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AbstractFetal sex contributes to the determination of obstetric outcome, as pregnancies carrying male babies seem to have an increased risk of maternal-fetal complications. Most studies have been conducted on singleton pregnancies, whereas less evidence is available for twins. A 10-year retrospective observational study was conducted on a cohort of 1180 women with twin pregnancy delivered at a single tertiary hospital. Clinical data on maternal characteristics, and obstetric and neonatal outcomes were collected, and the analysis was performed on monochorionic (MC) and dichorionic (DC) diamniotic twins separately. The group of DC twins included 837 cases, and those conceived by assisted reproductive technologies (ART) were more likely to have one or both female fetuses rather than males. The incidence of hypertensive disorders of pregnancy (HDP) was higher in same-sex pairs than in opposite-sex pairs. No differences were found regarding other obstetric and neonatal outcomes among the three sex-pairing groups. The MC twins group included 228 cases, and in female-carrying pregnancies a higher incidence of gestational diabetes (GDM) was observed compared to the male group. Furthermore, male pairs had significantly lower Apgar scores than females. Fetal sex seems to have a mild effect in twins compared to singleton pregnancies, suggesting a more complex set of factors contributing to pregnancy outcome in multiple pregnancies. However, we observed a higher incidence of HDP among same-sex DC pairs, a higher rate of GDM among MC female-female pairs, and a worse adaptation to extrauterine life among male-male pairs in MC twins.

New challenges in vaccination policies: the role of General Practitioners. The phenomenon of "Vaccine Hesintacy" and the consequent decrease in vaccination coverage with the re-ignition of some epidemic outbreaks has led Italian national and regional authorities to set a new vaccination plan (PNPV 2017-19) and even coercive measures such as the the Law n.119/2017. In addition, there have been initiatives by scientific societies also in order to increase involvement of professionals in information and education campaigns. Among the professional figures involved, the general practitioners represents the starting point from which to regain the citizen's trust. This article assesses their important role in the implementation of vaccination policies in Italy by identifying the essential points of the campaigns carried out on their patients.

OUR CLAIM: "The Botanical Gardens are, par excellence, responsible for carrying out the important mission of the conservation of our flora, through specific actions on live plants and their seeds, along with education and outreach aimed at spreading a new environmental culture, more careful and respectful of the essential needs of life, more sensible to the aesthetic and scientific value of the national flora" To overcome the isolation and strengthen their role in our society, the University Botanical Gardens have become promoters of national and European consortiums: examples are the working group "Botanical and Historic Gardens" of the Italian Botanical Society (1) and, on the global level, the Botanic Garden Conservation International (2). Aims and tasks of the Botanical Gardens in the second millennium have been the topic of a thorough debate, with specific references to the provisions of the United Nations Programme for a sustainable development. In particular, the Action Plan for Botanic Gardens in the European Union (3) identifies the following major assets: scientific research, conservation of plant diversity, public advisory services on it, environmental education related to it. To pursue these objectives, initiatives are constantly needed to enhance the visibility of the institutions involved and help them to perform their functions. in this contest was born FLORINTESA FLORINTESA is a program agreement, funded by the Italian Ministry of Education (MIUR) with identification code ACPR12_00201, involving as partners ENEA, Plinianum Forum and the Italian Botanical Society, which contributes to bridge the still existing gap between the scientific research, the technical action of conservation and preservation of plant diversity and the public awareness on such themes. The main objectives of the FLORINTESA can be summarized as follows: - Establishing an institutional network service for information and dissemination on the flora of Italy, with reference to the role of Botanical Gardens as centers of research and knowledge on the national flora, as well as on the assessment and conservation of its rarest species,; - Disseminating and publicizing the activities of the University Botanical Gardens for the flora of Italy; - Increasing the visibility of the Italian Botanical Society and of its working group on "Botanical and Historic Gardens"; - Disseminating the achievements and helpful assistance offered by the Botanical Gardens in the implementation of the National Strategy for Biodiversity (4) and the Natura 2000 Network (5), through initiatives such as the Italian Germplasm Banks Network (6), the International Foundation pro Herbario Mediterraneo (7), the pan-Mediterranean Genmeda network (8), the Horti Mediterranei Educational Network (9). The flora of Italy will be the leitmotif of the actions envisaged in FLORINTESA, highlighting the unique role of the University Botanical Gardens and their respective institutions as "engines of knowledge" on the national flora heritage, as "engines of awareness" on the important issue of conservation of flora and habitats, as "engines of passion" for the grateful acknowledgement of the role of plants as primary producers not only of resources in the natural ecosystems, but also of inspiring beauty in the human cultures. The kick-off meeting, open to all members of the Italian Botanical Society, will take place in Rome, at the Auditorium of the Accademia Nazionale dei Lincei, on January 23, 2014.

