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In the post-pandemic COVID-19 period, human activities have returned to normal and COVID-19 cases are usually mild. However, patients with multiple myeloma (MM) present an increased risk for breakthrough infections and severe COVID-19 outcomes, including hospitalization and death. The European Myeloma Network has provided an expert consensus to guide patient management in this era. Vaccination with variant-specific booster vaccines, such as the bivalent vaccine for the ancestral Wuhan strain and the Omicron BA.4/5 strains, is essential as novel strains emerge and become dominant in the community. Boosters should be administered every 6–12 months after the last vaccine shot or documented COVID-19 infection (hybrid immunity). Booster shots seem to overcome the negative effect of anti-CD38 monoclonal antibodies on humoral responses; however, anti-BCMA treatment remains an adverse predictive factor for humoral immune response. Evaluation of the immune response after vaccination may identify a particularly vulnerable subset of patients who may need additional boosters, prophylactic therapies and prevention measures. Pre-exposure prophylaxis with tixagevimab/cilgavimab is not effective against the new dominant variants and thus is no longer recommended. Oral antivirals (nirmatrelvir/ritonavir and molnupiravir) and remdesivir are effective against Omicron subvariants BA.2.12.1, BA.4, BA.5, BQ.1.1 and/or XBB.1.5 and should be administered in MM patients at the time of a positive COVID-19 test or within 5 days post symptoms onset. Convalescent plasma seems to have low value in the post-pandemic era. Prevention measures during SARS-CoV-2 outbreaks, including mask wearing and avoiding crowded places, seem prudent to continue for MM patients.

This contribution aims at an understanding, at a molecular scale, of the state of CO2 molecules absorbed in glassy poly(ether imide) (PEI). This issue has been challenged by combining different approaches that tackle the problem from both the experimental and the theoretical viewpoints and providing a comprehensive physicochemical picture. In situ FTIR spectroscopy and gravimetry were exploited to gather relevant experimental information, while molecular dynamics (MD), density functional theory (DFT), and statistical thermodynamics approaches were used to model the behavior of the binary system at different scales. Based on the findings of FTIR spectroscopy and on DFT and MD calculations, it was determined that, among the possible interaction configurations, some are prevailing. In particular, the carbon atom of carbon dioxide molecules establishes relatively weak interactions prevalently with the carbonyl groups of PEI. A quantitative estimate of such interaction has been provided by MD calculations. The system was also analyzed using a lattice fluid model, specifically developed to deal with sorption of low molecular weight compounds in glassy polymers, that is rooted on statistical thermodynamics, determining the values of the isosteric heat of sorption and carbon-dioxide-polymer interaction energy. Finally, experimental data of CO2-PEI mutual diffusivity have been interpreted using a semiempirical theoretical model accounting for the effects of the penetrant concentration, of energy barriers associated with the occurrence of an effective diffusive jump, and of a thermodynamic factor.

The degradation of performances for solar thermal collectors is linked to the decrease of the absorber efficiency caused by diffusion process, strongly dependent on temperature. The Standard procedure for qualification of solar absorbers surface durability defines the absorber temperature frequency function as one of the necessary parameters to estimate the failure time for collectors, but it only refers to applications at low temperatures like domestic hot water production (DHW). Because of this deficiency of the Standard, in order to make aging predictions for selective solar absorbers mounted on Evacuated Flat Plate Collectors (EFPCs) used for Mid-Temperature applications (with stagnation temperature over 573 K), in this paper a procedure to reconstruct their specific temperature frequency function, considering the high thermal efficiency and stagnation temperature, is provided. A dynamic simulation model of a small plant with a TVP-Solar EFPC is implemented in Simulink environment to obtain the yearly absorber temperature history in operating conditions and experimental data are collected to obtain the temperature trend of the EFPC under stagnation. The absorber temperature frequency function valid for EFPCs is presented for different operating temperatures considering that stagnation occurs for 30 days every year, as the Standard prescribes. 30 days of stagnation in a year is an unrealistic assumption for thermal collectors used for industrial application and, in order to give an indication in this sense, the variation of aging parameters for different stagnation periods (fallowing periods) is also presented. Using the simulation model for service-time, experimental data for stagnation and assuming the exact fallowing period for the solar plant, a greater accuracy of EFPC failure time evaluation can be obtained.

