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Cystic fibrosis (CF)-related central (CNS) and peripheral nervous system (PNS) disorders have not yet been fully described. We report the first case of post-infective neuromuscular hyperexcitability syndrome in a 23-year-old male patient with CF and pulmonary exacerbation. CNS radiological investigations were unremarkable and no autoantibodies were detected. The patient fully recovered after infectious state control and multidisciplinary assessment and no recurrence was observed at follow-up. In view of the rarity of this condition, an additional effort is advisable to collect data and define the optimal management strategy in patients with CF., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

Context. Classical Cepheids (DCEPs) are crucial for calibrating the extragalactic distance ladder, ultimately enabling the determination of the Hubble constant through the period-luminosity (PL) and period-Wesenheit (PW) relations that they exhibit. Hence, it is vital to understand how the PL and PW relations depend on metallicity. This is the purpose of the C-MetaLL survey, within which this work is situated. The DCEPs are also very important tracers of the young populations placed along the Galactic disc. Aims. We aim to enlarge the sample of DCEPs with accurate abundances from high-resolution spectroscopy. In particular, our goal is to extend the range of measured metallicities towards the metal-poor regime to better cover the parameter space. To this end, we observed objects in a wide range of Galactocentric radii, allowing us to study in detail the abundance gradients present in the Galactic disc. Methods. We present the results of the analysis of 331 spectra obtained for 180 individual DCEPs with a variety of high-resolution spectrographs. For each target, we derived accurate atmospheric parameters, radial velocities, and abundances for up to 29 different species. The iron abundances range between 0.5 and −1 dex with a rather homogeneous distribution in metallicity. Results. The sample presented in this paper was complemented with that already published in the context of the C-MetaLL survey, resulting in a total of 292 pulsators whose spectra have been analysed in a homogeneous way. These data were used to study the abundance gradients of the Galactic disc in a range of Galactocentric radii (RGC) spanning the range of 5–20 kpc. Conclusions. For most of the elements, we have found a clear negative gradient, with a slope of −0.064 ± 0.003 dex kpc−1 for [Fe/H] case. Through a qualitative fit with the Galactic spiral arms, we show how our farthest targets (RGC > 10 kpc) trace both the Outer and Outer Scutum-Centaurus arms. The homogeneity of the sample will be of pivotal importance for the study of the metallicity dependence of the DCEP PL relations. [ABSTRACT FROM AUTHOR]

Measles is a highly contagious viral disease spread through respiratory droplets. The number of reported cases increased worldwide in 2023, particularly in the European Region. Italy reported 213 cases in the first quarter of 2024, with most of them in unvaccinated adults aged 15-64. Maintaining high vaccination coverage is essential to prevent outbreaks, especially in healthcare settings where measles transmission is a significant risk. In our study, we collected serological and demographic information from all Italian and foreign medical students and residents (850) who underwent a pre-training assessment at the Tor Vergata Occupational Medicine Service, Rome, between 3 April 2023 and 31 January 2024. Of the 850 students and residents analyzed, we found only 546 (64.2%) with a protective level of IgG antibodies against measles, with a median IgG level of 2.00 AI. A significant proportion of students and residents were serologically non-immune, raising concerns about the potential risk of hospital transmission. To manage this risk, it is important to assess serological levels, vaccinate those with inadequate levels, and promote vaccination in the general population.

Context. Type II Cepheids (T2Cs) are the less frequently used counterparts of classical or type I Cepheids (CCs) which provide the primary calibration of the distance ladder for measuring the Hubble constant in the local Universe. In the era of the "Hubble tension", T2C variables together with the RR Lyrae stars and the tip of the red giant branch (TRGB) can potentially provide non-CC-dependent calibration of the cosmic distance ladder. Aims. Our goal is to provide an absolute calibration of the period–luminosity, period–luminosity–colour, and period–Wesenheit relations (PL, PLC, and PW, respectively) of T2Cs in the Large Magellanic Cloud (LMC), which traditionally serves as a crucial first anchor of the extragalactic distance ladder. Methods. We exploited time-series photometry in the near-infrared (NIR) Y,  J, and Ks bands for a sample of approximately 320 T2Cs in the Magellanic Clouds (MCs). These observations were acquired during 2009–2018 in the context of the VISTA survey of the Magellanic Clouds system (VMC), an ESO public survey. We supplemented the NIR photometry from the VMC survey with well-sampled optical light curves and accurate pulsation periods from the Optical Gravitational Lensing Experiment (OGLE) IV survey and the Gaia mission. We used the best-quality NIR light curves to generate custom templates for modelling sparsely sampled light curves in YJKs bands. Results. The best-fitting YJKs template light curves were used to derive accurate and precise intensity-averaged mean magnitudes and pulsation amplitudes of 277 and 62 T2Cs in the LMC and SMC, respectively. We used optical and NIR mean magnitudes for different T2C subclasses (BLHer, WVir, and RVTau) to derive PL/PLC/PW relations in multiple bands, which were calibrated with the geometric distance to the LMC as derived from eclipsing binaries and with the Gaia parallaxes. We used our new empirical calibrations of PL and PW relations to obtain distances to 22 T2C-host Galactic globular clusters, which were found to be systematically smaller by ∼0.1 mag and 0.03−0.06 mag than in the literature when the zero points are calibrated with the distance of the LMC or Gaia parallaxes, respectively. Better agreement is found between our distances and those based on RR Lyrae stars in globular clusters, providing strong support for using these population II stars together with the TRGB for future distance scale studies. [ABSTRACT FROM AUTHOR]

