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Background: Even though several therapeutic options are available, COVID-19 is still lacking a specific treatment regimen. One potential option is dexamethasone, which has been established since the early beginnings of the pandemic. The aim of this study was to determine its effects on the microbiological findings in critically ill COVID-19 patients. Methods: A multi-center, retrospective study was conducted, in which all the adult patients who had a laboratory-confirmed (PCR) SARS-CoV-2 infection and were treated on intensive care units in one of twenty hospitals of the German Helios network between February 2020–March 2021 were included. Two cohorts were formed: patients who received dexamethasone and those who did not, followed by two subgroups according to the application of oxygen: invasive vs. non-invasive. Results: The study population consisted of 1.776 patients, 1070 of whom received dexamethasone, and 517 (48.3%) patients with dexamethasone were mechanically ventilated, compared to 350 (49.6%) without dexamethasone. Ventilated patients with dexamethasone were more likely to have any pathogen detection than those without (p < 0.026; OR = 1.41; 95% CI 1.04–1.91). A significantly higher risk for the respiratory detection of Klebsiella spp. (p = 0.016; OR = 1.68 95% CI 1.10–2.57) and for Enterobacterales (p = 0.008; OR = 1.57; 95% CI 1.12–2.19) was found for the dexamethasone cohort. Invasive ventilation was an independent risk factor for in-hospital mortality (p < 0.01; OR = 6.39; 95% CI 4.71–8.66). This risk increased significantly in patients aged 80 years or older by 3.3-fold (p < 0.01; OR = 3.3; 95% CI 2.02–5.37) when receiving dexamethasone. Conclusion: Our results show that the decision to treat COVID-19 patients with dexamethasone should be a matter of careful consideration as it involves risks and bacterial shifts.

Abstract We investigate the viability of extending the Standard Model with S 1 and S 3 scalar leptoquarks when the flavour structure is parametrized in terms of Froggatt-Nielsen charges. In contrast to a similar analysis with a vector leptoquark, we find essentially two solutions for the charges that fit the experimental constraints, which are dominated by the current tensions in B decays. These two scenarios differ in their estimate of the anomalous magnetic moment of the muon, (g − 2), but they both predict sizeable contributions to τ → μγ, B ¯ s $$ {\overline{B}}_s $$ → τ ± μ ∓ and B + → K + τ + μ − decays, whose branching ratios are close to the current experimental limits.

Background: In order to control their anti-infectives consumption, hospitals are required to provide multidisciplinary teams comprising among others an infectiologist, a microbiologist and a pharmacist. Small hospitals though often do not dispose of the defaulted personnel. This study illustrates a solution for an antimicrobial stewardship program (ASP) in small community hospitals in a rural area in Germany. Methods: Four hospitals of ca. 200 beds each, jointly hired an antimicrobial stewardship expert to start a common ASP. This expert did rounds on every ward once a week, mostly as chard reviews with the physician in charge. Outside the rounds, he could be consulted by mail. Working time and number of visited patients were documented. Anti-infectives consumption, incidence of Clostridioides difficile infections (CDI) and mortality rates were retrieved from routinely collected data. The intervention period (01/2018–12/2018) was compared to the preintervention period (01/2017–12/2017). Results: 3321 patients were visited in the intervention period. In average, 20 patients were seen per day and 20 min were needed per patient/ chard. About 65% of the expert’s working time was needed for rounds, 15% for driving between the hospitals. The anti-infectives consumption of the 4 hospitals in the preintervention period amounted to 50 defined daily doses per 100 occupied bed days. The total consumption was reduced by 10% and of quinolones by 36%. The incidence of hospital-acquired CDI receded from 0.14 to 0.07 cases per 100 patient days (−50%, p = 0.001). The overall in-hospital mortality did not change. Conclusions: A single expert was able to implement a successfull ASP in 4 hospitals. While multidisciplinary antimicrobial stewardship teams are ideal for tertiary care hospitals, small hospitals need a more practical solution. This survey shows that one expert can be sufficient for several small hospitals even with the distances in a rural setting.