Background: For children with inflammatory bowel disease (IBD), understanding their condition may lead to better outcomes. Knowledge assessment is imperative to identify where education may be required. An IBD knowledge assessment tool (IBD-KID2) is available in English; the aim of this study was to translate IBD-KID2 in to Italian and assess its validity/reliability among children with IBD. Methods: IBD-KID2 has fifteen items, scoring one point per correct answer. IBD-KID2 items were assessed for cultural comprehension/relevance by Italian gastroenterologists using a content validity index; those items with a maximum score proportion

Small-grain farming systems in Mediterranean climatic regions are characterized by poor quality soils, high climate variability, and resulting heavy agrochemical reliance. The adoption of Conservation Agriculture, based on minimum tillage, permanent soil cover, and crop rotations, has improved soil quality, enhanced crop productivity, and help mitigate financial risk. However, emerging issues that threaten sustainability, such as herbicide resistance, inputs costs rising disproportionately to product prices, and increasing climate variability and unpredictability, drive the need for innovation in small-grain Mediterranean-based CA systems. The aim of the review was to evaluate a set of agroecological practices which constitute a Regenerative Agriculture (RA) concept, for their potential to address these challenges from a soil quality, crop productivity and whole-farm economics perspective. Organic soil amendments derived from agro-wastes, offer promising perspectives for supplying appropriate quantities of nutrients to reduce or replace mineral fertilisers and offset their economic and agroecological costs. Although the viability of microbial bioeffectors in small-grain agroecosystems was largely under question, non-microbial bioeffectors and certain combination options represent more efficient and cost-effective uses of this technology. Their widely reported abiotic stress priming functions and crop productivity enhancement under poor growing conditions may improve yield stability and financial resilience in small-grain Mediterranean CA systems. Finally, multi-species cover crops subjected to adaptive multi-paddock (AMP) grazing as a phase within the crop rotation may reduce weed pressure, enhance soil multi-functionality, and resilience against environmental stresses. To validate the potential of these technologies in Mediterranean small-grain systems, more long-term and context-specific research is called for.

The combination of elotuzumab, lenalidomide, and dexamethasone (EloRd) enhanced the clinical benefit over Rd with a manageable toxicity profile in the ELOQUENT-2 trial, leading to its approval in relapsed/refractory multiple myeloma (RRMM). The present study is a 3-year follow-up update of a previously published Italian real-life RRMM cohort of patients treated with EloRd. This revised analysis entered 319 RRMM patients accrued in 41 Italian centers. After a median follow-up of 36 months (range 6-55), 236 patients experienced disease progression or died. Median progression-free survival (PFS) and overall survival (OS) were 18.4 and 34 months, respectively. The updated multivariate analyses showed a significant reduction of PFS and OS benefit magnitude only in cases with ISS stage III. Major adverse events included grade 3/4 neutropenia (18.5%), anemia (15.4%), lymphocytopenia (12.5%), and thrombocytopenia (10.7%), while infection rates and pneumonia were 33.9% and 18.9%, respectively. No new safety signals with longer follow-up have been observed. Of 319 patients, 245 (76.7%) reached at least a partial remission. A significantly lower response rate was found in patients previously exposed to lenalidomide. In conclusion, our study confirms that EloRd is a safe and effective regimen for RRMM patients, maintaining benefits across multiple unfavorable subgroups. This article is protected by copyright. All rights reserved.

We report data on survival and complications for a longitudinal cohort of 709 transfusion-dependent β-thalassemia major patients (51.1% males) born between 1970 and 1997 and followed through 2020 at seven major centers in Italy. Overall survival probability at 30 years was 83.6% (95%CI: 78.5-89.1) in the oldest birth cohort (1970-1974) compared with 93.3% (95%CI: 88.6-98.3) in the youngest birth cohort (1985-1997) (p = 0.073). Females showed better survival than males (p = 0.022). There were a total of 93 deaths at a median age of 23.2 years with the most frequent disease-related causes being heart disease (n = 53), bone marrow transplant (BMT) complication (n = 10), infection (n = 8), liver disease (n = 4), cancer (n = 3), thromboembolism (n = 2) and severe anemia (n = 1). There was a steady decline in the number of deaths due to heart disease from the year 2000 onwards and no death from BMT was observed after the year 2010. A progressive decrease in the median age of BMT was observed in younger birth cohorts (p 0.001). A total of 480 (67.7%) patients developed ≥1 complication. Patients in younger birth cohorts demonstrated better complication-free survival (p 0.001) which was comparable between sexes (p = 0.230). Independent risk factors for death in multivariate analysis included heart disease (HR: 4.63, 95%CI: 1.78-12.1, p = 0.002), serum ferritin1000 ng/mL (HR: 15.5, 95%CI: 3.52-68.2, p 0.001), male sex (HR: 2.75, 95%CI: 0.89-8.45, p = 0.078), and splenectomy (HR: 6.97, 95%CI: 0.90-54.0, p 0.063). Survival in patients with β-thalassemia major continues to improve with adequate access to care, best practice sharing, continued research, and collaboration between centers.