Emphasis on studies that seek sustainable energy alternatives to oil has increased over the last few years. Ethanol derived from sugarcane remains a promising technology for biofuel production. Waste from pineapple culture remains is a potential alternative raw material for biofuel production. The goal of this study was to determine the potential of residual biomass production of a pineapple crop, subjected to fertilization by different levels of nitrogen and potassium. The experiment was conducted in Northwest Paraná, in a commercial area in Santa Isabel do Ivaí-PR. The climate in this area is subtropical humid according to the Köppen classification, and has a sandy dystrophic red acrisol.The experimental design was a 4 × 4 factorial, where factor A:N doses (0; 11; 22; and 33 g per plant) and factor B:K2O doses (0; 11; 22; and 33 g per plant. The production of residual pineapple biomass responded differently to the N and K doses applied. Potassium fertilization had a positive linear correlation, up to the addition of 33 g plant-1 with a production of 5.88 Mg ha-1. A dose of 18.138 g plant-1 yielded in the maximum dry biomass production for nitrogen fertilization.

The conserved CD94/NKG2A inhibitory receptor is expressed by nearly all human and ∼50% of mouse uterine natural killer (uNK) cells. Binding human HLA-E and mouse Qa-1, NKG2A drives NK cell education, a process of unknown physiological importance influenced by HLA-B alleles. Here, we show that NKG2A genetic ablation in dams mated with wild-type males caused suboptimal maternal vascular responses in pregnancy, accompanied by perturbed placental gene expression, reduced fetal weight, greater rates of smaller fetuses with asymmetric growth, and abnormal brain development. These are features of the human syndrome pre-eclampsia. In a genome-wide association study of 7,219 pre-eclampsia cases, we found a 7% greater relative risk associated with the maternal HLA-B allele that does not favor NKG2A education. These results show that the maternal HLA-B→HLA-E→NKG2A pathway contributes to healthy pregnancy and may have repercussions on offspring health, thus establishing the physiological relevance for NK cell education. VIDEO ABSTRACT. ; This project was funded by the Wellcome Trust (awards 200841/Z/16/Z to FC and AM and RG86992 to NS and FC), the Medical Research Council (Grant MR/P001092/1 to AS, FC and AM). JAT received funding from the European Research Council under the European Union's Horizon 2020 research and innovation program (Grant Agreement 695551). OH was supported by a MedImmune-Cambridge PhD fellowship. JJ was supported by a Centre for Trophoblast Research PhD fellowship.

This paper outlines the characteristics of scientific leadership and the role of Scientific Associations with their specific activities. The recent activities of the Lombard Academy of Public Health are subsequently described, including the creation, in 2019, of the Academy of young leaders in public health. Comparing to other sectors, scientific leadership dynamics take into consideration different aspects. Besides awards (Nobel Prize or several other) and prestigious affiliations, eventual indicators might be academic roles, fundraising abilities, relevant positions among scientific associations, editors of prestigious journals or editorial series and, more recently, high bibliometric indicators. The peculiar topics of public health encompass interactions with institutions, authorities, politicians, involved in different levels in health policies. Recently, in Italy, the Ministry of Health has identified parameters to be accreditated as a scientific and technical association. The role of SItI (Italian Society of Hygiene), EUPHA, ASPHER, and WFPHA appears relevant in PH, in national and international contexts, with Italian praiseworthy members constantly achieving leading roles. Considering that few training opportunities aimed to improve research and leadership skills are available, Accademia Lombarda di Sanità Pubblica (ALSP) designed the AYLPH (Academy of Young Leaders in Public Health) program. AYLPH program is a 1-year training to shape leadership skills among young professionals. A set of didactic, theoretical and practical methods was offered and evaluated.

