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AbstractObjective:While peer influence is a well-documented risk factor for adolescent substance use, it remains unclear whether peer or parental attitudes have greater impact, and if this relationship is moderated by having a confidant and the relationship between adolescents and their confidant. Method: Pooled (2015–2018) National Survey on Drug Use and Health (NSDUH) data on adolescents (12–17 years) were used. Perceived peer and parental disapproval of tobacco, alcohol, and marijuana use were dichotomized. We assessed associations between disapproval and past-month tobacco (N = 51,352), alcohol (N = 51,407), and marijuana use (N = 51,355) using separate multivariable logistic regression models. We explored effect modification by the presence of a confidant, parental vs. non-parental disapproval, and peer vs. non-peer confidant relationship. Results: Peer and parental disapproval, presence of any confidant, and identifying a parental confidant were consistently protective against substance use; identifying a peer confidant increased odds of use across substances. For marijuana use, peer disapproval (adjusted odds ratio [aOR]: 0.07, 95% confidence interval [CI]: 0.06, 0.08) was more protective than parental disapproval (aOR: 0.13, 95% CI: 0.12, 0.15). The joint presence of peer/parental disapproval and any confidant decreased the odds of substance use beyond the individual effects of peer/parental disapproval and having a confidant. However, having a peer confidant attenuated the protective association between peer/parental disapproval and tobacco, alcohol, and marijuana use. Conclusions: Both peer and parental relationships are salient when considering the social context of adolescent substance use and should be considered when studying the effects of perceived disapproval.

High-throughput DNA sequencing methods that generate high quality data from reactions as small as 400 nL are developed, providing an approximate order of magnitude reduction in reagent use relative to standard protocols. Implementation of the procedures at high-throughput genome centers could have a substantial impact on the amount of data that can be generated per unit cost.

Protein structure analysis plays a primary role in understanding their biological functions. Being able to determine the atom depth index within the protein is crucial to gain insights into molecular interactions and structural stability. To address this need, the original version of Simple Atom Depth Index Calculator (SADIC) software was developed in 2006. However, with the rapid advancement of computational methodologies and the evolution of programming libraries, the original SADIC software has become obsolete and incompatible with modern computational environments. This is why we present SADIC v2, a modernized version of the software that is fully compatible and integrated with modern Python libraries.

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Objective: To report fixation stability changes in patients with different forms of infantile nystagmus syndrome (INS), who have undergone a visual rehabilitation through biofeedback fixation training (BFT) with microperimetry (MP).Design: Retrospective study.Methods: Patients 6 to 12 years-old with INS who performed BFT with MP. Initially 10 once-weekly followed by eight twice-weekly sessions of BFT during a minimum of 6 months period were performed. Visual acuity (VA) and MP fixation stability indices were analyzed, including displacement from fixation point (P1, P2) and percentage of retinal loci used during fixation attempt (BCEA 63% and 95%). Statistical analysis was conducted at baseline (BL), 10 weeks (W10) and 6 months (M6).Results: Twelve patients (mean age 8.9 years.) with INS completed the whole training session. All patients showed significant improvement in the mean BCEA fixation area (deg2): For BCEA@95% BL was 78.0, 46.1 at W10, and 27.4 at M6 (p-value = 0.004). For BCEA@63% BL was 27.3, 15.4 in W10, and 9.17 at M6 (p= 0.01). The ANOVA test for the FS indices of P1 and P2, as well as for BCVA showed no significant difference when compared at the same intervals.Conclusion: Fixation stability (FS) indices of BCEAs (63% and 95%) improved at W10 and M6, while P1 and P2 showed significant improvement at W10 but not at M6, probably because BCEA involves a much larger area than P1 and P2. VA did not show significant improvement at any time point.

The one-day-ahead forecasting of residential gas demand at country level is investigated by implementing and comparing five models: ridge regression, Gaussian process (GP), k-nearest neighbour, artificial neural network (ANN) and torus model. Italian demand data are used for testing the proposed algorithms. The most significant aspects of the pre-processing and feature engineering are discussed, lending particular attention to the role of one-day-ahead temperature forecasts. Our best model, in terms of root mean square error (RMSE), is the ANN; if the mean absolute error (MAE) is considered, the GP becomes the best model, although by a narrow margin. A novel contribution is the development of a model describing the propagation of temperature forecast errors to gas forecasting errors that is successfully validated on data. On the Italian data, it is shown that temperature errors account for 18% of the mean square error of gas demand forecasts. [Received: October 3, 2019; Accepted: November 9, 2019]

Gas demand is made of three components: residential, industrial, and thermoelectric gas demand. Herein, the one-day-ahead prediction of each component is studied, using Italian data as a case study. Statistical properties and relationships with temperature are discussed, as a preliminary step for an effective feature selection. Nine 'base forecasters' are implemented and compared: ridge regression, gaussian processes, nearest neighbours, artificial neural networks, torus model, LASSO, elastic net, random forest, and support vector regression (SVR). Based on them, four ensemble predictors are crafted: simple average, weighted average, subset average, and SVR aggregation. We found that ensemble predictors perform consistently better than base ones. Moreover, our models outperformed transmission system operator (TSO) predictions in a two-year out-of-sample validation. Such results suggest that combining predictors may lead to significant performance improvements in gas demand forecasting. [Received: June 30, 2019; Accepted: September 29, 2019]

This paper deals with one-day-ahead forecasting of Italian electricity demand (IED). The problem is addressed through machine learning techniques, nine base models (ridge regression, LASSO, elastic net, support vector machine, Gaussian process, k-nearest neighbour, random forest, artificial neural network and torus model) and five aggregation models based on base model predictions whose errors are automatically corrected by a SARIMA model. In addition to the ensemble models, we analyse also the time and spatial-time aggregations; indeed, the models first are applied to the daily IED time series, then repeated for the daily time series of each of the 24 hours and finally extended to each hour of each Italian zone for a total of 144 time series with daily frequency. Dimension reduction by the PCA is also pursued in order to reduce the computation times and investigate the possible risk of overfitting.