Introduction: Interferon regulatory factor 4 (IRF4) is a transcriptional factor with a key role in the modulation of inflammation and immune surveillance. The IRF4 gene is downregulated in Philadelphia-negative myeloproliferative neoplasms, and its expression is associated with prognosis and response to treatment. Methods: We evaluated the IRF4 expression kinetics during tyrosine kinase inhibitor (TKI) treatment in a cohort of 116 chronic myeloid leukemia (CML) patients to elucidate its role in the disease course. Results: A relationship between the IRF4 expression and the disease burden was observed at various disease stages. A correlation analysis between the International Scale (IS) and IRF4 values confirmed this close association. A significant increase is detected after 3 months of TKI treatment. Patients achieving an early molecular response (EMR) had higher IRF4 values at both diagnosis and after 3 months of therapy as compared to those failing the EMR target. Patients achieving treatment-free remission did not show IRF4 fluctuations during monitoring, while a decreased IRF4 expression emerged at the time of molecular relapse. Conclusion: Our data seem to confirm the relevance of IRF4 in the pathogenesis of CML, suggesting a pivotal role at the disease onset and a predictive value during the CML course.

PURPOSE Primary plasma cell leukemia (pPCL) is an aggressive subtype of multiple myeloma, which is distinguished from newly diagnosed multiple myeloma (NDMM) on the basis of the presence of ≥ 20% circulating tumor cells (CTCs). A molecular marker for pPCL is currently lacking, which could help identify NDMM patients with high-risk PCL-like disease, despite not having been recognized as such clinically. METHODS A transcriptomic classifier for PCL-like disease was bioinformatically constructed and validated by leveraging information on baseline CTC levels, tumor burden, and tumor transcriptomics from 154 patients with NDMM included in the Cassiopeia or HO143 trials and 29 patients with pPCL from the EMN12/HO129 trial. Its prognostic value was assessed in an independent cohort of 2,139 patients with NDMM from the HOVON-65/GMMG-HD4, HOVON-87/NMSG-18, EMN02/HO95, MRC-IX, Total Therapy 2, Total Therapy 3, and MMRF CoMMpass studies. RESULTS High CTC levels were associated with the expression of 1,700 genes, independent of tumor burden (false discovery rate < 0.05). Of these, 54 genes were selected by leave-one-out cross-validation to construct a transcriptomic classifier representing PCL-like disease. This not only demonstrated a sensitivity of 93% to identify pPCL in the validation cohort but also classified 10% of NDMM tumors as PCL-like. PCL-like MM transcriptionally and cytogenetically resembled pPCL, but presented with significantly lower CTC levels and tumor burden. Multivariate analyses in NDMM confirmed the significant prognostic value of PCL-like status in the context of Revised International Staging System stage, age, and treatment, regarding both progression-free (hazard ratio, 1.64; 95% CI, 1.30 to 2.07) and overall survival (hazard ratio, 1.89; 95% CI, 1.42 to 2.50). CONCLUSION pPCL was identified on the basis of a specific tumor transcriptome, which was also present in patients with high-risk NDMM, despite not being clinically leukemic. Incorporating PCL-like status into current risk models in NDMM may improve prognostic accuracy.

This paper uses an intersectional framework to account for the degree to which race, when intersecting gender, relates to teachers’ evaluations of US elementary school children over time. Drawing on longitudinal data from the 2011 Early Childhood Longitudinal Study-Kindergarten cohort, we employ growth curve modeling to study descriptive trends in teacher perceptions of student behavior from kindergarten through fifth grade. We find that educators’ perceptions of White, Asian American, and Latinx girls increase over time, while their perceptions of Black girls remain flat. Meanwhile, a different longitudinal trend emerges among boys. Although teachers’ views of Black boys decrease over time, their views of other boys increase to the levels of Black girls, or higher, by the end of fifth grade. This analysis reveals how teachers’ perceptions coalesce into an emerging hierarchy that—by the end of fifth grade—most sharply contrasts the behavior of Asian American girls and Black boys. Our intersectional approach and the theoretical framework informing it underscore the limits to considering how educators distinguish students by gender or race alone. Together, gender and race more fully account for differences in how educators perceive student behavior over time.

