene expression and cell proliferation. Our results provide evidence for a novel mechanism by which overexpression of ER beta through NCoR is able to down regulate ER alpha gene expression, thus blocking ER alpha's driving role on breast cancer cell growth.

Farnesoid X receptor inhibits tamoxifen-resistant MCF-7 breast cancer cell growth through downregulation of HER2 expression

Tamoxifen (Tam) treatment is a first-line endocrine therapy for estrogen receptor-α-positive breast cancer patients. Unfortunately, resistance frequently occurs and is often related with overexpression of the membrane tyrosine kinase receptor HER2. This is the rationale behind combined treatments with endocrine therapy and novel inhibitors that reduce HER2 expression and signaling and thus inhibit Tam-resistant breast cancer cell growth. In this study, we show that activation of farnesoid X receptor (FXR), by the primary bile acid chenodeoxycholic acid (CDCA) or the synthetic agonist GW4064, inhibited growth of Tam-resistant breast cancer cells (termed MCF-7 TR1), which was used as an in vitro model of acquired Tam resistance. Our results demonstrate that CDCA treatment significantly reduced both anchorage-dependent and anchorage-independent epidermal growth factor (EGF)-induced growth in MCF-7 TR1 cells. Furthermore, results from western blot analysis and real-time reverse transcription-PCR revealed that CDCA treatment reduced HER2 expression and inhibited EGF-mediated HER2 and p42/44 mitogen-activated protein kinase (MAPK) phosphorylation in these Tam-resistant breast cancer cells. Transient transfection experiments, using a vector containing the human HER2 promoter region, showed that CDCA treatment downregulated basal HER2 promoter activity. This occurred through an inhibition of nuclear factor-κB transcription factor binding to its specific responsive element located in the HER2 promoter region as revealed by mutagenesis studies, electrophoretic mobility shift assay and chromatin immunoprecipitation analysis. Collectively, these data suggest that FXR ligand-dependent activity, blocking HER2/MAPK signaling, may overcome anti-estrogen resistance in human breast cancer cells and could represent a new therapeutic tool to treat breast cancer patients that develop resistance.

[Reoperations in hyperparathyroidism]

Reoperative parathyroidectomy (PTx) is challenging for the surgeon. Before reintervention it is essential to evaluate the operative notes and pathology reports from the previous operation, the localization exams (sestaMIBI scintigraphy and ultrasound) and IOPTH assay are also essential. The surgeon is supposed to perfectly know the anatomy and embryology of parathyroid glands and experience with parathyroid surgery is still the most important predictor of success in reoperative PTx. Reinterventions in HPT have good results with a resolution of hyperparathyroidism in 85-90% for primary HPT and in 70% for secondary and tertiary HPT. Authors present their experience of 76 reinterventions after HPT I and 85 reinterventions after HPT II and III over a total of 2072 parathyroidectomies, carried out between January 1975 and October 2009.

Peroxisome proliferator-activated receptor gamma inhibits follicular and anaplastic thyroid carcinoma cells growth by upregulating p21Cip1/WAF1 gene in a Sp1-dependent manner

Peroxisome proliferator-activated receptor gamma (PPARgamma) has been demonstrated to be anti-neoplastic against various human tumors. The aim of this study was to delineate the molecular mechanism underlying PPARgamma ligand rosiglitazone (BRL) antiproliferative effects in follicular WRO and anaplastic FRO human thyroid carcinoma cells. BRL upregulated the p21Cip1/WAF1 levels in the two thyroid cancer cells, while did not modify the p53 protein content. Different evidences indicate that the p21Cip1/WAF1 upregulation by BRL requires a functional PPARgamma, since it was reversed by silencing PPARgamma and pretreatment with GW9662, an irreversible PPARgamma antagonist. Transient transfection assays showed that BRL triggered the transcriptional activity of p21Cip1/WAF1 promoter gene in a p53-independent way, being a p21Cip1/WAF1 promoter construct deleted in the p53 sites still activated by BRL. The Sp1 inhibitor mithramycin silenced the p21Cip1/WAF1 promoter activity suggesting an important role of Sp1 in mediating BRL activation. The electrophoretic mobility shift and chromatin immunoprecipitation (ChIP) assays evidenced a functional interaction between PPARgamma and Sp1 in regulating p21Cip1/WAF1. Intriguingly, ChIP analysis revealed in the p21Cip1/WAF1 gene promoter an increased recruitment of the RNA Pol II associated with an increased histone H3 acetylation and a reduced H3 methylation. The biological event, consistent with PPARgamma-induced WRO and FRO cell growth inhibition, was reversed by p21Cip1/WAF1 antisense oligonucleotides and was confirmed by increasing the PPARgamma expression, suggesting a crucial role exerted by p21Cip1/WAF1 in PPARgamma action. Our results further candidate BRL as a potential agent able to inhibit tumor progression of follicular and anaplastic thyroid carcinoma.