Absolute angular rotation rate measurements with sensitivity better than prad/s would be beneficial for fundamental science investigations. In this regard, large frame Earth based ring laser gyroscopes are top instrumentation as far as bandwidth, long-term operation, and sensitivity are concerned. Here, we demonstrate that the GINGERINO active-ring laser upper limiting noise is close to 2×10^{-15}  rad/s for ∼2×10^{5}  s of integration time, as estimated by the Allan deviation evaluated in a differential measurement scheme. This result is more than a factor of 10 better than the theoretical prediction so far accounted for ideal ring lasers shot-noise with the two beams counterpropagating inside the cavity considered as two independent propagating modes. This feature is related to the peculiarity of real ring laser system dynamics that causes phase crosstalking among the two counterpropagating modes. In this context, the independent beam model is, then, not applicable, and the measured noise limit falls below the expected one.

Highly contagious diseases, such as mumps, are a global concern as new epidemics continue to emerge, even in highly vaccinated populations. The risk of transmission and spread of these viruses is even higher for individuals who are more likely to be exposed, including healthcare workers (HCWs). In healthcare settings, both HCWs and patients are at risk of infection during the care process, potentially leading to nosocomial epidemic outbreaks. Mumps is often underestimated compared with measles and rubella, despite being milder and less likely to spread. In fact, the risk of complications following mumps infection is extremely high, especially if the disease occurs in adulthood. The measles-mumps-rubella (MMR) vaccine has been shown to be an excellent preventive measure. Unfortunately, the mumps component appears to be less effective in inducing immunity than those for measles and rubella (two-dose effectiveness of 85%, 95% and 97%, respectively). The main aim of our study was to investigate the prevalence of detectable mumps antibodies (serum IgG antibodies) in a cohort of Italian and foreign HCWs in relation to personal and occupational factors. We included in the study 468 subjects who underwent health surveillance at the Occupational Medicine Unit of the Tor Vergata Polyclinic in Rome during the period from January 2021 to March 2023. In our study, the proportion of HCWs found to be unprotected against mumps was very high (8.3%), and those found to be immune are below the WHO threshold for herd immunity (95%). From our data, it seems essential that all occupational health services carry out an accurate screening with a dose of anti-mumps antibodies to assess serological protection before starting a job, regardless of an individual's vaccination history. This approach is proving to be beneficial, accurate, as it allows all serologically non-immune individuals to be vaccinated in the workplace, including those who would be protected by their vaccination history but have lost the antibody response.

Context. Anomalous Cepheids (ACEPs) are intermediate-mass metal-poor pulsators that are mostly discovered in dwarf galaxies of the Local Group. However, recent Galactic surveys, including the Gaia Data Release 3, found a few hundred ACEPs in the Milky Way. Their origin is only poorly understood. Aims. We aim to investigate the origin and evolution of Galactic ACEPs by studying the chemical composition of their atmospheres for the first time. Methods. We used UVES at the Very Large Telescope to obtain high-resolution spectra for a sample of nine ACEPs belonging to the Galactic halo. We derived the abundances of 12 elements, C, Na, Mg, Si, Ca, Sc, Ti, Cr, Fe, Ni, Y, and Ba. We complemented these data with literature abundances from high-resolution spectroscopy for an additional three ACEPs that were previously incorrectly classified as type II Cepheids. This increased the sample to a total of 12 stars. Results. All the investigated ACEPs have an iron abundance [Fe/H] < −1.5 dex, as expected from theoretical predictions for these pulsators. The abundance ratios of the different elements to iron show that the chemical composition of ACEPs is generally consistent with that of the Galactic halo field stars, with the exception of sodium, which is found to be overabundant in 9 out of the 11 ACEPs where it was measured. This is very similar to the situation for second-generation stars in Galactic globular clusters. The same comparison with dwarf and ultra-faint satellites of the Milky Way reveals more differences than similarities. It is therefore unlikely that the bulk of Galactic ACEPs originated in a galaxy like this that subsequently dissolved into the Galactic halo. The principal finding of this work is the unexpected overabundance of sodium in ACEPs. We explored several hypotheses to explain this feature, finding that the most promising scenario is the evolution of low-mass stars in a binary system with either mass transfer or merging. Detailed modelling is needed to confirm this hypothesis. [ABSTRACT FROM AUTHOR]

Pulsating stars play a crucial role in the calibration of the cosmic distance scale as well as in tracing the properties of the associated stellar populations. In the era of large observational surveys and precise astrometric missions, it is crucial to rely on accurate stellar pulsation models able to predict the observed behaviors for different physical assumptions. Indeed, the relations currently used in the literature to derive individual and mean distances of mainly radially pulsating stars such as Cepheids and RR Lyrae are well physically understood, but are also known to depend on a number of often unknown parameters. Recent extensive sets of stellar pulsation models developed by various authors show how variations in the physical assumptions can affect the theoretical prediction of the instability strip boundaries, the morphology and amplitude of light and radial velocity curves, and the consequent Period-Luminosity, Period-Luminosity-Color and Period-Wesenheit relations. These aspects are discussed in the framework of current open problems in the field of classical pulsating stars. [ABSTRACT FROM AUTHOR]

