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1. O-02: RADIOMICS AND ARTIFICIAL INTELLIGENCE FOR IDENTIFICATION AND MONITORING OF SILENT CEREBRAL INFARCTS IN SICKLE CELL DISEASE: FIRST ANALYSIS FROM THE GENOMED4ALL EUROPEAN PROJECT

Author

BIONDI R., BOARO M., BIONDINI N., COLLADO GIMBERT A., ESCUDERO FERNANDEZ J., PINTO V., ROMANO N., VOI V., FERRERO G., CASALE M., CIRILLO M., PALAZZI G., CAVALLERI F., FORNI G., REGGIANI G., PERROTTA S., MANU PEREIRA M., ZAZO S., MARIAS K., DE MONTALEMBERT M., BARTOLUCCI P., VANBEERS E., ALVAREZ F., CREMONESI F., SANAVIA T., FARISELLI P., CASTELLANI G., MANARA R., and COLOMBATTI R.

Subjects
Diseases of the blood and blood-forming organs, RC633-647.5
Published
2022
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2. Strengthening health facilities for maternal and newborn care: experiences from rural eastern Uganda

Author

Gertrude Namazzi, Peter Waiswa, Margaret Nakakeeto, Victoria K. Nakibuuka, Sarah Namutamba, Maria Najjemba, Ruth Namusaabi, Abner Tagoola, Grace Nakate, Judith Ajeani, Stefan Peterson, and Romano N. Byaruhanga

Subjects
health system strengthening, maternal care, newborn care, neonatal mortality, kangaroo mother care, Uganda, Public aspects of medicine, RA1-1270
Abstract

Background: In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective: This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design: This health system strengthening study, part of the Uganda Newborn Study (UNEST), aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results: Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase) in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC) unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with less than 40% of health facilities reporting no stock-outs. Conclusion: Health system strengthening for care at birth and the newborn period is possible even in low-resource settings and can be associated with improved utilisation and outcomes. Through a participatory process with wide engagement, training, and improvements to support supervision and logistics, health workers were able to change behaviours and practices for maternal and newborn care. Local solutions are needed to ensure sustainability of medical commodities.

Published
2015
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5. Modeling Soil Processes: Review, Key Challenges, and New Perspectives

Author

Vereecken, H, Schnepf, A, Hopmans, JW, Javaux, M, Or, D, Roose, T, Vanderborght, J, Young, MH, Amelung, W, Aitkenhead, M, Allison, SD, Assouline, S, Baveye, P, Berli, M, Brüggemann, N, Finke, P, Flury, M, Gaiser, T, Govers, G, Ghezzehei, T, Hallett, P, Franssen, HJ Hendricks, Heppell, J, Horn, R, Huisman, JA, Jacques, D, Jonard, F, Kollet, S, Lafolie, F, Lamorski, K, Leitner, D, McBratney, A, Minasny, B, Montzka, C, Nowak, W, Pachepsky, Y, Padarian, J, Romano, N, Roth, K, Rothfuss, Y, Rowe, EC, Schwen, A, Šimůnek, J, Tiktak, A, Van Dam, J, Zee, SEATM, Vogel, HJ, Vrugt, JA, Wöhling, T, and Young, IM

Subjects
Physical Geography and Environmental Geoscience, Soil Sciences, Crop and Pasture Production, Environmental Engineering
Abstract

The remarkable complexity of soil and its importance to a wide range of ecosystem services presents major challenges to the modeling of soil processes. Although major progress in soil models has occurred in the last decades, models of soil processes remain disjointed between disciplines or ecosystem services, with considerable uncertainty remaining in the quality of predictions and several challenges that remain yet to be addressed. First, there is a need to improve exchange of knowledge and experience among the different disciplines in soil science and to reach out to other Earth science communities. Second, the community needs to develop a new generation of soil models based on a systemic approach comprising relevant physical, chemical, and biological processes to address critical knowledge gaps in our understanding of soil processes and their interactions. Overcoming these challenges will facilitate exchanges between soil modeling and climate, plant, and social science modeling communities. It will allow us to contribute to preserve and improve our assessment of ecosystem services and advance our understanding of climate-change feedback mechanisms, among others, thereby facilitating and strengthening communication among scientific disciplines and society. We review the role of modeling soil processes in quantifying key soil processes that shape ecosystem services, with a focus on provisioning and regulating services. We then identify key challenges in modeling soil processes, including the systematic incorporation of heterogeneity and uncertainty, the integration of data and models, and strategies for effective integration of knowledge on physical, chemical, and biological soil processes. We discuss how the soil modeling community could best interface with modern modeling activities in other disciplines, such as climate, ecology, and plant research, and how to weave novel observation and measurement techniques into soil models. We propose the establishment of an international soil modeling consortium to coherently advance soil modeling activities and foster communication with other Earth science disciplines. Such a consortium should promote soil modeling platforms and data repository for model development, calibration and intercomparison essential for addressing contemporary challenges.

Published
2016

6. Prediction of spatially variable unsaturated hydraulic conductivity using scaled particle-size distribution functions

Author

Nasta, P, Romano, N, Assouline, S, Vrugt, JA, and Hopmans, JW

Subjects
soil water retention, unsaturated soil hydraulic conductivity, particle-size distribution, pedotransfer function, spatial variability, simultaneous scaling, Environmental Engineering, Civil Engineering, Applied Economics, Physical Geography and Environmental Geoscience
Abstract

Simultaneous scaling of soil water retention and hydraulic conductivity functions provides an effective means to characterize the heterogeneity and spatial variability of soil hydraulic properties in a given study area. The statistical significance of this approach largely depends on the number of soil samples collected. Unfortunately, direct measurement of the soil hydraulic functions is tedious, expensive and time consuming. Here we present a simple and cost-effective hybrid scaling approach that combines the use of ancillary information (e.g., particle-size distribution and soil bulk density) with direct measurements of saturated soil water content and saturated hydraulic conductivity. Our results demonstrate that the presented approach requires far fewer laboratory measurements than conventional scaling methods to adequately capture the spatial variability of soil hydraulic properties. © 2013. American Geophysical Union. All Rights Reserved.

Published
2013

10. Monitoring of toxicities induced by Chimeric Antigen Receptor T-cell therapy: Protocol for a phenomenological study on the experiences of nurses

Author

Valentina Simonetti, Letizia Governatori, Francesco Galli, Cesare Tozzi, Romano Natalini, Andrea Toccaceli, Francesco Pastore, Giancarlo Cicolini, and Dania Comparcini

Subjects
hematology, nursing, car-t therapy, phenomenological, qualitative, Medicine, Nursing, RT1-120
Abstract

Introduction: Chimeric Antigen Receptor T-cell therapy (CAR-T) represents the most recent immunotherapy’s innovation to cure some refractory and/or relapsing haematological tumours. However, because of the life-threatening toxicities it might cause such as Cytokine Release Syndrome and Immune Cell Associated Neurotoxicity Syndrome, patients are closely monitored by nurses for the early identification of toxicities during the post-infusion phase of CAR-T cell therapy. Exploring the nurses’ experience with respect to any difficulties related to the monitoring is important since these issues can be perceived by patients and affect the nurse-patient’s caring relationship, considered as a shared lived experience between the patient and the nurse. Aim: This study aims to investigate haematology nurses’ lived experience with monitoring CAR-T’s induced toxicities. Materials and methods: A qualitative study following Cohen's phenomenological methodology will be conducted through semi-structured interviews in a sample of Italian nurses working in haematology units, who have had previous experience in the management of patients undergoing CAR-T therapy for at least two months and who have performed the monitoring for the same months of experience; the interviews will be audio-recorded and then transcribed verbatim. Two researchers will carry out the manual analysis and interpretation of the collected data independently, identifying themes and sub-themes. Conclusion: To explore the nurses’ experiences in this field could facilitate the identification of the educational needs, at individual and group level. Despite it is important to consider contextual variables, the findings of this study could contribute to develop evidence supporting advanced and specialized nursing care in the haematological setting.

Published
2024
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11. COSMOS-Europe: a European network of cosmic-ray neutron soil moisture sensors

Author

Bogena, H.R., Schrön, Martin, Jakobi, J., Ney, P., Zacharias, Steffen, Andreasen, M., Baatz, R., Boorman, D., Duygu, M.B., Eguibar-Galán, M.A., Fersch, B., Franke, T., Geris, J., González Sanchis, M., Kerr, Y., Korf, T., Mengistu, Z., Mialon, A., Nasta, P., Nitychoruk, J., Pisinaras, V., Rasche, D., Rosolem, R., Said, H., Schattan, P., Zreda, M., Achleitner, S., Albentosa-Hernández, E., Akyürek, Z., Blume, T., del Campo, A., Canone, D., Dimitrova-Petrova, K., Evans, J.G., Ferraris, S., Frances, F., Gisolo, D., Güntner, A., Herrmann, F., Iwema, J., Jensen, K.H., Kunstmann, H., Lidón, A., Looms, M.C., Oswald, S., Panagopoulos, A., Patil, A., Power, D., Rebmann, Corinna, Romano, N., Scheiffele, L., Seneviratne, S., Weltin, G., Vereecken, H., Bogena, H.R., Schrön, Martin, Jakobi, J., Ney, P., Zacharias, Steffen, Andreasen, M., Baatz, R., Boorman, D., Duygu, M.B., Eguibar-Galán, M.A., Fersch, B., Franke, T., Geris, J., González Sanchis, M., Kerr, Y., Korf, T., Mengistu, Z., Mialon, A., Nasta, P., Nitychoruk, J., Pisinaras, V., Rasche, D., Rosolem, R., Said, H., Schattan, P., Zreda, M., Achleitner, S., Albentosa-Hernández, E., Akyürek, Z., Blume, T., del Campo, A., Canone, D., Dimitrova-Petrova, K., Evans, J.G., Ferraris, S., Frances, F., Gisolo, D., Güntner, A., Herrmann, F., Iwema, J., Jensen, K.H., Kunstmann, H., Lidón, A., Looms, M.C., Oswald, S., Panagopoulos, A., Patil, A., Power, D., Rebmann, Corinna, Romano, N., Scheiffele, L., Seneviratne, S., Weltin, G., and Vereecken, H.

Abstract

Climate change increases the occurrence and severity of droughts due to increasing temperatures, altered circulation patterns, and reduced snow occurrence. While Europe has suffered from drought events in the last decade unlike ever seen since the beginning of weather recordings, harmonized long-term datasets across the continent are needed to monitor change and support predictions. Here we present soil moisture data from 66 cosmic-ray neutron sensors (CRNSs) in Europe (COSMOS-Europe for short) covering recent drought events. The CRNS sites are distributed across Europe and cover all major land use types and climate zones in Europe. The raw neutron count data from the CRNS stations were provided by 24 research institutions and processed using state-of-the-art methods. The harmonized processing included correction of the raw neutron counts and a harmonized methodology for the conversion into soil moisture based on available in situ information. In addition, the uncertainty estimate is provided with the dataset, information that is particularly useful for remote sensing and modeling applications. This paper presents the current spatiotemporal coverage of CRNS stations in Europe and describes the protocols for data processing from raw measurements to consistent soil moisture products. The data of the presented COSMOS-Europe network open up a manifold of potential applications for environmental research, such as remote sensing data validation, trend analysis, or model assimilation. The dataset could be of particular importance for the analysis of extreme climatic events at the continental scale. Due its timely relevance in the scope of climate change in the recent years, we demonstrate this potential application with a brief analysis on the spatiotemporal soil moisture variability.

Published
2022

12. S265: RADIOMICS AND ARTIFICIAL INTELLIGENCE FOR IDENTIFICATION AND MONITORING OF SILENT CEREBRAL INFARCTS IN SICKLE CELL DISEASE: FIRST ANALYSIS FROM THE GENOMED4ALL EUROPEAN PROJECT

Author

Boaro, M. P., primary, Biondi, R., additional, Biondini, N., additional, Collado Gimbert, A., additional, JM, E. F., additional, Pinto, V., additional, Romano, N., additional, Voi, V., additional, Ferrero, G. B., additional, Casale, M., additional, Cirillo, M., additional, Palazzi, G., additional, Cavalleri, F., additional, Forni, G. L., additional, Reggiani, G., additional, Perrotta, S., additional, Manu Pereira, M., additional, Zazo, S., additional, Marias, K., additional, De Montalembert, M., additional, Bartolucci, P., additional, van Beers, E., additional, Alvarez, F., additional, Cremonesi, F., additional, Sanavia, T., additional, Fariselli, P., additional, Castellani, G., additional, Manara, R., additional, and Colombatti, R., additional

Published
2022
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13. Study on intestinal parasitic infections and gut microbiota in cancer patients at a tertiary teaching hospital in Malaysia

Author

Sidi Omar Siti Farah Norasyikeen, Romano Ngui, Ab Rahman Syaza Zafirah, Muhammad Zarul Hanifah Md Zoqratt, Wilhelm Wei Han Eng, Qasim Ayub, Syafinaz Amin Nordin, Vesudian Narcisse Mary Sither Joseph, Sabri Musa, and Yvonne Ai Lian Lim

Subjects
Medicine, Science
Abstract

Abstract Intestinal parasitic infections (IPIs) can lead to significant morbidity and mortality in cancer patients. While they are unlikely to cause severe disease and are self-limiting in healthy individuals, cancer patients are especially susceptible to opportunistic parasitic infections. The gut microbiota plays a crucial role in various aspects of health, including immune regulation and metabolic processes. Parasites occupy the same environment as bacteria in the gut. Recent research suggests intestinal parasites can disrupt the normal balance of the gut microbiota. However, there is limited understanding of this co-infection dynamic among cancer patients in Malaysia. A study was conducted to determine the prevalence and relationship between intestinal parasites and gut microbiota composition in cancer patients. Stool samples from 134 cancer patients undergoing active treatment or newly diagnosed were collected and examined for the presence of intestinal parasites and gut microbiota composition. The study also involved 17 healthy individuals for comparison and control. Sequencing with 16S RNA at the V3–V4 region was used to determine the gut microbial composition between infected and non-infected cancer patients and healthy control subjects. The overall prevalence of IPIs among cancer patients was found to be 32.8%. Microsporidia spp. Accounted for the highest percentage at 20.1%, followed by Entamoeba spp. (3.7%), Cryptosporidium spp. (3.0%), Cyclospora spp. (2.2%), and Ascaris lumbricoides (0.8%). None of the health control subjects tested positive for intestinal parasites. The sequencing data analysis revealed that the gut microbiota diversity and composition were significantly different in cancer patients than in healthy controls (p