[Diagnosis of alexithymia in the workplace: definition and validation of an instrument]

The aim of this study is to provide, to develop and validate, a new instrument for measuring alexithymia in the workplace. To develop and validate the MAQ in the Italian population, verifying its psychometric properties, we involved 585 participants, ranged from 16 to 33 of age, divided by gender and level of schooling. All participants completed MAQ which contained 108 items, and then Principal Components Analysis with Oblimin rotation was elaborated to understand latent structure of alexithymia. The study showed Alexithymia is composed by five dimensions: (1) difficulty to communicate, (2) to identify emotions, (3) and to manage time such as a coping style, (4) diffident attachment, (5) and pragmatic way to think. The psychometric properties of MAQ and internal consistency were demonstrated to be robust. Reliability analysis by Alpha was significant. Hence, MAQ could be useful in evaluating of the main traits involved in Alexithymia.

The red wine phenolics piceatannol and myricetin act as agonists for estrogen receptor alpha in human breast cancer cells

Previous epidemiological reports have suggested that red wine intake is associated with beneficial health effects due to the ability of certain phytochemical components to exert estrogen-like activity. It has been also documented that estrogens induce the proliferation of hormone-dependent breast cancer cells by binding to and transactivating estrogen receptor (ER) alpha, which in turn interacts with responsive DNA sequences located within the promoter region of target genes. In order to provide further insight into the positive association between wine consumption and the incidence of breast carcinoma in postmenopausal women, we have evaluated the estrogenic properties of two abundant wine-derived compounds, named piceatannol (PIC) and myricetin (MYR), using as model systems the hormone-sensitive MCF7 and the endocrine-independent SKBR3 breast cancer cells. On the basis of our experimental evidence PIC and MYR may contribute to the estrogenicity of red wine since: (1) they transactivate endogenous ER alpha; (2) they activate the agonist-dependent activation function (AF) 2 of ER alpha and ER beta in the context of the Gal4 chimeric proteins; (3) they rapidly induce the nuclear immunodetection of ER alpha; (4) they regulate the expression of diverse estrogen target genes; (5) they compete with 17beta-estradiol for binding to ER alpha and ER beta; and--as a biological counterpart of the aforementioned abilities--(6) they exert stimulatory effects on the proliferation of MCF7 cells. Hence, the estrogenic activity of PIC and MYR might be considered at least as a potential factor in the association of red wine intake and breast tumors, particularly in postmenopausal women.

Virilization of the female spotted hyena cannot be explained by alterations in the amino acid sequence of the androgen receptor (AR)

The external genitalia of the female spotted hyena are male in character, consistent with virilization by androgens during embryogenesis that results in the fusion of the vaginal labia to form a pseudo scrotum and enlargement of the clitoris to form a phallus. Explanations advanced to account for these anatomic differences have centered on the production or metabolism of androgens in utero or on abnormalities of the androgen receptor (such as a constitutively active AR). The structure of the spotted hyena AR was examined at the level of genomic DNA and cDNA. Southern analysis detected two Eco RI endonuclease cleavage fragments (4.4 and 4.7 kb) that encode the bulk of the AR hormone-binding domain. Isolation of the smaller fragment from a size fractionated genomic library revealed that it contained exons 6, 7 and 8. The remaining portions of the coding sequence were cloned by RT-PCR and RACE analyses. The spotted hyena cDNA sequence predicts protein 912 amino acids in length, which is most closely related to the sequence of the dog AR. Although a number of differences in the predicted amino acid sequence are identified, particularly within the amino terminus, only single amino acid substitutions are present in the DNA- and ligand-binding domains compared to the human AR. In transfection assays, the spotted hyena AR does not exhibit constitutive activity and responds normally to a range of androgenic and non-androgenic ligands. These findings suggest that the structural changes in the AR do not account for the abnormal virilization in the female spotted hyena. These results serve to focus attention on processes proximal (an abnormality of hormone formation in situ) or distal (activation by other mechanisms of processes normally regulated by androgen) to the AR as the cause of the virilization.

In vitro antimicrobial activity of extracts and isolated constituents of Rubus ulmifolius

The antimicrobial activity on bacteria and fungi of increasing polarity extracts of Rubus ulmifolius and that of some isolated constituents, quercetin-3-O-beta-D-glucuronide; kaempferol-3-O-beta-D-glucuronide, gallic acid, ferulic acid and tiliroside was evaluated. The phenolic and tannins fractions showed an high antimicrobial activity.