Greater availability of food in the environment can lead to a reduction of rodents’ home range and foraging time, potentially affecting their detectability in live-trapping studies. Hence, a good understanding of the effect of food availability on species’ detectability is necessary for reliable ecological studies. In this work, we evaluate the effects of food availability on the live-trapping detectability of two hantavirus-host rodent species inhabiting Pampean agroecosystems in the Northern area of Buenos Aires province: Akodon azaraeand Oligoryzomys flavescens. We carried out a field experiment on an abandoned railway embankment during winter 2016. The experiment consisted of two capture-mark-and-recapture samplings of rodents with the addition of food supply between sampling periods. Using a relatively simple modeling approach, we found that A. azarae’s detectability decreased after food supply, in contrast with the increment observed during previous winters (without food addition), likely due to a lower foraging activity. On the other hand, O. flavescensincreased its detectability in spite of the similar conditions and temporal closeness between samplings, which might indicate some interaction between species. In addition, we observed a trap-phobic memory effect in O. flavescens, which could have important implications for capture-mark-and-recapture studies. Our findings highlight the importance of evaluating detectability as a dynamic feature, especially under variable environmental conditions.

Nerinetide, an eicosapeptide that interferes with post-synaptic density protein 95, is a neuroprotectant that is effective in preclinical stroke models of ischaemia-reperfusion. In this trial, we assessed the efficacy and safety of nerinetide in human ischaemia-reperfusion that occurs with rapid endovascular thrombectomy in patients who had an acute ischaemic stroke.

BackgroundDue to stigma and discrimination, gay, bisexual and other men who have sex with men (gbMSM) potentially carry a heightened burden of loneliness. This analysis investigates loneliness among gbMSM and its relationship with self-rated physical health, along with the mediating effect of depression.MethodsParticipants were recruited using respondent-driven sampling into the Momentum Health Study (February 2012–February 2015) with follow-up visits occurring every 6 months till February 2018. Using computer-assisted self-interviews, measures of loneliness were assessed using a 6-item Loneliness Scale for Emotional and Social Loneliness (lonely vs not lonely). Current physical health was self-assessed (poor, fair, good, very good or excellent). A multivariable generalised linear-mixed model with a logit link function was used to examine the relationship between loneliness and self-rated physical health. We further investigated the mediating effect of depressive symptomatology on this relationship via the Hospital Anxiety and Depression Scale.ResultsOf the 770 participants included, we found that 61% (n=471) experienced loneliness at baseline. Of the 674 (88%) who reported good/very good/excellentphysical health, 59% (n=391) reported loneliness, compared with 87% (n=80) of those in poor/fair self-rated physical health who reported feeling lonely. After adjustment for confounding, loneliness was associated with poor self-rated physical health (adjusted OR 1.71; 95% CI 1.13 to 2.60). Depressive symptomatology was found to partially mediate this relationship.CONCLUSIONThere may be a need for the integration of social, mental and physical health programming, targeted towards gbMSM, to alleviate the degree of loneliness experienced and its co-occurrence with poor self-rated physical health.

The diversity of herbivorous insects may arise from colonization and subsequent specialization on different host plants. Such specialization requires changes in several insect traits, which may lead to host race formation if they reduce gene flow among populations that feed on different plants. Behavioural changes may play a relevant role in host race formation, for example if different races evolve distinct sexual communication signals or adult phenology. Previous research has revealed differences in larval phenology in different host-associated populations of the browntail moth, Euproctis chrysorrhoea (Lepidoptera: Erebidae). Here, sex pheromones among populations of this species are compared, and pheromone trapping data obtained is used in the field to build a phenological model that tests whether populations that feed on different plants differ in their adult flight period. The chemical and electrophysiological analyses revealed that two E. chrysorrhoea populations (on Prunus and on Arbutus unedo) use the same sex pheromone component for mate finding. Our trapping data, however, showed that males fly on average 25 days earlier in populations whose larvae feed on A. unedo compared to those whose larvae feed on Quercus species. Although the shifted phenology described here may underlie host-plant specialization in E. chrysorrhoea, and adults of this species are short-lived, the use of a common sexual pheromone and a large overlap in flight periods suggest that host race formation via allochronic isolation is unlikely in this moth.

