Search

Abstract Objective Premature Progesterone Rise (PPR) is characterized by elevated serum progesterone concentrations either towards the end of the follicular phase or on the trigger day, surpassing a pre-defined threshold value. Aim of the study is to evaluate the impact of PPR exceeding 1.5 ng/ml at the time of hCG-trigger on embryo morphokinetic parameters and to identify predictive biomarkers of in IntraCytoplasmic Sperm Injection (ICSI) cycles outcomes. Methods It is a retrospective study including patients underwent ICSI cycles in the period 2020–2023. 58 patients were recruited in the study group showing P levels in the trigger day greater than or equal to 1.5 ng/ml. A matching control group of 58 patients with P levels below 1.5 ng/ml was after selected. The general characteristics of these patients, including age, Body Mass Index (BMI), antral follicle count (AFC), anti-Müllerian hormone (AMH) and follicle-stimulating hormone (FSH) levels, the type of infertility and smoking/non-smoking patients, were recorded on the day of their initial visit. Subsequently, data were collected regarding the number of eggs retrieved, mature eggs, successfully fertilized eggs, and embryos reaching the blastocyst stage. Additionally, the timing of embryonic development and the quality of obtained blastocysts, as assessed by the degree of expansion and the characteristics of the inner cell mass (ICM) and trophectoderm (TE), were evaluated using Time-Lapse technology. Results Elevated P levels exceeding 1.5 ng/ml on the trigger day were directly associated with a significantly larger number of antral follicles, consequently leading to a higher count of retrieved eggs, mature eggs, successfully fertilized eggs and embryos reaching the blastocyst stage. Furthermore, the analysis of morphokinetic parameters indicated faster division times and a notably greater number of high-grade blastocysts in the study group compared to the control group. Conclusions P levels ≥ 1.5 ng/ml on the trigger day did not negatively impact embryonic morphokinetic parameters, instead resulting in faster embryo development in the initial stages.

Abstract Background Silver-Russell Syndrome (SRS, MIM #180860) is a clinically and genetically heterogeneous disorder characterized by intrauterine and postnatal growth retardation; SRS is also accompanied by dysmorphic features such as triangular facial appearance, broad forehead, body asymmetry and significant feeding difficulties. The incidence is unknown but estimated at 1:30,000-100,000 live births. The diagnosis of SRS is guided by specific criteria described in the Netchine–Harbison clinical scoring system (NH-CSS). Case presentation Hereby we describe four patients with syndromic short stature in whom, despite fitting the criteria for SRS genetic analysis (and one on them even meeting the clinical criteria for SRS), molecular analysis actually diagnosed a different syndrome. Some additional features such as hypotonia, microcephaly, developmental delay and/or intellectual disability, and family history of growth failure, were actually discordant with SRS in our cohort. Conclusions The clinical resemblance of other short stature syndromes with SRS poses a risk of diagnostic failure, in particular when clinical SRS only criteria are met, allowing SRS diagnosis in the absence of a positive result of a genetic test. The presence of additional features atypical for SRS diagnosis becomes a red flag for a more extensive and thorough analysis. The signs relevant to the differential diagnosis should be valued as much as possible since a correct diagnosis of these patients is the only way to provide the appropriate care pathway, a thorough genetic counselling, prognosis definition, follow up setting, appropriate monitoring and care of possible medical problems.

Despite evidence indicating a decrease in ovarian reserve among BRCA patients, this factor seems to not impact their spontaneous fertility negatively.

Abstract A large number of non‐native trees (NNTs) have been introduced globally and widely planted, contributing significantly to the world's economy. Although some of these species present a limited risk of spreading beyond their planting sites, a growing number of NNTs are spreading and becoming invasive leading to diverse negative impacts on biodiversity, ecosystem functions and human well‐being. To help minimize the negative impacts and maximize the economic benefits of NNTs, Brundu et al. developed eight guidelines for the sustainable use of NNTs globally—the Global Guidelines for the Use of NNTs (GG‐NNTs). Here, we used an online survey to assess perceptions of key stakeholders towards NNTs, and explore their knowledge of and compliance with the GG‐NNTs. Our results show that stakeholders are generally aware that NNTs can provide benefits and cause negative impacts, often simultaneously and they consider that their organization complies with existing regulations and voluntary agreements concerning NNTs. However, they are not aware of or do not apply most of the eight recommendations included in the GG‐NNTs. We conclude that effectively managing invasions linked to NNTs requires both more communication efforts using an array of channels for improving stakeholder awareness and implementation of simple measures to reduce NNT impacts (e.g. via GG‐NNTs), and a deeper understanding of the barriers and reluctance of stakeholders to manage NNT invasions. Read the free Plain Language Summary for this article on the Journal blog.

