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Background and Aims Global warming is inducing a general earliness in the onset of grapevine phenological stages including ripening, a phenomenon that occurs often in the hottest seasons and which leads to unbalanced wines. Our aim was to assess the physiological basis of late leaf removal applied above the bunch area as a tool for delaying ripening. Methods and Results Potted cv. Sangiovese grapevines were subjected to leaf removal treatments applied preveraison (DEF‐I) and postveraison (DEF‐II) by pulling out six to seven primary leaves and laterals, if any, above the bunch zone; untouched vines served as the control. Whole‐canopy net CO2 gas exchange was monitored seasonally from 9 days before DEF‐I to 35 days after DEF‐II. Concurrently, single‐leaf gas exchange was assessed, and at harvest yield components, grape composition and the leaf‐to‐fruit ratio were determined. The seasonal carbon/yield ratio did not differ between treatments because of the high capacity for photosynthetic compensation shown by the DEF treatments and quantified as about a 35% higher net CO2 gas exchange per unit of leaf area per day. While ripening was temporarily retarded in both DEF treatments, with sugar content being lower and titratable acidity higher, a week later both treatments had fully or partially recovered; phenolic ripening was unaffected at either harvest date. Conclusions Defoliation above the bunch zone applied at lag‐phase and postveraison (average 12°Brix) was effective in temporarily delaying technological ripeness without affecting colour and phenolics. This result depended upon the high compensation capacity for photosynthesis shown by vines in both treatments. Significance of the Study The data provide a preliminary yet robust physiological background for targeting better field application of the technique.

Background and Aims The increasing interest by the wine market in sparkling white wines challenges how the desired grape composition can be achieved under the pressure of global warming. The aim of the present study was to assess the viability of summer pruning as a tool to pilot ripening towards desired compositional patterns. Methods and Results Ortrugo was subjected to basal leaf removal applied either at pre‐flowering (ELR) or in lag‐phase (LLR) and to bunch thinning (BT; removal of 50% of crop at lag‐phase) in comparison with untreated control (C). Treatments induced large variation in bunch mass (30% less in ELR vs BT), yield per vine (37 and 21% less in BT and ELR vs C) and total soluble solids at harvest (BT scored 2.9°Brix higher than that of C). Conversely, given the same harvest date, all practices failed to maintain titratable acidity (TA) at the threshold of 6.5 g/L. Conclusions The data suggest that crop regulation achieved in the high yielding Ortrugo, through either BT or ELR, increases sugar accumulation rate so that concurrent optimal TA level (≅6.5 g/L) can be easily achieved by slightly anticipating harvest date. Under conditions of thermal or light stress, or weather conducive to bunch rot, preference should be given to ELR. Significance of the Study Suitable summer pruning techniques might be used as flexible and powerful tools to direct ripening towards the desired crop composition.

Background:The epidemiological characteristics of the disease determine that patients with knee osteoarthritis (OA) are associated with at least one other long-term condition, which falls under the definition of multimorbidity. This can affect joint functionality and have a potential importance for patient management.Objectives:To determine the coexisting conditions in people with OA and whether the number of comorbidities were linked with knee functional status.Methods:In a cross-sectional study, patients who fulfilled the ACR classification criteria for knee OA (1991) were recruited from the University Rehabilitation Center. Data collection included demographics, present comorbidities and how these linked with pain intensity (0–100), and joint function according to Knee Injury and Osteoarthritis Outcomes Score (KOOS) with 5 domains (Pain, Symptoms, Activity in Daily Living (ADL), Sport and recreation (Sport/rec.) and Quality of life (QoL).Results:The study included 164 consecutive patients, mean age (M±SD) of 62,2±8,76 years, 77,4% females. The clinical exam and medical history analysis reveal 22 patients with a single chronic disease (OA-Gr.1) and 142 with 2 or more long-term conditions (Gr.2 patients with multimorbidity). The level of pain was similar in both groups (62,27±14,1 vs 61,7±17,1 mm, p>0.05). The KOOS results showed a reduction of knee function in both groups Gr1. (Pain-62,6 ±15,0, Symptoms –55,9±10,47, ADL –48,8±12,2, Sport/rec.– 21,8±12,4, and QoL –42,9±24,1,%) in Gr.2 (Pain-52,9±18,7, Symptoms –58,1±19,8, ADL-40,9±18,5, Sport/rec.– 14,8±21,9, and QoL –30,3±22,7,%), although joint functionality seem to be more affected in the Gr.2 with multimorbidity, there was no statistical difference (p>0.05). However, the increase in the number of associated pathologies correlates moderately with a degradation of the ability to do heavy activities and a lower quality of life (r=-0,3, p <0,0001).Conclusion:Multimorbidity leads to physical decline, and people with more conditions experience pronounced joint impairment, which seems to increase with a rising number of long-term conditions.REFERENCES:NIL.Acknowledgements:NIL.Disclosure of Interests:None declared.