Published
2024
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14. An optimised YOLOv4 deep learning model for efficient malarial cell detection in thin blood smear images

Author

Dhevisha Sukumarran, Khairunnisa Hasikin, Anis Salwa Mohd Khairuddin, Romano Ngui, Wan Yusoff Wan Sulaiman, Indra Vythilingam, and Paul Cliff Simon Divis

Subjects
Malaria, YOLOv4, Optimised, Residual network, Residual block, Object detection, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Malaria is a serious public health concern worldwide. Early and accurate diagnosis is essential for controlling the disease’s spread and avoiding severe health complications. Manual examination of blood smear samples by skilled technicians is a time-consuming aspect of the conventional malaria diagnosis toolbox. Malaria persists in many parts of the world, emphasising the urgent need for sophisticated and automated diagnostic instruments to expedite the identification of infected cells, thereby facilitating timely treatment and reducing the risk of disease transmission. This study aims to introduce a more lightweight and quicker model—but with improved accuracy—for diagnosing malaria using a YOLOv4 (You Only Look Once v. 4) deep learning object detector. Methods The YOLOv4 model is modified using direct layer pruning and backbone replacement. The primary objective of layer pruning is the removal and individual analysis of residual blocks within the C3, C4 and C5 (C3–C5) Res-block bodies of the backbone architecture’s C3-C5 Res-block bodies. The CSP-DarkNet53 backbone is simultaneously replaced for enhanced feature extraction with a shallower ResNet50 network. The performance metrics of the models are compared and analysed. Results The modified models outperform the original YOLOv4 model. The YOLOv4-RC3_4 model with residual blocks pruned from the C3 and C4 Res-block body achieves the highest mean accuracy precision (mAP) of 90.70%. This mAP is > 9% higher than that of the original model, saving approximately 22% of the billion floating point operations (B-FLOPS) and 23 MB in size. The findings indicate that the YOLOv4-RC3_4 model also performs better, with an increase of 9.27% in detecting the infected cells upon pruning the redundant layers from the C3 Res-block bodies of the CSP-DarkeNet53 backbone. Conclusions The results of this study highlight the use of the YOLOv4 model for detecting infected red blood cells. Pruning the residual blocks from the Res-block bodies helps to determine which Res-block bodies contribute the most and least, respectively, to the model’s performance. Our method has the potential to revolutionise malaria diagnosis and pave the way for novel deep learning-based bioinformatics solutions. Developing an effective and automated process for diagnosing malaria will considerably contribute to global efforts to combat this debilitating disease. We have shown that removing undesirable residual blocks can reduce the size of the model and its computational complexity without compromising its precision. Graphical Abstract

Published
2024
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15. Can Blebbistatin block the hypertrophy status in the zebrafish ex vivo cardiac model?

Author

Bonvissuto, Davide, Ceci, M., Lauri, C., Volpe, V., Bertone, R., Cervia, D., Sette, Claudio, Gornati, R., and Romano, N.

Subjects
Settore BIO/16 - ANATOMIA UMANA, Blebbistatin, Cardiomegaly, 4 or More Rings, Heterocyclic Compounds, 4 or More Rings, Cardiac hyperplasy, Cardiac hypertrophy, Ex vivo model, Phenylephrine, Zebrafish, Animals, Humans, Pericardium, Heterocyclic Compounds, Molecular Medicine, Molecular Biology
Abstract

Ex-vivo simple models are powered tools to study cardiac hypertrophy. It is possible to control the activation of critical genes and thus test the effects of drug therapies before the in vivo tests. A zebrafish cardiac hypertrophy developed by 500 μM phenylephrine (PE) treatment in ex vivo culture has been demonstrated to activate the essential expression of the embryonal genes. These genes are the same as those described in several previous pieces of research on hypertrophic pathology in humans. The efficacy of the chemical drug Blebbistatin (BL) on hypertrophy induced ex vivo cultured hearts is studied in this research. BL can inhibit the myosins and the calcium wave in counteracting the hypertrophy status caused by PE. Samples treated with PE, BL and PE simultaneously, or pre/post-treatment with BL, have been analysed for the embryonal gene activation concerning the hypertrophy status. The qRTPCR has shown an inhibitory effect of BL treatments on the microRNAs downregulation with the consequent low expression of essential embryonal genes. In particular, BL seems to be effective in blocking the hyperplasia of the epicardium but less effective in myocardium hypertrophy. The model can make it possible to obtain knowledge on the transduction pathways activated by BL and investigate the potential use of this drug in treating cardiac hypertrophy in humans.

Published
2022
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16. High HIV-1 diversity in immigrants resident in Italy (2008–2017)

Author

Maggiorella M. T., Sanarico N., Brindicci G., Monno L., Santoro C. R., Coppola N., Cuomo N., Azzurri A., Cesario F., Luciani F., El-Hamad I., D'Ettorre G., Turriziani O., Mazzuti L., Poggi A., Vichi F., Mariabelli E., Surace L., Berardelli G., Picconi O., Cenci A., Sernicola L., Rovetto C., Fulgenzi D., Belli R., Salvi E., Zeo P. D., Borsetti A., Ridolfi B., Losappio R., Zoboli F., Schietroma I., Cella E., Angeletti S., Ciccozzi M., D'Amato S., Ensoli B., Butto S., Angarano G., Babudieri S., Scheri G. C., Lichtner M., Martini S., Mazzella A., Romano N., Pansera A., Pontali E., Raddi A., Starnini G., Dell'Isola S., Maggiorella, M. T., Sanarico, N., Brindicci, G., Monno, L., Santoro, C. R., Coppola, N., Cuomo, N., Azzurri, A., Cesario, F., Luciani, F., El-Hamad, I., D'Ettorre, G., Turriziani, O., Mazzuti, L., Poggi, A., Vichi, F., Mariabelli, E., Surace, L., Berardelli, G., Picconi, O., Cenci, A., Sernicola, L., Rovetto, C., Fulgenzi, D., Belli, R., Salvi, E., Zeo, P. D., Borsetti, A., Ridolfi, B., Losappio, R., Zoboli, F., Schietroma, I., Cella, E., Angeletti, S., Ciccozzi, M., D'Amato, S., Ensoli, B., Butto, S., Angarano, G., Babudieri, S., Scheri, G. C., Lichtner, M., Martini, S., Mazzella, A., Romano, N., Pansera, A., Pontali, E., Raddi, A., Starnini, G., and Dell'Isola, S.

Subjects
0301 basic medicine, Male, Latin Americans, Immigration, Human immunodeficiency virus (HIV), lcsh:Medicine, HIV Infections, Drug resistance, medicine.disease_cause, Antiretroviral Therapy, Highly Active, Cluster Analysis, HIV Infection, lcsh:Science, Phylogeny, media_common, Recombination, Genetic, Multidisciplinary, Geography, virus diseases, High HIV-1 diversity in immigrants, Middle Aged, Italy, Medicine, Infectious diseases, Female, Human, Adult, Tuberculosis, media_common.quotation_subject, Science, 030106 microbiology, Emigrants and Immigrants, Article, 03 medical and health sciences, Population screening, Drug Resistance, Viral, medicine, Humans, Hepatitis, Cluster Analysi, lcsh:R, Genetic Variation, Emigrants and Immigrant, medicine.disease, Antiretroviral therapy, 030104 developmental biology, Mutation, HIV-1, lcsh:Q, Demography, Diversity (politics)
Abstract

The proportion of new diagnoses of HIV infection in immigrants residing in Italy raised from 11% in 1992 to 29.7% in 2018. To investigate the HIV clades circulating in this community a retrospective study was performed in 557 HIV-infected immigrants living in 12 Italian cities. Immigrants originated from East-Europe and Central-Asia (11.7%), North Africa and Middle East (7.3%), South and South-East Asia (7.2%), Latin America and the Caribbean (14.4%), and sub-Saharan Africa (59.4%). More than 87% of immigrants were on antiretroviral therapy (ART), although 26.6% of them were viremic. A 22.0% of immigrants had hepatitis (HBV and/or HCV) and/or tuberculosis. HIV phylogenetic analysis on sequences from 192 immigrants showed the presence of clades B (23.4%), G (16.1%), C (10.4%), A1 (9.4%), F1 (5.2%), D (1.6%) and Circulating Recombinant Forms (CRFs) (33.9%). CRF02_AG represented 72.3% of the total CRFs. Clusters between immigrants and Italian natives were also present. Drug resistance mutations to NRTI, NNRTI, and PI drug classes occurred in 29.1% of ART-treated and in 12.9% of ART-naïve individuals. These data highlight the need for tailored public health interventions in immigrants to avoid spreading in Italy of HIV genetic forms and ART-resistant variants, as well as HIV co-morbidities.

Published
2020

18. Bacterial image analysis using multi-task deep learning approaches for clinical microscopy

Author

Shuang Yee Chin, Jian Dong, Khairunnisa Hasikin, Romano Ngui, Khin Wee Lai, Pauline Shan Qing Yeoh, and Xiang Wu

Subjects
Bacteria detection, Bacteria classification, Deep learning, Object detection, YOLOv4, EfficientDet, Electronic computers. Computer science, QA75.5-76.95
Abstract

Background Bacterial image analysis plays a vital role in various fields, providing valuable information and insights for studying bacterial structural biology, diagnosing and treating infectious diseases caused by pathogenic bacteria, discovering and developing drugs that can combat bacterial infections, etc. As a result, it has prompted efforts to automate bacterial image analysis tasks. By automating analysis tasks and leveraging more advanced computational techniques, such as deep learning (DL) algorithms, bacterial image analysis can contribute to rapid, more accurate, efficient, reliable, and standardised analysis, leading to enhanced understanding, diagnosis, and control of bacterial-related phenomena. Methods Three object detection networks of DL algorithms, namely SSD-MobileNetV2, EfficientDet, and YOLOv4, were developed to automatically detect Escherichia coli (E. coli) bacteria from microscopic images. The multi-task DL framework is developed to classify the bacteria according to their respective growth stages, which include rod-shaped cells, dividing cells, and microcolonies. Data preprocessing steps were carried out before training the object detection models, including image augmentation, image annotation, and data splitting. The performance of the DL techniques is evaluated using the quantitative assessment method based on mean average precision (mAP), precision, recall, and F1-score. The performance metrics of the models were compared and analysed. The best DL model was then selected to perform multi-task object detections in identifying rod-shaped cells, dividing cells, and microcolonies. Results The output of the test images generated from the three proposed DL models displayed high detection accuracy, with YOLOv4 achieving the highest confidence score range of detection and being able to create different coloured bounding boxes for different growth stages of E. coli bacteria. In terms of statistical analysis, among the three proposed models, YOLOv4 demonstrates superior performance, achieving the highest mAP of 98% with the highest precision, recall, and F1-score of 86%, 97%, and 91%, respectively. Conclusions This study has demonstrated the effectiveness, potential, and applicability of DL approaches in multi-task bacterial image analysis, focusing on automating the detection and classification of bacteria from microscopic images. The proposed models can output images with bounding boxes surrounding each detected E. coli bacteria, labelled with their growth stage and confidence level of detection. All proposed object detection models have achieved promising results, with YOLOv4 outperforming the other models.

Published
2024
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19. Automated Identification of Malaria-Infected Cells and Classification of Human Malaria Parasites Using a Two-Stage Deep Learning Technique

Author

Dhevisha Sukumarran, Ee Sam Loh, Anis Salwa Mohd Khairuddin, Romano Ngui, Wan Yusoff Wan Sulaiman, Indra Vythilingam, Paul Cliff Simon Divis, and Khairunnisa Hasikin

Subjects
Machine learning, deep learning, biosurveillance, AI-monitoring, detection, Electrical engineering. Electronics. Nuclear engineering, TK1-9971
Abstract

The gold standard for diagnosing malaria remains microscopic examination; however, its application is frequently impeded by the lack of a standardized framework that guarantees uniformity and quality, particularly in scenarios with limited resources and high volume. This study suggests a novel and highly effective automated diagnostic approach that employs deep-learning object detectors to improve the accuracy and efficiency of malaria-infected cell detection and Plasmodium species classification to overcome these challenges. Plasmodium parasites were detected within thin blood stain images using the YOLOv4 and YOLOv5 models, which were optimized for this purpose. YOLOv5 obtains a slightly higher accuracy on the source dataset (mAP@ $0.5=96$ %) than YOLOv4 (mAP@ $0.5=89$ %), but YOLOv4 exhibits superior robustness and generalization across diverse datasets, as demonstrated by its performance on an independent validation set (mAP@ $0.5=90$ %). This robustness emphasizes the dependability of YOLOv4 for deployment in a variety of clinical settings. Furthermore, an automated process was implemented to produce bound single-cell images from YOLOv4’s localization outputs, thereby eradicating the necessity for conventional and time-consuming segmentation methods. The DenseNet-121 model, which was optimized for species identification, obtained an impressive overall accuracy of 95.5% in the subsequent classification stage, indicating excellent generalization across all malaria species. Accurate classification of Plasmodium species on microscopically thin blood films is essential for guiding appropriate therapy and preventing unnecessary anti-malarial treatments, which can lead to adverse effects and contribute to drug resistance. This research contributes to the field of automated malaria diagnosis by offering a comprehensive framework that substantially improves clinical decision-making, particularly in resource-limited environments.