The metachronic onset of diffuse large B-cell lymphoma (DLBCL) after classic Hodgkin lymphoma (cHL) is a rare event affecting patients’ outcomes. However, although several studies have investigated the prognostic role of this event, little is known about a hypothetical common origin of the two different neoplastic cells. Aims: To investigate a possible relationship between DLBCL and cHL, in this retrospective study of 269 patients with newly diagnosed cHL treated at Bari University Hospital (Italy) between 2007 and 2020, we analyzed data from 4 patients (3 male and 1 female) with cHL who subsequently developed DLBCL. Methods: Gene expression profile analysis, assessed by NanoString Lymphoma Subtype Assay, was performed to identify the cell of origin in the DLBCL cases, in addition to Hans’s algorithm. Results: Using Hans’s algorithm, all DLBCL cases showed a germinal center-B-Cell subtype. The gene expression profile evaluated by the NanoString Lymphoma Subtype Assay revealed two cases of the GCB molecular subtype, while the others were unclassified. After first-line chemotherapy, 1 patient achieved complete remission, 3 were non-responders (2 died of lymphoma within 6 months, whereas the other achieved complete remission after autologous and allogeneic stem cell transplantation and is still alive). Conclusions: The origin of the second neoplastic cell in patients with DLBCL with a previous history of cHL remains controversial, although the different immunophenotypic characteristics suggest that it may mainly arise de novo in a subject with a possible individual predisposition to develop lymphoid neoplasms.

Lymphoproliferative diseases arise when the physiological mechanisms that control the proliferation of T and B lymphocytes are disrupted, resulting in an uncontrolled and autonomous increase in immune cells leading to lymphocytosis and lymphadenopathy, and often to the involvement of extranodal sites. The differential diagnosis of malignant T cell tumors involves other neoplasms and non-clonal T cell proliferations. Immunological markers are essential, as a first step, to distinguish between T-cell and non-T-cell disorders. It must be established based on the configuration of the genes of the TCR chain to rule out that the picture is not reactive to other underlying diseases. This clinical review and accompanying case reports highlight the diagnostic challenges associated with indolent lymphoproliferative T-cell disorders, which in many cases may represent the clinical manifestation of a single disease. Particularly we focus on gastrointestinal manifestations that could be expression either of lymphoproliferative disorder either of autoimmune disease either of both. The correct interpretation of the different clinical situations can help in the diagnostic and therapeutic process.

This work deals with the performance evaluation of novel flat photovoltaic–thermal (PV–T) modules under vacuum. Through a 1D (dimensional) steady-state-energy-balance numerical model developed in MATLAB, two different layouts are studied: the first consisting of a photovoltaic (PV) cell installed just below the glass encapsulating the flat panel, and the second where the PV cell is placed on the selective solar absorber (SSA). In both cases the thermal and electrical efficiencies have been evaluated at different SSA operating temperatures, in the range of 323 K to 423 K. The analysis has been conducted at different energy bandgap (Ebg) of the PV cell and assuming a variable transmittance or emittance of the PV cell, depending on the design. The two systems efficiency comparison has been carried out at the same operating temperature. Overall, this work highlights the importance of high vacuum insulation, which guarantees the reduction of convective thermal losses, and shows that the maximum energy is produced for PV cells with Ebg≈1.5-1.7 eV, depending on layout and operating temperature, by including the thermal output in the PV–T​ optimization. The energy and exergy efficiencies obtainable using the proposed PV–T​ systems are considerably improved compared to the results previously reported in the literature.

Industrial heat and cooling applications are an essential fraction of the overall energy demand, mainly produced by fossil fuels. Solar thermal energy production can satisfy such a need by adopting the High Vacuum Flat Plate Collectors (HVFPCs) and increasing their efficiency. The absorptance and emittance of Selective Solar Absorbers (SSAs) determine the thermal efficiency of HVFPCs. Being the absorptance already maximized, the thermal emittance of the absorber should be minimized to increase further the operating temperature of the collector and its efficiency. This research aims to reduce the thermal emittance of commercially available Selective Solar Absorber by depositing a thin silver film on the aluminium substrate. So, in this work, the thermal stability of a silver coating has been investigated, and a diffusion barrier layer has been adopted to stabilize the coating performance up to 360 °C. The low-emissive layer of Ag and a diffusion barrier of CrOx guarantees a decrease of 11% in thermal emittance at 200 °C of commercially available SSA deposited on aluminium. Further emittance reduction can be obtained by depositing a thin Ag film on both sides of the aluminium substrate before the SSA deposition, proving to be a promising way to enhance the efficiency of HVFPCs.