Abstract We provide updated predictions for the hadronic decays $$\bar{B}_s^0\rightarrow D_s^{(*)+} \pi ^-$$ B ¯ s 0 → D s ( ∗ ) + π - and $$\bar{B}^0\rightarrow D^{(*)+} K^-$$ B ¯ 0 → D ( ∗ ) + K - . They are based on $${\mathcal {O}}(\alpha _s^2)$$ O ( α s 2 ) results for the QCD factorization amplitudes at leading power and on recent results for the $$\bar{B}_{(s)} \rightarrow D_{(s)}^{(*)}$$ B ¯ ( s ) → D ( s ) ( ∗ ) form factors up to order $$\mathcal{O}(\Lambda _\mathrm{QCD}^2/m_c^2)$$ O ( Λ QCD 2 / m c 2 ) in the heavy-quark expansion. We give quantitative estimates of the matrix elements entering the hadronic decay amplitudes at order $$\mathcal{O}(\Lambda _\mathrm{QCD}/m_b)$$ O ( Λ QCD / m b ) for the first time. Our results are very precise, and uncover a substantial discrepancy between the theory predictions and the experimental measurements. We explore two possibilities for this discrepancy: non-factorizable contributions larger than predicted by the QCD factorization power counting, and contributions beyond the Standard Model. We determine the $$f_s/f_d$$ f s / f d fragmentation fraction for the CDF, D0 and LHCb experiments for both scenarios.

Abstract Background COVID-19 in Italy has led to the need to reorganize hospital protocols with a significant risk of interruption to cancer treatment programs. In this report, we will focus on a management model covering the two phases of the COVID-19 emergency, namely lockdown-phase I and post-lockdown-phase II. Methods The following steps were taken in the two phases: workload during visits and radiotherapy planning, use of dedicated routes, measures for triage areas, management of suspected and positive COVID-19 cases, personal protective equipment, hospital environments and intra-institutional meetings and tumor board management. Due to the guidelines set out by the Ministry of Health, oncological follow-up visits were interrupted during the lockdown-phase I; consequently, we set about contacting patients by telephone, with laboratory and instrumental exams being viewed via telematics. During the post-lockdown-phase II, the oncological follow-up clinic reopened, with two shifts operating daily. Results By comparing our radiotherapy activity from March 9 to May 4 2019 with the same period in 2020 during full phase I of the COVID-19 emergency, similar results were achieved. First radiotherapy visits, Simulation Computed Tomography and Linear Accelerator treatments amounted to 123, 137 and 151 in 2019 compared with 121, 135 and 170 in 2020 respectively. There were no cases of COVID-19 positivity recorded either in patients or in healthcare professionals, who were all negative to the swab tests performed. Conclusion During both phases of the COVID-19 emergency, the planned model used in our own experience guaranteed both continuity in radiotherapy treatments whilst neither reducing workload nor interrupting treatment and, as such, it ensured the safety of cancer patients, hospital environments and staff.