Published
2024
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20. Prevalence of acquired resistance mutations in a large cohort of perinatally infected HIV-1 patients

Author

Ungaro, R., Taramasso, L., Bruzzone, B., Vicenti, I., Galli, L., Borghi, V., Francisci, D., Pecorari, M., Zoncada, A., Callegaro, A. P., Paolini, E., Monno, L., Bonora, S., Di Biagio, A., ARCA Study Group, Giacometti, A., Butini, L., del Gobbo, R., Bagnarelli, P., Tacconi, D., Corbelli, G., Zanussi, S., Punzi, G., Maggiolo, F., Calza, L., Carla Re, M., Pristera, R., Turconi, P., Mandas, A., Tini, S., Amadio, G., Sighinolfi, L., Corsi, P., Di Pietro, M., Colao, G., Tosti, A., Setti, M., Cenderello, G., Trezzi, M., Orani, A., Arcidiacono, I., Degiuli, A., De Gennaro, M., Chiodera, A., Scalzini, A., Palvarini, L., Todaro, G., Rusconi, S., Gismondo, M. R., Micheli, V., Biondi, M. L., Capetti, A., Meraviglia, P., Boeri, E., Mussini, C., Soria, A., Vecchi, L., Santirocchi, M., Brustia, D., Ravanini, P., Dal Bello, F., Romano, N., Mancuso, S., Calzetti, C., Maserati, R., Filice, G., Baldanti, F., Parruti, G., Polilli, E., Sacchini, D., Martinelli, C., Consolini, R., Vatteroni, L., Vivarelli, A., Nerli, A., Lenzi, L., Magnani, G., Ortolani, P., Andreoni, M., Fimiani, C., Palmisano, L., Di Giambenedetto, S., Vullo, V., Turriziani, O., Montano, M., Antinori, A., Zaccarelli, M., Dentone, C., Gonnelli, A., De Luca, A., Palumbo, M., Ghisetti, V., Delle Foglie, P., Rossi, C., Mondino, V., Malena, M., Grossi, P., Seminari, E., Poletti, F., Ungaro R., Taramasso L., Bruzzone B., Vicenti I., Galli L., Borghi V., Francisci D., Pecorari M., Zoncada A., Callegaro A.P., Paolini E., Monno L., Bonora S., Di Biagio A., Giacometti A., Butini L., del Gobbo R., Bagnarelli P., Tacconi D., Corbelli G., Zanussi S., Punzi G., Maggiolo F., Calza L., Carla Re M., Pristera R., Turconi P., Mandas A., Tini S., Amadio G., Sighinolfi L., Corsi P., Di Pietro M., Colao G., Tosti A., Setti M., Cenderello G., Trezzi M., Orani A., Arcidiacono I., Degiuli A., De Gennaro M., Chiodera A., Scalzini A., Palvarini L., Todaro G., Rusconi S., Gismondo M.R., Micheli V., Biondi M.L., Capetti A., Meraviglia P., Boeri E., Mussini C., Soria A., Vecchi L., Santirocchi M., Brustia D., Ravanini P., Dal Bello F., Romano N., Mancuso S., Calzetti C., Maserati R., Filice G., Baldanti F., Parruti G., Polilli E., Sacchini D., Martinelli C., Consolini R., Vatteroni L., Vivarelli A., Nerli A., Lenzi L., Magnani G., Ortolani P., Andreoni M., Fimiani C., Palmisano L., Di Giambenedetto S., Vullo V., Turriziani O., Montano M., Antinori A., Zaccarelli M., Dentone C., Gonnelli A., De Luca A., Palumbo M., Ghisetti V., Delle Foglie P., Rossi C., Mondino V., Malena M., Grossi P., Seminari E., and Poletti F.

Subjects
Male, antiretroviral treatment, Infectious Disease Transmission, genotype, Human immunodeficiency virus (HIV), Drug Resistance, HIV Infections, Drug resistance, medicine.disease_cause, Retrospective Studie, Genotype, pol Gene Products, Human Immunodeficiency Viru, Prevalence, Medicine, Vertical, HIV Infection, Viral, pol Gene Products, Young adult, General Medicine, Infectious Diseases, Italy, Mutation (genetic algorithm), Female, Human Immunodeficiency Virus, Human, Microbiology (medical), Adult, Settore MED/17 - Malattie Infettive, Adolescent, Anti-HIV Agents, Young Adult, Acquired resistance, Drug Resistance, Viral, Humans, vertical HIV transmission, HIV-1, Mutation, Retrospective Studies, pol Gene Products, Human Immunodeficiency Virus, Infectious Disease Transmission, Vertical, HIV perinatally infection, business.industry, Anti-HIV Agent, Retrospective cohort study, Virology, Large cohort, business
Published
2019

22. General anaesthetic and airway management practice for obstetric surgery in England: a prospective, multicentre observational study

Author

Odor, P. M., Bampoe, S., Moonesinghe, S. R., Andrade, J., Pandit, J. J., Lucas, D. N., A’Court, A., Abdel-Gadir, D., Abdu, A., Abisogun, C., Aboud, Z., Abrams, J., Ackerman, A., Adamson, C., Addison, R., Adeyeye, A., Adler, R., Aduse-Poku, M., Adyanthaya, S., Ahmad, N., Ahmed, D., Ahmed, A., Akindele, B., Akindele, O., Akrimi, S., Al-Rawi, S., Ali, Y., Allam, J., Allana, A., Allen, K., Allen, O., Amaradasa, N., Amarasekara, L., Amoakwa-adu, F., Anandageetha, P., Anandakrishnan, S., Anandanadesan, R., Anderson, M., Apps, S., Aquilina, A., Arbane, G., Arch, A., Armstrong, S., Arya, R., Ashiru, G., Ashpole, K., Atkinson, C., Atkinson, F., Auer, E., Avery, B., Babio-Galan, M., Bader, H., Badham, G., Bagchi, S., Bailey, S., Baird, Y., Balaka, C., Baldwin, M., Balfour, P., Bali, S., Banks, S., Barclay, P., Barnes, L., Barnes, T., Barot, N., Barrett, S., Barrett, V., Barrett, K., Bates, L., Batte, K., Baytug, B., Behravesh, M., Bell, S., Benloch, R., Bentley, R., Berg, J., Berwick, C., Berwick, R., Bhadange, R., Bhattacharyya, S., Bielskute, E., Birch, S., Bird, S., Bird, Ruth, Birts, William, Black, Becky, Blagova, Tatyana, Blake, Holly, Blightman, Oliver, Blunden, Susara, Bolton, R., Borkett-Jones, C., Boselli, J., Bowen, M., Bowen, R., Bowyer, J., Boyle, H., Brar, Z., Bray, J., Brayshaw, S., Bressington, C., Brewer, A., Brice, N., Bridge, L., Briscoe, J., Brocklesby, S., Brown, H., Brown, S., Brunnen, D., Burijintichenna, K., Burnard, S., Burtt, A., Buswell, V., Bykar, H., Cairney, M., Calvert, C., Camarasa, L., Campbell, N., Campbell-Jones, F., Cantliffe, J., Carrol, W., Carvalho, J., Cashell, C., Cassie, S., Cassim, K., Chandler, M., Chapman, R., Charles, R., Chen, P., Cheyne, D., Chima, K., Chin, F., Chirvasuta, R., Shao Chong, M., Choudhury, S., Chowdhury, P., Christmas, T., Chughwani, S., Ciechanowicz, S., Clarey, E., Coe, R., Cohen, J., Coker, N., Collins, K., Collis, L., Comar, J., Conroy, M., Constantin, K., Corfe, J., Coulborn, E., Cowie, V., Crone, R., Cronin, J., Crooks, J., Crowther, N., Crowther, E., Cruz, C., Curtis, A., Curtis, S., Dabrowicz, A., Daines, N., Dalal, V., Dannatt, P., Das, D., Dash, J., Davidson, K., Davies, S., Davis, Y., Dawson, J., Dean, J., Dean, C., Denman, J., Desai, N., Dewan, P., Dimont, S., Donovan, C., Doraiswami, M., Doughty, K., Douglass, J., Dower, M., Downing, S., Duberry, W., Duckham, E., Dudgeon, L., Dukes, S., Dunn, L., Duraiswamy, V., Dwyer, A. O., Dyer, K., Eapen, S., Earl, M., Eason, S., Edwards, K., Edwards, Z., Egole, O., Ekpa, J., el-Amin, O., el-Boghdadly, K., Elbasir, O., Eldridge, J., Elgie, L., Ellington, M., Elliott, K., Elliott, J., Elmi, M., Elnoumeir, R., Emeakaraoha, E., Evans, M., Everett, M., Fabb, P., Farooq, H., Farrimond, R., Faulds, F., Fawcett, E., Feneley, A., Fernando, D., Ferns, J., Finlay, C., Fitzgerald, S., O’Flaherty, D., Fleet, M., Fletcher, L., Fludder, V., Follet, T., Forbes, J., Forth, M., Foster, G., Francis, J., Fraser, K., Friedman, L., Fruggeri, L., Fulton, L., Funnell, S., Gadre, A., Gandhi, A., Gardiner, H., Garner, Z., Garvey, G., Gately, T., George, R., Gillespie, S., Glover, S., Goddard, J., Goodman, B., Gopal, T., Graham, G., Green, D., Griffin, D., Griffith, J., Grigsby, S., Grindey, J., Griffiths, H., Groome, J., Grother, C., Grounds, G., Groves, A., Guha, A., Gunawardhana, A., Gupta, A., Gupta, R., Gutsell, J., Haddon, R., Hadi, D., Hadjipavlou, N., Hammerbeck, H., Hammon, L., Hammond, S., Hampanna, H., Hancock, H., Handapangoda, H., Haroon-Mowahed, Y., Harpham, D., Harris, G., Harrison, A., Harshan, D., Hartopp, A., Harty, E., Haslam, N., Hawkins, G., Hawkins, E., Hawksey, S., Hays, C., Hazelton, T., Heavyside, A., Hemeson, C., Henderson, K., Henry, O., Herbert, L., Higgins, N., Hilton, J., Hindmoor, C., Hitchcock, R., Hobbs, L., Homsy, M., Honeywell, C., Hoque, N., House, K., Howle, R., Tiller, A., Huniak, M., Hunte, J., Husain, T., Huson, C., Hussain, C., Hussain, T., Hussein, Z., Hyams, J., Hyde, E., Laverdino, M., Ignacka, A., Innes, E., Ioannidis, S., Iqbal, R., Ismail, F., Jackson, J., Jackson, M., Jackson, G., Jacobs, R., Jadhav, P., Jalaly, A., James, L., James, M., Jani, S., Jeganathan, C., Joannides, C., Johnson, R., Johnson, T., Johnston, C., Jones, R., Jones, T., Kadr, M., Kainth, R., Kane, J., Kanji, R., Kannanparambil, S., Kar, G., Kasianandan, T., Kaskos, H., Kavanagh, L., Kaye, R., Kelliher, L., Kelliot, S., Kelly, J., Kenyon, C., Kessack, L., Kestner, S., Khaku, M., Khaleeq, S., Khan, P., Khan, S., Kidwai, U., King, C., King, H., Kingston, E., Kok, W., Konig, R., Konstantinova, Z., Krishnan, P., Kua, J., Kuntumalla, K., Kursumovic, E., Kurzatkowski, K., Kuttambakam, H., Lane, K., Lane, S., Langton, A., Latif, H., Lau, N., Laxman, S., Laycock, H., Lee, R., Leonardi, S., Light, K., Lightfoot, H., Liu, S., Liyanage, S., Lowe, J., Lucas, N., Lungu, M., Lunn, M., Lynes, H., Machavarapu, K., Mackenzie, M., Magee, D., Major, J., Male, V., Malik, Z., Manso, K., Maquinana, M., Marciniak, K., Maronge, L., Marsh, C., Martella, C., Martin, N., Martins, N., Marway, J., Mason, L., Masood, N., Masters, J., Maton-Howarth, M., Mazzola, F., McAllister, T., McCarthy, R., McCormick, C., McCready, S., McDougall, S., Mcewan, L., McGarry, J., McKevitt, H., Mckinley, S., Mckskeane, A., McMaster, E., McMonagle, M., McNamara, H., McPhee, H., McRae, L., Mead, D., Meadows, E., Mehta, M., Meikle, J., Metodiev, Y., Michael, C., Millar, V., Miller, S., Miller, G., Milne, S., Miltsios, K., Misquita, L., Misquita, S., Mittal, M., Mohamed, M., Powell Monaghan, K., Monk, J., Monkhouse, A., Monks, D., Montague, L., Moon, A., Moran, J., Moreton, A., Morgan, E., Morgan, O., Morland, D., Morosan, M., Morris, K., Morris, A., Moser, C., Mount, M., Muir, C., Mupudzi, M., Murali, M., Murdoch, I., Murray, H., Murray, T., Murrell, K., Narasimha Murthy, G., Neeley, D., Nei, H., Neil, K., Nejim, T., Nel, M., Nicholson, A., Nicklin, A., Nolan, C., Nolan, T., Nurmi, E., O’Neill, B., Oakes, C., Oakes, N., Ochoa-Ferraro, M., Odeleye, N., Oliver, K., Oliver, M., Onslow, J., Onwochei, D., Oommen, T., Orr, T., Osagie, O., Osborn, H., Overend, J., Owston, H., Pack, E., Padhi, P., Palani, P., Pandey, R., Pandya, D., Panesar, N., Papageorgiou, C., Papanastasiou, G., Papoutsos, C., Pararajasingham, S., Parry, J., Patel, H., Patel, J., Patel, K., Patel, M., Patel, R., Patel, N., Pathak, S., Pearson, F., Peciulene, V., Peers, B., Peirce, B., Pepper, S., Perinpanayagam, J., Perry, H., Petrova, N., Phillips, T., Phillips, S., Phylactides, L., Pilkington, F., Plumb, J., Poimenidi, E., Sau Kuk Poon, A., Potter, T., Poultney, U., Powell, L., Prenter, A., Preston, K., Price, A., Pritchard, N., Pullen, J., Purohit, M., Quamina, C., Qureshi, J., Rajput, Z., Ramage, S., Ramanathan, T., Ranasinghe, U., Ranatunga, K., Rand, A., Randive, S., Rangarajan, D., Rao, C., Rao Pelluri, S., Ratnasingham, A., Razzaque, J., Reddy, A., Redington, K., Reel, E., Remeta, P., Ricco, F., Riccoboni, A., Rice, P., Rich, M., Richards, N., Riches, J., Ripoll, S., Roberts, F., Roberts, K., Robins, K., Robinson, S., Roche, S., Rojo, M., Carmela Romano, N., Rosser, H., Roughley, L., Routley, C., Rowley, C., Rudra, P., Russell, R., Ryan, C., Saad, C., Sadeghi, A., Salberg, A., Salota, V., Samuel, M., Samuels, R., Sanapala, S., Sanusi, S., Sarao, S., Sathyabhama, S., Saunders, Z., Sawarzynska-ryszka, B., Sceales, P., Schumacher, N., Schwartz, N., Sellers, C., Sellers, H., Sellick, J., Sen, S., Senaratne, D., Senbeto, S., Seneviratna, D., Setty, T., Shah, R., Shah, S., Shambly, J., Sharafudeen, S., Sharieff, I., Sharifi, L., Sharpe, L., Shaw, M., Sheldrake, I., Shinde, P., Shonfeld, A., Short, J., Siah, J., Sibug, S., Siddique, O., Siew, S., Simpson, M., Singleton, G., Sinha, K., Sinha, A., Sinnott, M., Sivadhas, H., Sivakumar, S., Sivarajan, B., Sivarajan, S., Skeoch, C., Slade, S., Slater, P., Smith, C., Smith, E., Smith, J., Smith, L., Smith, A., Smith, R., Smith, S., Smith, T., Smithers, H., Smolen, S., Smyth, C., Snel, T., Snipe, C., Soltanifar, S., Sonawane, N., Soundararaja, A., Spence, E., Spiliopoulos, M., Srivastava, C., Stacey, K., Stafford, H., Staines, N., Stead, R., Stevens, E., Stilwell, A., Stocks, G., Stokes, A., Stone, C., Straughan, B., Subbarathnam, V., Sudunagunta, S., Sultan, P., Suppiah, P., Surve, P., Sutherland, A., Swanton, R., Swarbrick, C., Swinson, A., Syrrakou, E., Tadbiri, S., Tamhane, P., Tamilselvan, P., Tan, A., Tanna, S., Tarft, H., Tarry, L., Taylor, I., Taylor, S., Tebbot, J., Theron, S., Thomas, M., Todd, S., Tolliday, H., Topham, C., Tovell, N., Traves, M., Trodd, D., Tufchi, A., Turley, K., Turnbull, M., Turnbull, C., Turner, O., Turner, W., Turney, S., Tyagi, E., Uncles, D., Unsworth, V., Vadnere, P., Varadan, R., Vasishta, V., Veal, A., Vedham, L., Venkaya, J., Verghese, M., Veronica, I., Vidanagamage, D., Vincent, R., Vyapury, V., Wain, H., Walbridge, F., Walker, E., Walsh, P., Walshe, E., Walters, M., Wan, Y., Wang, C., Wankhade, K., Waters, G., Watts, C., Webber, A., Wedgwood, T., Wee, M., Wellstead, S., White, A., Whitear, M., Whitefield, L., Wilkinson, S., Williams, L., Williams, R., Wilson, D., Wilson, S., Wimble, K., Winkley, E., Winslow, L., Winwright, P., Wloch, K., Wong, G., Wong, H., Man Wong, J., Wood, T., Wray, S., Wrench, I., Wu, J., Wynn, K., Yap, Y., Kuan Yeow, C., Young, E., Yusaf, A., Uz Zafar, S., Zeinali, D., Zhang, S., Zope, S., Zucco, L., Anwar, S., Blunt, N., Grover, V., Grailey, K., Gray, M., Highton, D., Hopkins, P., Kemp, H., Lo, Q., Martin, D., Morkane, C., O’Carroll, J., Oliver, C., Post, B., Visram, A., Wickham, A., General Paediatrics, Graduate School, Adult Psychiatry, and Pulmonology