Introduzione L'Accademia Lombarda di Sanità Pubblica (ALSP), Associazione no-profit fondata nel 2017, ha come obiettivo quello di promuovere il progresso in Sanità Pubblica (SP) attraverso il coinvolgimento di studiosi impegnati a vario titolo nei molteplici ambiti della SP come quello dell'igiene, dell'epidemiologia, della prevenzione, dell'ambiente, della direzione sanitarie, dell'edilizia sanitaria, del management, del diritto e dell'economia sanitaria. A tale scopo l'Accademia ha promosso, all'inizio del 2019, l'iniziativa Academy of Young Leader in Public Health (AYLPH). Si tratta di un percorso didattico-scientifico di un anno rivolto a 10 giovani con background formativo differente, fortemente motivati a sviluppare competenze di leadership in SP e già avviati a carriere professionali e di ricerca. Metodi Questo percorso formativo per i 10 giovani, selezionati con bando competitivo aperto ai soci, basa il suo metodo didattico-formativo su incontri con riconosciuti leader nazionali e internazionali di SP; visite a istituzioni; collaborazione a progetti di ricerca; training specifico sulla scrittura di lavori scientifici; opportunità di partecipare a convegni nazionali internazionali e a corsi brevi ad hoc. Risultati A metà programma, le attività condotte sono state: esperienza di team building in località montana; incontro con alcune importanti figure impegnate, a vari livelli, nella sanità pubblica come l'ex Ministro della salute Beatrice Lorenzin, l'Editor-in-chief della rivista European Journal of Public Health Peter Allebeck, il Presidente EUPHA Natasha Azzopardi-Muscat oltre ai past-Presidenti EUPHA Walter Ricciardi e Martin Mc Kee. Ha fatto seguito un corso intensivo sulle revisioni sistematiche che ha visto l'attivazione di 6 gruppi di ricerca coinvolti in altrettanti progetti di revisione sistematica della letteratura. Ulteriori attività sono state: la partecipazione all'Assemblea Generale dell'Organizzazione Mondiale della Sanità, la partecipazione al Deans' and Directos' Retreat dell'ASPHER e al Congresso Americano di Sanità Pubblica (APHA). Sono in programma anche un corso di Public speaking, presso l'Università di Pisa ed alcuni incontri ad hoc. Conclusioni Nel contesto attuale, in cui la salute delle persone è minata da un senso di sfiducia nei confronti delle Istituzioni, dalla mancata equità nell'accesso alle cure e da stili di vita scorretti, la SP ha necessità di formare nuovi leaders in grado di promuovere valori e guidare al cambiamento individuale, organizzativo e politico. La AYLPH rappresenta un'occasione formativa di alto livello per giovani professionisti interessati a conoscere e attuare strategie di leadership in SP.

This paper outlines the characteristics of scientific leadership and the role of Scientific Associations with their specific activities. The recent activities of the Lombard Academy of Public Health are subsequently described, including the creation, in 2019, of the Academy of young leaders in public health. Comparing to other sectors, scientific leadership dynamics take into consideration different aspects. Besides awards (Nobel Prize or several other) and prestigious affiliations, eventual indicators might be academic roles, fundraising abilities, relevant positions among scientific associations, editors of prestigious journals or editorial series and, more recently, high bibliometric indicators. The peculiar topics of public health encompass interactions with institutions, authorities, politicians, involved in different levels in health policies. Recently, in Italy, the Ministry of Health has identified parameters to be accreditated as a scientific and technical association. The role of SItI (Italian Society of Hygiene), EUPHA, ASPHER, and WFPHA appears relevant in PH, in national and international contexts, with Italian praiseworthy members constantly achieving leading roles. Considering that few training opportunities aimed to improve research and leadership skills are available, Accademia Lombarda di Sanità Pubblica (ALSP) designed the AYLPH (Academy of Young Leaders in Public Health) program. AYLPH program is a 1-year training to shape leadership skills among young professionals. A set of didactic, theoretical and practical methods was offered and evaluated.

