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The epiphytes of seagrass leaves constitute a peculiar community, comprised of a number of species specialized for this living substrate. Several studies report on the response of epiphytes to different pressures but no information exists about the effects of summer heatwaves, which have become frequent events in the last decades. This paper represents the first attempt to investigate the change in the leaf epiphyte community of the Mediterranean seagrass Posidonia oceanica due to the heatwave occurred in summer 2003. Thanks to a series of data collected seasonally between 2002 and 2006, and punctual data in the summers of 2014 and 2019, we assessed the change over time in the leaf epiphyte community. Temperature data trends were analysed through linear regression, while multivariate analyses (i.e., nMDS and SIMPER) were applied to cover data in order to assess changes over time in the epiphyte community. As a whole, the two most abundant taxa were the crustose coralline alga Hydrolithon and the encrusting bryozoan Electra posidoniae , which displayed the highest average cover values in summer (around 19%) and spring (around 9%), respectively. Epiphytes proved to be sensitive to temperature highs, displaying different effects on cover, biomass, diversity and community composition. Cover and biomass exhibited a dramatic reduction (more than 60%) after the disturbance. In particular, Hydrolithon more than halved, while E. posidoniae dropped sevenfold during summer 2003. While the former recovered comparatively quickly, the latter, as well as the whole community composition, apparently required 16 years to return to a condition similar to that of 2002. • Seagrass leaf epiphytes constitute a specialized community. • Epiphytes of Posidonia oceanica have been impacted by summer heatwave in 2003. • Epiphytic cover and biomass exhibited a dramatic reduction. • Epiphyte community composition required 16 years to recover. [ABSTRACT FROM AUTHOR]

Capillarity in wet granular materials induces cohesion and increases the material strength due to the attractive forces acting on capillary bridges. In the funicular state, water bridges may be not only formed between two grains but also binding three or more particles, which breaks the axial symmetry of the liquid bridge. This work presents a fundamental study on capillary forces and rupture behaviours of funicular water bridges between three spherical bodies at equilibrium (or static) configurations. Funicular water clusters are numerically solved by an energy minimization approach. Experimental comparisons are made by measuring capillary forces and these confirm the validity of the numerical solutions. Evolutions of capillary forces and rupture distances are investigated systematically by moving two spheres away from the centre. The fixed water volume condition and the constant mean curvature condition are studied respectively. Comparisons are made between the un-coalesced pendular liquid rings and the coalesced funicular bridge. For a same fixed total water volume, the capillary force is weakened by water bridge coalescence to a funicular bridge when the spheres are packed together, but the situation may vary for different contact angles and inter-particle distances. For the constant mean curvature condition, water bridge coalescence does not alter capillary force significantly when particles are packed closely, but the discrepancy is larger by increasing the gap. Funicular water bridge rupture criteria are also proposed based on the studied configurations. It is observed that in general the transmission from pendular to funicular state extends the rupture distance when it has a relatively high water volume or low air-water pressure difference. [ABSTRACT FROM AUTHOR]

Summary: Mucosal leishmaniasis of the upper respiratory tract is usually associated with the visceral form or is found in immunosuppressed individuals. This report presents a case of isolated mucosal leishmaniasis in an immunocompetent patient, whose diagnosis mainly rested on histology and positive polymerase chain reaction result for Leishmania donovani in the laryngeal tissue. A 59-year-old man, who never lived outside Italy, showed a subglottic mucosal polypoid-like lesion. The typical morphological picture and positive polymerase chain reaction result for L donovani by DNA extracted from laryngeal biopsy specimens allowed the diagnosis of mucosal leishmaniasis. Specific amphotericin B therapy was started, resulting in clinical and endoscopic improvement. Increased knowledge about the histological and molecular tissue analysis of Leishmania enhances the diagnostic testing for mucosal leishmaniasis, as primary mucosal leishmaniasis may occur in both immunosuppresed and immunocompetent patients who travel to or reside in areas endemic for Leishmania. [Copyright &y& Elsevier]