Background and purpose Computed tomography perfusion (CTP) and multiphase CT angiography (mCTA) help selection for endovascular treatment (EVT) in anterior ischemic stroke (AIS). Our aim was to investigate the ability of perfusion maps and collateral score to predict functional outcome after EVT.Patients and methods Patients with M1-middle cerebral artery occlusion, evaluated by mCTA and CTP and treated with EVT within six hours of onset, were enrolled. Perfusion parametric maps of cerebral blood flow (CBF), cerebral blood volume (CBV) and time to maximum of tissue residue function (Tmax) were generated; areas of altered perfusion were manually outlined to obtain volumes CBFv, CBVv, Tmax,v16-25sand Tmax,v9.5-25s. Diffusion-weighted imaging (DWI) at 24–36 hours was used to manually outline the ischemic core (volume: DWIv). Collateral vessels were assessed on mCTA considering extent and delay of maximal enhancement (six-point scale). Functional outcome was evaluated by modified Rankin Scale score at three months. Volumes in good and poor outcome groups were compared by Wilcoxon rank-sum test t, and their discriminative ability for outcome was determined by receiver operating characteristic analysis. A logistic regression model, including Tmax, CBF and collaterals, was used to differentiate good and poor outcome.Results Seventy-one patients (mean age 75 ± 11 years, range 45–99 years) were included. Tmax,v16-25s, Tmax,v9.5-25s, CBVv, CBFvand DWIvwere statistically different between the two groups. CBF had the best discriminative value for good and poor outcome (area under the curve (AUC) 0.73; 64.5% sensitivity; 74.4% specificity); the logistic regression model might be promising (AUC 0.79, 64.5% sensitivity, 82.1% specificity).Conclusions In patients with AIS, the combined use of CTP and mCTA predicts functional outcome of EVT and might allow better selection.

To evaluate, by Magnetic Resonance Imaging, if there is a typical pattern or severity of PRES in transplanted children for hemoglobinopathy. Secondary point was to investigate the pattern and severity of PRES in children with thalassemia-THAL and sickle-cell disease-SCD after autologous hematopoietic stem cell transplantation (aHSCT). Finally, we evaluate the presence of atypical PRES presentation and the involved area of central nervous system. Two neuroradiologists analyzed retrospectively MRI of 21 transplanted children for THAL or SCD treated with CI, with neurological symptoms and signs of PRES. The Bartynski and Boardman classification has been used for PRES pattern while McKinney scale for PRES severity. Fisher Exact Probability test or Chi-square test were used to compare the categorical data. In the 21 transplanted children the PRES severity was typically mild (85.7%) without preferring radiological pattern at MRI. The analysis didn't show significant association between PRES pattern or PRES severity and previous hemoglobinopathy (THAL or SCD). No atypical PRES presentation has been found. PRES severity in transplanted children for hemoglobinopathy is typically mild. Notwithstanding children affected by SCD have a damage on the capillary endothelium, after aHSCT our data didn't show a different PRES severity and pattern than THAL children.

ABSTRACTThe concurrent administration of COVID-19 and influenza vaccines has arisen as a promising approach to bolster protection against respiratory pathogens and improve vaccination rates. However, there remains a lack of data regarding the prevalence of co-administration across several vaccination campaigns, especially among healthcare workers (HCWs). Therefore, this study aims to shed light on the acceptance of co-administration strategies among HCWs during the two campaigns following the introduction of the anti-SARS-CoV-2 vaccine. A retrospective cohort study was conducted among the HCWs of the Fondazione Policlinico Universitario “A. Gemelli” IRCCS, a research hospital in Rome. Hospital administrative databases were accessed to gather information about vaccination for SARS-CoV-2 and influenza during the 2021/2022 and 2022/2023 vaccination campaigns. The study included 7399 HCWs. The co-administration of anti-SARS-CoV-2 and influenza vaccines presented a significant rise in 2022/2023 compared to the previous vaccination campaign (+38%): this was confirmed for every professional category, with the largest increases among resident doctors (+47%) and physicians (+44%), and also for every age category, but it was particularly evident for the youngest health professionals. The probability of co-administration uptake during the 2022/2023 campaign was significantly higher for males, and for those that received co-administration during the 2021/2022 campaign, while the probability was lower for nurses and administrative staff. This study highlights the co-administration procedure as a valuable and effective tool in annual vaccination campaigns for SARS-CoV-2 and influenza. The procedure’s safety and streamlined logistics make it increasingly attractive for implementation, particularly among HCWs.

Introduction This exploratory qualitative study assessed the feasibility of transitioning three face-to-face, cognitive behavioural interventions for adults with chronic health conditions to online delivery, by examining clinician and clients' satisfaction with intervention training and delivery.Method The interventions adapted for online delivery were: ‘Managing Chronic Disease’, a programme for individuals who were nonadherent to prescribed rehabilitation regimens; ‘Real-World Strategy Training’, an occupation-based intervention for individuals with subjective cognitive decline; and ‘Learning the Ropes’, a memory programme for persons with mild cognitive impairment. Two occupational therapists and one nurse received training in, and then delivered one of the three interventions. Qualitative feedback interviews with participants, and archived video recordings of intervention sessions were analysed thematically.Results Key features of each manualised intervention were evident in the online sessions and perceived by clients as enhancing engagement (for example, peer support and strategy training). Clinicians felt that meeting individually with intervention experts was helpful to problem-solve technical issues and ensure adherence to protocols.Conclusion Three cognitive behavioural interventions transitioned to online delivery were acceptable to older adults and clinicians. A next step would be to complete randomised controlled trials investigating whether the interventions yield equivalent health benefits, using online and face-to-face delivery.

