Search

Abstract Background Leishmania tarentolae is a protozoan isolated from geckoes (Tarentola annularis, Tarentola mauritanica), which is considered non-pathogenic and is transmitted by herpetophilic Sergentomyia spp. sand flies. This species occurs in sympatry with Leishmania infantum in areas where canine leishmaniasis is endemic. In the present study, we investigated the circulation of L. tarentolae and L. infantum in sand flies, dogs and lizards in a dog shelter in southern Italy, where canine leishmaniasis by L. infantum is endemic. Methods Sheltered dogs (n = 100) negative for Leishmania spp. (March 2020) were screened by immunofluorescence antibody test (IFAT) using promastigotes of both species at two time points (June 2020 and March 2021). Whole blood from dogs, tissues of Podarcis siculus lizards (n = 28) and sand flies (n = 2306) were also sampled and tested by a duplex real-time PCR (dqPCR). Host blood meal was assessed in sand flies by PCR. Results Overall, 16 dogs became positive for L. infantum and/or L. tarentolae by IFAT at one or both sampling periods. One canine blood sample was positive for L. infantum, whilst two for L. tarentolae by dqPCR. At the cytology of lizard blood, Leishmania spp. amastigote-like forms were detected in erythrocytes. Twenty-two tissue samples, mostly lung (21.4%), scored molecularly positive for L. tarentolae, corresponding to 10 lizards (i.e., 35.7%). Of the female Sergentomyia minuta sampled (n = 1252), 158 scored positive for L. tarentolae, four for L. infantum, and one co-infected. Two Phlebotomus perniciosus (out of 29 females) were positive for L. tarentolae. Engorged S. minuta (n = 10) fed on humans, and one P. perniciosus, positive for L. tarentolae, on lagomorphs. Conclusions Dogs and lacertid lizards (Podarcis siculus) were herein found for the first time infected by L. tarentolae. The detection of both L. tarentolae and L. infantum in S. minuta and P. perniciosus suggests their sympatric circulation, with a potential overlap in vertebrate hosts. The interactions between L. tarentolae and L. infantum should be further investigated in both vectors and vertebrate hosts to understand the potential implications for the diagnosis and control of canine leishmaniasis in endemic areas. Graphical abstract

Abstract Background Leishmania infantum and Dirofilaria immitis are among the most important canine vector-borne pathogens (CVBPs) of zoonotic concern in Europe. In endemic areas for both of these CVBPs, the use of systemic ectoparasiticides, such as afoxolaner (NexGard®; Boehringer Ingelheim Animal Health), may have the potential for controlling these infections. The aim of this study was to assess, for the first time, the insecticidal efficacy of NexGard® in decreasing the transmission of D. immitis and L. infantum to sheltered dogs living in a hyperendemic area, compared to the year before treatment, as well as its impact on the abundance of mosquito and sand fly populations. Methods All dogs (n = 179) enrolled in the study were divided into two groups based on their infection status at enrollment: a non-infected group (G1) and an infected group (G2; infected with D. immitis, L. infantum or both). The study was conducted from March 2020 to March 2021. In order to exclude all animals infected with L. infantum and D. immitis before March 2020 (sampling time: T0), dogs in G1 were sampled in June (T1; i.e. T0 + 90 days) and in October 2020 (T2; i.e. T0 + 210 days). From March to September 2020, all animals (G1 and G2) were weighed and treated monthly with NexGard®. Animals in G1 were tested for the last time in March 2021 (T3; i.e. T0 + 330 days) for assessing post-treatment incidence rate of infection and prevention efficacy. Results The post-treatment incidence of D. immitis was 3.7% (1/27; 95% confidence interval [CI]: 0.2–18.1) and that of L. infantum was 3.6% (3/83; 95% CI: 1.0–10.1). Considering the annual incidence in 2019 and 2020, the protective efficacy against D. immitis and L. infantum infections was 94.2 and 64%, respectively. Of the female mosquitoes collected (n = 146), only one pool out of 50 tested positive for D. immitis DNA, whereas out of 1252 female Sergentomya minuta specimens collected, only four tested positive for L. infantum (0.3%). Conclusions Afoxolaner is efficacious in decreasing the rate of transmission of both D. immitis and L. infantum; however, comparison of the pre- and post-treatment period demonstrated that there was a significant difference only in the seasonal incidences of D. immitis infection. Preventive measures are recommended throughout the year in endemic areas to reduce the risk of pathogen transmission to animals and humans. Graphical abstract