Subjects
medicine.medical_specialty, medicine.medical_treatment, Population, 03 medical and health sciences, 0302 clinical medicine, 030202 anesthesiology, medicine, Caesarean section, General anaesthesia, general anaesthesia, 030212 general & internal medicine, Rocuronium, General anaesthetic, education, Neuromuscular Blockade, education.field_of_study, airway management, obstetrics, business.industry, Tracheal intubation, Surgery, Anesthesiology and Pain Medicine, caesarean section, Airway management, business, medicine.drug
Abstract

There are no current descriptions of general anaesthesia characteristics for obstetric surgery, despite recent changes to patient baseline characteristics and airway management guidelines. This analysis of data from the direct reporting of awareness in maternity patients' (DREAMY) study of accidental awareness during obstetric anaesthesia aimed to describe practice for obstetric general anaesthesia in England and compare with earlier surveys and best-practice recommendations. Consenting patients who received general anaesthesia for obstetric surgery in 72 hospitals from May 2017 to August 2018 were included. Baseline characteristics, airway management, anaesthetic techniques and major complications were collected. Descriptive analysis, binary logistic regression modelling and comparisons with earlier data were conducted. Data were collected from 3117 procedures, including 2554 (81.9%) caesarean deliveries. Thiopental was the induction drug in 1649 (52.9%) patients, compared with propofol in 1419 (45.5%). Suxamethonium was the neuromuscular blocking drug for tracheal intubation in 2631 (86.1%), compared with rocuronium in 367 (11.8%). Difficult tracheal intubation was reported in 1 in 19 (95%CI 1 in 16-22) and failed intubation in 1 in 312 (95%CI 1 in 169-667). Obese patients were over-represented compared with national baselines and associated with difficult, but not failed intubation. There was more evidence of change in practice for induction drugs (increased use of propofol) than neuromuscular blocking drugs (suxamethonium remains the most popular). There was evidence of improvement in practice, with increased monitoring and reversal of neuromuscular blockade (although this remains suboptimal). Despite a high risk of difficult intubation in this population, videolaryngoscopy was rarely used (1.9%).

Published
2020

25. Spatial analyses of Plasmodium knowlesi vectors with reference to control interventions in Malaysia

Author

Sandthya Pramasivan, Romano Ngui, Nantha Kumar Jeyaprakasam, Van Lun Low, Jonathan Wee Kent Liew, and Indra Vythilingam

Subjects
Anopheles, Distribution, Leucosphyrus group, Predictive vector map, Malaysia, Infectious and parasitic diseases, RC109-216
Abstract

Abstract Background Malaria parasites such as Plasmodium knowlesi, P. inui, and P. cynomolgi are spread from macaques to humans through the Leucosphyrus Group of Anopheles mosquitoes. It is crucial to know the distribution of these vectors to implement effective control measures for malaria elimination. Plasmodium knowlesi is the most predominant zoonotic malaria parasite infecting humans in Malaysia. Methods Vector data from various sources were used to create distribution maps from 1957 to 2021. A predictive statistical model utilizing logistic regression was developed using significant environmental factors. Interpolation maps were created using the inverse distance weighted (IDW) method and overlaid with the corresponding environmental variables. Results Based on the IDW analysis, high vector abundances were found in the southwestern part of Sarawak, the northern region of Pahang and the northwestern part of Sabah. However, most parts of Johor, Sabah, Perlis, Penang, Kelantan and Terengganu had low vector abundance. The accuracy test indicated that the model predicted sampling and non-sampling areas with 75.3% overall accuracy. The selected environmental variables were entered into the regression model based on their significant values. In addition to the presence of water bodies, elevation, temperature, forest loss and forest cover were included in the final model since these were significantly correlated. Anopheles mosquitoes were mainly distributed in Peninsular Malaysia (Titiwangsa range, central and northern parts), Sabah (Kudat, West Coast, Interior and Tawau division) and Sarawak (Kapit, Miri, and Limbang). The predicted Anopheles mosquito density was lower in the southern part of Peninsular Malaysia, the Sandakan Division of Sabah and the western region of Sarawak. Conclusion The study offers insight into the distribution of the Leucosphyrus Group of Anopheles mosquitoes in Malaysia. Additionally, the accompanying predictive vector map correlates well with cases of P. knowlesi malaria. This research is crucial in informing and supporting future efforts by healthcare professionals to develop effective malaria control interventions. Graphical Abstract

Published
2023
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29. PF786 REDUCTION OF CARDIAC OUTCOMES IN THALASSEMIA MAJOR THANKS TO A TEN-YEAR NATIONAL ITALIAN NETWORKING

Author

Meloni, A., primary, Pistoia, L., additional, Bisconte, M.G., additional, Ciancio, A., additional, Quarta, A., additional, Cosmi, C., additional, Maddaloni, D., additional, Romano, N., additional, Sorrentino, F., additional, Carrà, A., additional, Schicchi, N., additional, Grassedonio, E., additional, Positano, V., additional, and Pepe, A., additional

Published
2019
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31. Elemental Composition of Natural Nanoparticles and Fine Colloids in European Forest Stream Waters and Their Role as Phosphorus Carriers

Author

Gottselig, Nina, Amelung, W, Kirchner, J W, Bol, R, Eugster, Werner, Granger, S J, Hernández-Crespo, C, Herrmann, F, Keizer, J. J, Korkiakoski, M, Laudon, H, Lehner, I, Löfgren, S, Lohila, A, Macleod, C J A, Mölder, M, Müller, C, Nasta, P, Nischwitz, V, Paul-Limoges, Eugénie, Pierret, M C, Pilegaard, K, Romano, N, Sebastià, M T, Stähli, M, Voltz, M, Vereecken, H, Siemens, J, Klumpp, E, University of Zurich, Klumpp, E, Gottselig, N., Amelung, W., Kirchner, J. W., Bol, R., Eugster, W., Granger, S. J., Hernandez-Crespo, C., Herrmann, F., Keizer, J. J., Korkiakoski, M., Laudon, H., Lehner, I., Löfgren, S., Lohila, A., Macleod, C. J. A., Mã¶lder, M., Mölder, C., Nasta, Paolo, Nischwitz, V., Paul-Limoges, E., Pierret, M. C., Pilegaard, K., Romano, Nunzio, Sebastià, M. T., Stähli, M., Voltz, M., Vereecken, H., Siemens, J., and Klumpp, E.

Subjects
2300 General Environmental Science, 10122 Institute of Geography, 2304 Environmental Chemistry, Hidrologia, 1902 Atmospheric Science, ddc:550, chemical composition, chemical element, colloid, forested catchment, headwater, nanoparticle, organic carbon, phosphorus, stream water, Europe, 2306 Global and Planetary Change, 910 Geography & travel, Aigua--Contaminació, Aigua--Química, Cursos d'aigua
Abstract

Biogeochemical cycling of elements largely occurs in dissolved state, but many elements may also be bound to natural nanoparticles (NNP, 1-100 nm) and fine colloids (100-450 nm). We examined the hypothesis that the size and composition of stream water NNP and colloids vary systematically across Europe. To test this hypothesis, 96 stream water samples were simultaneously collected in 26 forested headwater catchments along two transects across Europe. Three size fractions (1-20 nm, >20-60 nm, >60 nm) of NNP and fine colloids were identified with Field Flow Fractionation coupled to inductively coupled plasma mass-spectrometry and an organic carbon detector. The results showed that NNP and fine colloids constituted between 2±5% (Si) and 53±21% (Fe; mean ± SD) of total element concentrations, indicating a substantial contribution of particles to element transport in these European streams, especially for P and Fe. The particulate contents of Fe, Al and organic C were correlated to their total element concentrations, but those of particulate Si, Mn, P and Ca were not. The fine colloidal fractions >60 nm were dominated by clay minerals across all sites. The resulting element patterns of NNP

Published
2017
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32. XVIIIth scientific meeting of the Italian Association of Developmental and Comparative Immunobiology (IADCI), 8 - 10 February 2017, Department for Innovation in Biological, Agro-food and Forest systems (DIBAF), University of Tuscia, Viterbo, Italy

Author

Scapigliati, G, Fausto, A M, Mazzini, M, Romano, N, Buonocore, F, Picchietti, S, and Belardinelli, M C

Subjects
lcsh:Biology (General), education, lcsh:QH301-705.5, health care economics and organizations, humanities
Abstract

Invertebrate Survival Journal, Vol 14 No 1 (2017)

Published
2017

36. Gut microbiome of helminth-infected indigenous Malaysians is context dependent

Author

Mian Zi Tee, Yi Xian Er, Alice V. Easton, Nan Jiun Yap, Ii Li Lee, Joseph Devlin, Ze Chen, Kee Seong Ng, Poorani Subramanian, Angelina Angelova, Oyebola Oyesola, Shushan Sargsian, Romano Ngui, Daniel P. Beiting, Christopher Chiong Meng Boey, Kek Heng Chua, Ken Cadwell, Yvonne Ai Lian Lim, P’ng Loke, and Soo Ching Lee

Subjects
Helminth, Microbiome, Metagenomic sequencing, Indigenous population, Albendazole, Microbial ecology, QR100-130
Abstract

Abstract Background While microbiomes in industrialized societies are well characterized, indigenous populations with traditional lifestyles have microbiomes that are more akin to those of ancient humans. However, metagenomic data in these populations remains scarce, and the association with soil-transmitted helminth infection status is unclear. Here, we sequenced 650 metagenomes of indigenous Malaysians from five villages with different prevalence of helminth infections. Results Individuals from villages with higher prevalences of helminth infections have more unmapped reads and greater microbial diversity. Microbial community diversity and composition were most strongly associated with different villages and the effects of helminth infection status on the microbiome varies by village. Longitudinal changes in the microbiome in response to albendazole anthelmintic treatment were observed in both helminth infected and uninfected individuals. Inference of bacterial population replication rates from origin of replication analysis identified specific replicating taxa associated with helminth infection. Conclusions Our results indicate that helminth effects on the microbiota were highly dependent on context, and effects of albendazole on the microbiota can be confounding for the interpretation of deworming studies. Furthermore, a substantial quantity of the microbiome remains unannotated, and this large dataset from an indigenous population associated with helminth infections is a valuable resource for future studies. Video Abstract

Published
2022
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37. Declining Prevalence of HIV-1 Drug Resistance in Antiretroviral Treatment-exposed Individuals in Western Europe

Author

De Luca, A, Dunn, D, Zazzi, M, Camacho, R, Torti, C, Fanti, I, Kaiser, R, Sönnerborg, A, Codoñer, Fm, Van Laethem, K, Vandamme, Am, Bansi, L, Ghisetti, V, van de Vijver DA, Asboe, D, Prosperi, Mc, Di Giambenedetto, S, Collaborators: Giacometti A, SEHERE collaboration in C. h. a. i. n., Butini, L, del Gobbo, R, Menzo, S, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Maggiolo, F, Callegaro, A, Calza, L, Pristerà, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Colao, G, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, Penco, G, Trezzi, M, Orani, A, Pardelli, R, De Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Monforte, Ad, Cicconi, P, Rusconi, S, Gismondo, Mr, Micheli, V, Biondi, Ml, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Santirocchi, M, Brustia, D, Ravanini, P, Dal Bello, F, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Baldanti, F, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, Rita, De Luca, A, Dunn, D, Zazzi, M, Camacho, R, Torti, C, Fanti, I, Kaiser, R, Sönnerborg, A, Codoñer, F, Van Laethem, K, Vandamme, A, Bansi, L, Ghisetti, V, Van De Vijver, D, Asboe, D, Prosperi, M, Di Giambenedetto, S, Mancuso, S, and Virology