ACE2 is a mono-carboxypeptidase with remarkable vasculo-protective properties, and its expression in the human placenta plays a central role in blood pressure homeostasis and fetal perfusion. Therefore, an alteration in the placental expression of ACE2 could be responsible for reduced placental perfusion and infantile hemangioma (IH) development. Study placentae were collected from patients affected by IHs who were referred to our Dermatology Clinic from 2016 to 2022, while control placentae were randomly collected while matching cases for gestational age. Immunohistochemical investigations were performed with a recombinant anti-ACE2 rabbit monoclonal antibody. A total of 47 placentae were examined, including 20 study placentae and 27 control ones. The mean placental weight was significantly lower in the study group (380.6 g vs. 502.3 g; p = 0.005), while subclinical chorioamnionitis occurred more frequently in the study group (20% vs. 0%, p = 0.03). The mean ACE2 expression was dramatically lower in the study group (χ2 = 42.1 p < 0.001), and the mean placental weight was significantly lower when ACE2 was not expressed compared to the 25–75% and >75% classes of expression (p < 0.05). This study demonstrated that ACE2, as a marker for tissue hypoxia, is dramatically hypo-expressed in placentae belonging to mothers who delivered one or more babies with IH compared to the controls.

ObjectiveThe diagnosis of malignant mesothelioma (MM) can be devastating for both patients and caregivers, who may experience intense suffering from a physical, psychological, and interpersonal perspective. Despite the extensive literature on caregiver distress, there is a lack of validated measures to provide evidence of psychological distress of caregivers of MM patients. Therefore, in a previous study we developed the Mesothelioma Psychological Distress Tool–Caregivers (MPDT-C) to evaluate the specific profile of psychological distress in this population. This paper describes the item selection, factor analysis, and psychometric evaluation of the revised MPDT-C.MethodsThe analyses of this work first aimed to confirm the previous factorial structure. In the case of nonfit, it aimed to find an alternative structure and causes of nonfit in the model. Examination of the fit of the factorial model was conducted using a Bayesian approach.ResultsThe final version of the MPDT-C is a 7-item self-report questionnaire consisting of one factor (Burden for the caregiver).ConclusionHaving a short self-report questionnaire to assess the psychological distress experienced by caregivers of MM patients has several advantages. First, it is suited to epidemiological studies where multiple variables and measures are involved. Second, it is easy to administer and does not take much time to complete. Therefore, the MPDT-C can also be administered in clinical contexts, perhaps when MM patients attend follow-up medical evaluation. Lastly, short measures are less affected by cognitive fatigue, which is very common in a long battery of tests and could affect response reliability.

Citalopram intoxications can lead to Serotonin Syndrome (SS) development, characterized by altered mental status, seizures, autonomic instability, hyperthermia and extrapyramidal signs. We review the literature about pediatric acute citalopram intoxications, and we report a case of severe SS in an infant associated to Posterior Reversible Encephalopathy Syndrome (PRES) treated with cyproheptadine as an antidote. An adequate12-month-old girl displayed a sudden global neurological regression with hypotonia, prolonged occipital seizures, right hemiparesis and a progressive wakefulness reduction associated with blindness. Plasmatic concentration of citalopram was equal to 3225 ng/mL (50-110 ng/mL). MRI revealed a transient bilateral caudate and putamen hyperintensity, associated to an occipital cortical and subcortical hyperintensity. She was treated with IV cyproheptadine with progressive benefit in few days. Only 4 children with citalopram intoxication are previously described with neurological involvement. Pediatric citalopram intoxication could cause SS leading to PRES, and cyproheptadine could be used with benefit.