We examined outcomes of haploidentical hematopoietic cell transplantation (haplo-HCT) using T-cell receptor αβ+(TCRαβ+)/CD19+-depleted grafts (TCR group, 14 patients) in children with hemoglobinopathies. Patients received a preparative regimen consisting of busulfan, thiotepa, cyclophosphamide, and antithymocyte globulin preceded by fludarabine, hydroxyurea, and azathioprine. The median follow-up among surviving patients was 3.9 years. The 5-year probabilities of overall survival (OS) and disease-free survival (DFS) were 84% and 69%, respectively. The incidence of graft failure was 14%. We compared outcomes to a historical group of 40 patients with hemoglobinopathies who received CD34+-selected grafts (CD34 group). The median follow-up of surviving patients for the CD34 group was 7.5 years. The 5-year probabilities of OS and DFS were 78% and 39%, respectively. The CD34 group had a significantly higher incidence of graft failure (45%) than the TCR group (14%) (P= .048). The incidences of grades 2 to 4 acute graft-versus-host disease (GVHD) in the TCR and CD34 groups were 28% and 29%, respectively, and 21% and 10% (P= .1), respectively, for extensive chronic GVHD. Viral reactivation was common in both groups. The overall incidence of posttransplant lymphoproliferative disorders for the entire group was 16%. Among all patients, 5 developed autoimmune hemolytic anemia or thrombocytopenia, with the overall cumulative incidence of 11%. The 2 groups showed suboptimal CD4+recovery within the first 6 months of transplantation with no significant difference between groups. These data demonstrate that TCRαβ+/CD19+-depleted grafts are associated with a reduced incidence of graft failure, but delayed immune reconstitution and associated morbidity and mortality remain a significant challenge.

BackgroundSwallowing difficulties are arising in an increasing number of patients, especially in elderly people. When deglutition ability is completely compromised, enteral administration of a drug via feeding tubes is used. Licensed pharmacists have to compound the original solid forms to enable this drug therapy.ObjectivesTo evaluate the possibility of compounding original commercial tablets to produce a liquid formulation suitable for administering via a feeding tube.MethodsTwo liquid formulations containing potassium canrenoate 5 mg/mL were prepared: a standard solution obtained by solubilising raw material and an extemporaneous preparation obtained by dissolving film-coated 100 mg tablets. Spectrophotometric determinations (UV range) of the drug established chemical stability of the analyte up to 60 days. Samples were tested for microbial growth. Gravimetric quantifications of liquid formulations were used to check any weight loss during the different steps before enteral administration.ResultsUV data confirmed the chemical stability of potassium canrenoate up to 60 days. Samples showed no microbial growth. A higher weight loss was recorded in extemporaneous preparations than in the standard solution (10.7% vs 7.6%) according to the gravimetric quantification.ConclusionIt is possible to compound the original tablets into a liquid formulation suitable for administration via a feeding tube.

ABSTRACTThe COVID-19 vaccination campaign in Italy started in December 2020, and, due to the Omicron variant’s emergence, a second booster dose was recommended for high-risk individuals and healthcare workers from July 2022. The aim of the study was to evaluate the vaccination coverages for the COVID-19 second booster dose and to identify predictors of its acceptance within the population of medical residents (MRs) of the Fondazione Policlinico Universitario “A. Gemelli” IRCCS (FPG) University Hospital. The study was conducted at FPG from October 4th to December 21st, 2022, and COVID-19 second booster dose and influenza vaccines were administered. The study analyzed collected data and conducted multivariate logistic regressions to explore potential predictors of vaccination adherence. The analyses performed were compared with the sample enrolled in FPG residency programs at the start of the COVID-19 vaccination campaign. 1968 MRs were involved in the 2022–2023 vaccination campaign (mean age 28.97, SD 3.44), and the second booster dose of COVID-19 vaccination coverage was low (18.80%). Almost all participants opted for co-administration of COVID-19 and influenza vaccinations, leading to a similar rate of influenza vaccination coverage (16.26%). Being a frontline resident, meaning a direct involvement in managing COVID-19 patients and vaccination campaigns, was the main predictor of vaccination adherence (OR 1.72, 95% CI 1.25–2.17). The dropping in influenza vaccination coverage in 2022–2023 and the low adherence to COVID-19 second booster dose among young physicians is concerning, calling for tailored vaccination campaigns and interventions.