COVID-19 typically presents with flu-like symptoms due to the viral infection itself. The most severe cases are characterised by lung damage, an important factor in fatal outcome due to alveolar damage. In some cases, patients develop a long COVID with persistent symptoms of chest pain and fatigue. Causes, including organ damage or inflammation, are being investigated. Clinical outcomes are variable and permanent lung damage is not fully understood, while vaccination is effective against severe infection but its effect on respiratory function in mild cases remains uncertain. This retrospective study aims to analyse changes in lung function in HCWs who had COVID-19 between 2020 and 2022, comparing their spirometric test results before and after the pandemic and taking into account their vaccination status. 321 HCWs were included in the study. The study examined spirometric parameters both before and after the pandemic, and all measured outcomes except the FEV1/FVC ratio showed a significant decrease during the study period. We then assessed the association between SARS-CoV-2 infection and changes in lung function parameters, analysing infections in 2020, 2021 and 2022 separately. We found a statistically significant difference in Forced vital capacity (FVC) between infected and non-infected subjects in 2020 and 2021, but not in 2022. To evaluate the protective effect of SARS-CoV-2 vaccination on respiratory function, a linear regression analysis was performed using changes in FVC, Forced expiratory volume in 1 s (FEV1), FVC/FEV1 ratio and Peak expiratory flow (PEF) as dependent variables. The analysis showed that the decline in FVC was significantly lower in subjects who had been vaccinated prior to infection. The study concludes that subclinical SARS-CoV-2 infections in 2020 and 2021 worsened respiratory parameters (FVC and FEV1), but vaccination protected against these effects. Even healthy individuals with previous infections showed respiratory changes, with vaccination providing protection, especially for FVC decline. This highlights the importance of vaccinating healthcare workers against COVID-19., (© 2023. The Author(s).)

Background: Rubella is a contagious viral infection that occurs most often in children and young adults. Rubella is the leading vaccine-preventable cause of birth defects. Rubella infection in pregnant women may cause fetal death or congenital defects known as congenital rubella syndrome. There is no specific treatment for rubella, but the disease is preventable by vaccination with an efficacy of over 95%. Vaccination coverage is still below the recommended levels and many cases have occurred worldwide. The COVID-19 pandemic has had a negative impact on the immunization programs and the quality of disease surveillance worldwide. Operators of the healthcare setting are at increased risk of infection due to their work duties and should receive preventive vaccination or serologic protection to work in a healthcare setting., Aims: To evaluate the serological evidence of rubella IgG antibodies in female healthcare operators of childbearing age, to assess the risk of a breakthrough infection and the need for an additional dose of vaccine., Methods: We collected age and antibody titers from 449 young female operators aged <50 years who underwent the periodic surveillance at the Occupational Medicine Unit of the Policlinico Tor Vergata, Rome, from January to July 2022. Subjects were considered immune if the anti-rubella IgG titer was >11.00 IU/mL., Results: The rate of serologically unprotected subjects was 9.13% (41/449). The mean age of protected subjects was 26.93 years, while the mean age of unprotected subjects was 28.24 years. Age did not correlate with mean titer on statistical analysis ( p = 0.10). The acceptance rate among unprotected operators was 31.7%. A positive attitude towards vaccination was found in 11/28 (39.3%) of the unvaccinated subjects, while a negative tendency was found in 2/28 (7.1%) of these subjects; most of the unvaccinated operators 15/28 (53.6%) prefer to postpone the administration of the vaccine. When compared with a similar population from the pre-pandemic period, the actual proportion of immune female subjects was not significantly different from that found in 2019 (90.87% vs. 90.3%)., Conclusions: Protection against rubella was suboptimal among female healthcare workers of childbearing age. Acceptance of the rubella vaccine among these operators was low. Most of those who were hesitant intended to postpone the vaccination, while a minority had negative attitudes toward vaccination. A policy of mandatory vaccination policy should overcome the reluctance of operators.

The immune system in humans is regulated by the circadian rhythm. Published studies have reported that the time of vaccination is associated with the immune response to vaccine for some pathogens. Our study aimed to evaluate the association between time of dose administration of challenge HBV vaccine and seroconversion for anti-HBs in medical students vaccinated at birth who were found to be unprotected at pre-training screening. Humoral protection for HBV was assessed in 885 medical students vaccinated during childhood. In total, 359 (41.0%) of them showed anti-HBs titer < 10 UI/mL and received a challenge dose of HBV vaccine followed by post-vaccination screening 30-60 days later. The challenge dose elicited a protective immune response (anti-HBs IgG titer > 10 UI/mL) in 295 (83.8%) individuals. Seroconversion was significantly associated with female gender and time of vaccination after controlling for age group and nationality at logistic regression analysis. Students who received the booster dose in the morning had a higher response rate than those who received the vaccine in the afternoon (OR 1.93; 95% C.I. 1.047-3.56: p < 0.05). This finding suggests that morning administration of the HBV booster may result in a better immune response in susceptible individuals.