Subjects
Male, Multivariate analysis, Databases, Factual, Drug Resistance, HIV Infections, Drug resistance, 0302 clinical medicine, Retrospective Studie, Risk Factors, Epidemiology, Genotype, pol Gene Products, Human Immunodeficiency Viru, Odds Ratio, Prevalence, Immunology and Allergy, HIV Infection, 030212 general & internal medicine, pol Gene Products, Viral, Multivariate Analysi, media_common, 0303 health sciences, Drug Resistance Prevalence HIV-1, Middle Aged, Resistance mutation, 3. Good health, Reverse Transcriptase Inhibitor, Europe, Infectious Diseases, Reverse Transcriptase Inhibitors, epidemiology, Female, Multiple, Human Immunodeficiency Virus, Human, Drug, Adult, medicine.medical_specialty, Evolution, media_common.quotation_subject, Sexual Behavior, antiretroviral therapy, Infectious Disease, Biology, Settore MED/17 - MALATTIE INFETTIVE, Evolution, Molecular, 03 medical and health sciences, Databases, SDG 3 - Good Health and Well-being, Drug Resistance, Multiple, Viral, medicine, Humans, HIV Protease Inhibitor, Factual, Retrospective Studies, 030306 microbiology, Risk Factor, Molecular, Retrospective cohort study, Odds ratio, HIV Protease Inhibitors, CD4 Lymphocyte Count, drug resistance, genotyping, HIV-1, Multivariate Analysis, Mutation, pol Gene Products, Human Immunodeficiency Virus, Immunology, Demography
Abstract

HIV-1 drug resistance represents a major obstacle to infection and disease control. This retrospective study analyzes trends and determinants of resistance in antiretroviral treatment (ART)-exposed individuals across 7 countries in Europe. Of 20 323 cases, 80% carried at least one resistance mutation: these declined from 81% in 1997 to 71% in 2008. Predicted extensive 3-class resistance was rare (3.2% considering the cumulative genotype) and peaked at 4.5% in 2005, decreasing thereafter. The proportion of cases exhausting available drug options dropped from 32% in 2000 to 1% in 2008. Reduced risk of resistance over calendar years was confirmed by multivariable analysis. © 2013 The Author.

Published
2013
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38. Salinity-induced changes to the survival, growth and glycogen distribution in the early fry stages of silver barb, Barbodes gonionotus (Bleeker, 1850)

Author

Romano, N., Syukri, F., Karami, A., Omar, N., Khalid, N. I., Romano, N., Syukri, F., Karami, A., Omar, N., and Khalid, N. I.

Abstract

Five‐week‐old silver barb, Barbodes gonionotus, fry (initial length = 10 mm) were subjected to different salinities of 0, 3, 6 or 9 ppt for 17 days, to then assess their survival and growth. Whole body histological sections were stained with Periodic‐acid Schiff (PAS). Groups of 15 fish were triplicated in each treatment with an ambient temperature (26–28°C). Results showed that growth and condition factor significantly decreased and increased (p < .05), respectively, with the increased salinities after 17 days. While survival was similar (p > .05), between 0 and 6 ppt (at 98% and 87%, respectively), the decrease was significant at 9 ppt (22%). In addition, the fry at 9 ppt had fewer gill mucous cells as well as reduced PAS positive staining intensity within the liver and intestine. This suggests energy was becoming exhausted, leading to mortalities and lower growth. Silver barb early fry were relatively sensitive to elevated salinity, which was likely due to their young age, but short‐term exposure to 3–6 ppt can be used to decrease potential freshwater diseases in the early nursery culture.

Published
2017

39. Elemental composition of natural nanoparticles and fine colloids in European forest stream waters and their role as phosphorus carriers

Author

Gottselig, N., Amelung, W., Kirchner, J.W., Bol, R., Eugster, W., Granger, S.J., Hernández-Crespo, C., Herrmann, F., Keizer, J.J., Korkiakoski, M., Laudon, H., Lehner, I., Löfgren, S., Lohila, A., Macleod, C.J.A., Mölder, M., Müller, Christin, Nasta, P., Nischwitz, V., Paul-Limoges, E., Pierret, M.C., Pilegaard, K., Romano, N., Sebastià, M.T., Stähli, M., Voltz, M., Vereecken, H., Siemens, J., Klumpp, E., Gottselig, N., Amelung, W., Kirchner, J.W., Bol, R., Eugster, W., Granger, S.J., Hernández-Crespo, C., Herrmann, F., Keizer, J.J., Korkiakoski, M., Laudon, H., Lehner, I., Löfgren, S., Lohila, A., Macleod, C.J.A., Mölder, M., Müller, Christin, Nasta, P., Nischwitz, V., Paul-Limoges, E., Pierret, M.C., Pilegaard, K., Romano, N., Sebastià, M.T., Stähli, M., Voltz, M., Vereecken, H., Siemens, J., and Klumpp, E.

Abstract

Biogeochemical cycling of elements largely occurs in dissolved state, but many elements may also be bound to natural nanoparticles (NNP, 1–100 nm) and fine colloids (100–450 nm). We examined the hypothesis that the size and composition of stream water NNP and colloids vary systematically across Europe. To test this hypothesis, 96 stream water samples were simultaneously collected in 26 forested headwater catchments along two transects across Europe. Three size fractions (~1–20 nm, >20–60 nm, and >60 nm) of NNP and fine colloids were identified with Field Flow Fractionation coupled to inductively coupled plasma mass spectrometry and an organic carbon detector. The results showed that NNP and fine colloids constituted between 2 ± 5% (Si) and 53 ± 21% (Fe; mean ± SD) of total element concentrations, indicating a substantial contribution of particles to element transport in these European streams, especially for P and Fe. The particulate contents of Fe, Al, and organic C were correlated to their total element concentrations, but those of particulate Si, Mn, P, and Ca were not. The fine colloidal fractions >60 nm were dominated by clay minerals across all sites. The resulting element patterns of NNP <60 nm changed from North to South Europe from Fe- to Ca-dominated particles, along with associated changes in acidity, forest type, and dominant lithology.

Published
2017

40. Modeling soil processes: key challenges and new perspectives

Author

Vereecken, H., Schnepf, A., Hopmans, J.W., Javaux, M., Or, D., Roose, T., Vanderborght, J., Young, M., Amelung, W., Aitkenhead, M., Allison, S.D., Assouline, S., Baveye, P., Berli, M., Bruggemann, N., Finke, P., Flury, M., Gaiser, T., Govers, G., Ghezzehei, T., Hallett, P., Hendricks Franssen, H.J., Heppell, J., Horn, R., Huisman, J.A., Jacques, D., Jonard, F., Kollet, S., Lafolie, F., Lamorski, K., Leitner, D., McBratney, A., Minasny, B., Montzka, C., Nowak, W., Pachepsky, Y., Padarian, J., Romano, N., Roth, K., Rothfuss, Y., Rowe, E.C., Schwen, A., Simunek, J., Van Dam, J., van der Zee, S.E.A.T.M., Vogel, H.j., Vrugt, J.A., Wohling, T., and Young, I.M.

Abstract

The remarkable complexity of soil and its importance to a wide range of ecosystem services presents 133 major challenges to the modeling of soil processes. Although major progress in soil models has 134 occurred in the last decades, models of soil processes remain disjointed between disciplines or 135 ecosystem services, with considerable uncertainty remaining in the quality of predictions and several 136 challenges that remain yet to be addressed. Firstly, there is a need to improve exchange of knowledge 137 and experience amongst the different disciplines in soil science and to reach out to other Earth science 138 communities. Secondly, the community needs to develop a new generation of soil models based on a 139 systemic approach comprising relevant physical, chemical, and biological processes to address critical 140 knowledge gaps in our understanding of soil processes and their interactions. Overcoming these 141 challenges will facilitate exchanges between soil modeling and climate, plant, and social science 142 modeling communities. It will allow us to contribute to preserve and improve our assessment of 143 ecosystem services and advance our understanding of climate-change feedback mechanisms, amongst 144 others, thereby facilitating and strengthening communication among scientific disciplines and society. 145 In this paper we review the role of modeling soil processes in quantifying key soil processes that shape 146 ecosystem services with focus on provisioning and regulating services. We then identify key 147 challenges in modeling soil processes including the systematic incorporation of heterogeneity and 148 uncertainty, the integration of data and models, and strategies for effective integration of knowledge 149 on physical, chemical and biological soil processes. We discuss how the soil modeling community 150 could best interface with modern modeling activities in other disciplines such as climate, ecology, and 151 plant research and how to weave novel observation and measurement techniques into soil models. We 152 propose to establish an international soil modeling consortium to coherently advance soil modeling 153 activities and foster communication with other Earth science disciplines. Such a consortium should 154 promote soil modeling platforms and data repository for model development, calibration and inter-155 comparison essential for addressing contemporary challenges.

Published
2016

41. Modeling soil processes : Review, key challenges, and new perspectives

Author

Vereecken, H., Schnepf, A., Hopmans, J.W., Javaux, M., Or, D., Roose, T., Vanderborght, J., Young, M.H., Amelung, W., Aitkenhead, M., Allison, S.D., Assouline, S., Baveye, P., Berli, M., Brüggemann, N., Finke, P., Flury, M., Gaiser, T., Govers, G., Ghezzehei, T., Hallett, P., Hendricks Franssen, H.J., Heppell, J., Horn, R., Huisman, J.A., Jacques, D., Jonard, F., Kollet, S., Lafolie, F., Lamorski, K., Leitner, D., Mcbratney, A., Minasny, B., Montzka, C., Nowak, W., Pachepsky, Y., Padarian, J., Romano, N., Roth, K., Rothfuss, Y., Rowe, E.C., Schwen, A., Šimůnek, J., Tiktak, A., van Dam, Jos, van der Zee, S.E.A.T.M., Vogel, H.J., Vrugt, J.A., Wöhling, T., Young, I.M., Vereecken, H., Schnepf, A., Hopmans, J. W., Javaux, M., Or, D., Roose, T., Vanderborght, J., Young, M. H., Amelung, W., Aitkenhead, M., Allison, S. D., Assouline, S., Baveye, P., Berli, M., Brüggemann, N., Finke, P., Flury, M., Gaiser, T., Govers, G., Ghezzehei, T., Hallett, P., Franssen, H. J. H., Heppell, J., Horn, R., Huisman, J. A., Jacques, D., Jonard, F., Kollet, S., Lafolie, F., Lamorski, K., Leitner, D., Mcbratney, A., Minasny, B., Montzka, C., Nowak, W., Pachepsky, Y., Padarian, J., Romano, Nunzio, Roth, K., Rothfuss, Y., Rowe, E. C., Schwen, A., Šimůnek, J., Tiktak, A., Van Dam, J., van der Zee, S. E. A. T. M., Vogel, H. J., Vrugt, J. A., Wöhling, T., and Young, I. M.

Subjects
Soil Physics and Land Management, WIMEK, Life Science, Bodemfysica en Landbeheer, root water-uptake, sediment transport models, diffuse-reflectance spectroscopy, arbuscular mycorrhizal fungi, multiple ecosystem services, saturated-unsaturated flow, ground-penetrating radar, synthetic-aperture radar, digital elevation model, organic-matter dynamics, GeneralLiterature_MISCELLANEOUS
Abstract

The remarkable complexity of soil and its importance to a wide range of ecosystem services presents major challenges to the modeling of soil processes. Although major progress in soil models has occurred in the last decades, models of soil processes remain disjointed between disciplines or ecosystem services, with considerable uncertainty remaining in the quality of predictions and several challenges that remain yet to be addressed. First, there is a need to improve exchange of knowledge and experience among the different disciplines in soil science and to reach out to other Earth science communities. Second, the community needs to develop a new generation of soil models based on a systemic approach comprising relevant physical, chemical, and biological processes to address critical knowledge gaps in our understanding of soil processes and their interactions. Overcoming these challenges will facilitate exchanges between soil modeling and climate, plant, and social science modeling communities. It will allow us to contribute to preserve and improve our assessment of ecosystem services and advance our understanding of climate-change feedback mechanisms, among others, thereby facilitating and strengthening communication among scientific disciplines and society. We review the role of modeling soil processes in quantifying key soil processes that shape ecosystem services, with a focus on provisioning and regulating services. We then identify key challenges in modeling soil processes, including the systematic incorporation of heterogeneity and uncertainty, the integration of data and models, and strategies for effective integration of knowledge on physical, chemical, and biological soil processes. We discuss how the soil modeling community could best interface with modern modeling activities in other disciplines, such as climate, ecology, and plant research, and how to weave novel observation and measurement techniques into soil models. We propose the establishment of an international soil modeling consortium to coherently advance soil modeling activities and foster communication with other Earth science disciplines. Such a consortium should promote soil modeling platforms and data repository for model development, calibration and intercomparison essential for addressing contemporary challenges.

