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Abstract Introduction Clinical indications on how to approach caregiving with a person living with dementia underline the need “to have an empathic attitude” requiring the caregiver to view the world from the perspective of the person with dementia. However, it is not easy for the caregiver to understand the perspective their patients have on day‐to‐day experiences. To put the caregivers in the person with dementia's shoes, the Virtual Dementia Tour (VDT) was developed in 2001, and has been administered to millions of health professionals, community leaders, and family caregivers. Method In this paper we present the Italian version of the VDT and discuss its internal validity and test–retest reliability for the pre–post experience survey defined by the VDT procedure. Results An Italian sample (N = 419; mean age = 44.8; standard deviation 14.2) completed the tour and a 5‐item survey provided before and after the experience revealed the disposition toward people with dementia changed. Discussion The VDT Italian version wasrevealed to be valid in supporting a positive perspective change in the perception of dementia as is seen in the original VDT used in English‐speaking countries. Highlights Empathy predicts a higher quality of caregiving for the person living with dementia. The Virtual Dementia Tour (VDT) provides an experience from the person living with dementia's perspective and supports empathy. We present the first Italian version of VDT and its manual translation and validation. Italian VDT internal consistency and test–retest reliability were calculated. Results confirms the reliability and validity of the Italian VDT for empathy.

Background Few large-scale international studies have broadly characterized the burden of atopic dermatitis (AD) across age groups among children and adolescents. Objectives To better characterize the AD burden in paediatric patients by disease severity. Methods This cross-sectional, web-based survey of paediatric patients (6 months to < 18 years old) was conducted in 18 countries representing North America, Latin America, Europe, Middle East/Eurasia and East Asia. Patients with diagnosed AD were identified based on the International Study of Asthma and Allergies in Childhood criteria and self-/parent-report of ever being told by a physician that they or their child had eczema. AD severity was assessed using the Patient-Oriented Eczema Measure and Patient Global Assessment. Outcomes included measures of itch, skin pain, sleep, health-related quality of life (HRQoL), missed school days and atopic comorbidities. Results The survey included 1489 children aged 6 months to < 6 years; 2898 children aged 6 to < 12 years; and 3078 adolescents aged 12 to < 18 years diagnosed with AD. Although the burden of mild AD was substantial, paediatric patients with moderate or severe AD had more itch, skin pain, sleep problems and impaired HRQoL, and missed more school days relative to those with mild AD; greater burden was observed among those with severe relative to moderate AD. At least one atopic comorbidity was present in 92.5% of all respondents. Conclusions These results highlight the burden of AD in paediatric patients, especially those with moderate-to-severe disease, and suggest the need for assessments that include the impact of AD on function and daily life. [ABSTRACT FROM AUTHOR]

Background: To compare the diagnostic yield of echocardiography and cardiovascular MRI (CMR) to detect structural sources of embolism, in patients with ischemic stroke with a secondary analysis of non-stroke populations.Methods and Results: We searched MEDLINE/Embase (from 01.01.2000 to 24.04.2021) for studies including CMR to assess prespecified sources of embolism. Comparison included transthoracic and/or transesophageal echocardiography. Two authors independently screened studies, extracted data and assessed bias using the QUADAS-2 tool. Estimates of diagnostic yield were reported and pooled. Twenty-seven studies with 2,525 patients were included in a study-level analysis. Most studies had moderate to high risk of bias. Persistent foramen ovale, complex aortic plaques, left ventricular and left atrial thrombus were the most common pathologies. There was no difference in the yield of left ventricular thrombus detection between both modalities for stroke populations (4 studies), but an increased yield of CMR in non-stroke populations (28.1 vs. 16.0%, P < 0.001, 10 studies). The diagnostic yield in stroke patients for detection of persistent foramen ovale was lower in CMR compared to transoesophageal echocardiography (29.3 vs. 53.7%, P < 0.001, 5 studies). For both echocardiography and CMR the clinical impact of the management consequences derived from many of the diagnostic findings remained undetermined in the identified studies.Conclusions: Echocardiography and CMR seem to have similar diagnostic yield for most cardioaortic sources of embolism except persistent foramen ovale and left ventricular thrombus. Randomized controlled diagnostic trials are necessary to understand the impact on the management and potential clinical benefits of the assessment of structural cardioaortic stroke sources.Registration: PROSPERO: CRD42020158787.

Neisseria meningitidis is a strictly human pathogen and is the major cause of septicemia and meningitis worldwide. Factor H binding protein (fHbp) is a meningococcal surface-exposed lipoprotein that binds the human Complement factor H allowing the bacterium to evade the host innate immune response. FHbp is also a key antigen in two vaccines against N. meningitidis serogroup B. Although the fHbp gene is present in most circulating meningococcal strains, level of fHbp expression varies among isolates and has been correlated to differences in promoter sequences upstream of the gene. Here we elucidated the sequence determinants that control fHbp expression in globally circulating strains. We analyzed the upstream fHbp intergenic region (fIR) of more than 5800 strains representative of the UK circulating isolates and we identified eleven fIR sequence alleles which represent 88% of meningococcal strains. By engineering isogenic recombinant strains where fHbp expression was under the control of each of the eleven fIR alleles, we confirmed that the fIR sequence determines a specific and distinct level of expression. Moreover, we identified the molecular basis for variation in expression through polymorphisms within key regulatory regions that are known to affect fHbp expression. We experimentally established three expression groups, high-medium-low, that correlated directly with the susceptibility to killing mediated by anti-fHbp antibodies and the ability of the meningococcal strain to survive within human serum. By using this sequence classification and information about the variant, we predicted fHbp expression in the panel of UK strains and we observed that strains with higher expressing fIR alleles are more likely associated with invasive disease. Overall, our findings can contribute to understand and predict vaccine coverage mediated by fHbp as well as to shed light on the role of this virulence factor in determining an invasive phenotype.