The COVID-19 pandemic has severely affected health systems worldwide and raised the issue of vaccine hesitancy. In 2022, the World Health Organization reported an outbreak of measles infection among people over 20 years of age in the European Region. Previous studies found low rates of measles immunization among Italian healthcare workers (HCWs) and medical students. Vaccine hesitancy is a relevant cause of low immunization rate among HCWs and the general population. We aim to evaluate the measles vaccine uptake among medical students of a large teaching hospital, compared to the pre-pandemic period. This is a retrospective observational study, that evaluated the immune status and the vaccine acceptance rate for measles in medical students at the University of Tor Vergata, Rome, who underwent occupational health surveillance from 1 January to 1 December 2022. We also compared the data with the results of a pre-pandemic survey conducted in 2018. Vaccine uptake among unprotected medical students was 59.5%. The data showed no significant difference in vaccine uptake compared with the pre-COVID-19 period. Conversely, the rate of serologically immune subjects to measles increased from 89.66% in 2018 to 97.45% in 2022 as a result of the recent mandatory vaccination policy. Despite efforts to tackle vaccine hesitancy during the COVID-19 pandemic, measles vaccine uptake is still low among young adults starting their medical training, and their compliance with free workplace vaccination offers is suboptimal. Occupational health services should raise awareness among workers and work together to implement strategies to achieve comprehensive measles vaccination coverage among occupational health workers.

Classical Cepheids (DCEPs) are the first fundamental step in the calibration of the cosmological distance ladder. Furthermore, they represent powerful tracers in the context of Galactic studies. We have collected high-resolution spectroscopy with UVES@VLT for a sample of 65 DCEPs. The majority of them are the faintest DCEPs ever observed in the Milky Way. For each target, we derived accurate atmospheric parameters, radial velocities, and abundances for 24 different species. The resulting iron abundances range between +0.3 and −1.1 dex with the bulk of stars at [Fe/H] ∼ −0.5 dex. Our sample includes the most metal-poor DCEPs observed so far with high-resolution spectroscopy. We complement our sample with literature data obtaining a complete sample of 637 DCEPs and use Gaia Early Data Release 3 (EDR3) photometry to determine the distance of the DCEPs from the period–Wesenheit–Metallicity relation. Our more external data trace the Outer arm [at Galactocentric radius (RGC) ∼ 16–18 kpc] which appears significantly warped. We investigate the metallicity gradient of the Galactic disc using this large sample, finding a slope of −0.060 ± 0.002 dex kpc−1, in very good agreement with previous results based both on DCEPs and open clusters. We also report a possible break in the gradient at RGC = 9.25 kpc with slopes of −0.063 ± 0.007 and −0.079 ± 0.003 dex kpc−1 for the inner and outer sample, respectively. The two slopes differ by more than 1σ. A more homogeneous and extended DCEPs sample is needed to further test the plausibility of such a break. [ABSTRACT FROM AUTHOR]

Background: Measles infection in the hospital setting is a major issue. Despite the availability of an effective vaccine, measles outbreaks continue to occur in some European countries. We aimed to evaluate the immunological status of medical students attending the Tor Vergata Polyclinic (PTV)., Methods: Measles antibodies titers were assessed by venipuncture on a sample of 2717 medical students who underwent annual health surveillance visits from January 2021 to March 2023. Subjects showing serum IgG values above 1.0 S/CO were considered serologically protected. Personal data, country of origin, and main demographic characteristic were also collected., Results: 66.7% (1467 Italian and 346 foreign) of medical students showed protective IgG antibodies levels. Female students were serologically immune more frequently than males (68.6% vs. 63.3%; p < 0.01 at Chi2). The mean antibody titer was 1.72 S/CO, significantly higher in females than males (1.67 vs. 1.75, respectively; p < 0.05), and significantly related to age ( p < 0.01). Albanian students, who were the largest foreign population in our study, showed a low serological protection rate (40/90: 44.4%)., Conclusions: The proportion of serologically non-immune students is high, raising concerns about the possible risk of hospital transmission. Substantial differences in the rate of immunity have been found between subjects coming from different parts of Europe and the world. Pre-training assessment of all medical students and vaccination of susceptible individuals is highly recommended, particularly for those from low immunization rate countries.

Erratum: Cepheid metallicity in the Leavitt law (C-metall) survey - I. HARPS-N@TNG spectroscopy of 47 classical Cepheids and 1 BL Her variables Keywords: errata; addenda; stars: abundances; stars: distances; stars: fundamental parameters; stars: variables: Cepheids; distance scale EN errata addenda stars: abundances stars: distances stars: fundamental parameters stars: variables: Cepheids distance scale 2887 2890 4 09/29/22 20221030 NES 221030 This is an erratum to the paper Cepheid metallicity in the Leavitt law (C-metall) survey - I. HARPS-N@TNG spectroscopy of 47 classical Cepheids and 1 BL Her variables, published in MNRAS, 2021, 508, 4047-4071. Errata, stars: abundances, stars: distances, stars: fundamental parameters, distance scale, addenda, stars: variables: Cepheids. [Extracted from the article]