Published
2016

42. Plantar pain is not always fasciitis

Author

Romano, N., primary, Fischetti, A., additional, Prono, V., additional, Migone, S., additional, Barbieri, F., additional, Pizzorni, C., additional, Garlaschi, G., additional, and Cimmino, M.A., additional

Published
2017
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43. Effect of the Uganda Newborn Study on care-seeking and care practices: a cluster-randomised controlled trial

Author

Kerber, Kate, Peterson, Stefan, Waiswa, Peter, Lawn, Joy E., Sankoh, Osman, Claeson, Mariam, Pariyo, George, Kallander, Karin, Akuze, Joseph, Namazzi, Gertrude, Ekirapa-Kiracho, Elizabeth, Sengendo, Hanifah, Aliganyira, Patrick, Okuga, Monica, Kemigisa, Margaret, Namutamba, Sarah, Timša, Līga, Marrone, Gaetano, Ekirapa, Elizabeth, Nakakeeto, Margaret, Nakibuuka, Victoria K., Najjemba, Maria, Namusaabi, Ruth, Tagoola, Abner, Nakate, Grace, Ajeani, Judith, Byaruhanga, Romano N., Tetui, Moses, Forsberg, Birger C., Hanson, Claudia, Kiguli, Juliet, Namusoko, Sarah, Nalwadda, Christine K., Guwatudde, David, Sitrin, Deborah, Guenther, Tanya, Sharma, Srijana, Ashish, KC, Rubayet, Sayed, Bhadra, Subrata, Ligowe, Reuben, Chimbalanga, Emmanuel, Sewell, Elizabeth, and Moran, Allisyn

Subjects
neonatal mortality, newborn health, essential newborn care, Newborn Health in Uganday, care-seeking, maternal health, neonatal, community health worker, private health care, community health workers, kangaroo mother care, formative research, antenatal care, newborn, sociocultural influences, postnatal care, community-based, Uganda, traditional birth attendants, public health care, postnatal, birth preparedness, health policy, Newborn Health in Uganda, home visit, postpartum depression, health system strengthening, newborn care, qualitative, stillbirth, referral, Special Issue: Newborn Health in Uganda, maternal care, pregnancy, pregnancy loss, randomised controlled trial
Abstract

Background Care for women and babies before, during, and after the time of birth is a sensitive measure of the functionality of any health system. Engaging communities in preventing newborn deaths is a promising strategy to achieve further progress in child survival in sub-Saharan Africa. Objective To assess the effect of a home visit strategy combined with health facility strengthening on uptake of newborn care-seeking, practices and services, and to link the results to national policy and scale-up in Uganda. Design The Uganda Newborn Study (UNEST) was a two-arm cluster-randomised controlled trial in rural eastern Uganda. In intervention villages volunteer community health workers (CHWs) were trained to identify pregnant women and make five home visits (two during pregnancy and three in the first week after birth) to offer preventive and promotive care and counselling, with extra visits for sick and small newborns to assess and refer. Health facility strengthening was done in all facilities to improve quality of care. Primary outcomes were coverage of key essential newborn care behaviours (breastfeeding, thermal care, and cord care). Analyses were by intention to treat. This study is registered as a clinical trial, number ISRCTN50321130. Results The intervention significantly improved essential newborn care practices, although many interventions saw major increases in both arms over the study period. Immediate breastfeeding after birth and exclusive breastfeeding were significantly higher in the intervention arm compared to the control arm (72.6% vs. 66.0%; p=0.016 and 81.8% vs. 75.9%, p=0.042, respectively). Skin-to-skin care immediately after birth and cord cutting with a clean instrument were marginally higher in the intervention arm versus the control arm (80.7% vs. 72.2%; p=0.071 and 88.1% vs. 84.4%; p=0.023, respectively). Half (49.6%) of the mothers in the intervention arm waited more than 24 hours to bathe the baby, compared to 35.5% in the control arm (p, Background There is a lack of literature on how to adapt new evidence-based interventions for maternal and newborn care into local health systems and policy for rapid scale-up, particularly for community-based interventions in low-income settings. The Uganda Newborn Study (UNEST) was a cluster randomised control trial to test a community-based care package which was rapidly taken up at national level. Understanding this process may help inform other studies looking to design and evaluate with scale-up in mind. Objective This study aimed to describe the process of using evidence to design a community-based maternal and newborn care package in rural eastern Uganda, and to determine the dissemination and advocacy approaches used to facilitate rapid policy change and national uptake. Design We reviewed UNEST project literature including meeting reports and minutes, supervision reports, and annual and midterm reports. National stakeholders, project and district staff were interviewed regarding their role in the study and perceptions of what contributed to uptake of the package under evaluation. Data related to UNEST formative research, study design, implementation and policy influence were extracted and analysed. Results An advisory committee of key players in development of maternal and newborn policies and programmes in Uganda was constituted from many agencies and disciplines. Baseline qualitative and quantitative data collection was done at district, community and facility level to examine applicability of aspects of a proposed newborn care package to the local setting. Data were summarised and presented to stakeholders to adapt the intervention that was ultimately tested. Quarterly monitoring of key activities and events around the interventions were used to further inform implementation. The UNEST training package, home visit schedule and behaviour change counselling materials were incorporated into the national Village Health Team and Integrated Community Case Management packages while the study was ongoing. Conclusions Designing interventions for national scale-up requires strategies and planning from the outset. Use of evidence alongside engagement of key stakeholders and targeted advocacy about the burden and potential solutions is important when adapting interventions to local health systems and communities. This approach has the potential to rapidly translate research into policy, but care must be taken not to exceed available evidence while seizing the policy opportunity., Background Community health workers (CHWs) have been employed in a number of low- and middle-income countries as part of primary health care strategies, but the packages vary across and even within countries. The experiences and motivations of a multipurpose CHW in providing maternal and newborn health have not been well described. Objective This study examined the perceptions of community members and experiences of CHWs around promoting maternal and newborn care practices, and the self-identified factors that influence the performance of CHWs so as to inform future study design and programme implementation. Design Data were collected using in-depth interviews with six local council leaders, ten health workers/CHW supervisors, and eight mothers. We conducted four focus group discussions with CHWs. Respondents included 14 urban and 18 rural CHWs. Key themes explored included the experience of CHWs according to their various roles, and the facilitators and barriers they encounter in their work particular to provision of maternal and newborn care. Qualitative data were analysed using manifest content analysis methods. Results CHWs were highly appreciated in the community and seen as important contributors to maternal and newborn health at grassroots level. Factors that positively influence CHWs included being selected by and trained in the community; being trained in problem-solving skills; being deployed immediately after training with participation of local leaders; frequent supervision; and having a strengthened and responsive supply of services to which families can be referred. CHWs made use of social networks to identify pregnant and newly delivered women, and were able to target men and the wider family during health education activities. Intrinsic motivators (e.g. community appreciation and the prestige of being ‘a doctor’), monetary (such as a small transport allowance), and material incentives (e.g. bicycles, bags) were also important to varying degrees. Conclusions There is a continued role for CHWs in improving maternal and newborn care and linking families with health services. However, the process for building CHW programmes needs to be adapted to the local setting, including the process of training, deployment, supervision, and motivation within the context of a responsive and available health system., Background Promotion of birth preparedness and raising awareness of potential complications is one of the main strategies to enhance the timely utilisation of skilled care at birth and overcome barriers to accessing care during emergencies. Objective This study aimed to investigate factors associated with birth preparedness in three districts of eastern central Uganda. Design This was a cross-sectional baseline study involving 2,010 women from Iganga [community health worker (CHW) strategy], Buyende (vouchers for transport and services), and Luuka (standard care) districts who had delivered within the past 12 months. ‘Birth prepared’ was defined as women who had taken all of the following three key actions at least 1 week prior to the delivery: 1) chosen where to deliver from; 2) saved money for transport and hospital costs; and 3) bought key birth materials (a clean instrument to cut the cord, a clean thread to tie the cord, cover sheet, and gloves). Logistical regression was performed to assess the association of various independent variables with birth preparedness. Results Only about 25% of respondents took all three actions relating to preparing for childbirth, but discrete actions (e.g. financial savings and identification of place to deliver) were taken by 75% of respondents. Variables associated with being prepared for birth were: having four antenatal care (ANC) visits [adjusted odds ratio (ORA)=1.42; 95% confidence interval (CI) 1.10–1.83], attendance of ANC during the first (ORA=1.94; 95% CI 1.09–3.44) or second trimester (ORA=1.87; 95% CI 1.09–3.22), and counselling on danger signs during pregnancy or on place of referral (ORA=2.07; 95% CI 1.57–2.74). Other associated variables included being accompanied by one's husband to the place of delivery (ORA=1.47; 95% CI 1.15–1.89), higher socio-economic status (ORA=2.04; 95% CI 1.38–3.01), and having a regular income (ORA=1.83; 95% CI 1.20–2.79). Women from Luuka and Buyende were less likely to have taken three actions compared with women from Iganga (ORA=0.72; 95% CI 0.54–0.98 and ORA=0.37; 95% CI 0.27–0.51, respectively). Conclusions Engaging CHWs and local structures during pregnancy may be an effective strategy in promoting birth preparedness. On the other hand, if not well designed, the use of vouchers could disempower families in their efforts to prepare for birth. Other effective strategies for promoting birth preparedness include early ANC attendance, attending ANC at least four times, and male involvement., Background In Uganda maternal and neonatal mortality remains high due to a number of factors, including poor quality of care at health facilities. Objective This paper describes the experience of building capacity for maternal and newborn care at a district hospital and lower-level health facilities in eastern Uganda within the existing system parameters and a robust community outreach programme. Design This health system strengthening study, part of the Uganda Newborn Study (UNEST), aimed to increase frontline health worker capacity through district-led training, support supervision, and mentoring at one district hospital and 19 lower-level facilities. A once-off supply of essential medicines and equipment was provided to address immediate critical gaps. Health workers were empowered to requisition subsequent supplies through use of district resources. Minimal infrastructure adjustments were provided. Quantitative data collection was done within routine process monitoring and qualitative data were collected during support supervision visits. We use the World Health Organization Health System Building Blocks to describe the process of district-led health facility strengthening. Results Seventy two per cent of eligible health workers were trained. The mean post-training knowledge score was 68% compared to 32% in the pre-training test, and 80% 1 year later. Health worker skills and competencies in care of high-risk babies improved following support supervision and mentoring. Health facility deliveries increased from 3,151 to 4,115 (a 30% increase) in 2 years. Of 547 preterm babies admitted to the newly introduced kangaroo mother care (KMC) unit, 85% were discharged alive to continue KMC at home. There was a non-significant declining trend for in-hospital neonatal deaths across the 2-year study period. While equipment levels remained high after initial improvement efforts, maintaining supply of even the most basic medications was a challenge, with less than 40% of health facilities reporting no stock-outs. Conclusion Health system strengthening for care at birth and the newborn period is possible even in low-resource settings and can be associated with improved utilisation and outcomes. Through a participatory process with wide engagement, training, and improvements to support supervision and logistics, health workers were able to change behaviours and practices for maternal and newborn care. Local solutions are needed to ensure sustainability of medical commodities., Background In Uganda and elsewhere, the private sector provides an increasing and significant proportion of maternal and child health services. However, little is known whether private care results in better quality services and improved outcomes compared to the public sector, especially regarding care at the time of birth. Objective To describe the characteristics of care-seekers and assess newborn care practices and services received at public and private facilities in rural eastern Uganda. Design Within a community-based maternal and newborn care intervention with health systems strengthening, we collected data from mothers with infants at baseline and endline using a structured questionnaire. Descriptive, bivariate, and multivariate data analysis comparing nine newborn care practices and three composite newborn care indicators among private and public health facilities was conducted. Results The proportion of women giving birth at private facilities decreased from 25% at baseline to 17% at endline, whereas overall facility births increased. Private health facilities did not perform significantly better than public health facilities in terms of coverage of any essential newborn care interventions, and babies were more likely to receive thermal care practices in public facilities compared to private (68% compared to 60%, p=0.007). Babies born at public health facilities received an average of 7.0 essential newborn care interventions compared to 6.2 at private facilities (p, Background Stillbirths do not register amongst national or global public health priorities, despite large numbers and known solutions. Although not accounted in statistics – these deaths count for families. Part of this disconnect is that very little is known about the lived experiences and perceptions of those experiencing this neglected problem. Objective This study aimed to explore local definitions and perceived causes of stillbirths as well as coping mechanisms used by families affected by stillbirth in rural eastern Uganda. Design A total of 29 in-depth interviews were conducted with women who had a stillbirth (14), men whose wives experienced a stillbirth (6), grandmothers (4), grandfathers (1), and traditional birth attendants (TBAs) (4). Participants were purposively recruited from the hospital maternity ward register, with additional recruitment done through community leaders and other participants. Data were analysed using content analysis. Results Women and families affected by stillbirth report pregnancy loss as a common occurrence. Definitions and causes of stillbirth included the biomedical, societal, and spiritual. Disclosure of stillbirth varies with women who experience consecutive or multiple losses, subject to potential exclusion from the community and even the family. Methods for coping with stillbirth were varied and personal. Ritual burial practices were common, yet silent and mainly left to women, as opposed to public mourning for older children. There were no formal health system mechanisms to support or care for families affected by stillbirths. Conclusion In a setting with strong collective ties, stillbirths are a burden borne by the affected family, and often just by the mother, rather than the community as a whole. Strategies are needed to address preventable stillbirths as well as to follow up with supportive services for those affected., Background The first week of life is the time of greatest risk of death and disability, and is also associated with many traditional beliefs and practices. Identifying sick newborns in the community and referring them to health facilities is a key strategy to reduce deaths. Although a growing area of interest, there remains a lack of data on the role of sociocultural norms and practices on newborn healthcare-seeking in sub-Saharan Africa and the extent to which these norms can be modified. Objective This study aimed to understand the community's perspective of potential sociocultural barriers and facilitators to compliance with newborn referral. Method In this qualitative study, focus group discussions (n=12) were conducted with mothers and fathers of babies aged less than 3 months. In addition, in-depth interviews (n=11) were also held with traditional birth attendants and mothers who had been referred by community health workers to seek health-facility-based care. Participants were purposively selected from peri-urban and rural communities in two districts in eastern Uganda. Data were analysed using latent content analysis. Results The community definition of a newborn varied, but this was most commonly defined by the period between birth and the umbilical cord stump falling off. During this period, newborns are perceived to be vulnerable to the environment and many mothers and their babies are kept in seclusion, although this practice may be changing. Sociocultural factors that influence compliance with newborn referrals to seek care emerged along three sub-themes: community understanding of the newborn period and cultural expectations; the role of community health actors; and caretaker knowledge, experience, and decision-making autonomy. Conclusion In this setting, there is discrepancy between biomedical and community definitions of the newborn period. There were a number of sociocultural factors that could potentially affect compliance to newborn referral. The widely practised cultural seclusion period, knowledge about newborn sickness, individual experiences in households, perceived health system gaps, and decision-making processes were facilitators of or barriers to compliance with newborn referral. Designers of newborn interventions need to address locally existing cultural beliefs at the same time as they strengthen facility care., Background Nearly all newborn deaths occur in low- or middle-income countries. Many of these deaths could be prevented through promotion and provision of newborn care practices such as thermal care, early and exclusive breastfeeding, and hygienic cord care. Home visit programmes promoting these practices were piloted in Malawi, Nepal, Bangladesh, and Uganda. Objective This study assessed changes in selected newborn care practices over time in pilot programme areas in four countries and evaluated whether women who received home visits during pregnancy were more likely to report use of three key practices. Design Using data from cross-sectional surveys of women with live births at baseline and endline, the Pearson chi-squared test was used to assess changes over time. Generalised linear models were used to assess the relationship between the main independent variable – home visit from a community health worker (CHW) during pregnancy (0, 1–2, 3+) – and use of selected practices while controlling for antenatal care, place of delivery, and maternal age and education. Results There were statistically significant improvements in practices, except applying nothing to the cord in Malawi and early initiation of breastfeeding in Bangladesh. In Malawi, Nepal, and Bangladesh, women who were visited by a CHW three or more times during pregnancy were more likely to report use of selected practices. Women who delivered in a facility were also more likely to report use of selected practices in Malawi, Nepal, and Uganda; association with place of birth was not examined in Bangladesh because only women who delivered outside a facility were asked about these practices. Conclusion Home visits can play a role in improving practices in different settings. Multiple interactions are needed, so programmes need to investigate the most appropriate and efficient ways to reach families and promote newborn care practices. Meanwhile, programmes must take advantage of increasing facility delivery rates to ensure that all babies benefit from these practices.