Selected type and non-type material belonging to the genus Orthocladius van der Wulp, 1874 (Diptera: Chironomidae) sensu GOETGHEBUER (1940-1950), deposited in the Royal Belgian Institute of Natural Sciences (RBINS), originally comprising specimens dry pinned or stored in isinglass, were mounted on microscope slides and re-examined. Other chironomids present in the RBINS collection belonging to other genera were also examined. Fifty slides were prepared and identified to species, or to generic level when the condition of the specimens did not allow species identification. The following types, representing taxa formerly considered as nomina dubia, were examined and the concerned species are stated here as valid: Georthocladius collarti (Goetghebuer, 1941) comb. nov., Georthocladius scaturiginis (Goetghebuer, 1940) comb. nov., Lapposmittia succinea (Goetghebuer, 1942) comb. nov., Orthocladius (Euorthocladius) tolleti Goetghebuer, 1944 (new subgenus placement), Orthocladius (Orthocladius) timoni Goetghebuer & Timon-David, 1939, Pseudorthocladius hockaiensis (Goetghebuer, 1933). Orthocladius (Orthocladius) mitisi Goetghebuer, 1938, previously stated as junior synonym of Orthocladius (Orthocladius) glabripennis (Goetghebuer, 1921), is reinstated as valid species. The following new synonyms are proposed: Georthocladius (Georthocladius) collarti = Parachaetocladius retezati Albu, 1972: 19, syn. nov.; Cricotopus (Paratrichocladius) rufiventris (Meigen, 1830) = Orthocladius franzi Goetghebuer, 1949, syn. nov.; Cricotopus (Paratrichocladius) skirwithensis Edwards, 1929 = Orthocladius nigritus Goetghebuer, 1938, syn. nov. = Paratrichocladius spiesi Ashe & O’Connor, 2012; Hydrobaenus distylus (Potthast, 1914) = Orthocladius antennalis Goetghebuer, 1944, syn. nov. Lectotypes of Orthocladius collarti Goetghebuer, 1941, Orthocladius antennalis Goetghebuer, 1944, Orthocladius timoni Goetghebuer & Timon-David, 1939, and Orthocladius hockaiensis Goetghebuer, 1933 are designated. Non-type material assigned to Orthocladius was also mounted on slides and identified. Although a list of the non-Orthocladius taxa is also provided, no taxonomic changes are proposed for the latter.

Mutational characterisation in multiple myeloma (MM) currently relies on bone marrow (BM) biopsy, which fails to capture the putative spatial and genetic heterogeneity of this multifocal disease. Analysis of plasma (PL)-derived circulating free tumour DNA (ctDNA) as an adjunct to BM biopsy, for mutational characterisation and tracking disease progression, was evaluated. Paired BM MM cell DNA and ctDNA from 33 relapsed/refractory (RR) and 15 newly diagnosed (ND) patients were analysed for KRAS, NRAS, BRAFand TP53mutations using the OnTarget Mutation Detection (OMD) platform. OMD detected 128 mutations (PL=31, BM=59, both=38) indicating the presence of PL mutations (54%). A higher frequency of PL-only mutations was detected in RR patients than ND (27.2% vs 6.6%, respectively), authenticating the existence of spatial and genetic heterogeneity in advanced disease. Activating RASmutations were more highly prevalent than previously described with 69% harboring at least one RASmutation. Sequential ctDNA quantitation with droplet digital PCR through longitudinal PL tracking of specific clones in seven patients demonstrated changes in fractional abundance of certain clones reflective of the disease status. We conclude that ctDNA analysis as an adjunct to BM biopsy represents a noninvasive and holistic strategy for improved mutational characterisation and therapeutic monitoring of MM.

We describe a case of a 25-year-old male with a diagnosis of acute disseminated encephalomyelitis (ADEM) following infection with Campylobacter jejuni, which is implicated in various human pathologies regarding the central nervous system (CNS) with acute course like Guillain-Barré syndrome (GBS), Miller-Fisher syndrome (MFS), Bickerstaff’s brainstem encephalitis (BEE), acute transverse myelitis (ATM) as well as ADEM. These conditions are caused by cross-reactivity between Campylobacter’s epitopes and cells of the CNS that causes an immunomediated inflammatory demyelination of the CNS. In the acute phase, magnetic resonance (MR) can detect pathologic signal intensity at the CNS with areas of pathologic contrast enhancement at cortical and spinal white matter that normalize over time or can be stable. These findings can be associated with edema in parts of the CNS. The lesions typically appear at different times during the disease course and also can have a different evolution. Our purpose therefore was to describe the clinical course and MR findings of this case and perform a critical review of the literature.

To candidate children as bone marrow donors raises two main concerns: donor safety and adequate marrow cell dose. Data in the field are limited and guidelines for child donor care management are lacking. In this context, we herein report the experience collected in our center by comparing very-young donors (defined as age ≤ 3 years) with young donors (defined as age > 3 years) who donated bone marrow (BM) for patients affected by beta-globin disorders.

Hepatitis E virus (HEV), with the zoonotic transmission, is one of the main agents causing acute hepatitis. In individuals with chronic liver disease, the infection can cause acute on chronic liver disease (ACLD) and can lead to fulminant liver failure. This study aimed to analyze the impact of HEV infection in a cohort of cirrhotic individuals from Rosario, Santa Fe.

Although HEV infection is asymptomatic or self-limiting in most individuals, in immunocompromised patients, such as those infected with HIV, viral replication can persist for more than three months leading to chronic infection with progression to cirrhosis. Argentina is considered a country with low endemicity for HEV; however, seroprevalence data in HIV-infected populations are scarce and, to date, there are very few reports that provide accurate information on the impact of HEV infection in these immunosuppressed patients in our region. This study aimed to evaluate the prevalence of HEV infection in HIV-positive individuals from Rosario, Santa Fe.