Background: Hesitancy remains one of the major hurdles to vaccination, regardless of the fact that vaccines are indisputable preventive measures against many infectious diseases. Nevertheless, vaccine hesitancy or refusal is a growing phenomenon in the general population as well as among healthcare workers (HCWs). Many different factors can contribute to hesitancy to COVID-19 vaccination in the HCWs population, including socio-demographic characteristics (female gender, low socio-economical status, lower age), individual beliefs regarding vaccine efficacy and safety, as well as other factors (occupation, knowledge about COVID-19, etc.). Understanding the determinants of accepting or refusing the COVID-19 vaccination is crucial to plan specific interventions in order to increase the rate of vaccine coverage among health care workers. Methods: We conducted a cross-sectional online survey on HCWs in seventeen Italian regions, between 30 June and 4 July 2021, in order to collect information about potential factors related to vaccine acceptance and hesitancy. Results: We found an overall vaccine uptake rate of 96.4% in our sample. Acceptance was significantly related to job task, with physicians showing the highest rate of uptake compared to other occupations. At univariate analysis, the HCWs population’s vaccine hesitancy was significantly positively associated with fear of vaccination side effects (p < 0.01), and negatively related to confidence in the safety and efficacy of the vaccine (p < 0.01). Through multivariate analysis, we found that only the fear of possible vaccination side effects (OR: 4.631, p < 0.01) and the confidence in vaccine safety and effectiveness (OR: 0.35 p < 0.05) remained significantly associated with hesitancy. Conclusion: Action to improve operator confidence in the efficacy and safety of the vaccine should improve the acceptance rate among operators.

Healthcare workers (HCWs) are at increased risk of SARS-CoV-2 infection because of their occupational exposure. Moreover, they can be a vehicle for the virus transmission among patients. The vaccination of healthcare personnel against COVID-19 is crucial in fighting the spread of SARS-CoV-2 infection, together with strict sanitary procedures that aim to limit the risk of contagion. Unfortunately, even if COVID-19 vaccination has been proved one of the most effective tools for protecting against COVID-19, many healthcare professionals are not yet vaccinated. The aim of the current review is to contribute to identifying an effective strategy for COVID-19 prevention especially among non-vaccinated HCWs. In this review, we collected the most recent and relevant findings from literature on the protection of unvaccinated HCWs, identifying three types of measures as principal actions to protect those operators: addressing vaccine hesitancy, improving non-pharmaceutical interventions and promoting actions at personal level (respiratory hygiene, hand hygiene and use of PPE). All these interventions are very effective in preventing contagion, if well respected and conducted; nevertheless, it is essential to promote vaccination, as it is the most effective measure.

We demonstrate that a middle sized ring laser gyroscope (RLG) can be a very sensitive and robust instrument for rotational seismology, even if it operates in a quite noisy environment. The RLG has a square cavity, 1.60×1.60 m 2 , and it lies in a plane orthogonal to the Earth's rotational axis. The Fabry-Perot optical cavities along the diagonals of the square were accessed, and their lengths were locked to a reference laser. Through a quite simple locking circuit, we were able to keep the sensor fully operative for 14 days. We verified that the prototype properties are compatible with the seismic requirements. The obtained long term stability is of the order of 3 nanorad/s, and the short term sensitivity is close to 2 n a n o r a d / s ⋅ H z -1/2 . These results are limited only by the noisy environment; our laboratory is located in a building downtown.

Classical Cepheids (DCEPs) are the most important primary indicators of the extragalactic distance scale. Establishing the dependence on metallicity of their period–luminosity and period–Wesenheit (PLZ / PWZ) relations has deep consequences on the calibration of secondary distance indicators that lead to the final estimate of the Hubble constant (H 0). We collected high-resolution spectroscopy for 47 DCEPs plus 1 BL Her variables with HARPS-N@TNG and derived accurate atmospheric parameters, radial velocities, and metal abundances. We measured spectral lines for 29 species and characterized their chemical abundances, finding very good agreement with previous results. We re-determined the ephemerides for the program stars and measured their intensity-averaged magnitudes in the V, I, J, H, K s bands. We complemented our sample with literature data and used the Gaia Early Data Release 3 (EDR3) to investigate the PLZ / PWZ relations for Galactic DCEPs in a variety of filter combinations. We find that the solution without any metallicity term is ruled out at more than the 5σ level. Our best estimate for the metallicity dependence of the intercept of the PLK s, PWJK s, PWVK s, and PWHVI relations with three parameters is −0.456 ± 0.099, −0.465 ± 0.071, −0.459 ± 0.107, and −0.366 ± 0.089 mag dex−1, respectively. These values are significantly larger than the recent literature. The present data are still inconclusive to establish whether or not also the slope of the relevant relationships depends on metallicity. Applying a correction to the standard zero-point offset of the Gaia parallaxes has the same effect of reducing by ∼22 per cent the size of the metallicity dependence on the intercept of the PLZ / PWZ relations. [ABSTRACT FROM AUTHOR]