Background. L'Accademia Lombarda di Sanità Pubblica (ALSP), Associazione no-profit fondata nel 2017, ha come obiettivo quello di promuovere il progresso in Sanità Pubblica (SP) attraverso il coinvolgimento di studiosi impegnati a vario titolo nei molteplici ambiti della SP come quello dell'igiene, dell'epidemiologia, della prevenzione, dell'ambiente, della direzione sanitarie, dell'edilizia sanitaria, del management, del diritto e dell'economia sanitaria. A tale scopo l'Accademia ha promosso, per il corrente anno 2019, l'iniziativa Academy of Young Leader in Public Health (AYLPH). È un percorso didattico-scientifico, teorico-pratico, di un anno rivolto a giovani con background formativo differente, fortemente motivati a sviluppare competenze di leadership in Public Health e già avviati a carriere professionali e di ricerca. Metodi. Il metodo didattico formativo si è basato su: incontri con riconosciuti leader nazionali e internazionali di Public Health, collaborazione a progetti di ricerca, elaborazione di programmi sperimentali su Indicatori di Qualità in Sanità e sul Piano Nazionale Esiti (PNE), scrittura di lavori scientifici in materia di Health Management e di Igiene e Sanità Pubblica. I membri AYLPH, suddivisi in cinque sottogruppi, hanno elaborato 5 revisioni sistematiche aventi oggetto "Volumi ed esiti", "Inceneritori e Salute", "Attività fisica e Depressione", "Vaccinologia", "Data mining per Risk Management". Risultati. Una pubblicazione di rilievo internazionale, 5 revisioni sistematiche, una cerimonia conclusiva e un Team di giovani promettenti. Alla luce di questa brillante esperienza, l'Accademia Lombarda di Sanità Pubblica promuove per il prossimo 2020 percorsi formativi di giovani leaders in Sanità Pubblica con la realizzazione di campagne di comunicazione in Sanità, progetti integrati di edilizia sanitaria applicata alla riorganizzazione dell'Ospedale per Intensità di Cure, progetti "Lean" e di miglioramento della performance clinica e organizzativa, programmi di riduzione del rischio con applicazione degli standard Joint Commission International. Discussione. Nel contesto attuale di carenza di medici specialisti nelle strutture SSN, incluse le private accreditate, è fondamentale la formazione del giovane medico in formazione specialistica che, già nel corso dell'ultimo anno di specializzazione, ai sensi del comma 547 della legge n.145/2018, cosi come modificato dalla Legge n. 60/2019, è ammesso a partecipare ai concorsi pubblici per Dirigente Medico della disciplina inerente il Corso di Specializzazione e dunque ad entrare precocemente nel difficile e sempre più esigente mondo del lavoro. L'ALSP vuole formare giovani leaders in Sanità Pubblica offrendo loro competenze multidisciplinari, all'avanguardia in relazione allo sviluppo tecnologico, igienico-sanitarie, strategiche e gestionali necessarie per implementare nuovi modelli organizzativi. Mission. L'ALSP ha necessità di promuovere valori e guidare i giovani leaders al cambiamento individuale, organizzativo e politico. La AYLPH rappresenta un'occasione formativa di alto livello per giovani professionisti interessati a conoscere e attuare strategie di leadership in Sanità Pubblica.

This paper outlines the characteristics of scientific leadership and the role of Scientific Associations with their specific activities. The recent activities of the Lombard Academy of Public Health are subsequently described, including the creation, in 2019, of the Academy of young leaders in public health. Comparing to other sectors, scientific leadership dynamics take into consideration different aspects. Besides awards (Nobel Prize or several other) and prestigious affiliations, eventual indicators might be academic roles, fundraising abilities, relevant positions among scientific associations, editors of prestigious journals or editorial series and, more recently, high bibliometric indicators. The peculiar topics of public health encompass interactions with institutions, authorities, politicians, involved in different levels in health policies. Recently, in Italy, the Ministry of Health has identified parameters to be accreditated as a scientific and technical association. The role of SItI (Italian Society of Hygiene), EUPHA, ASPHER, and WFPHA appears relevant in PH, in national and international contexts, with Italian praiseworthy members constantly achieving leading roles. Considering that few training opportunities aimed to improve research and leadership skills are available, Accademia Lombarda di Sanità Pubblica (ALSP) designed the AYLPH (Academy of Young Leaders in Public Health) program. AYLPH program is a 1-year training to shape leadership skills among young professionals. A set of didactic, theoretical and practical methods was offered and evaluated.

