scispace - formally typeset
Search or ask a question

Showing papers by "University of Naples Federico II published in 2020"


Journal ArticleDOI
Theo Vos1, Theo Vos2, Theo Vos3, Stephen S Lim  +2416 moreInstitutions (246)
TL;DR: Global health has steadily improved over the past 30 years as measured by age-standardised DALY rates, and there has been a marked shift towards a greater proportion of burden due to YLDs from non-communicable diseases and injuries.

5,802 citations


Journal ArticleDOI
TL;DR: In this article, the authors present guidelines for the management of patients with coronary artery disease (CAD), which is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries.
Abstract: Coronary artery disease (CAD) is a pathological process characterized by atherosclerotic plaque accumulation in the epicardial arteries, whether obstructive or non-obstructive. This process can be modified by lifestyle adjustments, pharmacological therapies, and invasive interventions designed to achieve disease stabilization or regression. The disease can have long, stable periods but can also become unstable at any time, typically due to an acute atherothrombotic event caused by plaque rupture or erosion. However, the disease is chronic, most often progressive, and hence serious, even in clinically apparently silent periods. The dynamic nature of the CAD process results in various clinical presentations, which can be conveniently categorized as either acute coronary syndromes (ACS) or chronic coronary syndromes (CCS). The Guidelines presented here refer to the management of patients with CCS. The natural history of CCS is illustrated in Figure 1.

3,448 citations


Book
Georges Aad1, E. Abat2, Jalal Abdallah3, Jalal Abdallah4  +3029 moreInstitutions (164)
23 Feb 2020
TL;DR: The ATLAS detector as installed in its experimental cavern at point 1 at CERN is described in this paper, where a brief overview of the expected performance of the detector when the Large Hadron Collider begins operation is also presented.
Abstract: The ATLAS detector as installed in its experimental cavern at point 1 at CERN is described in this paper. A brief overview of the expected performance of the detector when the Large Hadron Collider begins operation is also presented.

3,111 citations


Journal ArticleDOI
TL;DR: The largest declines in risk exposure from 2010 to 2019 were among a set of risks that are strongly linked to social and economic development, including household air pollution; unsafe water, sanitation, and handwashing; and child growth failure.

3,059 citations


Journal ArticleDOI
B. P. Abbott1, R. Abbott1, T. D. Abbott2, Sheelu Abraham3  +1271 moreInstitutions (145)
TL;DR: In 2019, the LIGO Livingston detector observed a compact binary coalescence with signal-to-noise ratio 12.9 and the Virgo detector was also taking data that did not contribute to detection due to a low SINR but were used for subsequent parameter estimation as discussed by the authors.
Abstract: On 2019 April 25, the LIGO Livingston detector observed a compact binary coalescence with signal-to-noise ratio 12.9. The Virgo detector was also taking data that did not contribute to detection due to a low signal-to-noise ratio, but were used for subsequent parameter estimation. The 90% credible intervals for the component masses range from to if we restrict the dimensionless component spin magnitudes to be smaller than 0.05). These mass parameters are consistent with the individual binary components being neutron stars. However, both the source-frame chirp mass and the total mass of this system are significantly larger than those of any other known binary neutron star (BNS) system. The possibility that one or both binary components of the system are black holes cannot be ruled out from gravitational-wave data. We discuss possible origins of the system based on its inconsistency with the known Galactic BNS population. Under the assumption that the signal was produced by a BNS coalescence, the local rate of neutron star mergers is updated to 250-2810.

1,189 citations


Journal ArticleDOI
TL;DR: While ACE2 is essential for viral invasion, there is no evidence that ACE inhibitors or angiotensin receptor blockers (ARBs) worsen prognosis, Hence, patients should not discontinue their use.
Abstract: The novel coronavirus disease (COVID-19) outbreak, caused by SARS-CoV-2, represents the greatest medical challenge in decades. We provide a comprehensive review of the clinical course of COVID-19, its comorbidities, and mechanistic considerations for future therapies. While COVID-19 primarily affects the lungs, causing interstitial pneumonitis and severe acute respiratory distress syndrome (ARDS), it also affects multiple organs, particularly the cardiovascular system. Risk of severe infection and mortality increase with advancing age and male sex. Mortality is increased by comorbidities: cardiovascular disease, hypertension, diabetes, chronic pulmonary disease, and cancer. The most common complications include arrhythmia (atrial fibrillation, ventricular tachyarrhythmia, and ventricular fibrillation), cardiac injury [elevated highly sensitive troponin I (hs-cTnI) and creatine kinase (CK) levels], fulminant myocarditis, heart failure, pulmonary embolism, and disseminated intravascular coagulation (DIC). Mechanistically, SARS-CoV-2, following proteolytic cleavage of its S protein by a serine protease, binds to the transmembrane angiotensin-converting enzyme 2 (ACE2) -a homologue of ACE-to enter type 2 pneumocytes, macrophages, perivascular pericytes, and cardiomyocytes. This may lead to myocardial dysfunction and damage, endothelial dysfunction, microvascular dysfunction, plaque instability, and myocardial infarction (MI). While ACE2 is essential for viral invasion, there is no evidence that ACE inhibitors or angiotensin receptor blockers (ARBs) worsen prognosis. Hence, patients should not discontinue their use. Moreover, renin-angiotensin-aldosterone system (RAAS) inhibitors might be beneficial in COVID-19. Initial immune and inflammatory responses induce a severe cytokine storm [interleukin (IL)-6, IL-7, IL-22, IL-17, etc.] during the rapid progression phase of COVID-19. Early evaluation and continued monitoring of cardiac damage (cTnI and NT-proBNP) and coagulation (D-dimer) after hospitalization may identify patients with cardiac injury and predict COVID-19 complications. Preventive measures (social distancing and social isolation) also increase cardiovascular risk. Cardiovascular considerations of therapies currently used, including remdesivir, chloroquine, hydroxychloroquine, tocilizumab, ribavirin, interferons, and lopinavir/ritonavir, as well as experimental therapies, such as human recombinant ACE2 (rhACE2), are discussed.