Volatile compounds from three cultivars of Olea europaea from Italy

The chemical compositions of the volatile fractions from three Olea europaea L. cultivars (Leccino, Frantoio, and Cipressino) were examined by GC and GC-MS. The results showed that the cultivars can be distinguished on the basis of the volatile fraction compositions.

Aromatase messenger RNA is derived from the proximal promoter of the aromatase gene in Leydig, Sertoli, and germ cells of the rat testis

It has long been recognized that individual cell types within the testes possess the capacity to synthesize estrogen. A number of studies on different species have demonstrated that the levels of aromatase expression and the patterns of regulation are distinct between the different cell types of the testes. Whereas a variety of promoters have been shown to contribute to the patterns of aromatase expression in different cell lineages, studies using ovarian RNA, testis RNA, and Leydig cell tumor lines have demonstrated that the same promoter (promoter II) was used in each. Recent experiments using potent aromatase inhibitors or analysis of animals in which the genes encoding the estrogen receptor-alpha (ER-alpha) or the aromatase, P450, are defective, have confirmed the importance of local estrogen formation in normal testicular function. In order to permit experiments to identify the elements controlling aromatase expression in the individual cell compartments of the testes, we prepared RNA from purified preparations of Leydig, Sertoli, and germ cells. Using specific oligonucleotide primers, the sites of initiation of the aromatase mRNA were determined using rapid amplification of cDNA ends (RACE) and nucleotide sequence analysis of the resulting cDNA fragments. Our results indicate that aromatase mRNA is derived from the proximal promoter (PII) of the aromatase gene in each of the major cell types of the rat testes.

Bone mineral density is inversely related to parathyroid hormone in adolescent girls

Preventive programs aimed at maximizing peak bone mass as a way of reducing the risk of osteoporotic fractures later in life should take into account the contribution of nutritional factors to bone mass accumulation in young age. The role of calcium and energy intakes on radial mineral density was investigated in 200 healthy girls (aged 11-15 yr) simultaneously evaluating serum changes of insulin-like growth factor-I (IGF-I), parathyroid hormone (PTH) and osteocalcin (OC). Dietary calcium and energy intakes were assessed by a 3-day food record method, bone mineral density (BMD) was performed at ultradistal (ud) and proximal (pr) radial sites using dual energy X-ray absorptiometry. Calcium consumption below the levels suggested by Dietary Reference Intakes in more than 80% of population studied was not related to BMD, which in turn markedly increased in post-compared to premenarcheal girls. Interestingly, in a multiple regression analysis PTH was inversely related to BMD after adjustment for calcium intake, bone age and menarche. Serum IGF-I was positively associated to energy intakes and bone age in girls before menarche, who exhibited the highest values of OC. Our data highlighted the role of food habits in modulating some hormonal response that might influence bone mineral apposition during adolescent age. Low calcium consumption associated to enhanced PTH values, if persisting, could be responsible for reduced rate of gain in bone mineral density. Thus, to optimize bone mineralization during the critical period of rapid body growth adequate intakes of calcium and energy should be recommended.

In vitro antimicrobial activity of extracts and isolated constituents of Geum rivale

The antimicrobial activity of extracts of Geum rivale (Rosaceae) and that of some isolated constituents, on bacteria and fungi, was evaluated. The activity was concentrated in the triterpenes fraction and, for gram+ and gram- bacteria, also in the flavonoids fraction.

Parathyroid hormone is elevated but bone markers and density are normal in young female subjects who consume inadequate dietary calcium

Dietary Ca and osteocalcin (OC), parathyroid hormone (PTH), 25-hydroxyvitamin D (25-OH-D), insulin-like growth factor (IGF)-I and sex hormone binding globulin (SHBG) were assessed simultaneously to bone mineral density (BMD) in 200 adolescent girls (aged 11-15 years) and 100 young women (aged 20-23 years), selected from the lowest and highest end of the Ca intake distribution of a larger population sample. Ca intake was evaluated by food frequency questionnaires, BMD was measured by dual energy x-ray absorptiometry at ultradistal and proximal radius of non-dominant arm, bone age was estimated from x-rays of left hand and wrist according to Tanner et al. (1983). Surprisingly, mean Ca intakes were below the dietary reference intakes in the subgroups of girls and women with the highest measured Ca consumption. Postmenarcheal, but not premenarcheal girls showed radial densities as high as the women and in no group was BMD associated with Ca intake. In all adolescents serum PTH was negatively related to dietary Ca. In girls before menarche IGF-I was positively associated with bone age, while in the same subjects the negative relationship between SHBG and BMD pointed to the crucial role of bioavailable sex steroids on bone mass apposition in early puberty. OC levels decreased progressively with age, while serum 25-OH-D significantly increased after menarche. In conclusion, although in adolescents low Ca intake has not been shown to induce any immediate deleterious effect on radial density, the compensatory hypersecretion of PTH supports the need for an adequate Ca intake to achieve peak bone mass.