Abstract Papaya (Carica papaya) is a trioecious species with female, male, and hermaphrodite plants. Given the sex segregation, selecting hermaphroditic plants is vital for orchard establishment due to their greater commercial value. However, selecting hermaphrodite plants through sexing is laborious and costly. Moreover, environmental stressors can exacerbate the issue by potentially inducing abnormal flower development, thus affecting fruit quality. Despite these challenges, the molecular mechanisms governing sex development in papaya remain poorly understood. Thus, this study aimed to identify proteins associated with sex development in female and hermaphrodite flowers of papaya through comparative proteomic analysis. Proteins from flower buds at the early and late developmental stages of three papaya genotypes (UENF-CALIMAN 01, JS12, and Sunrise Solo 72/12) were studied via proteomic analysis via the combination of the shotgun method and nanoESI-HDMSE technology. In buds at an early stage of development, 496 (35.9%) proteins exhibited significantly different abundances between sexes for the SS72/12 genotype, 139 (10%) for the JS12 genotype, and 165 (11.9%) for the UC-01 genotype. At the final stage of development, there were 181 (13.5%) for SS72/12, 113 (8.4%) for JS12, and 125 (9.1%) for UC-01. The large group of differentially accumulated proteins (DAPs) between the sexes was related to metabolism, as shown by the observation of only the proteins that exhibited the same pattern of accumulation in the three genotypes. Specifically, carbohydrate metabolism proteins were up-regulated in hermaphrodite flower buds early in development, while those linked to monosaccharide and amino acid metabolism increased during late development. Enrichment of sporopollenin and phenylpropanoid biosynthesis pathways characterizes hermaphrodite samples across developmental stages, with predicted protein interactions highlighting the crucial role of phenylpropanoids in sporopollenin biosynthesis for pollen wall formation. Most of the DAPs played key roles in pectin, cellulose, and lignin synthesis and were essential for cell wall formation and male flower structure development, notably in the pollen coat. These findings suggest that hermaphrodite flowers require more energy for development, likely due to complex pollen wall formation. Overall, these insights illuminate the molecular mechanisms of papaya floral development, revealing complex regulatory networks and energetic demands in the formation of male reproductive structures.

Abstract Invasive species significantly impact biodiversity and ecosystem services, yet understanding these effects at large spatial scales remains a challenge. Our study addresses this gap by assessing the current and potential future risks posed by 94 invasive species to seven key ecosystem services in Europe. We demonstrate widespread potential impacts, particularly on outdoor recreation, habitat maintenance, crop provisioning, and soil and nitrogen retention. Exposure to invasive species was higher in areas with lower provision of ecosystem services, particularly for regulating and cultural services. Exposure was also high in areas where ecosystem contributions to crop provision and nitrogen retention were at their highest. Notably, regions vital for ecosystem services currently have low invasion suitability, but face an average 77% increase in potential invasion area. Here we show that, while high-value ecosystem service areas at the highest risk represent a small fraction of Europe (0-13%), they are disproportionally important for service conservation. Our study underscores the importance of monitoring and protecting these hotspots to align management strategies with international biodiversity targets, considering both invasion vulnerability and ecosystem service sustainability.

Pertussis is a vaccine-preventable respiratory disease. Pertussis vaccination is currently mandatory for all children in Italy, and is administered in three doses at the beginning of the third, fifth, and twelfth month of life, respectively. Booster doses are also recommended at five-six years, at eleven-twelve years, and then once every ten years. Healthcare workers (HCWs) are a high-risk population for pertussis. Strategies to increase HCWs’ compliance to this vaccination have not been investigated in depth. Our study investigates the determinants of acceptance of a “soft nudge” vaccination campaign in a large hospital in Apulia (Southern Italy).HCWs from the Gynaecology and Neonatology Units of Bari’s Policlinico General Hospital were screened in June 2023 for pertussis vaccination. Non-vaccinated subjects were offered a vaccination appointment. Vaccination determinants were studied, and a logistic regression model was built to identify determinants that significantly influence vaccination acceptance.At the time of screening, only 31.34% of target HCWs (68/217) had already been vaccinated. After the active call intervention, vaccine coverage rose to 70.00% (152/217). Significantly higher coverage was found in the Neonatology Unit (30/43, 69.77%) than in the Gynaecology unit (54/106, 50.94%) (Chi2: 4.41; p-value: 0.036). A logistic regression model confirmed a higher compliance to vaccination in HCWs staffed in the Neonatology Unit (Chi2: 2.08; 95%CI: 1.04 – 4.73; p-value: 0.038).Our intervention increased vaccination coverage in a high-risk cohort. The solicitation was effective, as communication with a trained specialist might have improved the subjects’ perception of vaccination and individual risk of contagion and transmission to others. A synergistic approach, mixing active call with a vaccination mandate, might have greater effectiveness.