1,060 citations


Journal ArticleDOI
Florian Götzinger, Begoña Santiago-García1, Antoni Noguera-Julian, Miguel Lanaspa2, Laura Lancella3, Francesca Ippolita Calò Carducci3, Natalia Gabrovska4, Svetlana Velizarova4, Petra Prunk5, Veronika Osterman5, Uros Krivec5, Andrea Lo Vecchio6, Delane Shingadia7, Delane Shingadia8, Antoni Soriano-Arandes, Susana Melendo, Marcello Lanari, Luca Pierantoni, Noémie Wagner9, Arnaud G L'Huillier9, Ulrich Heininger3, Nicole Ritz3, Nicole Ritz10, Srini Bandi3, Nina Krajcar, Srđan Roglić, Mar Santos1, Christelle Christiaens, Marine Creuven, Danilo Buonsenso, Steven B. Welch, Matthias Bogyi, Folke Brinkmann11, Marc Tebruegge10, Marc Tebruegge12, Marc Tebruegge7, Jasmin Pfefferle, Angela Zacharasiewicz, Angelika Berger, Roland Berger, Volker Strenger, Daniela S. Kohlfürst, Anna Zschocke, Benoît Bernar, Burkhard Simma, Edda Haberlandt, Christina Thir, Ariane Biebl, Koen Vanden Driessche, Tine Boiy, Daan Van Brusselen, An Bael, Sara Debulpaep, Petra Schelstraete, Ivan Pavic, Ulrikka Nygaard, Jonathan P. Glenthoej, Lise Heilmann Jensen, Ilona Lind, Mihhail Tistsenko, Ulle Uustalu, Laura Buchtala, Stephanie Thee, Robin Kobbe, Cornelius Rau, Nicolaus Schwerk, Michael Barker, Maria Tsolia, Irini Eleftheriou, Patrick Gavin, Oksana Kozdoba, Borbàla Zsigmond, Piero Valentini13, Piero Valentini14, Inga Ivaškeviciene, Rimvydas Ivaškevicius, Valentina Vilc, Elisabeth Schölvinck, Astrid Rojahn15, Anastasios Smyrnaios, Claus Klingenberg, Isabel Carvalho, Andreia Ribeiro, Anna Starshinova, Ivan Solovic, Lola Falcón, Olaf Neth, Laura Minguell, Matilde Bustillo, Aida M. Gutiérrez-Sánchez, Borja Ibanez, Francesc Ripoll, Beatriz Soto, Karsten Kötz, Petra Zimmermann16, Hanna Schmid, Franziska Zucol, Anita Niederer, Michael Buettcher, Benhur Şirvan Çetin, Olga Bilogortseva, Vera Chechenyeva, Alicia Demirjian, Fiona Shackley, Lynne McFetridge, Lynne Speirs, Conor Doherty, Laura Jones, Paddy McMaster, Clare S. Murray, Frances Child, Yvonne Beuvink, Nick Makwana, Elisabeth Whittaker, Amanda Williams, Katy Fidler, Jolanta Bernatoniene, R Song, Zoe Oliver, Andrew Riordan 
TL;DR: Key data on children and adolescents with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection across Europe to inform physicians and health-care service planning during the ongoing pandemic are captured to reflect the current uncertainties regarding specific treatment options.

918 citations


Journal ArticleDOI
TL;DR: COVID-19 seems not to be very different from SARS regarding its clinical features, however, it has a fatality rate lower than that of SARS and MERS and the possibility cannot be excluded that because of the less severe clinical picture of CO VID-19 it can spread in the community more easily than Mers and SARS.

827 citations


Journal ArticleDOI
25 Mar 2020
TL;DR: Pregnancy and perinatal outcomes of Coronavirus (CoV) spectrum infections, and particularly COVID-19 disease due to SARS-COV-2 infection during pregnancy were reported, including miscarriage, preterm birth, pre-eclampsia, pre term prelabor rupture of membranes, fetal growth restriction, and mode of delivery.
Abstract: Objective The aim of this systematic review was to report pregnancy and perinatal outcomes of coronavirus spectrum infections, and particularly coronavirus 2019 (COVID-19) disease because of severe acute respiratory syndrome–coronavirus-2 infection during pregnancy. Data Sources Medline, Embase, Cinahl, and Clinicaltrials.gov databases were searched electronically utilizing combinations of word variants for coronavirus or severe acute respiratory syndrome or SARS or Middle East respiratory syndrome or MERS or COVID-19 and pregnancy. The search and selection criteria were restricted to English language. Study Eligibility Criteria Inclusion criteria were hospitalized pregnant women with a confirmed coronavirus related–illness, defined as severe acute respiratory syndrome (SARS), Middle East respiratory syndrome (MERS), or COVID-19. Study Appraisal and Synthesis Methods We used meta-analyses of proportions to combine data and reported pooled proportions, so that a pooled proportion may not coincide with the actual raw proportion in the results. The pregnancy outcomes observed included miscarriage, preterm birth, preeclampsia, preterm prelabor rupture of membranes, fetal growth restriction, and mode of delivery. The perinatal outcomes observed were fetal distress, Apgar score Results Nineteen studies including 79 hospitalized women were eligible for this systematic review: 41 pregnancies (51.9%) affected by COVID-19, 12 (15.2%) by MERS, and 26 (32.9%) by SARS. An overt diagnosis of pneumonia was made in 91.8%, and the most common symptoms were fever (82.6%), cough (57.1%), and dyspnea (27.0%). For all coronavirus infections, the pooled proportion of miscarriage was 64.7% (8/12; 95% confidence interval, 37.9-87.3), although reported only for women affected by SARS in two studies with no control group; the pooled proportion of preterm birth Conclusion In hospitalized mothers infected with coronavirus infections, including COVID-19, >90% of whom also had pneumonia, preterm birth is the most common adverse pregnancy outcome. COVID-19 infection was associated with higher rate (and pooled proportions) of preterm birth, preeclampsia, cesarean, and perinatal death. There have been no published cases of clinical evidence of vertical transmission. Evidence is accumulating rapidly, so these data may need to be updated soon. The findings from this study can guide and enhance prenatal counseling of women with COVID-19 infection occurring during pregnancy, although they should be interpreted with caution in view of the very small number of included cases.