Critical years and stages of puberty for radial bone mass apposition during adolescence

The acquisition of radial mineral density was evaluated in relation to anthropometric characteristics, menarche status, calcium intake and physical activity in a healthy young female population (200 girls and 100 women, respectively aged 11-16 yrs and 20-24 yrs) living in an area of Southern Italy. We performed bone mineral density (BMD) by dual energy X-ray absorptiometry on the ultradistal and middistal radius. Dietary calcium intake was evaluated by a detailed Food Frequency Questionnaire and confirmed by a 3-day record. A questionnaire on energy expenditure was used to assess physical activity in each participant. Morning blood samples were drawn from fasting girls to measure 25-hydroxycalciferol (25 OH-D). We found current calcium above the levels reported by Recommended Dietary Allowances (RDA) in only 31% of women and 6% of girls. BMD steadily increased up to the age of 16 and was increased in postmenarcheal girls compared to premenarcheals of the same pubertal stage. Bone density was also significantly related to age, weight and height in postmenarcheal adolescents, while in girls before and after menarche, no relation was observed between radial BMD and calcium intake or physical activity. In the presence of comparable calcium-intake values recorded in pre- and in postmenarcheal girls, the latter subgroup displayed a marked increase of 25 OH-D serum levels. Our study revealed a calcium intake lower than the RDA in a large percentage of healthy girls and young women, and emphasized the importance of menarche occurrence in bone mass acquisition during pubertal development.

The effect of dietary calcium intake on bone mineral density in healthy adolescent girls and young women in southern Italy

BACKGROUND

The association between forearm bone mineral areal density (BMD) and dietary calcium, anthropometric characteristics, puberty, and physical activity was studied for the first time in 200 girls (aged 11-15 years) and 100 women (aged 20-23 years) living in Southern Italy.

METHODS

The BMD was assessed by dual energy x-ray absorptiometry at ultradistal (ud) and proximal (pr) radial sites and dietary calcium was evaluated using Food Frequency Questionnaires and detailed 3-day food records.

RESULTS

For population samples grouped according to low and high calcium intake levels, forearm densities were quite similar among both girls and women. Independently of calcium intake, girls displayed strong correlations between ud/pr-BMD and age, bone age, weight, height and BMI. Furthermore, in girls of similar age and BMI, radial densities were substantially increased following menarche. Positive relationships between weight, BMI and both ud/pr-BMD were only evident in women with high calcium intake.

CONCLUSIONS

This study showed that different calcium intake values do not appear to affect forearm mineral densities at the ages investigated, however puberty represents the major event in radial bone mass acquisition during adolescence.

Antimicrobial activity of extracts of Mutisia acuminata var. acuminata

The biological activity of methanol and water extracts of Mutisia acuminata Ruiz et Pavon var. acuminata (Asteraceae) against bacteria and fungi (spores and mycelia) was evaluated. The role of pH of the medium in antimicrobial activity was investigated.

[Classification of congenital heart diseases and surgical interventions in pediatric cardiology for the standardization of hospitalization records]

The utilization of DRGs for the evaluation of hospital activity requires the availability, on a current basis, of coded in-patient records (Hospital Discharge Form, SDO) with information concerning nosology of the patient and procedures performed. Consequently, the promotion of a standardized use of ICD.9 and ICD.9.CM code systems (International Classification of Diseases, 9th Revision, and International Classification of Diseases, 9th Revision, Clinical Modification) among clinicians is necessary. The National Research Council, Council Research Hospital for Cardiology and Cardiac Surgery (CREAS-IFC-CNR) has promoted the establishment of a permanent work group for the evaluation of the activity in the field of pediatric cardiology and cardiosurgery at a national level. In co-operation with two leading institution (AO "Bambino Gesù", Rome; AO "G. Gaslini", Genoa) an in-patient survey has been promoted including an overall revision of the ICD.9.CM code systems both for diagnosis and procedures in order to improve the standardization of data. Besides, the fitness of DRGs allocation by different codes has been judged. Some general and specific suggestions upon codes adequacy and DRGs identification have emerged from this study. The aim of this paper is to spread this preliminary standardization activity of the group as a contribution to the improvement of in-patient coded records quality.