Abstract We carry out a comprehensive analysis of the full set of $${\bar{B}}_q \rightarrow D_q^{(*)}$$ B¯q→Dq(∗) form factors for spectator quarks $$q=u,d,s$$ q=u,d,s within the framework of the Heavy-Quark expansion (HQE) to order $${\mathcal {O}}\left( \alpha _s, 1/m_b, 1/m_c^2\right) $$ Oαs,1/mb,1/mc2 . In addition to the available lattice QCD calculations we make use of two new sets of theoretical constraints: we produce for the first time numerical predictions for the full set of $${\bar{B}}_s \rightarrow D_s^{(*)}$$ B¯s→Ds(∗) form factors using Light-Cone sum rules with $$B_s$$ Bs -meson distribution amplitudes. Furthermore, we reassess the QCD three-point sum rule results for the Isgur-Wise functions entering all our form factors for both $$q=u,d$$ q=u,d and $$q=s$$ q=s spectator quarks. These additional constraints allow us to go beyond the commonly used assumption of $$SU(3)_F$$ SU(3)F symmetry for the $${{\bar{B}}}_s\rightarrow D_s^{(*)}$$ B¯s→Ds(∗) form factors, especially in the unitarity constraints which we impose throughout our analysis. We find the coefficients of the IW functions emerging at $${\mathcal {O}}\left( 1/m_c^2\right) $$ O1/mc2 to be consistent with the naive $${\mathcal {O}}\left( 1\right) $$ O1 expectation, indicating a good convergence of the HQE. While we do not find significant SU(3) breaking, the explicit treatment of $$q=s$$ q=s as compared to a simple symmetry assumption renders the unitarity constraints more effective. We find that the (pseudo)scalar bounds are saturated to a large degree, which affects our theory predictions. We analyze the phenomenological consequences of our improved form factors by extracting $$|V_{cb}|$$ |Vcb| from $${\bar{B}}\rightarrow D^{(*)}\ell \nu $$ B¯→D(∗)ℓν decays and producing theoretical predictions for the lepton-flavour universality ratios R(D), $$R(D^*)$$ R(D∗) , $$R(D_s)$$ R(Ds) and $$R(D_s^*)$$ R(Ds∗) , as well as the $$\tau $$ τ - and $$D_q^*$$ Dq∗ polarization fractions for the $${\bar{B}}_q\rightarrow D_q^{(*)}\tau \nu $$ B¯q→Dq(∗)τν modes.

Background: According to extrapolations, around 35,000 patients in Germany develop hospital acquired infections (HAI) with a multidrug-resistant organism (MDRO) every year, and about 1500 of them die. Previous estimations were based on laboratory data and prevalence studies. Aim of this study was to establish the incidences of hospital acquired MDRO infections and the resulting deaths by expert review. Methods: Data on patients suffering from a hospital acquired MDRO infection were collected from 32 hospitals from all care levels. Records of patients with MDRO infection who died in the year 2016 underwent an onsite review by two experts to determine the impact of the infection, if any, on the cause of death. Results: A total of 714,108 in-patients were treated in 32 hospitals participating in the study. Of these patients, 1136 suffered a hospital acquired MDRO infection (1.59 per 1000 patients). 215 patients with an MDRO infection died [0.301 per 1000, (95% CI 0,261–0,341)], but only in 78 cases this was estimated as the cause of death [0.109 per 1000 patients (95% CI 0.085–0.133)]. Conclusion: By putting the above rates in relation to the total number of in-patients in Germany, it can be rated that around 31,052 patients per year suffer a hospital acquired MDRO infection, and 2132 patients die from it. These results from our reviewer investigation confirm earlier extrapolations. Keywords: Mortality, Multi drug resistant organism, Antibiotics, Expert review, Hospital acquired infection

Abstract Extending the Standard Model with higher-dimensional operators in an effective field theory (EFT) approach provides a systematic framework to study new physics (NP) effects from a bottom-up perspective, as long as the NP scale is sufficiently large compared to the energies probed in the experimental observables. However, when taking into account the different quark and lepton flavours, the number of free parameters in- creases dramatically, which makes generic studies of the NP flavour structure infeasible. In this paper, we address this issue in view of the recently observed “flavour anomalies” in B-meson decays, which we take as a motivation to develop a general framework that allows us to systematically reduce the number of flavour parameters in the EFT. This framework can be easily used in global fits to flavour observables at Belle II and LHCb as well as in analyses of flavour-dependent collider signatures at the LHC. Our formalism represents an extension of the well-known minimal-flavour-violation approach, and uses Froggatt-Nielsen charges to define the flavour power-counting. As a relevant illustration of the formalism, we apply it to the flavour structures which could be induced by a U 1 vector leptoquark, which represents one of the possible explanations for the recent hints of flavour non-universality in semileptonic B-decays. We study the phenomenological viability of this specific framework performing a fit to low-energy flavour observables.