813 citations


Journal ArticleDOI
31 Mar 2020-PLOS ONE
TL;DR: Based on the publicly available epidemiological data for Hubei, China from January 11 to February 10, 2020, estimates of the main epidemiological parameters are provided, including an estimation of the case fatality and case recovery ratios, along with their 90% confidence intervals as the outbreak evolves.
Abstract: Since the first suspected case of coronavirus disease-2019 (COVID-19) on December 1st, 2019, in Wuhan, Hubei Province, China, a total of 40,235 confirmed cases and 909 deaths have been reported in China up to February 10, 2020, evoking fear locally and internationally. Here, based on the publicly available epidemiological data for Hubei, China from January 11 to February 10, 2020, we provide estimates of the main epidemiological parameters. In particular, we provide an estimation of the case fatality and case recovery ratios, along with their 90% confidence intervals as the outbreak evolves. On the basis of a Susceptible-Infectious-Recovered-Dead (SIDR) model, we provide estimations of the basic reproduction number (R0), and the per day infection mortality and recovery rates. By calibrating the parameters of the SIRD model to the reported data, we also attempt to forecast the evolution of the outbreak at the epicenter three weeks ahead, i.e. until February 29. As the number of infected individuals, especially of those with asymptomatic or mild courses, is suspected to be much higher than the official numbers, which can be considered only as a subset of the actual numbers of infected and recovered cases in the total population, we have repeated the calculations under a second scenario that considers twenty times the number of confirmed infected cases and forty times the number of recovered, leaving the number of deaths unchanged. Based on the reported data, the expected value of R0 as computed considering the period from the 11th of January until the 18th of January, using the official counts of confirmed cases was found to be ∼4.6, while the one computed under the second scenario was found to be ∼3.2. Thus, based on the SIRD simulations, the estimated average value of R0 was found to be ∼2.6 based on confirmed cases and ∼2 based on the second scenario. Our forecasting flashes a note of caution for the presently unfolding outbreak in China. Based on the official counts for confirmed cases, the simulations suggest that the cumulative number of infected could reach 180,000 (with a lower bound of 45,000) by February 29. Regarding the number of deaths, simulations forecast that on the basis of the up to the 10th of February reported data, the death toll might exceed 2,700 (as a lower bound) by February 29. Our analysis further reveals a significant decline of the case fatality ratio from January 26 to which various factors may have contributed, such as the severe control measures taken in Hubei, China (e.g. quarantine and hospitalization of infected individuals), but mainly because of the fact that the actual cumulative numbers of infected and recovered cases in the population most likely are much higher than the reported ones. Thus, in a scenario where we have taken twenty times the confirmed number of infected and forty times the confirmed number of recovered cases, the case fatality ratio is around ∼0.15% in the total population. Importantly, based on this scenario, simulations suggest a slow down of the outbreak in Hubei at the end of February.

696 citations


Journal ArticleDOI
01 Apr 2020-Leukemia
TL;DR: An expert panel to critically evaluate and update the evidence to achieve goals to achieve a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR) in chronic myeloid leukemia.
Abstract: The therapeutic landscape of chronic myeloid leukemia (CML) has profoundly changed over the past 7 years. Most patients with chronic phase (CP) now have a normal life expectancy. Another goal is achieving a stable deep molecular response (DMR) and discontinuing medication for treatment-free remission (TFR). The European LeukemiaNet convened an expert panel to critically evaluate and update the evidence to achieve these goals since its previous recommendations. First-line treatment is a tyrosine kinase inhibitor (TKI; imatinib brand or generic, dasatinib, nilotinib, and bosutinib are available first-line). Generic imatinib is the cost-effective initial treatment in CP. Various contraindications and side-effects of all TKIs should be considered. Patient risk status at diagnosis should be assessed with the new EUTOS long-term survival (ELTS)-score. Monitoring of response should be done by quantitative polymerase chain reaction whenever possible. A change of treatment is recommended when intolerance cannot be ameliorated or when molecular milestones are not reached. Greater than 10% BCR-ABL1 at 3 months indicates treatment failure when confirmed. Allogeneic transplantation continues to be a therapeutic option particularly for advanced phase CML. TKI treatment should be withheld during pregnancy. Treatment discontinuation may be considered in patients with durable DMR with the goal of achieving TFR.

