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Background Interstitial lung disease (ILD) is a severe systemic manifestation of rheumatoid arthritis (RA). High-resolution computed tomography (HRCT) represents the gold standard for the diagnosis of ILD, but its routine use for screening programs is not advisable because of both high cost and X-ray exposure. Velcro crackles at lung auscultation occur very early in the course of interstitial pneumonia, and their detection is an indication for HRCT. Recently, we developed an algorithm (VECTOR) to detect the presence of Velcro crackles in pulmonary sounds and showed good results in a small sample of RA patients. The aim of the present investigation was to validate the diagnostic accuracy of VECTOR in a larger population of RA patients, compared with that of the reference standard of HRCT, from a multicentre study. Methods To avoid X-ray exposure, we enrolled 137 consecutive RA patients who had recently undergone HRCT. Lung sounds of all patients were recorded in 4 pulmonary fields bilaterally with a commercial electronic stethoscope (ES); subsequently, all HRCT images were blindly evaluated by a radiologist, and audio data were analysed by means of VECTOR. Results Fifty-nine of 137 patients showed ILD (43.1%). VECTOR correctly classified 115/137 patients, showing a diagnostic accuracy of 83.9% and a sensitivity and specificity of 93.2 and 76.9%, respectively. Conclusions VECTOR may represent the first validated tool for the screening of RA patients who are suspected for ILD and who should be directed to HRCT for the diagnosis. Moreover, early identification of RA-ILD could contribute to the design of prospective studies aimed at elucidating unclear aspects of the disease.

Background Hypersensitivity pneumonitis (HP) has a variable clinical course. Modelling of quantitative CALIPER-derived CT data can identify distinct disease phenotypes. Mortality prediction using CALIPER analysis was compared to the interstitial lung disease gender, age, physiology (ILD-GAP) outcome model. Methods CALIPER CT analysis of parenchymal patterns in 98 consecutive HP patients was compared to visual CT scoring by two radiologists. Functional indices including forced vital capacity (FVC) and diffusion capacity for carbon monoxide (DLco) in univariate and multivariate Cox mortality models. Automated stratification of CALIPER scores was evaluated against outcome models. Results Univariate predictors of mortality included visual and CALIPER CT fibrotic patterns, and all functional indices. Multivariate analyses identified only two independent predictors of mortality: CALIPER reticular pattern (p = 0.001) and DLco (p < 0.0001). Automated stratification distinguished three distinct HP groups (log-rank test p < 0.0001). Substitution of automated stratified groups for FVC and DLco in the ILD-GAP model demonstrated no loss of model strength (C-Index = 0.73 for both models). Model strength improved when automated stratified groups were combined with the ILD-GAP model (C-Index = 0.77). Conclusions CALIPER-derived variables are the strongest CT predictors of mortality in HP. Automated CT stratification is equivalent to functional indices in the ILD-GAP model for predicting outcome in HP. Key Points • Computer CT analysis better predicts mortality than visual CT analysis in HP . • Quantitative CT analysis is equivalent to functional indices for prognostication in HP . • Prognostication using the ILD - GAP model improves when combined with quantitative CT analysis .

The mobilization of fatty acids during food deprivation is a selective process studied in different species (humans, rodents, birds, viverrids). The aim of this work was to study the effect of fasting on selective mobilization in commercial pigs. A total of 16 barrows (Large White×Landrace (167 kg±12.5 kg live weight) were subdivided into two homogeneous groups, one subjected to 12 h and the other to 60 h of fasting (fasting time) before slaughtering. For each pig inner and outer backfat layer were sampled at slaughter and at ham trimming 24 h later (sampling time). Increasing the fasting time and the sampling time after slaughter caused an increase in the amount of free fatty acids in both layers. Therefore it can be argued that during fasting lipolysis is stimulated and remains active also after slaughtering. The factors that stimulate lipolysis determine a greater mobilization of unsaturated fatty acids than saturated ones. Thus fasting time may influence the suitability of pork for processing and conservation, since free fatty acids are more suitable for oxidation than the esterified ones.