Background Human Cytomegalovirus (HCMV) infection has been reported to be a cause of refractory ulcerative colitis (UC). Toxic megacolon (TM) is a rare but severe complication of an acute attack of UC. Objectives Aim of this study is to evaluate in a case-control study the association between HCMV and TM. Study design All patients who were admitted at Medicine Department of V. Cervello Hospital in Palermo (tertiary referral center) for a severe UC flare-up complicated by the onset of TM (diameter of the transverse colon > 6 cm) between January 1990 and November 2011 were identified through the electronic database. A total of 24 consecutive patients (16 male/8 female) with TM were identified. Each case of TM were individually matched by sex, age, extent of the underlying disease to 24 severe UC controls who did not develop TM. A further non matched control population of 48 severe UC was included. Haematoxilin and eosin stain, immunohistochemical procedure and nested polymerase chain reaction were performed to detect HCMV genes and proteins on rectal biopsies or surgical specimens. Pp65 antigenemia was performed in order to diagnose any possible systemic infection. HCMV frequency was compared between patients with and without TM during follow-up, using Fisher’s Exact test. Results and conclusions HCMV was detected in histological specimens of 11 patients (46%) with TM compared to 2 (9%) severe UC matched controls ( P = 0.0078) and 7 (14%) unmatched controls ( p = 0,003). In severe colitis the presence of HCMV is more frequently associated with TM. [ABSTRACT FROM AUTHOR]

Background Aneurysms affecting the aorta are a common condition associated with high mortality as a result of aortic dissection or rupture. Investigations of the pathogenic mechanisms involved in syndromic types of thoracic aortic aneurysms, such as Marfan and Loeys-Dietz syndromes, have revealed an important contribution of disturbed transforming growth factor (TGF)-β signaling. Objectives This study sought to discover a novel gene causing syndromic aortic aneurysms in order to unravel the underlying pathogenesis. Methods We combined genome-wide linkage analysis, exome sequencing, and candidate gene Sanger sequencing in a total of 470 index cases with thoracic aortic aneurysms. Extensive cardiological examination, including physical examination, electrocardiography, and transthoracic echocardiography was performed. In adults, imaging of the entire aorta using computed tomography or magnetic resonance imaging was done. Results Here, we report on 43 patients from 11 families with syndromic presentations of aortic aneurysms caused by TGFB3 mutations. We demonstrate that TGFB3 mutations are associated with significant cardiovascular involvement, including thoracic/abdominal aortic aneurysm and dissection, and mitral valve disease. Other systemic features overlap clinically with Loeys-Dietz, Shprintzen-Goldberg, and Marfan syndromes, including cleft palate, bifid uvula, skeletal overgrowth, cervical spine instability and clubfoot deformity. In line with previous observations in aortic wall tissues of patients with mutations in effectors of TGF-β signaling ( TGFBR1/2, SMAD3, and TGFB2 ), we confirm a paradoxical up-regulation of both canonical and noncanonical TGF-β signaling in association with up-regulation of the expression of TGF-β ligands. Conclusions Our findings emphasize the broad clinical variability associated with TGFB3 mutations and highlight the importance of early recognition of the disease because of high cardiovascular risk. [ABSTRACT FROM AUTHOR]

Abstract: Background: In preterm neonates, use of probiotic mixtures is increasingly popular and is effective in preventing NEC, fungal colonization, and improving feeding tolerance. However, concerns exist about safety and tolerability of long-lasting administration of living microrganisms to not-immunocompetent hosts. We report a 6-year, two-NICUs experience of routinary Lactobacillus rhamnosus GG (LGG) use in VLBW infants. Methods: Clinical charts review, retrospective study of VLBW infants admitted to two Italian NICUs in the years 2003–2008. Standard protocol of LGG administration consisted of 3x109 CFU/day, in single oral dose, since 4th day-of-life, for 4-to-6-week courses. Nutritional policy relied on administration of fresh, expressed mother''s milk, supplementation with preterm formula if needed. Data about LGG safety and tolerability, infections, feeding tolerance, microbiological clinical and surveillance cultures were retrieved and analysed. Results: Complete data were obtained for 743 of 811 VLBW infants. Mean birth-weight was 1056g; mean gestational age 29.5weeks. A total of 17,108 LGG doses were administered (mean 23.1/infant). No adverse effects or intolerances putatively attributable to LGG occurred. Overall, 5350 clinical and surveillance cultures from 13 different sites/devices were performed (mean: 7.2 cultures from 6.5 different sites/infant). None ever grew LGG, or other Lactobacilli. No clinical sepsis episode was attributable to LGG. Full enteral feeding was achieved at 19.2 mean days-of-life; 73% of infants were exclusively/partially breastfed. Fourteen NEC cases occurred (=1.9%), with 5 (=0.7%) being>2b stage. Conclusions: Routinary supplementation of probiotic LGG in a large, 6-year VLBW infants Italian cohort proved microbiologically safe and clinically well tolerated. [Copyright &y& Elsevier]