Journal ArticleDOI
TL;DR: Their added-value in the development of alternative, more effective antibiotics against multi-resistant Gram-negative bacteria has been highlighted and their production methods, physicochemical characterization, and pharmacokinetics are reviewed.
Abstract: Metal-based nanoparticles have been extensively investigated for a set of biomedical applications. According to the World Health Organization, in addition to their reduced size and selectivity for bacteria, metal-based nanoparticles have also proved to be effective against pathogens listed as a priority. Metal-based nanoparticles are known to have non-specific bacterial toxicity mechanisms (they do not bind to a specific receptor in the bacterial cell) which not only makes the development of resistance by bacteria difficult, but also broadens the spectrum of antibacterial activity. As a result, a large majority of metal-based nanoparticles efficacy studies performed so far have shown promising results in both Gram-positive and Gram-negative bacteria. The aim of this review has been a comprehensive discussion of the state of the art on the use of the most relevant types of metal nanoparticles employed as antimicrobial agents. A special emphasis to silver nanoparticles is given, while others (e.g., gold, zinc oxide, copper, and copper oxide nanoparticles) commonly used in antibiotherapy are also reviewed. The novelty of this review relies on the comparative discussion of the different types of metal nanoparticles, their production methods, physicochemical characterization, and pharmacokinetics together with the toxicological risk encountered with the use of different types of nanoparticles as antimicrobial agents. Their added-value in the development of alternative, more effective antibiotics against multi-resistant Gram-negative bacteria has been highlighted.

Journal ArticleDOI
TL;DR: On-field studies carried out inside Wuhan Hospitals showed the presence of SARS-COV-2 RNA in air samples collected in the hospitals and also in the surroundings, leading to the conclusion that the airborne route has to be considered an important pathway for viral diffusion.
Abstract: The COVID-19 pandemic caused the shutdown of entire nations all over the world. In addition to mobility restrictions of people, the World Health Organization and the Governments have prescribed maintaining an inter-personal distance of 1.5 or 2 m (about 6 feet) from each other in order to minimize the risk of contagion through the droplets that we usually disseminate around us from nose and mouth. However, recently published studies support the hypothesis of virus transmission over a distance of 2 m from an infected person. Researchers have proved the higher aerosol and surface stability of SARS-COV-2 as compared with SARS-COV-1 (with the virus remaining viable and infectious in aerosol for hours) and that airborne transmission of SARS-CoV can occur besides close-distance contacts. Indeed, there is reasonable evidence about the possibility of SARS-COV-2 airborne transmission due to its persistence into aerosol droplets in a viable and infectious form. Based on the available knowledge and epidemiological observations, it is plausible that small particles containing the virus may diffuse in indoor environments covering distances up to 10 m from the emission sources, thus representing a kind of aerosol transmission. On-field studies carried out inside Wuhan Hospitals showed the presence of SARS-COV-2 RNA in air samples collected in the hospitals and also in the surroundings, leading to the conclusion that the airborne route has to be considered an important pathway for viral diffusion. Similar findings are reported in analyses concerning air samples collected at the Nebraska University Hospital. On March 16th, we have released a Position Paper emphasizing the airborne route as a possible additional factor for interpreting the anomalous COVID-19 outbreaks in northern Italy, ranked as one of the most polluted areas in Europe and characterized by high particulate matter (PM) concentrations. The available information on the SARS-COV-2 spreading supports the hypothesis of airborne diffusion of infected droplets from person to person at a distance greater than two meters (6 feet). The inter-personal distance of 2 m can be reasonably considered as an effective protection only if everybody wears face masks in daily life activities.

Journal ArticleDOI
Richard J. Abbott1, T. D. Abbott2, Sheelu Abraham3, Fausto Acernese4  +1330 moreInstitutions (149)
TL;DR: In this article, the authors reported the observation of gravitational waves from a binary-black-hole coalescence during the first two weeks of LIGO and Virgo's third observing run.
Abstract: We report the observation of gravitational waves from a binary-black-hole coalescence during the first two weeks of LIGO’s and Virgo’s third observing run. The signal was recorded on April 12, 2019 at 05∶30∶44 UTC with a network signal-to-noise ratio of 19. The binary is different from observations during the first two observing runs most notably due to its asymmetric masses: a ∼30 M⊙ black hole merged with a ∼8 M⊙ black hole companion. The more massive black hole rotated with a dimensionless spin magnitude between 0.22 and 0.60 (90% probability). Asymmetric systems are predicted to emit gravitational waves with stronger contributions from higher multipoles, and indeed we find strong evidence for gravitational radiation beyond the leading quadrupolar order in the observed signal. A suite of tests performed on GW190412 indicates consistency with Einstein’s general theory of relativity. While the mass ratio of this system differs from all previous detections, we show that it is consistent with the population model of stellar binary black holes inferred from the first two observing runs.