In lower mammals, locomotion seems to be mainly regulated by subcortical and spinal networks. On the contrary, recent evidence suggests that in humans the motor cortex is also significantly engaged during complex locomotion tasks. However, a detailed understanding of cortical contribution to locomotion is still lacking especially during stereotyped activities. Here, we show that cortical motor areas finely control leg muscle activation during treadmill stereotyped walking. Using a novel technique based on a combination of Reliable Independent Component Analysis, source localization and effective connectivity, and by combining electroencephalographic (EEG) and electromyographic (EMG) recordings in able-bodied adults we were able to examine for the first time cortical activation patterns and cortico-muscular connectivity including information flow direction. Results not only provided evidence of cortical activity associated with locomotion, but demonstrated significant causal unidirectional drive from contralateral motor cortex to muscles in the swing leg. These insights overturn the traditional view that human cortex has a limited role in the control of stereotyped locomotion, and suggest useful hypotheses concerning mechanisms underlying gait under other conditions.One sentence summaryMotor cortex proactively drives contralateral swing leg muscles during treadmill walking, counter to the traditional view of stereotyped human locomotion.

Abstract Background In the past years, robotic systems have become increasingly popular in upper limb rehabilitation. Nevertheless, clinical studies have so far not been able to confirm superior efficacy of robotic therapy over conventional methods. The personalization of robot-aided therapy according to the patients’ individual motor deficits has been suggested as a pivotal step to improve the clinical outcome of such approaches. Methods Here, we present a model-based approach to personalize robot-aided rehabilitation therapy within training sessions. The proposed method combines the information from different motor performance measures recorded from the robot to continuously estimate patients’ motor improvement for a series of point-to-point reaching movements in different directions. Additionally, it comprises a personalization routine to automatically adapt the rehabilitation training. We engineered our approach using an upper-limb exoskeleton. The implementation was tested with 17 healthy subjects, who underwent a motor-adaptation paradigm, and two subacute stroke patients, exhibiting different degrees of motor impairment, who participated in a pilot test undergoing rehabilitative motor training. Results The results of the exploratory study with healthy subjects showed that the participants divided into fast and slow adapters. The model was able to correctly estimate distinct motor improvement progressions between the two groups of participants while proposing individual training protocols. For the two pilot patients, an analysis of the selected motor performance measures showed that both patients were able to retain the improvements gained during training when reaching movements were reintroduced at a later stage. These results suggest that the automated training adaptation was appropriately timed and specifically tailored to the abilities of each individual. Conclusions The results of our exploratory study demonstrated the feasibility of the proposed model-based approach for the personalization of robot-aided rehabilitation therapy. The pilot test with two subacute stroke patients further supported our approach, while providing encouraging results for the applicability in clinical settings. Trial registration This study is registered in ClinicalTrials.gov (NCT02770300, registered 30 March 2016, https://clinicaltrials.gov/ct2/show/NCT02770300 )