The interrelations and sequencing of interleukins are complex (inter)actions where each interleukin can stimulate the secretion of its preceding interleukin. In this paper, we attempt to summarize the currently known roles of IL-4, IL-13, IL-31, and IL-33 from a multi-disciplinary perspective. In order to conduct a comprehensive review of the current literature, a search was conducted using PubMed, Google Scholar, Medscape, UpToDate, and Key Elsevier for keywords. The results were compiled from case reports, case series, letters, and literature review papers, and analyzed by a panel of multi-disciplinary specialist physicians for relevance. Based on 173 results, we compiled the following review of interleukin signaling and its clinical significance across a multitude of medical specialties. Interleukins are at the bed rock of a multitude of pathologies across different organ systems and understanding their role will likely lead to novel treatments and better outcomes for our patients. New interleukins are being described, and the role of this inflammatory cascade is still coming to light. We hope this multi-discipline review on the role interleukins play in current pathology assists in this scope.

Knee osteoarthritis (OA) is an increasingly common and disabling problem in worldwide. Exercises are considered the cornerstone of non-surgical management of knee OA and is recommended in all current clinical guidelines. The diversity of exercise programs determines the need to compare their efficiency, in order to recommend the best option for the patient. The aim of the present study was to compare the effect on knee functionality of conventional exercises program and combinate with manual therapy in patients with knee osteoarthritis. 164 patients that fulfilled the ACR classification criteria for knee osteoarthritis (127 females and 37 males) ranging in age from 42 to 84 years (mean 62,2 SD 8,76), participated in a 10 days two-arm randomized trial. One group (Gr.1) received an exercises program, the other group additionally manual therapy methods (Gr.2). Pain and function were measured with a Visual Analogue Scale (VAS, mm) and Knee Injury and Osteoarthritis Outcomes Score (KOOS) with 5 domains (Pain, Symptoms, Activity in Daily Living (ADL), Sport and recreation (Sport/rec.) and Quality of life (QoL)). In the Gr.1 were 82 patients mean age 61,8±9,2 years and in Gr.2 – 82 patients 62,7±8,3 years (p>0.05). The initial level of pain (63,4±14,2 vs 60,2±18,8mm) and knee functionality according to KOOS (Tab1.) were similar in both groups, p>0.05. After 10 days rehabilitation program, VAS in Gr.1 was 39,6±14,8 mm, in Gr.2- 28,5±11,6 mm, (p<0.01). The KOOS results at the end of the rehabilitation program were with improvement, statistically significative in the Gr.2 (p<0,05). The reduction of pain and recovery of function were found in both groups, with better results in patients who received manual therapy and exercises program. This study supports the routine manual therapy in rehabilitation program in patients with knee osteoarthritis. None declared. Table 1.The KOOS results at baseline and after 10 days of rehabilitation program.KOOS scales (M±SD), %Group 1Group 2BaselineAfter 10 daysBaselineAfter 10 daysPain55,5 ±13,863,4±13,653,0±22,364,3±19,1Symptoms59,0±18,765,6±18,156,6±19,069,0±15,9ADL46,3±15,554,5±16,043,0±19,955,1±18,2Sport/rec15,6±17,323,1±19,616,0±24,330,5±23,6QoL29,3±22,236,5± 22,934,8±23,950,6±18,9

Background:Physical rehabilitation is proposed as a method of non-pharmacological treatment of knee osteoarthritis (OA) by the EULAR and OARSI recommendations. At the same time, presence of concomitant diseases could influence the condition of patients and the outcomes of the rehabilitation program.Objectives:To evaluate the frequency of comorbidities in OA patients and to appreciate their impact on outcomes of the physical rehabilitation program.Methods:A prospective control case study was conducted in the University Rehabilitation Center. The patients underwent clinical examination, VAS scale was used to assess level of pain, and Knee Injury and Osteoarthritis Outcome Score (KOOS) with 5 domains (Pain, Symptoms, ADL, Sport, QoL) for joint function assessment. These parameters were evaluated at the onset of the program (T0) and at the end of the 10th day (T1). Medical data records, general clinical exam and Charlson Comorbidities Index (CCI) assessed the comorbidities.Results:48 patients with OA were included in the study, 37 patients of them were found with comorbidities. The most frequent associated diseases were: cardiovascular- 76.6%, obesity-59.9%, and endocrine - 12.9% cases. At T0, significantly lower levels in the group with comorbidities were identified on the domains Pain, Sport and QoL. The CCI in patients with comorbidities was 3.29 ± 0.14 points (82.1% for 1-year survival rate). At the T1 moment, we found an improvement in joint functionality in both groups. The mean value of the VAS score group of patients without comorbidities decreased from 48,18 mm to 21,36 mm (p <0.05) and for the group of patients with comorbidities – 64,2 at / 36,2 mm (p<0.001). Significant improvement in joint function in the comorbidities group was in Pain (p <0.01), Sport (p <0.05) and Qol (p <0.01) domains, at the same in patients without comorbidities, the improvement was significant in all 5 domains.Conclusion:Comorbidities are highly associated to knee osteoarthritis and prove to have a negative influence on the results of the physical rehabilitation program; therefore, we would recommend to apply individualized rehabilitation programs adapted to the associated conditions of each patient.Disclosure of Interests:None declared