Summary: Development and repair of the vertebrate skeleton requires the precise coordination of bone-forming osteoblasts and bone-resorbing osteoclasts. In diseases such as osteoporosis, bone resorption dominates over bone formation, suggesting a failure to harmonize osteoclast and osteoblast function. Here, we show that mice expressing a constitutively nuclear NFATc1 variant (NFATc1nuc) in osteoblasts develop high bone mass. NFATc1nuc mice have massive osteoblast overgrowth, enhanced osteoblast proliferation, and coordinated changes in the expression of Wnt signaling components. In contrast, viable NFATc1-deficient mice have defects in skull bone formation in addition to impaired osteoclast development. NFATc1nuc mice have increased osteoclastogenesis despite normal levels of RANKL and OPG, indicating that an additional NFAT-regulated mechanism influences osteoclastogenesis in vivo. Calcineurin/NFATc signaling in osteoblasts controls the expression of chemoattractants that attract monocytic osteoclast precursors, thereby coupling bone formation and bone resorption. Our results indicate that NFATc1 regulates bone mass by functioning in both osteoblasts and osteoclasts. [Copyright &y& Elsevier]

ABSTRACT: Importance: NEC is a common and severe complication in premature neonates, particularly those with very-low-birth-weight (VLBW, <1500 g at birth). Probiotics including lactobacillus rhamnosus GG (LGG) proved effective in preventing NEC in preterm infants in several RCTs. Objective: Lactoferrin, a mammalian milk glycoprotein involved in innate immune host defences, can reduce the incidence of NEC in animal models, and its action is enhanced by LGG. We tried to assess whether bovine lactoferrin (BLF), alone or with the probiotic LGG, has a similar effect in human infants, something that has not yet been studied. Design: An international, multicenter, randomized, double-blind, placebo-controlled trial conducted from October 1st, 2007 through July 31st, 2010. Setting: Thirteen Italian and New Zealand tertiary neonatal intensive care units. Participants: 743 VLBW neonates were assessed until discharge for development of NEC. Intervention: Infants were randomly assigned to receive orally either BLF (100 mg/day) alone (group LF; n = 247) or with LGG (at 6×109 CFU/day; group BLF + LGG; n = 238), or placebo (Control group; n = 258) from birth until day 30 of life (45 for neonates <1000 g at birth). Main outcome measures: ≥ stage 2 NEC; death-and/or-≥ stage 2 NEC prior to discharge. Results: Demographics, clinical and management characteristics of the 3 groups were similar, including type of feeding and maternal milk intakes. NEC incidence was significantly lower in groups BLF and BLF + LGG [5/247 (2.0%)] and 0/238 (0%), respectively] than in controls [14/258 (5.4%)] (RR = 0.37; 95% CI: 0.136–1.005; p = 0.055 for BLF vs. control; RR = 0.00; p < 0.001 for BLF + LGG vs. control). The incidence of death-and/or-NEC was significantly lower in both treatment groups (4.0% and 3.8% in BLF and BLF + LGG vs. 10.1% in control; RR = 0.39; 95% CI: 0.19–0.80; p = 0.008. RR = 0.37; 95% CI: 0.18–0.77; p = 0.006, respectively). No adverse effects or intolerances to treatment occurred. Conclusions and relevance: Compared with placebo, BLF supplementation alone or in combination with LGG reduced the incidence of ≥ stage 2 NEC and of death-and/or ≥ stage 2 NEC in VLBW neonates. BLF might be a promising strategy to prevent NEC in NICU settings. Further data on larger sample sizes are warranted before BLF can be widespreadly used in clinical settings. Trial registration: ISRCTN53107700–http://www.controlled-_trials.com/ISRCTN53107700. [Copyright &y& Elsevier]