Journal ArticleDOI
TL;DR: The BJP has been and remains an active advocate of the ARRIVE guidelines and the Editor in Chief of the BJP is a member of the new team that was assembled, which triggered a reappraisal of the guidelines led by the NC3Rs who, in 2018, established a new, international Working Group to review and update the ARrIVE guidelines.
Abstract: The BJP has been and remains an active advocate of the ARRIVE (Animal Research: Reporting of in vivo Experiments) guidelines (Kilkenny, Browne, Cuthill, Emerson, & Altman, 2010a) that were established by the National Centre for the Replacement, Refinement and Reduction of Animals in Research (NC3Rs) in 2010. The ARRIVE guidelines need no introduction and we will not rehearse the arguments in depth here, other than to restate that the lack of key in vivo experimental details has been identified as a major contributing factor to the poor reproducibility of pre-clinical research. This fact was the primary driver for establishment by the NC3Rs of the first version of the ARRIVE guidelines. ARRIVE provided a 20-point checklist, specifying all of the experimental details (procedures and fixed factors) that should be included in manuscripts for proper reporting of animal research. The guidelines were rapidly endorsed internationally by funding bodies, universities, learned societies and, importantly, Life Science journals. Currently there are 1,046 journals endorsing ARRIVE including BJP, which was one of the original six influential journals that published the guidelines in full in 2010 (Kilkenny, Browne, Cuthill, Emerson, & Altman, 2010b). However, ARRIVE has not had the effect that was originally hoped for, despite this widespread support and endorsement. In 2016 and in 2018 assessments of adherence of articles published in endorsing journals identified a lack of engagement. As an example, one systematic review of reports of studies investigating acute lung injury revealed that, of the items expected for ARRIVE compliance, only 45% of those advised for inclusion in the Methods, and only 29% of those for inclusion in the Results section, were present (Avey et al., 2016). Moreover, formal endorsement of the ARRIVE guidelines by journals did not necessarily improve compliance (Leung, Rousseau-Blass, Beauchamp, & Pang, 2018). Such disappointing reports of outcome triggered a reappraisal of the guidelines led by the NC3Rs who, in 2018, established a new, international Working Group to review and update the ARRIVE guidelines to generate ARRIVE 2.0 (Percie du Sert et al., 2018). As with the team of experts brought together to establish the first iteration of ARRIVE, the Editor in Chief of the BJP is a member of the new team that was assembled. As such, the BJP has been well-placed to influence the content, testing and final publication of both iterations of the guidelines. In 2015, the BJP published an editorial reporting findings from a survey of compliance with ARRIVE in articles published in 2014 in two issues of the journal (McGrath & Lilley, 2015). The results were not as had been hoped for, as was also evident from assessments elsewhere, and revealed scope for improving compliance in respect of both the design of the (animal) experiments and the description of experimental procedures. To help remedy this problem, a checklist was developed that provided an aide memoire of the details of the animals and research procedures that should be reported in manuscripts submitted to the journal. A further editorial focussed on experimental design and data analysis (Curtis et al., 2018) for all types of experimental data published in the journal, including those emanating from experiments with animals, was also published. A key issue with many of the studies reported in BJP prior to this related to inadequate experimental design and inappropriate statistical analysis. At the same time, the Instructions to Authors were revised, to include the new rubric, and the editorial scrutiny of these aspects of the peer review process was tightened up. As a further prompt, in 2016, authors were required to make a Declaration as part of the submission process, to confirm that their manuscript was ARRIVE compliant. In addition to these measures, two new ‘specialist’ editors were appointed: a Design & Analysis Advisor and a Consulting Editor in ARRIVE Guidelines and Animal Welfare. The brief of the latter was to monitor ARRIVE compliance in BJP publications and to assist Senior Editors with their appraisal of manuscripts. All these changes still remain in place with the addition of a Consulting Editor in Statistical Analysis to ensure that the research reports match BJP criteria and so qualify for publication.

Journal ArticleDOI
TL;DR: The ESPGHAN 2012 coeliac disease (CD) diagnostic guidelines aimed to guide physicians in accurately diagnosing CD and permit omission of duodenal biopsies in selected cases.
Abstract: OBJECTIVES The ESPGHAN 2012 coeliac disease (CD) diagnostic guidelines aimed to guide physicians in accurately diagnosing CD and permit omission of duodenal biopsies in selected cases. Here, an updated and expanded evidence-based guideline is presented. METHODS Literature databases and other sources of information were searched for studies that could inform on 10 formulated questions on symptoms, serology, HLA genetics, and histopathology. Eligible articles were assessed using QUADAS2. GRADE provided a basis for statements and recommendations. RESULTS Various symptoms are suggested for case finding, with limited contribution to diagnostic accuracy. If CD is suspected, measurement of total serum IgA and IgA-antibodies against transglutaminase 2 (TGA-IgA) is superior to other combinations. We recommend against deamidated gliadin peptide antibodies (DGP-IgG/IgA) for initial testing. Only if total IgA is low/undetectable, an IgG-based test is indicated. Patients with positive results should be referred to a paediatric gastroenterologist/specialist. If TGA-IgA is ≥10 times the upper limit of normal (10× ULN) and the family agrees, the no-biopsy diagnosis may be applied, provided endomysial antibodies (EMA-IgA) will test positive in a second blood sample. HLA DQ2-/DQ8 determination and symptoms are not obligatory criteria. In children with positive TGA-IgA <10× ULN at least 4 biopsies from the distal duodenum and at least 1 from the bulb should be taken. Discordant results between TGA-IgA and histopathology may require re-evaluation of biopsies. Patients with no/mild histological changes (Marsh 0/I) but confirmed autoimmunity (TGA-IgA/EMA-IgA+) should be followed closely. CONCLUSIONS CD diagnosis can be accurately established with or without duodenal biopsies if given recommendations are followed.

