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Psoriasis is a major chronic inflammatory skin disease, affecting about 3% of the population in Italy, whose management require experienced specialists in order to guarantee high-quality standards of care. The pandemic coronavirus (2019-nCoV; COVID-19) has changed the approach to all patients requiring close contact during a visit, including dermatologic consultations. In Italy, true outbreak begun in Lombardy, by February 21, 2020 with exponential contagion, surpassing China in the number of deaths. This article is protected by copyright. All rights reserved.We have read with great interest Dr Recalcati's review about skin manifestations in COVID-19 as it is the first report on this subject1 . In a recent review on clinical characteristics of coronavirus disease 2019 in China, rash was observed in 0,2% of cases2 . However, from the trained eyes of a dermatologist, this percentage may be higher. This article is protected by copyright. All rights reserved.Telomeres are DNA-protein complexes at the ends of chromosomes essential for maintaining genetic stability. Defects in genes coding telomere maintenance proteins rarely occur, resulting in accelerated telomere shortening. Termed short telomere syndromes (STSs), these conditions have diverse clinical manifestations, including premature hair greying, bone marrow failure, pulmonary fibrosis, early-onset malignancy, and cirrhosis. However, liver histopathologic changes have not been thoroughly described in STS patients. Here, we report a case of a patient with clinically-suspected cirrhosis and striking hepatocyte large cell change (LCC) on liver biopsy who was found to have an underlying STS. This article is protected by copyright. All rights reserved.We have read with great interest the article Cutaneous manifestations in COVID-19 a first perspective by Recalcati S.1 This article is the first report of the cutaneous manifestations in Coronavirus Disease 2019 (COVID-19) patients during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in Lombardy, Italy. This article is protected by copyright. All rights reserved.Immune dysregulation contributes to the pathogenesis of pediatric acute liver failure (PALF). Our aim is to identify immune activation markers (IAMs) in PALF that are associated with a distinct clinical phenotype and outcome. Among 47 PALF study participants, 12 IAMs collected ≤ 6 days after enrollment were measured by flow cytometry and IMMULITE assay on blood NK and CD8+ lymphocytes and subjected to unsupervised hierarchical analyses. A derivation cohort utilizing 4 of 12 IAMs which were available in all participants (% perforin+ and % granzyme+ CD8 cells, absolute number of CD8 cells, soluble interleukin-2 receptor level) were sufficient to define High (n=10), Medium (n=15), and Low IAM (n=22) cohorts. High IAM was more frequent among those with indeterminate etiology than those with defined diagnoses (80% vs 20%, p less then 0.001). High IAM associated with higher peak serum total bilirubin levels than low IAM (median peak TB of 21.7 vs 4.8 mg/dL; p less then 0.001) and peak coma grades. 21-day outcomes differed between groups with liver transplantation more frequent in high IAM participants (62.5%) than those with medium (28.2%) or low IAM (4.8%) (p=0.002); no deaths were reported. In an independent validation cohort (n=71) enrolled in a prior study, segregation of IAM groups with etiology, initial biochemistries, and short-term outcomes were similar, although not statistically significant. High serum aminotransferases, total bilirubin levels and leukopenia at study entry predicted a high immune activation profile. Conclusion Four circulating T-lymphocyte activation markers identify a subgroup of PALF participants with evidence of immune activation associated with a distinct clinical phenotype and liver transplantation. These biomarkers may identify PALF participants eligible for future clinical trials of early targeted immunosuppression. This article is protected by copyright. All rights reserved.SGLT2-I (empagliflozin, canagliflozin and dapagliflozin) are the most recently approved drugs for type 2 diabetes (TD2) T2D is common in patients with cirrhosis, particularly in those with non-alcoholic steatohepatitis (NASH). SGLT2-I appear to be safe and well-tolerated in cirrhosis3 and because, besides promoting urinary glucose excretion, they also promote sodium excretion, they could have an additional benefit in those with ascites. This article is protected by copyright. All rights reserved.A skin rash has been reported in 2 out of 1.099 patients presenting with Coronavirus disease 2019 in China [1], as in 14 of 48 patients with the same disease in Italia, but unfortunately without further description of its semiology [2]. We wish to report here the case of a woman who presented, coincidently with Covid-19, a skin rash that had an original picture. This article is protected by copyright. All rights reserved.Since December 2019, an outbreak of 2019 novel coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been spreading worldwide. This has risen concern among patients undergoing biologics and physicians who administer them, as far as the possible increase of incidence and severity of COVID-19 in this delicate population concerns. This article is protected by copyright. All rights reserved.Conservation science needs more high-quality impact evaluations, especially ones that explore mechanisms of success or failure. Randomized control trials (RCTs) provide particularly robust evidence of the effectiveness of interventions (although they have been criticized as reductionist and unable to provide insights into mechanisms), but there have been few such experiments investigating conservation at the landscape scale. Epigenetic Reader Domain inhibitor We explored the impact of Watershared, an incentive-based conservation program in the Bolivian Andes, with one of the few RCTs of landscape-scale conservation in existence. There is strong interest in such incentive-based conservation approaches as some argue they can avoid negative social impacts sometimes associated with protected areas. We focused on social and environmental outcomes based on responses from a household survey in 129 communities randomly allocated to control or treatment (conducted both at the baseline in 2010 and repeated in 2015/16). We controlled for incomplete program uptake by combining standard RCT analysis with matching methods and investigated mechanisms by exploring intermediate and ultimate outcomes according to the underlying theory of change.