Cynthia De la Garza-Ramos,1 S Ali Montazeri,1 Kaitlyn R Musto,1 Melissa D Kapp,1 Andrew R Lewis,1 Gregory Frey,1 Ricardo Paz-Fumagalli,1 Sumera Ilyas,2 Denise M Harnois,3 Umair Majeed,4 Tushar Patel,3 Beau Toskich1 1Division of Interventional Radiology, Mayo Clinic Florida, Jacksonville, FL, USA; 2Division of Gastroenterology and Hepatology, Mayo Clinic Rochester, Rochester, MN, USA; 3Department of Transplant, Mayo Clinic, Florida, FL, USA; 4Division of Hematology and Medical Oncology, Mayo Clinic Florida, Jacksonville, FL, USACorrespondence: Beau Toskich, Division of Interventional Radiology, Mayo Clinic Florida, 4500 San Pablo Road, Jacksonville, FL, 32224, USA, Tel +1 904-953-1496, Email Toskich.Beau@mayo.eduPurpose: To compare the outcomes of radiation segmentectomy for early-stage hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD) versus hepatitis C virus (HCV).Materials and Methods: A retrospective analysis of consecutive patients with NAFLD- or HCV-related HCC treated with radiation segmentectomy from 01/2017-06/2022 was performed. Eligibility criteria included solitary tumor ≤ 8 cm or up to 3 HCC ≤ 3 cm, ECOG 0– 1, and absence of vascular invasion or extrahepatic spread. Imaging best response was assessed per modified Response Evaluation Criteria in Solid Tumors. Target tumor and overall progression, time-to-progression (TTP), and overall survival (OS) were calculated. All outcomes were censored for liver transplantation (LT). Complete pathologic response (CPN) was assessed in patients who underwent LT.Results: Of 142 patients included (NAFLD: 61; HCV: 81), most had cirrhosis (NAFLD: 87%; HCV: 86%) and small tumors (median size NAFLD: 2.3 cm; HCV: 2.5 cm). Patients with NAFLD had higher BMI (p< 0.001) and worse ALBI scores (p=0.003). Patients with HCV were younger (p< 0.001) and had higher AFP levels (p=0.034). Median radiation dose (NAFLD: 508 Gy; HCV: 452 Gy) and specific activity (NAFLD: 700 Bq; HCV: 698 Bq) were similar between cohorts. Objective response was 100% and 97% in the NAFLD and HCV cohorts, respectively. Target tumor progression occurred in 1 (2%) NAFLD and 8 (10%) HCV patients. Target tumor TTP was not met for either cohort. Overall progression occurred in 23 (38%) NAFLD and 39 (48%) HCV patients. Overall TTP was 17.4 months (95% CI 13.5– 22.2) in NAFLD and 13.5 months (95% CI 0.4– 26.6) in HCV patients (p=0.86). LT was performed in 27 (44%) NAFLD and 33 (41%) HCV patients, with a CPN rate of 63% and 54%, respectively. OS was not met in the NAFLD cohort and was 53.9 months (95% CI 32.1– 75.7) in the HCV cohort (p=0.15).Conclusion: Although NAFLD and HCV are associated with different mechanisms of liver injury, patients with early-stage HCC treated with radiation segmentectomy achieve comparable outcomes.Keywords: hepatocellular carcinoma, radiation segmentectomy, NAFLD, viral hepatitis

CancerCare Manitoba (CCMB) introduced virtual visits at the beginning of the COVID-19 pandemic to replace many in-person visits. This study examines the impact of virtual visits for cancer care on travel distance, travel time, and carbon dioxide (CO2) emissions. We included all visits to CCMB for invasive and in situ cancers from 1 April 2020 to 31 December 2022. Data were extracted from CCMB’s electronic health record. The percentage of visits done virtually by month was reported by age, gender, cancer diagnosis, and regional health authority of residence. Postal codes for patients’ residences and clinic locations were converted into latitude and longitude values. Travel distance, travel time, and CO2 emissions associated with travel were estimated. The percentage of virtual visits was highest during the months when COVID-19 restrictions were present in Manitoba and represent more than 50% of such monthly visits. Virtual visits increased with age, were highest among men with urogenital cancer, and were lowest among northern Manitoba residents. The median travel time per visit ranged from 30 min in Winnipeg to 15 h in the Northern Region. The estimated travel distance saved varied from 420,000 to 750,000 km per month. Estimated travel time saved varied from 5500 to 9600 h per month. Estimated CO2 emissions prevented varied from 87 to 155 metric tons per month. Virtual care is an important tool for better supporting those living with cancer by substantially decreasing travel distance and time. Virtual care also contributes to reducing greenhouse gas emissions.