Background:Interstitial lung disease (ILD) represents the most frequent pulmonary manifestation of primary Sjogren’s syndrome (pSS), with a prevalence ranging between 6-70% in different retrospectives studies. Non-specific interstitial pneumonia (NSIP) is recognized as the most common ILD disorder, followed by organizing pneumonia (OP), usual interstitial pneumonia (UIP) and lymphocytic interstitial pneumonia (LIP), specifically associated with pSS but less frequent.Objectives:To investigate the prevalence of fibrosing patterns in a monocentric cohort of pSS patients evaluated for lung involvement in a cross-sectional study.Methods:In a cross-sectional study all patients fulfilling ACR/EULAR classification criteria for pSS and with a known diagnosis of ILD were enrolled; the other patients were carefully investigated for signs or symptoms suggestive for ILD (including the search for velcro crackles with a digital device); when suspect, patients underwent to high resolution computed tomography (HRCT). An expert radiologist re-evaluated all HRCT for classifying the ILD pattern as: UIP, fibrotic NSIP, fibrotic OP, NSIP, OP, LIP, indeterminate.Results:One hundred and eighty-five pSS patients were enrolled; among them 34 showed ILD (18.4%) with the following features: M/F 3/31, median age 57 (range 24-80), median FVC 90% (39-127%), median DLCO 49% (20-84%). Patients were classified in two groups according to radiologic classification: the group 1 (18 pts 52,9%) included UIP (13 patients, 38.2%), fibrotic NSIP (4, 11.8%), fibrotic OP (1 2.9%); the group 2 (16 pts, 47.1%) included NSIP (6, 17.6%), OP (4, 11.8%), indeterminate (4, 11.8%), LIP (2, 5.9%). No significant differences were observed between the two groups with the exception of anti-SSB positivity more frequently detected in non-fibrosing pattern (p 0, 043).Conclusion:Despite previous observations, our data suggest a high prevalence of fibrosing ILD pattern in pSS patients. We participate at a multidisciplinary team with expert pulmonologists and radiologists and some patients of our cohort firstly referred to pulmonologist for appearance of ILD before the diagnosis of pSS, contributing to the possible selection of more severe lung disease. However, these data suggest first of all that pSS should always be considered in differential diagnosis of fibrosing ILD; moreover, since fibrosing ILD is thought to have a worse response to immunosuppressive drugs, the role of new possible therapeutic strategies such as anti-fibrotic could represent an important field of interest.Disclosure of Interests:None declared

HERMES-Pathfinder is a space-borne mission based on a constellation of six nano-satellites flying in a low-Earth orbit. The 3U CubeSats, to be launched in early 2025, host miniaturized instruments with a hybrid Silicon Drift Detector/scintillator photodetector system, sensitive to both X-rays and gamma-rays. A seventh payload unit is installed onboard SpIRIT, an Australian-Italian nano-satellite developed by a consortium led by the University of Melbourne and launched in December 2023. The project aims at demonstrating the feasibility of Gamma-Ray Burst detection and localization using miniaturized instruments onboard nano-satellites. The HERMES flight model payloads were exposed to multiple well-known radioactive sources for spectroscopic calibration under controlled laboratory conditions. The analysis of the calibration data allows both to determine the detector parameters, necessary to map instrumental units to accurate energy measurements, and to assess the performance of the instruments. We report on these efforts and quantify features such as spectroscopic resolution and energy thresholds, at different temperatures and for all payloads of the constellation. Finally we review the performance of the HERMES payload as a photon counter, and discuss the strengths and the limitations of the architecture.

A study was conducted to evaluate the effect of diets based on hulled or hulless (normal- and low-amylose) barley varieties on growth performance and carcass characteristics in heavy growing-finishing pigs for the production of protected designation of origin (PDO) Italian products. The study was performed with 40 gilts and 40 barrows (Italian Duroc × Italian Large White). Four diets were formulated: 1) corn-based diet (control), 2) control diet with 80% of a normal-amylose hulled barley variety named Cometa (Cometa), 3) control diet with 80% of a normal-amylose hulless barley variety named Astartis (Astartis), and 4) control diet with 80% of a low-amylose hulless barley variety named Alamo (Alamo). The diets were formulated according to 3 growth phases (P1, 40 to 80 kg BW; P2, 80 to 120 kg BW; and P3, 120 to 170 kg BW), with the same Lys:DE ratio (2.60, 2.20, and 1.80, respectively in P1, P2, and P3) according to the NRC requirements for P1 and P2 and according to requirements for high-performing pigs for P3. The diets were analyzed for their in vitro starch digestion potentials (predicted glycemic index, pGI) and for their resistant starch (RS) contents. In P1, P2, and P3, the Alamo diet had the numerically lowest RS contents and greatest pGI values, whereas the control diet had the numerically greatest RS contents and the lowest pGI values. Throughout the study, the pigs fed Cometa and Alamo diets grew faster (P < 0.01) than those fed the control diet, whereas pigs receiving Astartis diet grew in a similar manner to those receiving all the other diets. Pigs fed Cometa and Alamo achieved greater final BW (P < 0.01) compared with those fed the control diet. The pigs receiving the Astartis diet had a mean final BW similar to that of the pigs fed other diets. Throughout the study, the control group had a lower grams per megacalorie DE (P < 0.01) compared with the pigs fed diets with barley, whereas the gain per megacalorie of DE (G/Mcal DE) was greater (P < 0.01) for the pigs fed hulled barley compared with the pig fed hulless barleys. No difference in carcass characteristics was found among treatments (P > 0.05). This study showed that diets based both on hulled and hulless barley might be suitable for the heavy pig breeding intended to the production of Italian PDO products. In addition, hulled or low-amylose hulless barley could be valuable to support maximum pig growth performance without affecting carcass composition.