Abstract Background For long time, canine leishmaniosis (CanL) was considered endemic in the southern, central, and insular regions of Italy, whereas heartworm disease (HW) caused by Dirofilaria immitis was considered endemic in the northern region and in the swampy Po Valley. Following the reports of new foci of both diseases, in this study we update the distribution patterns and occurrence of new foci of CanL and HW discussing the main drivers for the changes in the epidemiology of these two important zoonotic canine vector-borne diseases. Methods Based on the statistical analyses of serological assays (n = 90,633) on L. infantum exposure and D. immitis infection performed by two reference diagnostic centres in Italy over a ten-year period (2009–2019) irrespective of the anamnesis of dogs. The distribution patterns of both parasites are herein presented along with the occurrence of new foci. Results Results highlighted the changing distribution patterns of L. infantum vs D. immitis infection in Italy. CanL is endemic in some areas of northern regions and HW has endemic foci in central and southern regions and islands. Significant differences in L. infantum exposure and HW infection prevalence among the study macroareas were detected. The overall results of the positive tested samples were 28.2% in southern Italy and islands, 29.6% in central Italy and 21.6% in northern Italy for L. infantum and 2.83% in northern Italy, 7.75% in central Italy and 4.97% in southern Italy and islands for HW. HW positivity significantly varied over years (χ 2 = 108.401, df = 10, P < 0.0001), gradually increasing from 0.77% in 2009 to 8.47% in 2016–2017. Conclusions New potential epidemiological scenarios are discussed according to a range of factors (e.g. environmental modifications, occurrence of competent insect vectors, transportation of infected animals to non-endemic areas, chemoprophylaxis or vector preventative measures), which may affect the current distribution. Overall, the results advocate for epidemiological surveillance programmes, more focussed preventative and control measures even in areas where few or no cases of both diseases have been diagnosed.

Giardia duodenalis is a protozoan parasite known for its ability to cause gastrointestinal disease in human and non-human mammals. In the UK, the full impact of this parasite has yet to be fully explored, due to the limited testing which has been undertaken in humans and the low-resolution assemblage-typing methods currently available. Rather than being primarily a travel-associated condition, a recent study has highlighted that an endemic Giardia cycle is present in the UK, although the source of human disease is unclear in the majority of cases. This study focussed on the improvement of one of the commonly used assemblage-typing assays, a nested topoisomerase phosphate (tpi) PCR, to increase the amplification success rate across both human and companion animal samples. After comparing published primers to full Giardia reference genomes, this marker protocol was optimised and then deployed to test a substantial number of human (n ​= ​79) and companion animal (n ​= ​174) samples to gain an insight into the molecular epidemiology of Giardia in the UK. One assemblage A1 and eleven assemblage A2 genotypes were detected in humans, along with and 25 assemblage B genotypes. Assemblage A1 genotypes, known to be human-infective, were found in three feline and one canine sample, while one feline sample contained assemblage A2. Additionally, four feline samples contained assemblage B, which is recognised as potentially human-infective. This study demonstrates the presence of potentially human-infective Giardia genotypes circulating in the companion animal population, notably with 17.4% (8/46) of feline-derived Giardia strains being potentially zoonotic. Using a modified tpi-based genotyping assay, this work highlights the potential for domestic pets to be involved in the endemic transmission of giardiasis in the UK and underlines the need for appropriate hygiene measures to be observed when interacting with both symptomatic and asymptomatic animals. It also serves to underline the requirement for further studies to assess the zoonotic risk of Giardia associated with companion animals in high-income countries.

Organizations engaged in business, regardless of the industry in which they operate, must be able to extract knowledge from the data available to them. Often the volume of customer and supplier data is so large, the use of advanced data mining algorithms is required. In particular, machine learning algorithms make it possible to build predictive models in order to forecast customer demand and, consequently, optimize the management of supplies and warehouse logistics. We base our analysis on the use of the XGBoost as a predictive model, since this is now considered to provide the more efficient implementation of gradient boosting, shown with a numerical comparison. Preliminary tests lead to the conclusion that the XGBoost regression model is more accurate in predicting future sales in terms of various error metrics, such as MSE (Mean Square Error), MAE (Mean Absolute Error), MAPE (Mean Absolute Percentage Error) and WAPE (Weighted Absolute Percentage Error). In particular, the improvement measured in tests using WAPE metric is in the range 15–20%.