This paper explores deterioration in Alzheimer’s Disease using Machine Learning. Subjects were split into two datasets based on baseline diagnosis (Cognitively Normal, Mild Cognitive Impairment), with outcome of deterioration at final visit (a binomial essentially yes/no categorisation) using data from the Alzheimer’s Disease Neuroimaging Initiative (demographics, genetics, CSF, imaging, and neuropsychological testing etc). Six machine learning models, including gradient boosting, were built, and evaluated on these datasets using a nested cross-validation procedure, with the best performing models being put through repeated nested cross-validation at 100 iterations. We were able to demonstrate good predictive ability using CART predicting which of those in the cognitively normal group deteriorated and received a worse diagnosis (AUC = 0.88). For the mild cognitive impairment group, we were able to achieve good predictive ability for deterioration with Elastic Net (AUC = 0.76).

Machine learning models that aim to predict dementia onset usually follow the classification methodology ignoring the time until an event happens. This study presents an alternative, using survival analysis within the context of machine learning techniques. Two survival method extensions based on machine learning algorithms of Random Forest and Elastic Net are applied to train, optimise, and validate predictive models based on the English Longitudinal Study of Ageing ELSA cohort. The two survival machine learning models are compared with the conventional statistical Cox proportional hazard model, proving their superior predictive capability and stability on the ELSA data, as demonstrated by computationally intensive procedures such as nested cross-validation and Monte Carlo validation. This study is the first to apply survival machine learning to the ELSA data, and demonstrates in this case the superiority of AI based predictive modelling approaches over the widely employed Cox statistical approach in survival analysis. Implications, methodological considerations, and future research directions are discussed., Henry Musto is joint first author

T-cell redirecting bispecific antibodies (BsAbs) and chimeric antigen receptor T cells (CAR T cells) have revolutionised multiple myeloma therapy, but adverse events such as cytokine release syndrome, immune effector cell-associated neurotoxicity syndrome (ICANS), cytopenias, hypogammaglobulinaemia, and infections are common. This Policy Review presents a consensus from the European Myeloma Network on the prevention and management of these adverse events. Recommended measures include premedication, frequent assessing for symptoms and severity of cytokine release syndrome, step-up dosing for several BsAbs and some CAR T-cell therapies; corticosteroids; and tocilizumab in the case of cytokine release syndrome. Other anti-IL-6 drugs, high-dose corticosteroids, and anakinra might be considered in refractory cases. ICANS often arises concomitantly with cytokine release syndrome. Glucocorticosteroids in increasing doses are recommended if needed, as well as anakinra if the response is inadequate, and anticonvulsants if convulsions occur. Preventive measures against infections include antiviral and antibacterial drugs and administration of immunoglobulins. Treatment of infections and other complications is also addressed.

In recent years, the growth of wild ungulates has increased the focus on their health monitoring. In particular, the health status of wild boars is relevant for the economic impact on the pig industry. The Emilia-Romagna region activated a wildlife monitoring plan to better evaluate the health status of the wild boar population. Between 2011 and 2021, samples of found dead and hunted wild boar have been examined for trichinellosis, tuberculosis, brucellosis, african swine fever, classical swine fever, Aujeszky’s disease, swine vesicular disease, and swine influenza A. Trichinella britovi was identified in 0.001% of the examined wild boars; neither M. bovis nor M. tuberculosis were found in M. tuberculosis complex positive samples; 2.3% were positive for Brucella suis; 29.4% of the sera were positive for Aujeszky’s disease virus; and 0.9% of the samples were positive for swine influenza A virus. With an uncertain population estimate, the number of animals tested, the number of positives, and the sampling method do not allow us to make many inferences but suggest the need to implement and strengthen the existing surveillance activity, as it seems to be the only viable alternative for safeguarding animal and human health.

Introduction: Remdesivir (REM) and monoclonal antibodies (mAbs) could alleviate severe COVID-19 in at-risk outpatients. However, data on their use in hospitalized patients, particularly in elderly or immunocompromised hosts, are lacking. Methods: All consecutive patients hospitalized with COVID-19 at our unit from 1 July 2021 to 15 March 2022 were retrospectively enrolled. The primary outcome was the progression to severe COVID-19 (P/F < 200). Descriptive statistics, a Cox univariate–multivariate model, and an inverse probability treatment-weighted (IPTW) analysis were performed. Results: Overall, 331 subjects were included; their median (q1–q3) age was 71 (51–80) years, and they were males in 52% of the cases. Of them, 78 (23%) developed severe COVID-19. All-cause in-hospital mortality was 14%; it was higher in those with disease progression (36% vs. 7%, p < 0.001). REM and mAbs resulted in a 7% (95%CI = 3–11%) and 14% (95%CI = 3–25%) reduction in the risk of severe COVID-19, respectively, after adjusting the analysis with the IPTW. In addition, by evaluating only immunocompromised hosts, the combination of REM and mAbs was associated with a significantly lower incidence of severe COVID-19 (aHR = 0.06, 95%CI = 0.02–0.77) when compared with monotherapy. Conclusions: REM and mAbs may reduce the risk of COVID-19 progression in hospitalized patients. Importantly, in immunocompromised hosts, the combination of mAbs and REM may be beneficial.