The presentation of carbon monoxide poisoning is non-specific and highly variable. Hyperbaric oxygen therapy is used for the treatment of this condition. Various reports show the occurrence of self-limiting seizures after carbon monoxide poisoning and as a consequence of hyperbaric oxygen therapy. Contrary to the seizures, status epilepticus has been rarely observed in these conditions. The exact pathophysiology underlying seizures and status epilepticus associated with carbon monoxide poisoning and hyperbaric oxygen therapy is not really clear, and some elements appear to be common to both conditions. We describe a case of non-convulsive status epilepticus in a patient with carbon monoxide poisoning treated with hyperbaric oxygen therapy. The mechanism, MRI findings and implications are discussed.

A 20-year-old boy was admitted to our Hospital for recurrent pleural effusion, effort breathless and initial signs of right heart failure. He had primary diagnosis, in childhood, of secundum ASD and had undergone, at the age of 16 years, ASD repair with patch. A MRI showed anomalous connection of two pulmonary veins in highest superior vena cava. We performed a modified Warden procedure with a prosthetic conduit. We report the advantages of this technique in reintervention in adult congenital patient.

This small, nonrandomized study indicates that a modified conditioning protocol including busulfan, thiotepa, and cyclophosphamide is effective, safe and increases thalassemia-free survival compared to busulfan and cyclophosphamide in class 3 patients with thalassemia receiving HLA-matched sibling bone marrow transplants

ABSTRACTVaccine hesitancy in healthcare workers (HCWs) has been studied for various contagious diseases, but there is still insufficient knowledge about this phenomenon for COVID-19. We developed and validated a knowledge, attitude, and practice survey of 39 questions to assess Italian HCWs’ hesitancy toward vaccination in general (general hesitancy), COVID-19 vaccination (COVID-19 hesitancy), and public health injunctive measures (refusal of obligations). The survey was administered through a web platform between July and November 2021. Three multivariable logistic regressions were performed to evaluate the association between the explored dimensions of hesitancy and the potential determinants investigated. Out of 2,132 respondents with complete answers, 17.0% showed to be generally hesitancy toward vaccination, 32.3% were hesitant on COVID-19 vaccination, while 18.8% were categorized as refusing obligations. A significant protective effect against all three dimensions of hesitancy was found for increasing fear of COVID-19, advising COVID-19 vaccination to relatives and patients, having received flu vaccination in the previous year and having higher levels of education. Better self-rated knowledge about COVID-19 vaccines and reading up institutional sources were significantly protective against general and COVID-19 hesitancy, while being a physician rather than another healthcare professional was protective only against COVID-19 hesitancy. Conversely, increasing age and referring to colleagues to expand knowledge about COVID-19 were positively associated with COVID-19 hesitancy. The determinants of general hesitancy, COVID-19 hesitancy and the refusal of obligations are mostly overlapping. Given the great influence they exert on patients and communities, it is pivotal to limit HCWs vaccine hesitancy through appropriate training activities.

The Water Framework Directive (WFD), 2000/60/EC, requires an integrated approach to the monitoring and assessment of the quality of surface water bodies. The chemical status assessment is based on compliance with legally binding Environmental Quality Standards (EQSs) for selected chemical pollutants (priority substances) of EU-wide concern. In the context of the mandate for the period 2010 to 2012 of the subgroup Chemical Monitoring and Emerging Pollutants (CMEP) under the Common Implementation Strategy (CIS) for the WFD, a specific task was established for the elaboration of a technical report on aquatic effect-based monitoring tools. The activity was chaired by Sweden and co-chaired by Italy and progressively involved several Member States and stakeholders in an EU-wide drafting group. The main aim of this technical report was to identify potential effect-based tools (e.g. biomarkers and bioassays) that could be used in the context of the different monitoring programmes (surveillance, operational and investigative) linking chemical and ecological status assessment. The present paper summarizes the major technical contents and findings of the report.

Multiple familial meningiomas occur in rare genetic syndromes, particularly neurofibromatosis type 2. The association of meningiomas and cerebral cavernous malformations (CCMs) has been reported in few patients in the medical literature. The purpose of our study is to corroborate a preferential association of CCMs and multiple meningiomas in subjects harbouring mutations in the PDCD10gene (also known as CCM3). Three members of an Italian family affected by seizures underwent conventional brain Magnetic Resonance Imaging (MRI) with gadolinium contrast agent including gradient echo (GRE) imaging. The three CCM-causative genes were sequenced by Sanger method. Literature data reporting patients with coexistence of CCMs and meningiomas were reviewed. MRI demonstrated dural-based meningioma-like lesions associated to multiple parenchymal CCMs in all affected individuals. A disease-causative mutation in the PDCD10gene (p.Gln112PhefsX13) was identified. Based on neuroradiological and molecular data as well as on literature review, we outline a consistent association between PDCD10mutations and a syndrome of CCMs with multiple meningiomas. This condition should be considered in the differential diagnosis of multiple/familial meningioma syndromes. In case of multiple/familial meningioma the use of appropriate MRI technique may include GRE and/or susceptibility-weighted imaging (SWI) to rule out CCM. By contrast, proper post-gadolinium scans may aid defining dural lesions in CCM patients and are indicated in PDCD10-mutated individuals.