The literature is rich in techniques and methods to perform Continuous Authentication (CA) using biometric data, both physiological and behavioral. As a recent trend, less invasive methods such as the ones based on context-aware recognition allows the continuous identification of the user by retrieving device and app usage patterns. However, a still uncovered research topic is to extend the concepts of behavioral and context-aware biometric to take into account all the sensing data provided by the Internet of Things (IoT) and the smart city, in the shape of user habits. In this paper, we propose a meta-model-driven approach to mine user habits, by means of a combination of IoT data incoming from several sources such as smart mobility, smart metering, smart home, wearables and so on. Then, we use those habits to seamlessly authenticate users in real time all along the smart city when the same behavior occurs in different context and with different sensing technologies. Our model, which we called WoX+, allows the automatic extraction of user habits using a novel Artificial Intelligence (AI) technique focused on high-level concepts. The aim is to continuously authenticate the users using their habits as behavioral biometric, independently from the involved sensing hardware. To prove the effectiveness of WoX+ we organized a quantitative and qualitative evaluation in which 10 participants told us a spending habit they have involving the use of IoT. We chose the financial domain because it is ubiquitous, it is inherently multi-device, it is rich in time patterns, and most of all it requires a secure authentication. With the aim of extracting the requirement of such a system, we also asked the cohort how they expect WoX+ will use such habits to securely automatize payments and identify them in the smart city. We discovered that WoX+ satisfies most of the expected requirements, particularly in terms of unobtrusiveness of the solution, in contrast with the limitations observed in the existing studies. Finally, we used the responses given by the cohorts to generate synthetic data and train our novel AI block. Results show that the error in reconstructing the habits is acceptable: Mean Squared Error Percentage (MSEP) 0.04%.

Background: Diabetic retinopathy (DR) is a neurovascular disease, characterized by a deficiency of brain-derived neurotrophic factor (BDNF), a regulator of autophagy. Beta-hydroxybutyrate (BHB), previously reported as a protective agent in DR, has been associated with BDNF promotion. Here, we investigated whether systemic BHB affects the retinal levels of BDNF and local autophagy in diabetic mice with retinopathy; Methods: C57BL/6J mice were administered with intraperitoneal (i.p.) streptozotocin (STZ) (75 mg/kg) injection to develop diabetes. After 2 weeks, they received i.p. injections of BHB (25–50–100 mg/kg) twice a week for 10 weeks. Retinal samples were collected in order to perform immunofluorescence, Western blotting, and ELISA analysis; Results: BHB 50 mg/kg and 100 mg/kg significantly improved retinal BDNF levels (p < 0.01) in diabetic mice. This improvement was negatively associated with autophagosome–lysosome formations (marked by LC3B and ATG14) and to higher levels of connexin 43 (p < 0.01), a marker of cell integrity. Moreover, BHB administration significantly reduced M1 microglial activation and autophagy (p < 0.01); Conclusions: The systemic administration of BHB in mice with DR improves the retinal levels of BDNF, with the consequent reduction of the abnormal microglial autophagy. This leads to retinal cell safety through connexin 43 restoration.

Brain lesions caused by cerebral ischemia lead to network disturbances in both hemispheres, causing a subsequent reorganization of functional connectivity both locally and remotely with respect to the injury. Quantitative electroencephalography (qEEG) methods have long been used for exploring brain electrical activity and functional connectivity modifications after stroke. However, results obtained so far are not univocal. Here, we used basic and advanced EEG methods to characterize how brain activity and functional connectivity change after stroke. Thirty-three unilateral post stroke patients in the sub-acute phase and ten neurologically intact age-matched right-handed subjects were enrolled. Patients were subdivided into two groups based on lesion location: cortico-subcortical (CS, n = 18) and subcortical (S, n = 15), respectively. Stroke patients were evaluated in the period ranging from 45 days since the acute event (T0) up to 3 months after stroke (T1) with both neurophysiological (resting state EEG) and clinical assessment (Barthel Index, BI) measures, while healthy subjects were evaluated once. Brain power at T0 was similar between the two groups of patients in all frequency bands considered (δ, θ, α, and β). However, evolution of θ-band power over time was different, with a normalization only in the CS group. Instead, average connectivity and specific network measures (Integration, Segregation, and Small-worldness) in the β-band at T0 were significantly different between the two groups. The connectivity and network measures at T0 also appear to have a predictive role in functional recovery (BI T1-T0), again group-dependent. The results obtained in this study showed that connectivity measures and correlations between EEG features and recovery depend on lesion location. These data, if confirmed in further studies, on the one hand could explain the heterogeneity of results so far observed in previous studies, on the other hand they could be used by researchers as biomarkers predicting spontaneous recovery, to select homogenous groups of patients for the inclusion in clinical trials.