Introduction The NHS Abdominal Aortic Aneurysm Screening Programme (NAAASP) was established nationally to reduce the number of deaths caused by ruptured AAA. NAAASP invites all men in their 65th year for a simple abdominal ultrasound scan. Across the country uptake to the programme varies greatly. The aim of this study is to determine the impact of deprivation on local screening programme attendance. Methods The attendance for patients invited to screening within the Leicester, Leicestershire and Rutland screening NAAASP programme between the years 2016 and 2021 was compared to indices of multiple deprivation (IMD) (derived from their Lower Layer Super Output Area (LSOA) for each patient). Multiple logistic regression was used to determine the most significant component contributing to the IMD score. Results 28,730 men in total were invited to attend. Mean IMD for those that attended screening was 15.6 versus 20.6 for non-attenders (P value Conclusion In line with the contemporary medical literature, social deprivation affects the uptake of the local National Abdominal Aortic Aneurysm Screening Programme (NAAASP). Health deprivation and disability, Outdoor living environment and adult education domains are most contributory to non-attendance.

Background: Although current guidelines recommend that mothers with suspected or confirmed SARS-CoV-2 infection should be encouraged to initiate and continue breastfeeding, up-to-date literature shows conflicting data regarding breastfeeding experiences in infected women. This survey aimed to report on the psychological impact of SARS-CoV-2 infection on breastfeeding practice and medical counselling in a single tertiary center in Southern Italy. Methods: One-hundred breastfeeding women with SARS-CoV-2 infection at delivery were given an anonymous questionnaire regarding breastfeeding and women’s perception of the impact of COVID-19 on breastfeeding. Results: 75% of women reported they had difficulty breastfeeding; among them, 66 (66%) declared that separation from their babies after delivery affected their ability to breastfeed. Incidence of reported difficulties in breastfeeding was higher in women who underwent caesarean section compared to women with vaginal delivery (56/65, 86.2% vs. 19/35, 54.3%, χ2 = 12.322, p < 0.001) and in women with a hospital stay of more than 5 days (48/57, 84.2% vs. 23/37, 62.2%, χ2 = 5.902, p = 0.015). Furthermore, the incidence of difficulties in breastfeeding was higher in women who subsequently decided to use exclusively infant formula compared to women who mixed maternal milk with infant formula and women who breastfed exclusively with maternal milk (48/49, 98% vs. 20/25, 80% vs. 7/26, 26.9%, χ2 = 46.160, p < 0.001). Conclusions: Our survey highlights the importance of healthcare support and information on hygiene practices to decrease the perceived stress related to breastfeeding for infected mothers under restrictions, especially in women undergoing cesarean section and with a long hospital stay.

Background Current data on dual biologic or small molecules therapy in children are limited. The aim of the study was to evaluate the effectiveness and safety of dual therapy in paediatric patients with IBD. Methods This was a retrospective multicenter study from 14 centers affiliated with the IBD interest and Porto groups of ESPGHAN. We included children with IBD who were treated with combination of biologic agents or biologic and small molecule, with at least 3 months of follow-up under this therapy. Demographic, clinical, laboratory, endoscopic and imaging data were collected. Adverse events were recorded. All analyses were done in the intention-to-treat population. Children that discontinued therapy were considered treatment failures and were imputed for non-response, while missing data was imputed according to the last observation carried forward method. Results Sixty-two children [35 Crohn's disease (CD), 27 ulcerative colitis (UC)], with a median age of 15.5 (IQR 13.1-16.8) years and disease duration of 3.8 (IQR 2.5-6.1) years were included. All children failed previous biologics and 47 (76%) failed at least two biologic agents. The dual therapy included anti-TNF agent and vedolizumab in 30 children (48%), anti-TNF and ustekinumab in 21 children (34%), vedolizumab and ustekinumab in 8 children (13%), and tofacitinib and other biologics in 3 children (5%). Clinical remission was observed in 21 (35%), 30 (50%) and 38 (63%) children at 3, 6 and 12 months, respectively. Of 27 children who were treated with corticosteroids at baseline, 20 (74.1%) were weaned within 3 months after the initiation of dual therapy. At 12 months of follow up, normalization of C-reactive protein and decrease in fecal calprotectin to < 250 mcg/g were achieved in 75% and 64%, respectively. Endoscopic and transmural healing were observed in 2/23 (9%) and 5/16 (31%) children, respectively. Male sex and diagnosis of UC were associated with higher likelihood of clinical remission (p=0.017 and p=0.020, respectively). Adverse events were reported in 29 (47%) children. While most adverse event were mild, 8 were regarded as serious and 6 (10%) led to discontinuation of dual therapy. The serious adverse events included infusion reaction to infliximab, fatigue and headache following vedolizumab infusion, severe skin eruptions (3 patients), cellulitis and skin abscess, elevated liver enzymes and deep vein thrombosis. Conclusion Dual biologic or small molecules therapy may be effective in children with otherwise refractory IBD. The risk of serious adverse events should be considered before recommending dual therapy.