Published
2015

44. First on-line survey of an international multidisciplinary working group (MightyMedic) on current practice in diagnosis, therapy and follow-up of dyslipidemias

Author

Stefanutti, C, D'Alessandri, G, Petta, A, Harada-Shiba, M, Julius, U, Soran, H, Moriarty, P. M, Romeo, S, Drogari, E, Jaeger, B. R, Bianciardi, G, Bosco, G, Cossu, M, De Fusco, G, Di Giacomo, S, Ewald, N, Gualdi, G, Lanti, A, Marson, P, Martino, F, Migliori, G, Parasassi, T, Pavan, A, Perla, F. M, Perrone, G, Pisciotta, L, Renga, S, Ries, W, and Romano, N

Subjects
medicine.medical_specialty, Time Factors, International Cooperation, Practice Patterns, Coronary artery disease, Dyslipidemia, Lipoprotein apheresis, Multicenter study, Survey, Biomarkers, Blood Component Removal, Cardiovascular Diseases, Cooperative Behavior, Dyslipidemias, Guideline Adherence, Health Care Surveys, Humans, Hypolipidemic Agents, Lipids, Molecular Diagnostic Techniques, Practice Guidelines as Topic, Practice Patterns, Physicians', Predictive Value of Tests, Risk Factors, Surveys and Questionnaires, Treatment Outcome, Internet, Internal Medicine, Cardiology and Cardiovascular Medicine, Multidisciplinary approach, medicine, Parallel field, Therapeutic apheresis, Physicians', business.industry, General Medicine, medicine.disease, Clinical trial, Current practice, Family medicine, Physical therapy, business
Abstract

The MightyMedic (Multidisciplinary International Group for Hemapheresis TherapY and MEtabolic DIsturbances Contrast) Working Group has been founded in 2013. The leading idea was to establish an international network of interdisciplinary nature aimed at working to cross national borders research projects, clinical trials, educational initiatives (meetings, workshops, summer schools) in the field of metabolic diseases, namely hyperlipidemias, and diabetes, preventive cardiology, and atherosclerosis. Therapeutic apheresis, its indications and techniques, is a parallel field of investigation. The first on-line survey of the Group has been completed in the first half of 2014. The survey included # 24 Centers in Italy, Germany, Greece, UK, Sweden, Japan and USA. Relevant data have been collected on current practice in diagnosis, therapy and follow-up of dyslipidemias. 240 subjects with hyperlipidemia and treated with lipoprotein apheresis have been reported in the survey, but a large percentage of patients (35%) who could benefit from this therapeutic option are still treated by conventional drug approach. Genetic molecular diagnosis is performed in only 33% of patients while Lipoprotein(a) (Lp(a)) is included in cardiovascular disease risk assessment in 71% of participating Centers. New detailed investigations and prospective multicenter studies are needed to evaluate changes induced by the impact of updated indications and strategies, as well as new treatment options, targeting standardization of therapeutic and diagnostic approaches. (C) 2015 Elsevier Ireland Ltd. All rights reserved.

Published
2015
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45. Search for invisible decays of the Higgs boson produced in association with a hadronically decaying vector boson in pp collisions at, root s=8 TeV with the ATLAS detector

Author

Aad, G, Abbott, B, Abdallah, J, Abdinov, O, Aben, R, Abolins, M, Abouzeid, O, Abramowicz, H, Abreu, H, Abreu, R, Abulaiti, Y, Acharya, B, Adamczyk, L, Adams, D, Adelman, J, Adomeit, S, Adye, T, Affolder, A, Agatonovic Jovin, T, Aguilar Saavedra, J, Ahlen, S, Ahmadov, F, Aielli, G, Akerstedt, H, Akesson, T, Akimoto, G, Akimov, A, Alberghi, G, Albert, J, Albrand, S, Alconada Verzini, M, Aleksa, M, Aleksandrov, I, Alexa, C, Alexander, G, Alexopoulos, T, Alhroob, M, Alimonti, G, Alio, L, Alison, J, Alkire, S, Allbrooke, B, Allport, P, Aloisio, A, Alonso, A, Alonso, F, Alpigiani, C, Altheimer, A, Gonzalez, B, Alvarez Piqueras, D, Alviggi, M, Amadio, B, Amako, K, Amaral Coutinho, Y, Amelung, C, Amidei, D, Amor Dos Santos, S, Amorim, A, Amoroso, S, Amram, N, Amundsen, G, Anastopoulos, C, Ancu, L, Andari, N, Andeen, T, Anders, C, Anders, G, Anders, J, Anderson, K, Andreazza, A, Andrei, V, Angelidakis, S, Angelozzi, I, Anger, P, Angerami, A, Anghinolfi, F, Anisenkov, A, Anjos, N, Annovi, A, Antonelli, M, Antonov, A, Antos, J, Anulli, F, Aoki, M, Bella, L, Arabidze, G, Arai, Y, Araque, J, Arce, A, Arduh, F, Arguin, J, Argyropoulos, S, Arik, M, Armbruster, A, Arnaez, O, Arnal, V, Arnold, H, Arratia, M, Arslan, O, Artamonov, A, Artoni, G, Asai, S, Asbah, N, Ashkenazi, A, Asman, B, Asquith, L, Assamagan, K, Astalos, R, Atkinson, M, Atlay, N, Auerbach, B, Augsten, K, Aurousseau, M, Avolio, G, Axen, B, Ayoub, M, Azuelos, G, Baak, M, Baas, A, Bacci, C, Bachacou, H, Bachas, K, Backes, M, Backhaus, M, Badescu, E, Bagiacchi, P, Bagnaia, P, Bai, Y, Bain, T, Baines, J, Baker, O, Balek, P, Balestri, T, Balli, F, Banas, E, Banerjee, S, Bannoura, A, Bansil, H, Barak, L, Baranov, S, Barberio, E, Barberis, D, Barbero, M, Barillari, T, Barisonzi, M, Barklow, T, Barlow, N, Barnes, S, Barnett, B, Barnett, R, Barnovska, Z, Baroncelli, A, Barone, G, Barr, A, Barreiro, F, da Costa, J, Bartoldus, R, Barton, A, Bartos, P, Bassalat, A, Basye, A, Bates, R, Batista, S, Batley, J, Battaglia, M, Bauce, M, Bauer, F, Bawa, H, Beacham, J, Beattie, M, Beau, T, Beauchemin, P, Beccherle, R, Bechtle, P, Beck, H, Becker, K, Becker, M, Becker, S, Beckingham, M, Becot, C, Beddall, A, Bednyakov, V, Bee, C, Beemster, L, Beermann, T, Begel, M, Behr, J, Belanger Champagne, C, Bell, P, Bell, W, Bella, G, Bellagamba, L, Bellerive, A, Bellomo, M, Belotskiy, K, Beltramello, O, Benary, O, Benchekroun, D, Bender, M, Bendtz, K, Benekos, N, Benhammou, Y, Noccioli, E, Garcia, J, Benjamin, D, Bensinger, J, Bentvelsen, S, Beresford, L, Beretta, M, Berge, D, Kuutmann, E, Berger, N, Berghaus, F, Beringer, J, Bernard, C, Bernard, N, Bernius, C, Bernlochner, F, Berry, T, Berta, P, Bertella, C, Bertoli, G, Bertolucci, F, Bertsche, C, Bertsche, D, Besana, M, Besjes, G, Bylund, O, Bessner, M, Besson, N, Betancourt, C, Bethke, S, Bevan, A, Bhimji, W, Bianchi, R, Bianchini, L, Bianco, M, Biebel, O, Bieniek, S, Biglietti, M, De Mendizabal, J, Bilokon, H, Bindi, M, Binet, S, Bingul, A, Bini, C, Black, C, Black, 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Suzuki, S, Suzuki, Y, Svatos, M, Swedish, S, Swiatlowski, M, Sykora, I, Sykora, T, Ta, D, Taccini, C, Tackmann, K, Taenzer, J, Taffard, A, Tafirout, R, Taiblum, N, Takai, H, Takashima, R, Takeda, H, Takeshita, T, Takubo, Y, Talby, M, Talyshev, A, Tam, J, Tan, K, Tanaka, J, Tanaka, R, Tanaka, S, Tannenwald, B, Tannoury, N, Tapprogge, S, Tarem, S, Tarrade, F, Tartarelli, G, Tas, P, Tasevsky, M, Tashiro, T, Tassi, E, Tavares Delgado, A, Tayalati, Y, Taylor, F, Taylor, G, Taylor, W, Teischinger, F, Castanheira, M, Teixeira Dias, P, Temming, K, Ten Kate, H, Teng, P, Teoh, J, Tepel, F, Terada, S, Terashi, K, Terron, J, Terzo, S, Testa, M, Teuscher, R, Therhaag, J, Theveneaux Pelzer, T, Thomas, J, Thomas Wilsker, J, Thompson, E, Thompson, P, Thompson, R, Thompson, A, Thomsen, L, Thomson, E, Thomson, M, Thun, R, Tibbetts, M, Torres, R, Tikhomirov, V, Tikhonov, Y, Timoshenko, S, Tiouchichine, E, Tipton, P, Tisserant, S, Todorov, T, Todorova Nova, S, Tojo, J, Tokar, S, Tokushuku, K, Tollefson, K, Tolley, E, Tomlinson, L, Tomoto, M, Tompkins, L, Toms, K, Torrence, E, Torres, H, Torro Pastor, E, Toth, J, Touchard, F, Tovey, D, Trefzger, T, Tremblet, L, Tricoli, A, Trigger, I, Trincaz Duvoid, S, Tripiana, M, Trischuk, W, Trocme, B, Troncon, C, Trottier McDonald, M, Trovatelli, M, True, P, Truong, L, Trzebinski, M, Trzupek, A, Tsarouchas, C, Tseng, J, Tsiareshka, P, Tsionou, D, Tsipolitis, G, Tsirintanis, N, Tsiskaridze, S, Tsiskaridze, V, Tskhadadze, E, Tsukerman, I, Tsulaia, V, Tsuno, S, Tsybychev, D, Tudorache, A, Tudorache, V, Tuna, A, Tupputi, S, Turchikhin, S, Turecek, D, Turra, R, Turvey, A, Tuts, P, Tykhonov, A, Tylmad, M, Tyndel, M, Ueda, I, Ueno, R, Ughetto, M, Ugland, M, Uhlenbrock, M, Ukegawa, E, Unal, G, Undrus, A, Unel, G, Ungaro, E, Unno, Y, Unverdorben, C, Urban, J, Urquijo, P, Urrejola, P, Usai, G, Usanova, A, Vacavant, L, Vacek, V, Vachon, B, Valderanis, C, Valencic, N, Valentinetti, S, Valero, A, Valery, L, Valkar, S, Valladolid Gallego, E, Vallecorsa, S, Valls Ferrer, J, Van Den Wollenberg, W, Van Der Deij, P, Van der Geer, R, van der Graaf, H, Van Der Leeuw, R, van Eldik, N, van Gemmeren, P, Van Nieuwkoop, J, van Vupen, I, van Woerden, M, Vanadia, M, Vandelli, W, Vanguri, R, Vaniachine, A, Vannucci, E, Vardanyan, G, Vari, R, Varnes, E, Varol, T, Varouchas, D, Vartapetian, A, Varvell, K, Vazeille, E, Schroeder, T, Veatch, J, Veloso, F, Velz, T, Veneziano, S, Ventura, A, Ventura, D, Venturi, M, Venturi, N, Venturini, A, Vercesi, V, Verducci, M, Verkerke, W, Vermeulen, J, Vest, A, Vetterli, M, Viazo, O, Vichou, I, Vickey, T, Boeriu, O, Viehhauser, G, Viel, S, Vigne, R, Villa, M, Perez, M, Vilucchi, E, Vincter, M, Vinogradov, V, Vivarelli, I, Vaque, F, Vlachos, S, Vladoiu, D, Vlasak, M, Vogel, M, Vokac, P, Volpi, G, Vopi, M, von der Schmitt, H, von Radziewski, H, von Toerne, E, Vorobel, V, Vorobev, K, Vos, M, Voss, R, Vossebeld, J, Vranjes, N, Milosavljevic, M, Vrba, V, Vreeswijk, M, Vuillermet, R, Vukotic, I, Vykydal, Z, Wagner, P, Wagner, W, Wahlberg, H, Wahrmund, S, Wakabayashi, J, Walder, J, Walker, R, Walkowiak, W, Wang, C, Wang, F, Wang, H, Wang, J, Wang, K, Wang, R, Wang, S, Wang, T, Wang, X, Wanotayaroj, C, Warburton, A, Ward, C, Wardrope, D, Warsinsky, M, Washbrook, A, Wasicki, C, Watkins, P, Watson, A, Watson, I, Watson, M, Watts, G, Watts, S, Waugh, B, Webb, S, Weber, M, Weber, S, Webster, J, Weidberg, A, Weiner, B, Weingarten, J, Weiser, C, Weits, H, Wells, P, Wenaus, T, Wengler, T, Wenig, S, Wermes, N, Werner, M, Werner, P, Wessels, M, Wetter, J, Whalen, K, Wharton, A, White, A, White, M, White, R, White, S, Whiteson, D, Wickens, F, Wiedenmann, W, Wielers, M, Wienemann, P, Wiglesworth, C, Wiik Fuchs, L, Wildauer, A, Wilkens, H, Williams, H, Williams, S, Wills, C, Willocq, S, Wilson, A, Wilson, J, Wingerter Seez, I, Winklmeier, F, Winter, B, Wittgen, M, Wittkowski, J, Wollstadt, S, Wolter, M, Wolters, H, Wosiek, B, Wotschack, J, Woudstra, M, Wozniak, K, Wu, M, Sl, W, Wu, X, Wu, Y, Wyatt, T, Wynne, B, Xella, S, Xu, D, Xu, L, Yabsley, B, Yacoob, S, Yakabe, R, Yamada, M, Yamaguchi, Y, Yamamoto, A, Yamamoto, S, Yamanaka, T, Yamauchi, K, Yamazaki, Y, Yan, Z, Yang, H, Yang, Y, Yao, L, Yao, W, Yasu, Y, Yatsenko, E, Wong, K, Ye, J, Ye, S, Yeletskikh, I, Yen, A, Yildirim, E, Yorita, K, Yoshida, R, Yoshihara, K, Young, C, Youssef, S, Dr, Y, Yu, J, Jm, Y, Yuan, L, Yurkewicz, A, Yusuff, I, Zabinski, B, Zaidan, R, Zaitsev, A, Zalieckas, J, Zaman, A, Zambito, S, Zanello, L, Zanzi, D, Zeitnitz, C, Zeman, M, Zemla, A, Zengel, K, Zenin, O, Zenis, T, Zerwas, D, Zhang, D, Zhang, F, Zhang, J, Zhang, L, Zhang, R, Zhang, X, Zhang, Z, Zhao, X, Zhao, Y, Zhao, Z, Zhemchugov, A, Zhong, J, Zhou, B, Zhou, C, Zhou, L, Zhou, N, Zhu, C, Zhu, H, Zhu, J, Zhu, Y, Zhuang, X, Zhukov, K, Zibell, A, Zieminska, D, Zimine, N, Zimmermann, C, Zimmermann, S, Zinonos, Z, Zinser, M, Ziolkowski, M, Zivkovic, L, Zobernig, G, Zoccoli, A, zur Nedden, M, Zurzolo, G, and Zwalinski, L