Journal ArticleDOI
TL;DR: The molecular mechanisms responsible for the obesity-induced adipose tissue inflammation and progression toward obesity-associated comorbidities are summarized and the current therapeutic strategies are highlighted.
Abstract: Obesity is one of the major health burdens of the 21st century as it contributes to the growing prevalence of its related comorbidities, including insulin resistance and type 2 diabetes. Growing evidence suggests a critical role for overnutrition in the development of low-grade inflammation. Specifically, chronic inflammation in adipose tissue is considered a crucial risk factor for the development of insulin resistance and type 2 diabetes in obese individuals. The triggers for adipose tissue inflammation are still poorly defined. However, obesity-induced adipose tissue expansion provides a plethora of intrinsic signals (e.g., adipocyte death, hypoxia, and mechanical stress) capable of initiating the inflammatory response. Immune dysregulation in adipose tissue of obese subjects results in a chronic low-grade inflammation characterized by increased infiltration and activation of innate and adaptive immune cells. Macrophages are the most abundant innate immune cells infiltrating and accumulating into adipose tissue of obese individuals; they constitute up to 40% of all adipose tissue cells in obesity. In obesity, adipose tissue macrophages are polarized into pro-inflammatory M1 macrophages and secrete many pro-inflammatory cytokines capable of impairing insulin signaling, therefore promoting the progression of insulin resistance. Besides macrophages, many other immune cells (e.g., dendritic cells, mast cells, neutrophils, B cells, and T cells) reside in adipose tissue during obesity, playing a key role in the development of adipose tissue inflammation and insulin resistance. The association of obesity, adipose tissue inflammation, and metabolic diseases makes inflammatory pathways an appealing target for the treatment of obesity-related metabolic complications. In this review, we summarize the molecular mechanisms responsible for the obesity-induced adipose tissue inflammation and progression toward obesity-associated comorbidities and highlight the current therapeutic strategies.

Journal ArticleDOI
TL;DR: The most commonly used methods for the production and characterization of polymeric NPs are discussed, the association efficiency of the active compound to the polymeric core, and the in vitro release mechanisms are discussed.
Abstract: Polymeric nanoparticles (NPs) are particles within the size range from 1 to 1000 nm and can be loaded with active compounds entrapped within or surface-adsorbed onto the polymeric core. The term “nanoparticle” stands for both nanocapsules and nanospheres, which are distinguished by the morphological structure. Polymeric NPs have shown great potential for targeted delivery of drugs for the treatment of several diseases. In this review, we discuss the most commonly used methods for the production and characterization of polymeric NPs, the association efficiency of the active compound to the polymeric core, and the in vitro release mechanisms. As the safety of nanoparticles is a high priority, we also discuss the toxicology and ecotoxicology of nanoparticles to humans and to the environment.

Journal ArticleDOI
18 Aug 2020
TL;DR: In this article, the potential of spintronics in four key areas of application (memory, sensors, microwave devices, and logic devices) is examined and the challenges that need to be addressed in order to integrate spintronic materials and functionalities into mainstream microelectronic platforms.
Abstract: Spintronic devices exploit the spin, as well as the charge, of electrons and could bring new capabilities to the microelectronics industry However, in order for spintronic devices to meet the ever-increasing demands of the industry, innovation in terms of materials, processes and circuits are required Here, we review recent developments in spintronics that could soon have an impact on the microelectronics and information technology industry We highlight and explore four key areas: magnetic memories, magnetic sensors, radio-frequency and microwave devices, and logic and non-Boolean devices We also discuss the challenges—at both the device and the system level—that need be addressed in order to integrate spintronic materials and functionalities into mainstream microelectronic platforms This Review Article examines the potential of spintronics in four key areas of application —memories, sensors, microwave devices, and logic devices — and discusses the challenges that need be addressed in order to integrate spintronic materials and functionalities into mainstream microelectronic platforms

Journal ArticleDOI
TL;DR: There is an urgent need to develop effective therapies for COVID-19 patients and immunologists and clinicians are urged to consider the potential of targeting the complement system in these patients.
Abstract: There is an urgent need to develop effective therapies for COVID-19. Here, we urge immunologists and clinicians to consider the potential of targeting the complement system in these patients. This Comment article from Lambris and colleagues considers the therapeutic potential of targeting the complement system in patients with COVID-19.

Journal ArticleDOI
TL;DR: Almost all studies regarding natural compounds applications in wound healing by focusing on the chitosan-based bioactive wound dressing systems are collected, and the influence of bioactive compounds on their wound healing properties are reported.

Journal ArticleDOI
TL;DR: Quarantinerelated stress also results in sleep disturbances that in turn further worsen the stress and increase food intake thus giving rise to a dangerous vicious cycle, so it is important to consume food containing or promoting the synthesis of serotonin and melatonin at dinner.
Abstract: The world is currently experiencing the pandemic of coronavirus (CoV). In late 2019, the CoV infection began in Wuhan, Hubei, China. It had been originally called 2019 nCoV and it has been renamed CoVID-19 by the World Health Organization on February 2020. This epidemic began with animal-to-human infection, and the direct cause of death is generally due to ensuing severe atypical pneumonia. CoVID-19 has now been declared a pandemic by the World Health Organization, and people in all countries are under quarantine in order to reduce the spread of the virus, which then also lessens the impact on medical resources. Since quarantine is associated to the interruption of the work routine, this could be result in boredom. Boredom has been associated with a greater energy intake, as well as the consumption of higher quantities of fats, carbohydrates, and proteins [1]. Further, during quarantine continuously hearing or reading about the pandemic without a break can be stressful. Consequently, the stress pushes people toward overeating, mostly looking for sugary “comfort foods” [2]. This desire to consume a specific kind of food is defined as “food craving”, which is a multidimensional concept including emotional (intense desire to eat), behavioral (seeking food), cognitive (thoughts about food), and physiological (salivation) processes [3]. Of interest, a gender difference has been reported in food craving, with a higher prevalence in women than in men. Carbohydrate craving encourages serotonin production that in turn has a positive effect on mood. In a sense, carbohydrate-rich foods can be a way of self-medicating anti stress. The effect of carbohydrate craving on low mood is proportional to the glycemic index of foods. This unhealthy nutritional habit could increase the risk of developing obesity that beyond being a chronic state of inflammation, it is often complicated by heart disease, diabetes, and lung disease that have been demonstrated to increase the risk for more serious complications of CoVID-19 [4]. Quarantinerelated stress also results in sleep disturbances that in turn further worsen the stress and increase food intake thus giving rise to a dangerous vicious cycle. Therefore, it is important to consume food containing or promoting the synthesis of serotonin and melatonin at dinner. A considerable variety of plant species including roots, leaves, fruits, and seeds such as almonds, bananas, cherries, and oats contain melatonin and/or serotonin. These foods may also contain tryptophan, which is a precursor of serotonin and melatonin. Protein foods such as milk and milk products are the main sources of the sleep-inducing amino acid tryptophan. Moreover, tryptophan is involved in the regulation of satiety and caloric intake via serotonin that mainly lowers carbohydrate and fat intake, and inhibits neuropeptide Y, the most powerful hypothalamic orexigen peptides [5]. Further, beyond sleep-inducing properties, milk products such as yogurt could also augmented natural killer cell activity and reduce the risk of respiratory infections [6] During quarantine the increased intake of macronutrients could also be accompanied by micronutrients deficiency as occurs in obesity [7], which is commonly associated with impaired immune responses, particularly cell-mediated immunity, phagocyte function, cytokine production, secretory antibody response, antibody affinity, and the complement system, thus making more susceptible to viral infections [8]. Thus, during this time it is important to take care of nutritional habits, following a healthy and balanced nutritional pattern containing a high amount of minerals, antioxidants, and vitamins. Several studies reported that fruits and vegetables supplying micronutrients can boost immune function. This happens because some of * Giovanna Muscogiuri giovanna.muscogiuri@gmail.com