Background: Levodopa (LD) is the most effective drug in the treatment of Parkinson's disease (PD). Unfortunately, prolonged use of LD leads to complications, mainly motor/non-motor fluctuations (MNMF) and dyskinesias (DYS). Women seem more prone to develop such LD-related complications. Nonetheless, there is a paucity of prospective studies examining gender-related predictors of MNMF and DYS. Among several factors, which concur with a very complex scenario, changes in LD pharmacokinetics influence the drug's effectiveness. The present study aimed to assess gender-related differences in LD pharmacokinetics in patients with PD at their first-ever intake of LD., Materials and Methods: This is a multicentric study enrolling patients with PD, who were LD-naïve and received a single dose of LD/benserazide (100/25 mg) formulation. All participants gave their written informed consent, and the study was approved by the local Ethics Committees. To measure plasma LD concentrations and pharmacokinetic parameters (AUC, Cmax, Tmax, t 1/2 ), fasting blood samples were collected before drug intake and then at 8-time points until 260 min. LD concentrations were measured by ultra-high-performance liquid chromatography coupled with mass spectrometry (UHPLC-MS). Multiple linear regression analyses were performed to identify the predictors of the parameters., Results: Thirty-five patients (16 women and 19 men) were consecutively enrolled. Area under curve (AUC) and maximum plasma concentration (Cmax) were significantly higher in women than men ( p = 0.0006 and p = 0.0014, respectively). No statistically significant difference was found regarding Tmax and t 1/2 . Multiple linear regression analyses revealed that female sex (β = 1.559116, 95% CI 0.8314479 2.286785; p < 0.0001) and body mass index (BMI) (β = -0.0970631, 95% CI -0.1733004 -0.0208258; p = 0.014) significantly predicted AUC. Only female sex significantly predicted Cmax (β = 1,582.499, 95% CI 731.581 2,433.417; p = 0.001). Moreover, only BMI significantly predicted t 1/2 (β = 0.0756267, 95% CI 0.0143407 0.1369126; p = 0.017). Stratifying by gender, BMI was confirmed to significantly predict t 1/2 in women (β = 0.1300486, 95% CI 0.0172322 0.242865; p = 0.027), but not in men., Conclusion: This study provides novel insights on gender differences in LD pharmacokinetics, possibly contributing to the later development of motor complications and dyskinesia in PD., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Conti, Izzo, Russillo, Picillo, Amboni, Scaglione, Nicoletti, Cani, Cicero, De Bellis, Charlier, Giudice, Somma, Corbi, Barone, Filippelli and Pellecchia.)

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has had a tremendous impact on health services; hundreds of thousands of healthcare workers (HCWs) have died from coronavirus disease 2019 (COVID-19). The introduction of the BNT162b2 mRNA vaccine in Italy provided recipients with significant protection against COVID-19 within one to two weeks after the administration of the second of the two recommended doses. While the vaccine induces a robust T cell response, the protective role of factors and pathways other than those related to memory B cell responses to specific SARS-CoV-2 antigens remains unclear. This retrospective study aimed to evaluate the determinants of serological protection in a group of vaccinated HCWs ( n = 793) by evaluating circulating levels of antiviral spike receptor-binding domain (S-RBD) antibodies during the nine-month period following vaccination. We found that 99.5% of the HCWs who received the two doses of the BNT162b2 vaccine developed protective antibodies that were maintained at detectable levels for as long as 250 days after the second dose of the vaccine. Multivariate analysis was performed on anti-S-RBD titers in a subgroup of participants ( n = 173) that were evaluated twice during this period. The results of this analysis reveal that the antibody titer observed at the second time point was significantly related to the magnitude of the primary response, the time that had elapsed between the first and the second evaluation, and a previous history of SARS-CoV-2 infection. Of importance is the finding that despite waning antibody titers following vaccination, none of the study participants contracted severe COVID-19 during the observational period.

SARS-CoV-2 antibody assays are crucial in managing the COVID-19 pandemic. Approved mRNA COVID-19 vaccines are well known to induce a serum antibody responses against the spike protein and its RBD. Mucosal immunity plays a major role in the fight against COVID-19 directly at the site of virus entry; however, vaccine abilities to elicit mucosal immune responses have not been reported. We detected anti-SARS-CoV-2 IgA-S1 and IgG-RBD in three study populations (healthy controls, vaccinated subjects, and subjects recovered from COVID-19 infection) on serum, saliva, and nasal secretions using two commercial immunoassays (ELISA for IgA-S1 and chemiluminescent assay for IgG-RBD). Our results show that the mRNA BNT162b2 vaccine Comirnaty (Pfizer/BioNTech, New York, NY, USA) determines the production of nasal and salivary IgA-S1 and IgG-RBD against SARS-CoV-2. This mucosal humoral immune response is stronger after the injection of the second vaccine dose compared to subjects recovered from COVID-19. Since there is a lack of validated assays on saliva and nasal secretions, this study shows that our pre-analytical and analytical procedures are consistent with the data. Our findings indicate that the mRNA COVID-19 vaccine elicits antigen-specific nasal and salivary immune responses, and that mucosal antibody assays could be used as candidates for non-invasive monitoring of vaccine-induced protection against viral infection.