Introduction Kennedy’s disease (KD) is a progressive degenerative disorder affecting lower motor neurons. We investigated the correlation between disease severity and whole brain white matter microstructure, including upper motor neuron tracts, by using diffusion-tensor imaging (DTI) in eight patients with KD in whom disease severity was evaluated using the Amyotrophic Lateral Sclerosis Functional Rating Scale (ALSFRS).Methods From DTI acquisitions we obtained maps of fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (L1) and radial diffusivities (L2, L3). We then employed tract-based spatial statistics (TBSS) to investigate within-patient correlations of DTI invariants with ALSFRS and disease duration (DD).Results We found a significant correlation between low ALSFRS and 1) low FA values in association commissural and projection fibers, and 2) high L3 values in commissural tracts and fronto-parietal white matter. Additionally, we found a significant association between longer DD and 1) low FA in the genu and body of corpus callosum, association fibers and midbrain and 2) high L1 in projection and association tracts.Conclusions The associations between clinical variables and white matter microstructural changes in areas thought to be spared by the disease process support the hypothesis of a multisystem involvement in the complex pathogenic mechanisms responsible for the clinical disability of these patients.

Small budgets and big labors are two things that the late David Boder, psychology professor at Illinois Institute of Technology, had in common with IIT's Paul V. Galvin Library. In [...]

Plant height has a deep influence on the productivity of many crops, as it involves susceptibility to lodging, crop–weed competition, and the achievement of favorable harvest index. Nevertheless, modellers have practically ignored related ecophysiological processes, especially those modulated by management practices. The aim of this study was to analyze and model the processes involved with the effects of management on rice (Oryza sativaL.) elongation. Data were collected in two greenhouse experiments (2010–2011) where three factors (floodwater level, N fertilization, sowing density) were arranged in a split‐plot design with three replicates. The model proposed demonstrated its suitability in reproducing both the dynamics involved with tissue elongation in the different phenological phases and the effects of submergence and N luxury consumption on elongation rates. Relative root mean square error (RRMSE) ranged between 4.23 and 12.41% for different treatments and years. The inclusion of algorithms for the impact of agronomic practices on plant height in cropping system models would increase their suitability for scenario analyses and for in silico ideotyping studies, owing to the great interest shown by geneticists in related traits. Moreover, this study—performed with students of a Cropping Systems MS course—demonstrated once more the power of modeling within educational activities. In this case, models were not the subject of the teaching but tools for analyzing processes and formalizing new knowledge.

Bone marrow transplantation (BMT) performance can be limited by a lack of ideal donors, and the role of alternative donor hematopoietic cell transplantation in thalassemia is not well established. Here we used a new treatment protocol (Pc 26.1) in 16 thalassemia patients to perform BMT using phenotypically HLA-identical or 1-antigen–mismatched relatives (related donors [RDs]). We compared these results with HLA-matched sibling (matched sibling donors [MSDs]) BMT in 66 patients. The entire RD group and 88% of MSD group had sustained engraftment. Rejection incidence was 0% in the RD and 12% (95% confidence interval [95% CI], 6%-21%) in MSD groups (P = .15), with respective thalassemia-free survival probabilities of 94% (95% CI, 63%-99%) and 82% (95% CI, 70%-89%) (P = .24). Transplant-related mortality was 6% (95% CI, 1%-26%) in the RD group and 8% (95% CI, 3%-16%) in the MSD group (P = .83). The intensified new protocol was not associated with increased nonhematologic toxicity. The present data show that the Pc 26.1 preparative regimen allows thalassemia patients to safely undergo BMT from RDs who are not HLA-matched siblings, with transplant outcomes similar to patients with MSD grafts.

Xerostomia e ipofunzione delle ghiandole salivari sono condizioni con un’elevata prevalenza nella popolazione generale. Lo scopo delle presente monografia è quello di descrivere tali disordini e il loro trattamento, sottolineandone l’associazione con le molteplici patologie che possono essere alla base della loro eziopatogenesi.

A detailed understanding of the kinetics of DNA motion though nanometer-scale pores is important for the successful development of many of the proposed next-generation rapid DNA sequencing and analysis methods. Many of these approaches require DNA motion through nanopores to be slowed by several orders of magnitude from its native translocation velocity so that the translocation times for individual nucleotides fall within practical timescales for detection. With the increased dwell time of DNA in the pore, DNA-pore interactions begin to play an increasingly important role in translocation kinetics. In previous work, we and others observed that when the DNA dwell time in the pore is substantial (1 ms), DNA motion in α-hemolysin (α-HL) pores leads to nonexponential kinetics in the escape of DNA out of the pore. Here we show that a three-state model for DNA escape, involving stochastic binding interactions of DNA with the pore, accurately reproduces the experimental data. In addition, we investigate the sequence dependence of the DNA escape process and show that the interaction strength of adenine with α-HL is substantially lower relative to cytosine. Our results indicate a difference in the process by which DNA moves through an α-HL nanopore when the motion is fast (microsecond timescale) as compared with when it is slow (millisecond timescale) and strongly influenced by DNA-pore interactions of the kind reported here. We also show the ability of wild-type α-HL to detect and distinguish between 5-methylcytosine and cytosine based on differences in the absolute ionic current through the pore in the presence of these two nucleotides. The results we present here regarding sequence-dependent (and dwell-time-dependent) DNA-pore interaction kinetics will have important implications for the design of methods for DNA analysis through reduced-velocity motion in nanopores.