Journal ArticleDOI
TL;DR: Recommendations for the care of laboratory zebrafish (Danio rerio) are provided as part of the further implementation of Annex A to the European Convention on the protection of vertebrate animals used for experimental and other scientific purposes and the fulfilment of Article 33 of EU Directive 2010/63 concerning the housing and care of experimental animals.
Abstract: This article provides recommendations for the care of laboratory zebrafish (Danio rerio) as part of the further implementation of Annex A to the European Convention on the protection of vertebrate animals used for experimental and other scientific purposes, EU Commission Recommendation 2007/526/EC and the fulfilment of Article 33 of EU Directive 2010/63, both concerning the housing and care of experimental animals. The recommendations provide guidance on best practices and ranges of husbandry parameters within which zebrafish welfare, as well as reproducibility of experimental procedures, are assured. Husbandry procedures found today in zebrafish facilities are numerous. While the vast majority of these practices are perfectly acceptable in terms of zebrafish physiology and welfare, the reproducibility of experimental results could be improved by further standardisation of husbandry procedures and exchange of husbandry information between laboratories. Standardisation protocols providing ranges of husbandry parameters are likely to be more successful and appropriate than the implementation of a set of fixed guidance values neglecting the empirically successful daily routines of many facilities and will better reflect the wide range of environmental parameters that characterise the natural habitats occupied by zebrafish. A joint working group on zebrafish housing and husbandry recommendations, with members of the European Society for Fish Models in Biology and Medicine (EUFishBioMed) and of the Federation of European Laboratory Animal Science Associations (FELASA) has been given a mandate to provide guidelines based on a FELASA list of parameters, 'Terms of Reference'.

Journal ArticleDOI
TL;DR: Author(s): Bivins, Aaron; North, Devin; Ahmad, Arslan; Ahmed, Warish; Alm, Eric; Been, Frederic; Bhattacharya, Prosun; Bijlsma, Lubertus; Boehm, Alexandria B; Brown, Joe; Buttiglieri, Gianluigi; Calabro, Vincenza; Carducci, Annalaura; Castiglioni, Sara; Cetecioglu Guro
Abstract: Author(s): Bivins, Aaron; North, Devin; Ahmad, Arslan; Ahmed, Warish; Alm, Eric; Been, Frederic; Bhattacharya, Prosun; Bijlsma, Lubertus; Boehm, Alexandria B; Brown, Joe; Buttiglieri, Gianluigi; Calabro, Vincenza; Carducci, Annalaura; Castiglioni, Sara; Cetecioglu Gurol, Zeynep; Chakraborty, Sudip; Costa, Federico; Curcio, Stefano; de Los Reyes, Francis L; Delgado Vela, Jeseth; Farkas, Kata; Fernandez-Casi, Xavier; Gerba, Charles; Gerrity, Daniel; Girones, Rosina; Gonzalez, Raul; Haramoto, Eiji; Harris, Angela; Holden, Patricia A; Islam, Md Tahmidul; Jones, Davey L; Kasprzyk-Hordern, Barbara; Kitajima, Masaaki; Kotlarz, Nadine; Kumar, Manish; Kuroda, Keisuke; La Rosa, Giuseppina; Malpei, Francesca; Mautus, Mariana; McLellan, Sandra L; Medema, Gertjan; Meschke, John Scott; Mueller, Jochen; Newton, Ryan J; Nilsson, David; Noble, Rachel T; van Nuijs, Alexander; Peccia, Jordan; Perkins, T Alex; Pickering, Amy J; Rose, Joan; Sanchez, Gloria; Smith, Adam; Stadler, Lauren; Stauber, Christine; Thomas, Kevin; van der Voorn, Tom; Wigginton, Krista; Zhu, Kevin; Bibby, Kyle

Journal ArticleDOI
Rafael Lozano1, Nancy Fullman1, John Everett Mumford1, Megan Knight1  +902 moreInstitutions (380)
TL;DR: To assess current trajectories towards the GPW13 UHC billion target—1 billion more people benefiting from UHC by 2023—the authors estimated additional population equivalents with UHC effective coverage from 2018 to 2023, and quantified frontiers of U HC effective coverage performance on the basis of pooled health spending per capita.