In this article we will discuss the first Coronavirus (Covid-19) lockdown and its immediate aftermath on the lives of migrant sex workers living and working in France, drawing on original interviews gathered between May and July 2020. Since 2016 in France, sex workers have worked under the so-called Swedish model legal framework criminalising the demand of sexual services. This has meant that sex workers, both migrant and non-migrant, have had to find various strategies to continue working within a criminalised environment infringing upon their rights and safety. Research in the French context has largely shown that the introduction of the Swedish model increased the financial precarity and impacted in significant, detrimental ways the physical and mental health of sex workers (Le Bail & Giametta 2018). In the context of the existing hardship to which migrant sex workers were exposed under this repressive regime in France, this article investigates if and how the law enforcement and emergency measures around the Covid-19 crisis aggravated their already precarious living conditions. Our analysis here demonstrates that both institutional racism (e.g., government policies and law enforcement targeting racialized migrants) and interpersonal stigmatisation (e.g., poor treatment and stereotyping by clients and civil society) must be combated to reduce the discrimination against migrant sex workers that is amplified in times of crisis.

While political science has probed the ideological, political, economic and even psychological motivations behind the drive to war, socialist theory has made a unique contribution by highlighting the relationship between the development of capitalism and war. There’s a long and rich tradition of the Left’s opposition to militarism that dates back to the International Working Men’s Association. It is an excellent resource for understanding the origins of war under capitalism and helping leftists maintain our clear opposition to it. In this article, the author examines the position of all the main currents (socialist, socialdemocratic, communist, anarchist and feminist) intellectuals (Engels, Kropotkin, Malatesta, Jaurès, Luxemburg, Lenin, Mao and Khrushchev) of the Left on the war and its different declinations (‘war of defence’, ‘just war’, ‘revolutionary war’).

Not available.

Pembuatan Charger Station dengan mengimplementasikan Buck-Boost Converter dengan sumber energi yang dihasilkan panel surya bertujuan untuk memudahkan masyarakat pada saat berwisata ke suatu tempat, terutama wisata outdoor karena kurang tersedianya tempat untuk pengisian baterai pada Handphone. Dalam artikel ini akan dibahas suatu perancangan dan Simulasi Sistem Charging Station Dengan mempertimbangkan Tegangan Masuk pada Buck-Boost Converter. Pada perancangan sistem ini memperhatikan buck-boost converter untuk dapat memberikan tegangan yang masuk kedalam Aki agar bisa mengecas dan bisa mengeluarkan tegangan yang diinginkan. Sistem ini dirancang dan disimulasikan dengan program proteus dengan tegangan paling rendah sebesar 9.5 Volt sampai tegangan paling tinggi sebesar 18 Volt. Tegangan yang diinginkan dari makalah ini sebesar 13.6 Volt. Hasil dari penelitian ini menunjukkan bahwa berapapun nilai tegangan masuk pada rangkaian dalam rentang 9.5 - 18 Volt bisa mengeluarkan tegangan sebesar 13.6 Volt dengan nilai rata-rata error sebesar 0.021 Volt.

The understanding of clonal hematopoiesis (CH) and its features is rapidly evolving in step with the spread of sequencing techniques. Indeed, CH detection is now an emerging aspect in clinical practice. The awareness of CH intersects with consolidated diagnostic paths, thus exposing 'grey zone' circumstances under the magnifying lens of clinicians. The interpretation of genomic data poses, in some cases, a true clinical challenge, sometimes further complicating the route to diagnosis. The line separating different entities is thin. The present work aims to review some of these challenging situations to help clinicians keep their balance along this tightrope.