ABSTRACT The phosphorus (P) rates recommended for corrective fertilization-P of soils from southern Brazil may be insufficient to reach the critical level for optimal plant growth. This study aimed to quantify the fertilizer-P rates for total correction fertilization with varying soil buffering capacity in the states of Rio Grande do Sul (RS) and Santa Catarina (SC). Soil samples from 0.00-0.10 and 0.10-0.20 m layers were collected from 41 locations distributed in both states. Twelve P rates were applied to each soil, varying between 0 and 100 % of the maximum adsorption capacity (P-max), and incubated for 20 days. After incubation, the extractable P was determined by Mehlich-1. Based on the relationship between applied rates and extracted P, the P buffer capacity (trP_M1) of the soils was quantified, relating it to soil properties. The trP_M1 values, that is, amounts of P2O5 required to increase 1 mg dm-3 of P extracted by Mehlich-1, varied between 2.4 and 34.5 kg ha-1 of P2O5. A multiple explanatory equation for the variable P was generated, in which only P-max, clay content, and initial P availability have a significant effect. The P buffer capacity was significantly higher in the soils with the highest clay content, and there was a reduction in trP_M1 for soils with higher initial P availability. Considering 270 soil samples with low P, the P rate to reach the sufficient levels may be 2-folds higher than the values currently indicated for the RS and SC states, especially for soils with more than 40 % of clay. Phosphorus rates for corrective fertilization must be based on the soil clay content and in P initial availability. The fertilizer-P in clayey soils must be increased.

Here, we describe the case of a COVID-19 patient who developed recurring ventilator-associated pneumonia caused by Pseudomonas aeruginosa that acquired increasing levels of antimicrobial resistance (AMR) in response to treatment. Metagenomic analysis revealed the AMR genotype, while immunological analysis revealed massive and escalating levels of T-cell activation. These were both SARS-CoV-2 and P. aeruginosa specific, and bystander activated, which may have contributed to this patient’s persistent symptoms and radiological changes.

This article aims to investigate the reasons that push an author to rewrite a great classic, if the motivation of marketing is not pertinent. In the rewriting practice there are works that arise from deeper expressive needs and it would be completely wrong to explain them through purely opportunistic reasons; in fact, it is possible that the author uses the mask of the well-known character to express, by rethinking it, some complex, unexpressed, uncomfortable or difficult aspects of himself or society. We will try to show the plausibility of this hypothesis through the analysis of one of the most successful rewritings of the Liaisons Dangereuses by Laclos, Le Mauvais genre by Laurent de Graeve, trying at the same time to highlight one of the implications related to the connection between fiction and truth.

Riblets are micro-grooves capable of decreasing skin-friction drag, but recent work suggests that additional benefits are possible for other components of aerodynamic drag. The effect of riblets on a fixed-wing, low-speed Unmanned Aerial Vehicle (UAV) on the total aerodynamic drag are assessed here for the first time by means of RANS simulations. Since the microscopic scale of riblets precludes their direct representation in the geometric model of the UAV, we model riblets via a homogenised boundary condition applied on the smooth wall. The boundary condition consists in a suitably tuned partial slip, which assumes riblets to be locally aligned with the flow velocity, and to possess optimal size. Several configurations of riblets coverage are considered to extract the potential for drag reduction of different parts of the aircraft surface. Installing riblets with optimal size over the complete surface of the UAV leads to a reduction of 3% for the drag coefficient of the aircraft. In addition to friction reduction, analysis shows a significant additional form of drag reduction localised on the wing. By installing riblets only on the upper surface of the wing, total drag reduction remains at 1.7%, with a surface coverage that is only 29%, thus yielding a significant improvement in the cost–benefit ratio.

Neisseria meningitidis colonizes the nasopharynx of humans, and pathogenic strains can disseminate into the bloodstream, causing septicemia and meningitis. NHBA is a surface-exposed lipoprotein expressed by all N. meningitidis strains in different isoforms. Diverse roles have been reported for NHBA in heparin-mediated serum resistance, biofilm formation, and adherence to host tissues. We determined that temperature controls the expression of NHBA in all strains tested, with increased levels at 30–32 °C compared to 37 °C. Higher NHBA expression at lower temperatures was measurable both at mRNA and protein levels, resulting in higher surface exposure. Detailed molecular analysis indicated that multiple molecular mechanisms are responsible for the thermoregulated NHBA expression. The comparison of mRNA steady-state levels and half-lives at 30 °C and 37 °C demonstrated an increased mRNA stability/translatability at lower temperatures. Protein stability was also impacted, resulting in higher NHBA stability at lower temperatures. Ultimately, increased NHBA expression resulted in higher susceptibility to complement-mediated killing. We propose that NHBA regulation in response to temperature downshift might be physiologically relevant during transmission and the initial step(s) of interaction within the host nasopharynx. Together these data describe the importance of NHBA both as a virulence factor and as a vaccine antigen during neisserial colonization and invasion.