Personalization of gait neuroprosthetics is paramount to ensure their efficacy for users, who experience severe limitations in mobility without an assistive device. Our goal is to develop assistive devices that collaborate with and are tailored to their users, while allowing them to use as much of their existing capabilities as possible. Currently, personalization of devices is challenging, and technological advances are required to achieve this goal. Therefore, this paper presents an overview of challenges and research directions regarding an interface with the peripheral nervous system, an interface with the central nervous system, and the requirements of interface computing architectures. The interface should be modular and adaptable, such that it can provide assistance where it is needed. Novel data processing technology should be developed to allow for real-time processing while accounting for signal variations in the human. Personalized biomechanical models and simulation techniques should be developed to predict assisted walking motions and interactions between the user and the device. Furthermore, the advantages of interfacing with both the brain and the spinal cord or the periphery should be further explored. Technological advances of interface computing architecture should focus on learning on the chip to achieve further personalization. Furthermore, energy consumption should be low to allow for longer use of the neuroprosthesis. In-memory processing combined with resistive random access memory is a promising technology for both. This paper discusses the aforementioned aspects to highlight new directions for future research in gait neuroprosthetics. ; AK is funded by a faculty endowment by adidas AG. MA, SKH, NM, MN, RJQ, R-DR, RJT are supported by NSF CPS grant 1739800, VA Merit Reviews A2275-R and 3056, and the NIH (5T32EB004314-15, R01 NS040547-13). MS and AG are funded by the European Research Council (ERC) under the European Union's Horizon 2020 research and innovation programme (Grant agreement No. 803035). AJd-A, JMF-L, and JCM are supported by coordinated grants RTI2018-097290-B-C31/C32/C33 (TAILOR project) funded by MCIN/AEI/10.13039/501100011033 and by "ERDF A way of making Europe". MR is funded by the Lo3-ML project by the Federal Ministry for Education, Science and Technology (BMBF) (Funding No. 16ES1142K). AC, SS, and MV were supported by the European Research Council (ERC) under the project NGBMI (759370), the Einstein Stiftung Berlin, the ERA-NET NEURON project HYBRIDMIND (BMBF, 01GP2121A and -B) and the BMBF project NEO (13GW0483C).

Heart failure is a pressing worldwide public-health problem with millions of patients having worsening heart failure. Despite all the available therapies, the condition carries a very poor prognosis. Existing therapies provide symptomatic and clinical benefit, but do not fully address molecular abnormalities that occur in cardiomyocytes. This shortcoming is particularly important given that most patients with heart failure have viable dysfunctional myocardium, in which an improvement or normalization of function might be possible. Although the pathophysiology of heart failure is complex, mitochondrial dysfunction seems to be an important target for therapy to improve cardiac function directly. Mitochondrial abnormalities include impaired mitochondrial electron transport chain activity, increased formation of reactive oxygen species, shifted metabolic substrate utilization, aberrant mitochondrial dynamics, and altered ion homeostasis. In this Consensus Statement, insights into the mechanisms of mitochondrial dysfunction in heart failure are presented, along with an overview of emerging treatments with the potential to improve the function of the failing heart by targeting mitochondria. ; Stealth BioTherapeutics; NIH (NHLBI) [R01 HL123647, R15 HL122922]; NIH [R01 HL123647, R15 HL122922, NIA R01 AG049762, NHLBI R01 HL131458, R01HL126928, R01HL107715, R01 AT008375]; European Union; European Commission [FP7-242209-BIOSTAT-CHF] ; The roundtable discussion in Stresa, Italy, was organized by Logica Med LLC and funded by an unrestricted grant from Stealth BioTherapeutics. We thank Fumiko Inoue (Logica Med) for her help in organizing the roundtable meeting. The authors also acknowledge BioCentric, Inc. for their assistance with developing previous versions of the manuscript Figures. D.A.B. has received research grants from the NIH (NHLBI R01 HL123647 and R15 HL122922) and Stealth BioTherapeutics. B.L.S. is supported by research grants from the NIH (NIA R01 AG049762, NHLBI R01 HL131458, R01HL126928, and R01HL107715) and Stealth BioTherapeutics. S.R.S. is supported by grants from the NIH (R01 HL123647, R15 HL122922, and R01 AT008375). J.B. has received research support from the NIH and the European Union. A.A.V. is supported by a grant from the European Commission (FP7-242209-BIOSTAT-CHF).