Summary: Background: Retinopathy of prematurity (ROP) is a multifactorial disease, but little is known about its relationships with neonatal nutritional policies. Human, maternal milk is the best possible nutritional option for all premature infants, including those at high risk for severe complications of prematurity, such as ROP. Objective: This is a secondary analysis of data collected during two multicenter RCTs performed consecutively (years 2004 through 2008) by a network of eleven tertiary NICUs in Italy. The two trials aimed at assessing effectiveness of fluconazole prophylaxis (Manzoni et al., N Engl J Med 2007 Jun 14;356(24):2483–95), and of bovine lactoferrin supplementation (Manzoni et al., JAMA 2009 Oct 7;302(13):1421–8), in prevention of invasive fungal infection, and of late-onset sepsis in VLBW infants, respectively. We tested the hypothesis that exclusive feeding with fresh maternal milk may prevent ROP of any stage – as defined by the ETROP study – in VLBW neonates, compared to formula feeding. Methods: We analyzed the database from both trials. Systematic screening for detection of ROP was part of the protocol of both studies. The definition of threshold ROP was as defined by the ETROP study. Univariate analysis was performed to look for significant associations between ROP and several possible associated factors, and among them, the type of milk feeding (maternal milk or formula for preterms). When an association was indicated by p < 0.05, multiple logistic regression was used to determine the factors significantly associated with ROP. Results: In both trials combined, 314 infants received exclusively human maternal milk (group A), and 184 a preterm formula because their mothers were not expected to breastfeed. The clinical, demographical and management characteristics of the neonates did not differ between the two groups, particularly related to the presence of the known risk factors for ROP. Overall, ROP incidence (any stage) was significantly lower in infants fed maternal milk (11 of 314; 3.5%) as compared to formula-fed neonates (29 of 184; 15.8%) (RR 0.14; 95% CI 0.12–0.62; p = 0.004). The same occurred for threshold ROP (1.3% vs. 12.3%, respectively; RR 0.19; 95% CI 0.05–0.69; p = 0.009). At multivariate logistic regression controlling for potentially confounding factors that were significantly associated to ROP (any stage) at univariate analysis (birth weight, gestational age, days on supplemental oxygen, systemic fungal infection, outborn, hyperglycaemia), type of milk feeding retained significance, human maternal milk being protective with p = 0.01. Conclusions: Exclusive human, maternal milk feeding since birth may prevent ROP of any stage in VLBW infants in the NICU. [Copyright &y& Elsevier]

Background:: AAP and Italian Neonatology Society (SIN) recommend palivizumab (PVZ) prophylaxis in infants at high-risk for severe RSV infection. We evaluated safety, effectiveness and compliance to PVZ program in neonates at increased RSV risk but who did not qualify for prophylaxis according to AAP–SIN Guidelines. Methods:: Retrospective, 8-year cohort study from a large tertiary Italian NICU. RSV hospitalizations, adverse events, and compliance to prophylaxis program were compared between infants who qualified for PVZ according to AAP–SIN guidelines (GroupA, n =461) and infants at increased risk of severe RSV disease for various underlying chronic diseases/conditions, and who received off-label, compassionate PVZ outside of guidelines (GroupB, n =51). Results:: GroupB included infants with inherited chromosomal syndromes (n =6: partial chromosomic translocations, Poland, Cornelia DeLange syndromes); Down syndrome (n =7); cystic fibrosis (n =1); congenital neuromuscular disorders (n =7: Steinert, Werdnig–Hoffman, Thomsen diseases [three were oxygen-dependent, two had tracheostomy); severe laryngomalacia with recurrent apnoea (n =4); severe gastroesophageal reflux (n =5: three were under 24-hour-monitoring for prior ALTE episodes); diaphragmatic herniation after surgery (n =3); cerebral palsy with recurrent apnoeas (n =6); severe immunity defects/inherited immunity disorders (n =4: congenital HIV infection [two], DiGeorge, Wiskott–Aldrich syndromes [one each]); and infants >33 weeks g.a. but severely SGA (n =8: mean birth-weight=945 g [±380]). PVZ administration was safe and well tolerated; no adverse events were reported. Compliance to enrolment was high and similar (92% in A vs.100% in B; p =0.15); however, the proportion of enrolled infants who completed the scheduled courses was significantly higher in B than in A (96.1% vs. 86.0%; p =0.03). The overall rate of RSV-related hospitalizations was very low (2.1%), and similar in both groups (2.2% in A vs. 2.0% in B; p =0.99). Conclusions:: Palivizumab is safe in vulnerable infants at high-risk of severe RSV infections but who fall outside of the current prophylaxis guidelines. Compliance with palivizumab prophylaxis programs is high among infants with underlying chronic diseases. [Copyright &y& Elsevier]