EDP-938 is a novel non-fusion replication inhibitor of respiratory syncytial virus (RSV). It is highly active against all RSV-A and B laboratory strains and clinical isolates tested in vitro in various cell lines and assays, with half-maximal effective concentrations (EC50s) of 21, 23 and 64 nM against Long (A), M37 (A) and VR-955 (B) strains, respectively, in the primary human bronchial epithelial cells (HBECs). EDP-938 inhibits RSV at a post-entry replication step of the viral life cycle as confirmed by time-of-addition study, and the activity appears to be mediated by viral nucleoprotein (N). In vitro resistance studies suggest that EDP-938 presents a higher barrier to resistance compared to viral fusion or non-nucleoside L polymerase inhibitors with no cross-resistance observed. Combinations of EDP-938 with other classes of RSV inhibitors lead to synergistic antiviral activity in vitro. Finally, EDP-938 has also been shown to be efficacious in vivo in a non-human primate model of RSV infection.

Standard chemotherapy treatment for Diffuse large B-cell lymphoma (DLBCL), including cyclophosphamide, doxorubicin, vincristine and prednisone, in association with rituximab (CHOP-R) are considered associated to the development of secondary tumors. In this clinical setting, therapy-related myeloid neoplasms (t-MNs) represent one of the most common secondary tumors. In this case we describe, A 58-year-old patient diagnosed with DLBCL and treated with the CHOP-R therapeutic scheme, developed after 4 years a widespread gingival enlargement, diagnosed as acute myelomonocytic leukemia and then confirmed by overall clinical-pathological features. Therapy related neoplasms can be an aggressive complication of cytotoxic treatments of neoplastic and non-neoplastic diseases. Gingival hyperplasia could represent an early manifestation of these systemic pathologies.

Background: The prognosis of patients with advanced gastric cancer remains overall poor despite some recent innovations and the development of new therapeutic approaches. Current European guidelines do not recommend any specific treatment for patients with advanced gastric cancer refractory to two or more previous chemotherapy regimens, making this setting “orphan.” Immunotherapy is quickly evolving also for this malignancy even if with controversial results and the correct patient selection is still debated, especially for Western patients. The phase III ONO-4538-12 “ATTRACTION-2” represents the current landmark trial for the development of immunotherapy for pretreated Asian patients and led to the approval of Nivolumab in some Asian countries, while only previous phase trials are available for Caucasians. Complete radiological response is anecdotic and has never been described both in the pivotal trial both in the others with Western patients enrolled.Case presentation: We report two cases of heavily pretreated Western elderly patients with metastatic gastric cancer who experienced durable complete radiological response to Nivolumab “off label” (more than 20 months to date) in a clinical practice context. Molecular analysis of potential predictive factors has been performed (PD-L1, EBV, MSI, and TMB) on primary tumor sample.Conclusions: Despite the lack of evidence for Western patients and the controversial outcome with the use of checkpoint inhibitors in previous settings, immunotherapy may dramatically change the prognosis and the natural history of pretreated Western metastatic gastric cancer, in a correctly selected population. Microsatellite instability and tumor mutational burden may be reliable predictive factors also for Caucasians. There is an urgent need for a change in clinical practice also for this “orphan” patients and more efforts are needed in order to clarify the role of predictive factors for a correct patient selection and better chances of survival for this awful malignancy.

Following the Mass Mortality Events (MMEs) of the pen shell P. nobilis in Campania region and Sicily, a survey of moribund P. nobilis specimens was also conducted in other Italian regions (Campania, Tuscany, Sardinia, and Apulia) and Spain (Catalunya). Histopathological and molecular examination of 27 specimens of P. nobils revealed different types of pathogens associated with tissue lesions, morbidity and mortality. Presence of Mycobacterium, Vibrio species, Haplosporidium pinnae and Perkinsus sp. were detected, differently distributed into the areas. The Mycobacterium sp., previously reported in Campania and Sicily samples, was observed in all the analyzed areas and individuals, associated to systemic inflammatory lesions. In Spain, H. pinnae was observed in 36% of cases, always associated to the Mycobacterium sp. Molecular study using hsp65 genes and Internal Transcriber Spacer ITS support that a new species of Mycobacteria is infecting P. nobilis, close to M. triplex and belonging to the group of M. simiae complex with M. sherrisi. Presence of Perkinsus spp. resembling P. mediterraneus was observed in 2 out of 13 Italian individuals whose presence should be addressed as potential risk for shellfish aquaculture of the area. Vibrio spp. were also detected in some case. The preliminary results of this study suggest that Mycobacterium sp., Vibrio spp., H. pinnae and Perkinsus sp. cooperate to disease pathogenesis, being Mycobacterium and Haplosporidium most of the time involved. Vigilant inspection of those areas where MME is now starting, along with continuous systematic surveys, are crucial to define the spatiotemporal progress of mortality and the role of every single pathogen in the disease outcome.