Subjects
Settore FIS/01 - Fisica Sperimentale
Published
2015

47. Genotypic and phenotypic characterization of Escherichia coli isolated from indigenous individuals in Malaysia

Author

Vanitha Mariappan, Soo Tein Ngoi, Yvonne Ai Lian Lim, Romano Ngui, Kek Heng Chua, and Cindy Shuan Ju Teh

Subjects
genotypic, indigenous, malaysia, phenotypic, verocytotoxin (vt)-producing escherichia coli (vtec), Medicine
Abstract

Objective(s): The occurrence of asymptomatic verocytotoxin (VT)-producing Escherichia coli (VTEC) infections among humans in recent years is posing a high risk to public health. Thus, the role of asymptomatic human carriers as a source of dissemination should not be underestimated. This study aimed to elucidate the phenotypic and genotypic characteristics of E. coli in the stool samples collected from indigenous individuals in Malaysia. Materials and Methods: E. coli strains (n=108) were isolated from stool samples obtained from 41 indigenous individuals. All strains were subjected to Repetitive Extragenic Palindromic-Polymerase Chain Reaction (REP-PCR) typing and confirmation of VTEC variants. Non-duplicate strains were selected based on REP-PCR profiles and further subjected to antimicrobial susceptibility test (AST). The genotypic and phenotypic characteristics of the strains were then correlated with the demographic data of the subjects. Results: A total of 66 REP-PCR profiles grouped in 53 clusters (F=85%) were obtained. Four genetically distinct strains were confirmed as VTEC (eaeA-positive). The predominant resistance was against ampicillin (34.2%), followed by trimethoprim-sulfamethoxazole (32.9%), ampicillin-sulbactam (5.5%), and ciprofloxacin (1.4%). All isolates were sensitive to amoxicillin-clavulanate, cefuroxime, ceftriaxone, imipenem, and meropenem. Conclusion: Genetically diverse E. coli and VTEC strains were found to colonize the intestines of the indigenous populations. This study is important for the prospective surveillance of E. coli among the indigenous individuals in Malaysia, especially in asymptomatic VTEC infection and antimicrobial resistance phenomenon.

Published
2022
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48. Tobacco use among medical students in Europe: results of a multicentre study using the Global Health Professions Student Survey

Author

La Torre, G, Kirch, W, Bes Rastrollo, M, Ramos, Rm, Czaplicki, M, Gualano, MARIA ROSARIA, Thümmler, K, Ricciardi, W, Boccia, A, GHPSS Collaborative Group, Siliquini, Roberta, Manzoli, L, Firenze, A, Romano, N, Zscheppang, A, Valero Juan, L. F., La Torre, G., Kirch, W., Bes-Rastrollo, M., Ramos, R.M., Czaplicki, M., Gualano, M.R., Thümmler, K., Ricciardi, W., Boccia, A., Siliquini, R., Manzoli, L., Firenze, A., Romano, N., Zscheppang, A., and Valero Juan, L.F.

Subjects
Gerontology, Adult, Male, medicine.medical_specialty, Medical psychology, Students, Medical, Cross-sectional study, medicine.medical_treatment, education, Population, MEDLINE, Settore MED/42 - Igiene Generale E Applicata, Young Adult, europe, medical students, tobacco smoking, Global health, medicine, Prevalence, Humans, Young adult, Medical student, education.field_of_study, business.industry, Smoking, Public Health, Environmental and Occupational Health, General Medicine, Medical students, Confidence interval, Medical students, Tobacco smoking, Tobacco smoking, Europe, Cross-Sectional Studies, Family medicine, Smoking cessation, Female, Smoking Cessation, business, Attitude to Health
Abstract

Objective: To examine smoking prevalence, knowledge and attitudes, and tobacco cessation training among university students attending European medical schools using the Global Health Professional Students Survey approach. Methods: A cross-country, cross-sectional study was performed among 12 medical schools in four countries in Europe (Germany, Italy, Poland and Spain). The survey was performed during the second semester of the third year of study from March to May 2009. Results: In total, 2249 subjects entered the study (overall response rate 92%). The overall prevalence of smoking among medical students was 29.3% (95% confidence interval 28.1-34.7), with percentages ranging from 28% in Germany to 31.3% in Italy. This study found that more than two-thirds of medical students believe that health professionals are role models for patients, with different beliefs in Poland (89.6%) and Germany (77.7%) vs Italy and Spain (57.2% and 54.4%, respectively) (P < 0.001). Smoking cessation training at medical school was only reported by 16.5% of students (lowest proportion in Italy, 3.5%) (P < 0.001). In terms of smoking cessation methods, the vast majority (89.8%) of medical students were aware of nicotine patches and gum (highest prevalence in Spain, 96.3%), and 24.4% were aware of the use of antidepressants (highest prevalence in Germany, 33.6%). Conclusion: This European survey found that the prevalence of smoking was higher among medical students than the general population. There is a strong need to provide medical students with training in smoking cessation techniques

Published
2012

49. Genotypic resistance profiles associated with virological failure to darunavir-containing regimens: a cross-sectional analysis

Author

Sterrantino, G, Zaccarelli, M, Colao, G, Baldanti, F, Di Giambenedetto, S, Carli, T, Maggiolo, F, Zazzi, M, Giacometti, A, Butini, L, Del Gobbo, R, Bagnarelli, P, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Callegaro, A, Calza, L, Re, MC, Pristera, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, di Biagio, A, Penco, G, Trezzi, M, Orani, A, Pardelli, R, Arcidiacono, I, Degiuli, A, de Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Cicconi, P, Rusconi, S, Gismondo, MR, Micheli, V, Biondi ML, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Gerardo, AO, Santirocchi, M, Brustia, D, Maggiore, AO, Ravanini, P, Bello, FD, Romano, N, MANCUSO, Salvatrice, Calzetti, C, Maserati, R, Filice, G, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, di Giambenedetto, S, Colafigli, M, Vullo, V, Turriziani, O, Montano, M, Antinori, A, Dentone, C, Gonnelli, A, de Luca, A, Palumbo, M, Ghisetti, V, Bonora, S, Foglie, PD, Rossi, C, Mondino, V, Malena, M, Grossi, P, Seminari, E, Poletti, F., Sterrantino, G, Zaccarelli, M, Colao, G, Baldanti, F, Di Giambenedetto, S, Carli, T, Maggiolo, F, Zazzi, M, Giacometti, A, Butini, L, Del Gobbo, R, Bagnarelli, P, Tacconi, D, Corbelli, G, Zanussi, S, Monno, L, Punzi, G, Callegaro, A, Calza, L, Re, MC, Pristera, R, Turconi, P, Mandas, A, Tini, S, Zoncada, A, Paolini, E, Amadio, G, Sighinolfi, L, Zuccati, G, Morfini, M, Manetti, R, Corsi, P, Galli, L, Di Pietro, M, Bartalesi, F, Tosti, A, Di Biagio, A, Setti, M, Bruzzone, B, di Biagio, A, Penco, G, Trezzi, M, Orani, A, Pardelli, R, Arcidiacono, I, Degiuli, A, de Gennaro, M, Chiodera, A, Scalzini, A, Palvarini, L, Almi, P, Todaro, G, Cicconi, P, Rusconi, S, Gismondo, MR, Micheli, V, Biondi ML, Gianotti, N, Capetti, A, Meraviglia, P, Boeri, E, Mussini, C, Pecorari, M, Soria, A, Vecchi, L, Gerardo, AO, Santirocchi, M, Brustia, D, Maggiore, AO, Ravanini, P, Bello, FD, Romano, N, Mancuso, S, Calzetti, C, Maserati, R, Filice, G, Francisci, D, Parruti, G, Polilli, E, Sacchini, D, Martinelli, C, Consolini, R, Vatteroni, L, Vivarelli, A, Nerli, A, Lenzi, L, Magnani, G, Ortolani, P, Andreoni, M, Palamara, G, Fimiani, C, Palmisano, L, di Giambenedetto, S, Colafigli, M, Vullo, V, Turriziani, O, Montano, M, Antinori, A, Dentone, C, Gonnelli, A, de Luca, A, Palumbo, M, Ghisetti, V, Bonora, S, Foglie, PD, Rossi, C, Mondino, V, Malena, M, Grossi, P, Seminari, E, and Poletti, F

Subjects
Male, Time Factors, Cross-sectional study, Human immunodeficiency virus (HIV), Drug Resistance, HIV Infections, Drug resistance, medicine.disease_cause, Cohort Studies, Antiretroviral Therapy, Highly Active, Ritonavir-boosted darunavir, Genotype, HIV Infection, Treatment Failure, Viral, Genotypic resistance, Darunavir, Sulfonamides, General Medicine, Middle Aged, Virological failure, Infectious Diseases, Female, Human, medicine.drug, Adult, Microbiology (medical), Logistic Model, Time Factor, Antiretroviral Therapy, Settore MED/17 - MALATTIE INFETTIVE, Sulfonamide, Drug Resistance, Viral, medicine, Humans, Highly Active, Protease inhibitors, Cross-Sectional Studies, HIV Protease Inhibitors, HIV-1, Logistic Models, Mutation, HIV Protease Inhibitor, Cross-Sectional Studie, business.industry, Antiretroviral therapy, Virology, Protease inhibitor, Cohort Studie, business
Abstract

Introduction: This study aimed at defining protease (PR) resistance mutations associated with darunavir (DRV) failure and PR resistance evolution at DRV failure in a large database of treatment-experienced human immunodeficiency virus (HIV) patients. Results: Overall, 1,104 patients were included: 118 (10.7%) failed at a median observation time of 16 months. The mean number of PR mutations at baseline was 2.7, but it was higher in patients who subsequently failed DRV. In addition, the number of PR mutations increased at failure. The increase in the mean number of mutations was completely related to mutations considered to be associated with DRV resistance following the indications of the main DRV clinical trials. Discussion The higher statistical difference at baseline between failing versus non-failing patients was observed for the V32I and I84V mutations. At DRV failure, the major increase was still observed for V32I; I54L, V11I, T74P and I50V also increased. Despite the increment in the mean number of mutations per patient between baseline and failure, in 21 patients (17.8%) at baseline and 36 (30.5%) at failure, no PR mutation was detected. Conclusion: The HIV-DB interpretation algorithm identified few patients with full DRV resistance at baseline and few patients developed full resistance at DRV failure, indicating that complete resistance to DRV is uncommon. © Springer-Verlag 2011.

Published
2012

50. Il rifiuto della proprietà come valore spirituale e materiale nel'meriggio' del Medioevo

Author

Barbot,M, Béguin, K., Bettoni, A., Cozzo, P., D'Avray, D., Demonet, M-L., Feller, L, Gaffuri, L., Gaude-Ferragu, M., Genet, J-Ph., Della Misericordia, M., Mongini, G., Romano, N., Olivieri, A., Pradier, P-C., Zara, V., Boucheron, P., Genet, J-Ph, Andenna, Giancarlo, Andenna, Giancarlo (ORCID:0000-0003-0003-7674), Barbot,M, Béguin, K., Bettoni, A., Cozzo, P., D'Avray, D., Demonet, M-L., Feller, L, Gaffuri, L., Gaude-Ferragu, M., Genet, J-Ph., Della Misericordia, M., Mongini, G., Romano, N., Olivieri, A., Pradier, P-C., Zara, V., Boucheron, P., Genet, J-Ph, Andenna, Giancarlo, and Andenna, Giancarlo (ORCID:0000-0003-0003-7674)

Abstract

Ci si chiede se la proprietà sia un valore? Il rifiuto collettivo della proprietà, attuato dall'istituzione francescana, pose subito la questione della necessità di accettarla, o meglio di trattenerla, ma solo come "usum facti". Ciò portò ad una situazione di grande favore poiché si godevano i vantaggi della proprietà, senza sopportare i pesi, soprattutto in tasse, che il pieno possesso della proprietà procurava.

Published
2016

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