Context. Classical Cepheids (DCEPs) are the most important primary indicators for the extragalactic distance scale. Establishing the dependence on metallicity of their period–luminosity and period–Wesenheit (PL and PW) relations has deep consequences for the estimate of the Hubble constant (H0). Aims. We investigate the dependence on metal abundance ([Fe/H]) of the PL and PW relations for Galactic DCEPs. Methods. We combined proprietary and literature photometric and spectroscopic data, gathering a total sample of 413 Galactic DCEPs (372 fundamental mode, DCEP_F, and 41 first-overtone, DCEP_1O) and constructed new metallicity-dependent PL and PW relations in the near-infrared adopting the astrometry-based luminosity. Results. We find indications that the slopes of the PL(KS) and PW(J, KS) relations for Galactic DCEPs might depend on metallicity on the basis of the comparison with the Large Magellanic Cloud relationships. Therefore we used a generalized form of the PL and PW relations to simultaneously take the metallicity dependence of the slope and intercept of these relations into account. Conclusions. We calculated PL and PW relations that for the first time explicitly include a metallicity dependence of the slope and intercept terms. The quality of the available data is insufficient, however, and we cannot yet present conclusive results, but they are relevant from a methodological point of view. The new relations are linked to the geometric measurement of the distance to the Large Magellanic Cloud and allowed us to estimate a Gaia DR2 parallax zero-point offset Δϖ = 0.0615 ± 0.004 mas from the dataset of DCEPs used in this work. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has led to health, social and economic consequences for public health systems. As a result, the development of safe and effective vaccines, in order to contain the infection quickly became a priority. The first vaccine approved by the Italian Agency for Drugs Authorization (AIFA) was the BNT162b2 mRNA vaccine, developed by BioNTech and Pfizer (Comirnaty). Comirnaty contains a molecule called messenger RNA (mRNA), which is a nucleoside-modified RNA that encodes the SARS-CoV-2 spike glycoprotein. Even if data from phase I suggest that vaccine induced antibodies can persist for up to six months following the second shot of BNT vaccine, data regarding the real duration of immunological protection are lacking. In this study, we aimed to evaluate the duration of serological protection by detecting the presence of anti-S-RBD (receptor-binding domain) antibodies for SARS-CoV-2 among a large group of healthcare workers (HCWs) three months after vaccination. 99% of HCWs had a detectable titre of anti-S SARS-CoV-2 antibodies 90 days after the second vaccine shot. Elderly operators showed significantly lower levels of protective antibodies when compared to the younger ones, thus they could become unprotected earlier than other operators.

Renal cell carcinoma (RCC) represents around 3% of all cancers, within which clear cell RCC (ccRCC) are the most common type (70-75%). The RCC disease regularly progresses asymptomatically and upon presentation is recurrently metastatic, therefore, an early method of detection is necessary. The identification of one or more specific biomarkers measurable in biofluids (i.e., urine) by combined approaches could surely be appropriate for this kind of cancer, especially due to easy obtainability by noninvasive method. OLR1 is a metabolic gene that encodes for the Lectin-like oxidized low-density lipoprotein receptor-1 (LOX-1), implicated in inflammation, atherosclerosis, ROS, and metabolic disorder-associated carcinogenesis. Specifically, LOX-1 is clearly involved in tumor insurgence and progression of different human cancers. This work reports for the first time the presence of LOX-1 protein in ccRCC urine and its peculiar distribution in tumoral tissues. The urine samples headspace has also been analyzed for the presence of the volatile compounds (VOCs) by SPME-GC/MS and gas sensor array. In particular, it was found by GC/MS analysis that 2-Cyclohexen-1-one,3-methyl-6-(1-methylethyl)- correlates with LOX-1 concentration in urine. The combined approach of VOCs analysis and protein quantification could lead to promising results in terms of diagnostic and prognostic potential for ccRCC tumors.

Parkinson's disease (PD) and Multiple System Atrophy (MSA) are progressive neurodegenerative diseases with overlap of symptoms in early stages of disease. No reliable biomarker exists and the diagnosis is mainly based on clinical features. Several studies suggest that miRNAs are involved in PD and MSA pathogenesis. Our goal was to study two serum circulating microRNAs (miR-96-5p and miR-339-5p) as novel biomarkers for the differential diagnosis between PD and MSA. Serum samples were obtained from 51 PD patients, 52 MSA patients and 56 healthy controls (HC). We measured levels of miRNAs using quantitative PCR and compared the levels of miR-96-5p and miR-339-5p among PD, MSA and HC groups using a one-way analysis of variance. Correlations between miRNA expression and clinical data were calculated using Pearson's rho test. We used the miRTarBase to detect miRNA targets and STRING to evaluate co-expression relationship among target genes. MiR-96-5p was significantly increased in MSA patients compared with HC (Fold change (fc): 3.6; p = 0.0001) while it was decreased in PD patients compared with HC (Fold change: 4; p = 0.0002). Higher miR-96-5P levels were directly related to longer disease duration in MSA patients. We observed a significant increase of miR-339-5p in MSA patients compared with PD patients (fc: 2.5; p = 0.00013). miR-339-5p was increased in MSA patients compared with HC (fc: 2.4; p = 0.002). We identified 32 target genes of miR-96-5p and miR-339-5p, some of which are involved in neurodegenerative diseases. The study of those miRNAs could be useful to identify non-invasive biomarkers for early differential diagnosis between PD and MSA., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Vallelunga, Iannitti, Capece, Somma, Russillo, Foubert-Samier, Laurens, Sibon, Meissner, Barone and Pellecchia.)