A study was conducted to evaluate the quality and sensory properties of protected designation of origin (PDO) Parma ham and Piacentina neck obtained from heavy pigs (Italian Duroc × Italian Large White) fed barley-based diets. Four diets were tested: 1) a corn-based diet (control), 2) the control diet with 80% of a normal-amylose hulled barley variety (Cometa), 3) the control diet with 80% of a normal-amylose hulless barley variety (Astartis), and 4) the control diet with 80% of a low-amylose hulless barley variety (Alamo). All the meat products were analyzed for physicochemical and color parameters. The dry-cured hams and necks were also evaluated for sensory properties. The data of physicochemical, color, and sensory parameters were separately analyzed by multivariate factor analysis, and interpretation of each extracted factor was based on specific original variables loading on each one. The meat products obtained from pigs fed the barley-based diets differed from those obtained from the control pigs on the PUFA factors characterized by C18:2-6 and omega-3:omega-6 ratio. In particular, the meat products obtained from pigs fed the barley-based diets had a lower content of C18:2-6 and a higher omega-3:omega-6 ratio ( < 0.05) than the control. In fresh hams, iodine number and SFA (C16:0 and C18:0) in addition to PUFA and omega-3:omega-6 ratio loaded on the PUFA/SFA factor. The fresh hams produced from pigs fed the barley-based diets had subcutaneous fat (SC) with a lower iodine number and a higher SFA level compared with those produced from the control pigs ( < 0.05). A sex effect was measured for PUFA/SFA and oleic acid factors. In particular, the barrow SC had a lower SFA content, higher PUFA and C18:1-9 levels, and a higher iodine number ( < 0.05) than the gilt SC. There were no appreciable differences in the color and sensory properties of meat products obtained from pigs fed the different diets. The hams from barrows differed from those obtained from gilts on the lean properties factor describing properties related to aspect and odor of dry-cured hams. Indeed, the hams from barrows were depreciated compared with the hams from gilts for minor intensity, brightness, and uniformity of the lean, pinkish intermuscular fat and cured odor. In conclusion, barley could be used as a replacement for corn in heavy pig diets for the production of PDO Italian products without negative effects on the physicochemical, color, or sensory characteristics of meat products.

A study was conducted to evaluate the effect of 2 hulless barley varieties, with or without the addition of a nonstarch polysaccharide (NSP) enzyme complex (β-glucanase and xylanase), on growth performance of weaned piglets in a 42-d feeding study. The study was conducted with 140 piglets (PIC × Duroc). Pigs were allocated to pens (4 castrated males or 4 females per pen) based on BW and sex, and pens were assigned to 5 experimental diets with 4 pens of castrated males and 3 pens of females per treatment. Five isonitrogenous and isoenergetic diets were compared: 1) control corn-based diet (CTR), 2) diet with corn and wheat bran replaced by the Astartis hulless barley variety (AS), 3) diet with corn and wheat bran replaced by the AS supplemented with the NSP enzyme complex (ASE), 4) diet with corn and wheat bran replaced by the Alamo hulless barley variety (AL), and 5) diet with corn and wheat bran replaced by the AL supplemented with the NSP enzyme complex (ALE). The diets were formulated to meet or exceed nutrient requirements and offered in 2 phases: d 0 to 14 and d 14 to 42. At the end of the study, pigs fed AS and AL had equal weights as pigs fed CTR. Pigs fed the hulless barley diets had greater (P < 0.05) ADG during the second phase (P2) and overall phase, BW at d 42, and G:F during the P2 than those fed the CTR. Pigs fed the ASE and ALE had greater (P < 0.05) ADFI during the P2 and overall ADG than those fed the AS and AL. The increases in ADG during the P2 and final BW obtained with NSP enzyme supplementation were greater in pigs fed the AS than those fed the AL (barley × enzyme, P < 0.05). On the other hand, the NSP enzyme complex increased G:F in pigs fed the AS during the P2 and overall phase, but it had no effect on those fed the AL (barley × enzyme, P < 0.05). In conclusion, hulless barley with or without the NSP enzyme complex can be a replacement ingredient for corn and wheat bran in weaned pig diets. Addition of the NSP enzyme complex to AS variety, but not AL variety, improved growth performance of weanling pigs.