Chironomid larvae and pupae were studied in selected Mediterranean rivers with the aim of identifying pool and riffle taxa assemblages and of analysing their response to ecological quality gradients. Macroinvertebrate samples were collected in six Italian rivers along a pool‐riffle sequence in three seasons following a multihabitat sampling technique. Chironomids were identified as genus/species, other macroinvertebrates as family/genus. The main physico‐chemical, hydromorphological and geographical data were collected. Samples were ascribed to five quality classes according to the STAR_ICM index. Based on Chironomid taxa, principal component analysis (PCA) axis 1 represented an organic pollution gradient, axis 2 represented seasonality. Pool and riffle samples were significantly different according to taxa assemblages. Similar results were obtained with PCA based on the whole macrobenthic community. Indicator value (IndVal) analysis facilitated the detection of the Chironomid indicators of high/good quality pools (e.g. Conchapelopia pallidula, Rheopelopia ornata, Epoicocladius ephemerae) and riffles (Tvetenia calvescens, Eukiefferiella gracei). The Berger–Parker dominance index based on Chironomid assemblages in pools was correlated to PCA axis 1 and performed well in discriminating between quality classes. In riffles, no correlations to PCA axes were detected and a wide overlap between quality classes was present. Thus, assessment in the analysed river type may focus on pool mesohabitat as this seems to represent best the ecological gradient of sites. Copyright © 2009 John Wiley & Sons, Ltd.

We prospectively studied the pharmacokinetics (PK) and clinical outcomes of intravenous busulfan (Bu) in 71 children with preexisting liver damage who underwent hematopoietic stem cell transplantation for thalassemia. Intravenous Bu was administered every 6 hours as part of a conditioning regimen with PK-based dose adjustment to target a conservative area under the concentration-versus-time curve (AUC) range (900-1350 μMol*min). The first-dose Bu clearance (CL) was significantly higher than the subsequent daily CL that remained unchanged in the ensuing days. One-third of patients required dose escalation based on dose 1 AUC, whereas dose reduction was needed in the subsequent days. At doses 5, 9, and 13, 78%, 81%, and 87% of patients, respectively, achieved the target range of AUC. A population PK analysis confirmed that the first-dose CL was 20% higher and that body weight was the most important covariate to explain PK variability. Patients with variant GSTA1*B had a 10% lower Bu CL than wild-type. These results suggest that the disease-specific behavior of intravenous Bu PK should be considered for PK-guided dose adjustment in patients with thalassemia, and the use of a conservative AUC range resulted in low toxicity, good engraftment, and good survival rate.

Fetomaternal microchimerism suggests immunological tolerance between mother and fetus. Thus, we performed primary hematopoietic stem cell transplantation from a mismatched mother to thalassemic patient without an human leukocyte antigen–identical donor. Twenty-two patients with thalassemia major were conditioned with 60 mg/kg hydroxyurea and 3 mg/kg azathioprine from day −59 to −11; 30 mg/m2 fludarabine from day −17 to −11; 14 mg/kg busulfan starting on day −10; and 200 mg/kg cyclophosphamide, 10 mg/kg thiotepa, and 12.5 mg/kg antithymocyte globulin daily from day −5 to −2. Fourteen patients received CD34+-mobilized peripheral blood and bone marrow progenitor cells; 8 patients received marrow graft–selected peripheral blood stem cells CD34+ and bone marrow CD3/CD19-depleted cells. T-cell dose was adjusted to 2 × 105/kg by fresh marrow cell addback at the time of transplantation. Both groups received cyclosporine for graft-versus-host disease prophylaxis for 2 months after transplantation. Two patients died (cerebral Epstein-Barr virus lymphoma or cytomegalovirus pneumonia), 6 patients reject their grafts, and 14 showed full chimerism with functioning grafts at a median follow-up of 40 months. None of the 14 patients who showed full chimerism developed acute or chronic graft-versus-host disease. These results suggest that maternal haploidentical hematopoietic stem cell transplantation is feasible in patients with thalassemia who lack a matched related donor.

Fetomaternal microchimerism suggests immunological tolerance between mother and fetus. Thus, we performed primary hematopoietic stem cell transplantation from a mismatched mother to thalassemic patient without an human leukocyte antigen–identical donor. Twenty-two patients with thalassemia major were conditioned with 60 mg/kg hydroxyurea and 3 mg/kg azathioprine from day −59 to −11; 30 mg/m2fludarabine from day −17 to −11; 14 mg/kg busulfan starting on day −10; and 200 mg/kg cyclophosphamide, 10 mg/kg thiotepa, and 12.5 mg/kg antithymocyte globulin daily from day −5 to −2. Fourteen patients received CD34+-mobilized peripheral blood and bone marrow progenitor cells; 8 patients received marrow graft–selected peripheral blood stem cells CD34+and bone marrow CD3/CD19-depleted cells. T-cell dose was adjusted to 2 × 105/kg by fresh marrow cell addback at the time of transplantation. Both groups received cyclosporine for graft-versus-host disease prophylaxis for 2 months after transplantation. Two patients died (cerebral Epstein-Barr virus lymphoma or cytomegalovirus pneumonia), 6 patients reject their grafts, and 14 showed full chimerism with functioning grafts at a median follow-up of 40 months. None of the 14 patients who showed full chimerism developed acute or chronic graft-versus-host disease. These results suggest that maternal haploidentical hematopoietic stem cell transplantation is feasible in patients with thalassemia who lack a matched related donor.