Journal ArticleDOI
TL;DR: Assessing the effect of lockdown measures (or the lack of such measures) on the numbers of new infections at an international level suggests that lockdown is effective in reducing the R0, i.e. the number of people infected by each infected person, and that its efficacy continues to hold 20 days after the introduction of the policy.
Abstract: There has been much debate about the effectiveness of lockdown measures in containing COVID-19, and their appropriateness given the economic and social cost they entail. To the best of our knowledge, no existing contribution to the literature has attempted to gauge the effectiveness of lockdown measures over time in a longitudinal cross-country perspective. This paper aims to fill the gap in the literature by assessing, at an international level, the effect of lockdown measures (or the lack of such measures) on the numbers of new infections. Given this policy’s expected change in effectiveness over time, we also measure the effect of having a lockdown implemented over a given number of days (from 7 to 20 days). We pursue our objectives by means of a quantitative panel analysis, building a longitudinal dataset with observations from countries all over the world, and estimating the impact of lockdown via feasible generalized least squares fixed effect, random effects, generalized estimating equation, and hierarchical linear models. Our results show that lockdown is effective in reducing the number of new cases in the countries that implement it, compared with those countries that do not. This is especially true around 10 days after the implementation of the policy. Its efficacy continues to grow up to 20 days after implementation. Results suggest that lockdown is effective in reducing the R0, i.e. the number of people infected by each infected person, and that, unlike what has been suggested in previous analyses, its efficacy continues to hold 20 days after the introduction of the policy.

Journal ArticleDOI
TL;DR: Two important categories of natural plant biostimulants mentioned in this web article were two important categories such as humic acids and seaweed extracts, and their action on plants was proposed to be essentially hormonal.
Abstract: Recently, the agricultural sector is facing concomitant challenges of rising the productivity to feed the growing global population and increasing the resources use efficiency, while reducing the environmental impact on the ecosystems and human health. In fact, fertilizers and pesticides play a crucial role in agriculture, representing a powerful tool for growers to increase yield and guarantee continuous productivity throughout the seasons under both optimal and suboptimal conditions. In the last three decades, several technological innovations have been proposed to enhance the sustainability of agricultural production systems, through a significant reduction of synthetic agrochemicals like pesticides and fertilizers. A promising and environmental-friendly innovation would be the use of natural plant biostimulants (PBs) that enhance flowering, plant growth, fruit set, crop productivity, and nutrient use efficiency (NUE), and are able also to improve the tolerance against a wide range of abiotic stressors (Colla and Rouphael, 2015). PBs were initially defined by excluding some functionalities like fertilizers or plant protection products. In 1997, in Grounds Maintenance web-journal, Zhang and Schmidt from the Department of Crop and Soil Environmental Sciences of the Virginia Polytechnic Institute and State University, defined PBs as “materials that, in minute quantities, promote plant growth”. By using the statement “minute quantities” for describing PBs, the authors implicitly wanted to discriminate biostimulants from nutrients and soil amendments, which also promote plant growth, but are clearly applied in larger quantities. The PBs mentioned in this web article were two important categories such as humic acids and seaweed extracts, and their action on plants was proposed to be essentially hormonal. In 2012, the European Commission has assigned an ad hoc study on plant biostimulants to evaluate the substances and materials involved, which was published by du Jardin (2012) as: “The Science of Plant Biostimulants A bibliographic Analysis”. Based on the scientific literature (250 scientific articles using the term ‘biostimulant' in their titles and/or abstracts), the following definition was proposed: “Plant biostimulants are substances and materials, with the exception of nutrients and pesticides, which, when applied to plant, seeds or growing substrates in specific formulations, have the capacity to modify physiological processes of plants in a way that provides potential benefits to growth, development and/or stress responses”. du Jardin (2012) concluded that PBs are very heterogeneous materials, and proposed in his study eight categories of substances that acts as biostimulants: humic substances, complex organic materials (obtained from agro-industrial and urban waste products, sewage sludge extracts, composts, and manure), beneficial chemical elements (Al, Co, Na, Se, and Si), inorganic salts including phosphite, seaweed extracts (brown, red, and green

Journal ArticleDOI
TL;DR: This consensus document provides a perspective on what constitutes best practice in pharmacological research on bioactive preparations derived from natural sources, providing a perspective of what the leading specialist journals in the field consider as the core characteristics of good research.

Journal ArticleDOI
TL;DR: Understanding how plants manipulate their microbiome can aid in the design of next-generation microbial inoculants for targeted disease suppression and enhanced plant growth.
Abstract: Plants host a mesmerizing diversity of microbes inside and around their roots, known as the microbiome. The microbiome is composed mostly of fungi, bacteria, oomycetes, and archaea that can be either pathogenic or beneficial for plant health and fitness. To grow healthy, plants need to surveil soil niches around the roots for the detection of pathogenic microbes, and in parallel maximize the services of beneficial microbes in nutrients uptake and growth promotion. Plants employ a palette of mechanisms to modulate their microbiome including structural modifications, the exudation of secondary metabolites and the coordinated action of different defence responses. Here, we review the current understanding on the composition and activity of the root microbiome and how different plant molecules can shape the structure of the root-associated microbial communities. Examples are given on interactions that occur in the rhizosphere between plants and soilborne fungi. We also present some well-established examples of microbiome harnessing to highlight how plants can maximize their fitness by selecting their microbiome. Understanding how plants manipulate their microbiome can aid in the design of next-generation microbial inoculants for targeted disease suppression and enhanced plant growth.