BackgroundThe need for health surveillance of former workers exposed to asbestos was provided by law in Italy after the asbestos ban in 1992.ObjectivesWe describe the results of the health surveillance of former workers exposed to asbestos, conducted over 27 years, from 1994 to 2020, at the Operative Unit of Occupational Medicine of the University Hospital of Bari.Materials and methodsWe adopted the health surveillance protocol, which was validated at the national level in 2018.ResultsA total of 1,405 former workers exposed to asbestos were examined. We proceeded with diagnosing pathologies in 339 cases (24% of the cohort subjected to surveillance), with diagnoses of some cases involving multiple pathologies. Specifically, pleural plaques were diagnosed in 49.2% of the 339 cases, asbestosis in 35.9%, malignant pleural mesothelioma (MPM) in 20.3%, mesothelioma of the vaginal tunic of the testis (MTVT) in 9.1%, lung cancer in 5.8%, and laryngeal cancer in 0.8%.ConclusionDespite the 1992 asbestos ban, asbestos-related diseases remain a serious public health issue. It is important to establish criteria that ensure the health surveillance of formerly exposed workers minimizes costs, reduces the number of invasive examinations, and optimizes achievable results.

Nature exhibits an enormous diversity of organisms that thrive in extreme environments. From snow algae that reproduce at sub-zero temperatures to radiotrophic fungi that thrive in nuclear radiation at Chernobyl, extreme organisms raise many questions about the limits of life. Is there any environment where life could not “find a way”? Although many individual extremophilic organisms have been identified and studied, there remain outstanding questions about the limits of life and the extent to which extreme properties can be enhanced, combined or transferred to new organisms. In this review, we compile the current knowledge on the bioengineering of extremophile microbes. We summarize what is known about the basic mechanisms of extreme adaptations, compile synthetic biology’s efforts to engineer extremophile organisms beyond what is found in nature, and highlight which adaptations can be combined. The basic science of extremophiles can be applied to engineered organisms tailored to specific biomanufacturing needs, such as growth in high temperatures or in the presence of unusual solvents.

Introduction Healthcare workers (HCWs) susceptible to hepatitis B represent an important public health concern. National and international guidelines recommend assessing the hepatitis B immune status of all HCWs and possibly vaccinating those found to be seronegative (non-responders). We conducted a meta-analysis to estimate the rate of hepatitis B sero-susceptibility among HCWs in Italy and to explore possible options for the management of non-responders. Areas Covered Nineteen studies, selected from scientific articles available in the Scopus, MEDLINE/PubMed and ISI Web of Knowledge databases between 1 January 2016 and 22 April 2022, were included. The prevalence of HBV-susceptible HCWs was 27.1% (95%CI = 23.2–31.7%). In a comparison by sex (males vs. females) the RR was 1.16 (95%CI = 1.03–1.31), and by full-cycle vaccination period (adolescence vs. infancy) the RR was 0.30 (95%CI = 0.25–0.37). Occupational health screenings for hepatitis B, with subsequent vaccination of non-responders, and exclusion of susceptible HCWs from high-risk settings have been common management strategies. Expert opinion It is highly probable that a proportion of the next generation of medical students and HCWs will not show circulating IgG on serologic evaluation. Therefore, more targeted efforts are needed to identify these individuals and actively immunize them.

Amphibian populations are increasingly threatened by global change and the study of their genetic diversity is a major conservation priority. Western palearctic tree frog species of the Hyla arborea group are commonly distributed across Europe and the Middle East and many have declining populations. We performed a PRISMA systematic review to gain insight into the genetic diversity of H. arborea group. Sixteen published studies were included in the final qualitative analysis. While the genetic diversity of H. arborea group species was widely variable, it could often be explained by phylogeographic history. Populations in Western and Northern Europe had lower genetic diversity, with some populations also affected by habitat fragmentation. However, important regions of high genetic diversity were found in the Balkan peninsula for H. arborea sensu stricto and around the Black Sea for H. orientalis. Genetic diversity of H. molleri, H. savignyi, H. meridionalis, H. felixarabica, H. intermedia, H. sarda has been investigated only across extensive phylogeographical studies, while data regarding their genetic diversity at the local level are missing. Through our review, we identify knowledge gaps about the genetic diversity of the H. arborea group that require further investigation, of and illustrate how filling these gaps might translate into future conservation efforts.