Interstitial lung disease (ILD) is a severe systemic manifestation of rheumatoid arthritis (RA). High-resolution computed tomography (HRCT) represents the gold standard for the diagnosis of ILD, but its routine use for screening programs is not advisable because of both high cost and X-ray exposure. Velcro crackles at lung auscultation occur very early in the course of interstitial pneumonia, and their detection is an indication for HRCT. Recently, we developed an algorithm (VECTOR) to detect the presence of Velcro crackles in pulmonary sounds and showed good results in a small sample of RA patients. To avoid X-ray exposure, we enrolled 137 consecutive RA patients who had recently undergone HRCT. Lung sounds of all patients were recorded in 4 pulmonary fields bilaterally with a commercial electronic stethoscope (ES); subsequently, all HRCT images were blindly evaluated by a radiologist, and audio data were analysed by means of VECTOR. Fifty-nine of 137 patients showed ILD (43.1%). VECTOR correctly classified 115/137 patients, showing a diagnostic accuracy of 83.9% and a sensitivity and specificity of 93.2 and 76.9%, respectively. VECTOR may represent the first validated tool for the screening of RA patients who are suspected for ILD and who should be directed to HRCT for the diagnosis.

BackgroundInterstitial lung disease (ILD) includes a group of disorders of the pulmonary parenchyma including ILD secondary to environmental exposure, to sarcoidosis and connective tissue diseases, idiopathic pulmonary fibrosis, nonspecific interstitial pneumonitis. Unclassifiable-ILD (U-ILD) is defined when ILD cannot be included in one of these subtypes, because of inadequate findings or impossibility to complete diagnostic iter. Undifferentiated connective tissue disease (UCTD) is a systemic autoimmune diseases characterized by clinical and serological features typical of other CTD, but not fulfilling any of the existing classification criteria. It has been recently suggested that UCTD should be responsible for ILD, although the available classification criteria do not consider lung manifestations. Differential diagnosis between U-ILD or ILD secondary to UCTD (UCTD-ILD) can be difficult, but fundamental for therapeutic implications.ObjectivesTo evaluate the clinical and serological features of patients with ILD secondary to UCTD compared to unclassifiable ILD, to improve differential diagnosis and identify patients candidate to immuno-suppressive therapy. Secondary outcome was to construct a clinical algorithm, using a priori variables, helpful to predict ILD-UCTD in clinical practice.MethodsFrom September 2011 to November 2014, 50 patients referred to our Center were diagnosed for UCTD (26/50) or U-ILD (24/50), after a multidisciplinary discussion according to standard available criteria.ResultsMain features and comparison between UCTD-ILD and U-ILD are reported in the table. An inconsistent with usual interstitial pneumonia (UIP) pattern at high resolution computerized tomography (HRCT) was more frequently detected in UCTD-ILD compared to U-ILD. A predictive model based on Raynaud's phenomenon, ocular dryness, and antinuclear antibodies showed a predictive value of 85.7% (UCTD-ILD were correctly classified in 90.5% and U-ILD in 78.6%).Clinical and demographic features of patients with interstitial lung diseaseUCTDU-ILDpNumber of patients2624Sex19F/7M14F/10MnsAge at diagnosis61.7±12.767.1±9.1nsRaynaud's phenomenon68.0%29.4%0.027Oral dryness60.0%35.3%nsOcular dryness60.0%13.3%0.007Schirmer test41.6%4.2%0.006Arthritis19.2%00.05Skin manifestations30.4%00.029Thrombocytopenia16.7%18.2%nsAnemia33.3%18.2%nsAntinuclear antibodies87%52.4%0.02ENA38.1%10%nsRheumatoid factor13.6%9.1%nsUIP pattern to HRCT41.2%58.8%nsInconsitent with UIP pattern to HRCT66.7%33.3%ns ConclusionsLung involvement is a possible presenting symptom of UCTD; therefore, differential diagnosis with U-ILD is crucial due to the relevant therapeutic implications; a multidisciplinary approach, including rheumatologist, pulmonologist, radiologist, and pathologist, is mandatory. Some clinical-serological features potentially helpful in differential diagnosis should be carefully evaluatedDisclosure of InterestNone declared