Gastric cancer (GC) is the third cause of cancer-related death worldwide, with a different distribution, higher among Asians. GC is a multifactorial disease and 90% of cases are sporadic1. Helicobacter pylori is the most common etiological factor, shared with MALT Gastric Lymphoma1,2. Even if iTs incidence is declining, many efforts are focused on new target therapies3. In fact, the prognosis is often poor because GC is almost asymptomatic in the early stages, and the curability is related to the surgical treatment. The Cancer Genome Atlas (TCGA) has proposed a new classification in four subtypes, based on molecular categorization: EBV-positive, Microsatellite-instable (MSI), genomically stable, and chromosomally unstable4–6. EBV is estimated to be present in 9% of GCs, mainly located in fundus and corpus. Molecular alterations include the hypermetilation of the promoter CDKN2A, codifying for two proteins: p16 and p14, both of them are tumour suppressor7. Another mutation is alpha catalytic subunit of enzyme PIK3CA, present in 5-10% of the cases. PIK3 is involved in numerous cellular functions, including growth, proliferation, motility and differentiation8. Overexpression of JAK2 is observed in this subtype. This is a tyrosine kinase implied in signalling of numerous cytokine receptors. Through these receptors, STAT genes are activated and regulate genic transcription. Moreover, PD-1/2 and their ligands PD-L1/2 are often overexpressed in this molecular variant. These molecules are involved in an escape process of the cancer from the immune system, protecting the neoplastic cells from T-lymphocytes9. MSI are DNA repetitive sequences that can undergo to errors during the replication process. DNA errors are frequent in normal condition but are repaired by a group of proteins, mismatch repair proteins (MMRPs), responsible of recognize and correct DNA errors. This variant tends to accumulate many errors in the tumour genome. Four of these proteins, MLH1, PMS2, MSH2 and MSH6, are tested in case of Lynch syndrome suspect, but TCGA observed that MSI was present in about 21% of GCs10. The patients with this subtype have specific clinicopathological characteristics, like advanced age, female prevalence, intestinal subtype sec. Lauren, less incidence of lymph node metastasis, and a better prognosis11. Genomically stable GCs represent 19% of all GCs, according to TGCA. They have more often mutation of RHO-family GTPase activating proteins, like RAS, and the deregulation of adhesion and motility processes, like E-cadherin. They are histologically a diffuse-type aspect, and the prognosis is unfavourable12. Chromosomal instability GC subtype is the more conspicuous group, accounting about 45% of GCs13. There are many different chromosomal aberration, amplification of receptor of tyrosine kinase genes, MET, EGFR, HER2 and FGFR2, and have predominantly intestinal-type histology. Actually, genic amplifications are the principal target of new drug development. Among them, HER2 is the most studied. It is a tyrosine kinase receptor, encoded by the protooncogene ErbB2, located on chromosome 17q21, and is involved in cell growth and survivor14. Overexpression of HER2 receptor was identify prior in breast cancers, then also in GCs15. HER2 expression status is the only established predictive marker and is used to predict therapy response. It is tested by immunohistochemistry, and just in some cases, by FISH, but his prognostic role is still discussed, being associated to worst prognosis according to some authors16. The use of easier methods on tissues, such as immunohistochemistry and in situ hybridization for EBV and other clinical genes, could be used to apply molecular classification of gastric cancer for its significant prognostic stratification.