Healthcare workers (HCWs) have an increased risk to be exposed to infectious diseases compared to the general population. For this reason, according to the National Immunization and Prevention Plan, all HCWs should have demonstrable evidence of immunity to measles, mumps, rubella, varicella and Hepatitis B. Earlier studies have already shown that a large percentage of Italian operators lacked immune protection for one or more of those pathogens.The aim of this study was to evaluate the immunization status for vaccine-preventable diseases of HCWs in a large Italian teaching hospital. We retrospectively evaluated clinical records and serological data of HCWs who followed the occupational health surveillance program between January 1 and December 31 2019. We reviewed the clinical records of 1,017 HCWs: 393 males and 624 females with a median age of 35.69 y (range: 19-67). Protective IgG antibody values were documented in the 88.0%, 75.7%, 90.3%, 87.4% and 85.7% of the HCWs screened, respectively, against measles, mumps, rubella, varicella and Hepatitis B. Age was significantly related to serological protection against measles, mumps and varicella but was not significantly related to protective IgG levels for rubella and HBV.Female gender was significantly related to a higher protection rate against Hepatitis B (87.8 vs 82.4%; p < .01) whereas males were significantly more protected against varicella (92-4 vs 84.1%; p < .01).Our study shows suboptimal levels of protection among Italian HCWs and a consequent increased risk of infection for them and their patients. Public health policies should be focused on improving preventive strategies, including serological screening and workplace vaccination of nonimmune individuals.

In China and Italy, many cases of coronavirus disease 2019 (COVID-19) have occurred among healthcare workers (HCWs). Prompt identification, isolation and contact tracing of COVID-19 cases are key elements in controlling the COVID-19 pandemic. The aim of this study was to evaluate the rate of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) infection among HCWs exposed to patients with COVID-19 in relation to the main determinants of exposure. To assess the risk of exposure, we performed active symptom monitoring in 1006 HCWs identified as contacts of COVID19 cases. The presence of symptoms was statistically associated with a positive nasopharyngeal swab result. Only one subject was asymptomatic at the time of positive test. These data suggest that clinical history may help in the selection of subjects to be investigated by means of reverse transcriptase-polymerase chain reaction (RT-PCR) in the case of a shortage of diagnostic resources. We found that close contact (within 2 m for 15 min or more) was not statistically related to contagion. Regarding the use of personal protective equipment (PPE), only the use of facial masks was inversely related to the chance of becoming infected ( p < 0.01). In conclusion, our data show that unprotected contacts between HCWs should be considered a major route of HCW contagion, suggesting that the use of facial masks should be implemented even in settings where known patients with COVID-19 are not present.

Background: In the past few years, healthcare workers (HCWs) have been considered at higher risk for tuberculosis (TB) infection than the general population. On the other hand, recent studies have reported a low conversion rate among these workers. Recently, the Center for Disease Control (CDC) updated its recommendations, suggesting that an annual screening should not be performed in the absence of a documented exposure but only in workers with high-risk duties or with job tasks in settings at high risk of tuberculosis contagion (e.g., departments of infectious or pulmonary diseases). In fact, some studies showed that annual tuberculosis screening for all the HCWs was not cost-effective in countries with a low incidence of TB. In this study, we evaluated the conversion rate and the cost-effectiveness of two different tuberculosis screening strategies in a large population of Italian HCWs., Methods: In our retrospective study, we reviewed data coming from a tuberculosis screening conducted on 1451 HCWs in a teaching hospital of Rome. All workers were evaluated annually by means of the Quantiferon test (QFT) for a five-year period. Then, the conversion rate was calculated., Results: We found a cumulative conversion rate of 0.6%. Considering the cost of the QFT test (48.26 euros per person), the screening of the HCWs resulted in a high financial burden (38,902.90 euros per seroconversion). Only one seroconversion would have been missed by applying the CDC updated recommendations, with a relevant drop of the costs: 6756.40 euros per seroconversion, with a global save of 296,075.10 euros., Conclusion: The risk of TB conversion among our study population was extremely low and it was related to the risk classification of the setting. Giving these results, the annual tuberculosis screening appeared to not be cost effective. We conclude that a targeted screening would be a better alternative in HCWs with a higher risk of TB exposure.

Background Workers in pathology and anatomy laboratories may be exposed to formaldehyde. An evaluation of the early effects of this substance is, therefore, paramount. This preliminary study was conducted to evaluate if nasal cytology could be used as a tool to detect changes in nasal mucosa in workers exposed to formaldehyde. Aims To assess whether nasal cytology was able to reveal any alteration of nasal mucosa in workers exposed to formaldehyde compared to unexposed subjects, and to ascertain whether a specific pattern of alterations correlated with years of exposure in order to evaluate long-term occupational exposure effects. Methods The study included a group of workers exposed to formaldehyde and a group of non-exposed workers. All subjects underwent clinical examination, followed by nasal cytology. Pathological indices from each rhinocytograms were compared between the two groups. Results Nasal cytology revealed a chronic inflammatory non-allergic condition in the exposed group. Qualitative analysis of data distribution of neutrophils and mucous-secreting/ciliated cells ratio showed data clustering with a cut-off set at 15 years of exposure. The mean formaldehyde concentrations ranged from <0.04 to 0.15 parts per million (ppm). The maximum levels of formaldehyde concentrations ranged from 0.2 to 0.67 ppm. Conclusions Our data indicate that nasal cytology may be a promising tool for the health surveillance of workers exposed to formaldehyde and may also represent a useful research tool for the study of the health effects of other chemicals irritants for the upper airways. [ABSTRACT FROM AUTHOR]