Abstract We carry out an analysis of the full set of ten $$\bar{B}\rightarrow D^{(*)}$$ B¯→D(∗) form factors within the framework of the Heavy-Quark Expansion (HQE) to order $$\mathcal {O}\left( \alpha _s,\,1/m_b,\,1/m_c^2\right) $$ Oαs,1/mb,1/mc2 , both with and without the use of experimental data. This becomes possible due to a recent calculation of these form factors at and beyond the maximal physical recoil using QCD light-cone sum rules, in combination with constraints from lattice QCD, QCD three-point sum rules and unitarity. We find good agreement amongst the various theoretical results, as well as between the theoretical results and the kinematical distributions in $$\bar{B}\rightarrow D^{(*)}\lbrace e^-,\mu ^-\rbrace \bar{\nu }$$ B¯→D(∗){e-,μ-}ν¯ measurements. The coefficients entering at the $$1/m_c^2$$ 1/mc2 level are found to be of $$\mathcal {O}(1)$$ O(1) , indicating convergence of the HQE. The phenomenological implications of our study include an updated exclusive determination of $$|V_{cb}|$$ |Vcb| in the HQE, which is compatible with both the exclusive determination using the BGL parametrization and with the inclusive determination. We also revisit predictions for the lepton-flavour universality ratios $$R_{D^{(*)}}$$ RD(∗) , the $$\tau $$ τ polarization observables $$P_\tau ^{D^{(*)}}$$ PτD(∗) , and the longitudinal polarization fraction $$F_L$$ FL . Posterior samples for the HQE parameters are provided as ancillary files, allowing for their use in subsequent studies.

Vaccination plays a key role in tackling the ongoing SARS-CoV-2 pandemic but data regarding the individual’s protective antibody level are still pending. Our aim is to identify factors that influence antibody response following vaccination in healthcare workers. This single-center study was conducted at Evangelische Kliniken Gelsenkirchen, Germany. Healthcare workers were invited to answer a questionnaire about their vaccinations and adverse reactions. Subsequently, the level of anti-receptor binding domain (RBD) IgG antibody against SARS-CoV-2′s spike protein through blood samples was measured. For statistics, we used a defined correlation of protection (CoP) and examined risk factors associated with being below the given CoP. A total of 645 employees were included and most were female (n = 481, 77.2%). A total of 94.2% participants had received two doses of vaccines (n = 587) and 12.4% (n = 720) had been infected at least once. Most common prime-boost regimen was BNT162b2 + BNT162b2 (57.9%, n = 361). Age (p < 0.001), days since vaccination (p = 0.007), and the homologous vaccination regimen with ChAdOx + ChAdOx (p = 0.004) were risk factors for the antibody level being below the CoP, whereas any previous COVID-19 infection (p < 0.001), the number of vaccines (p = 0.016), and physical complaints after vaccination (p = 0.01) were associated with an antibody level above the CoP. Thus, age, vaccination regimen, days since vaccination, and previous infection influence the antibody level. These risk factors should be considered for booster and vaccinations guidelines.

We discuss the impact of the recent O(αs3) calculations of the semileptonic width of the b quark and of the relation between pole and kinetic heavy quark masses by Fael et al. on the inclusive determination of |Vcb|. The most notable effect is a reduction of the uncertainty. Our final result is |Vcb|=42.16(51)10−3.

The Versilia plain (NW Italy) experiences forms of tourism that are mainly limited to the beach area and concentrated in the summer season. The area is rich in cultural and natural heritage, not yet adequately enhanced. The presence of four local archaeological museums and a natural park offers a great opportunity to favour feasible archaeological and environmental tourism. The aim of this study is to use a holistic methodology to improve a different type of tourism in the study area. We propose a consilient multidisciplinary approach based on geological, biological and archaeological data in order to enhance the cultural and natural heritage of the Versilia plain. We have based our study on the reconstruction of palaeoenvironment maps showing the evolution of the territory and used them as a leitmotiv to link the archaeological museums and the natural park. We define real and virtual itineraries to create a synergy between the most important archaeological and natural sites and museums. It is possible to promote a different type of tourism in the study area by decreasing human impact and creating a relationship between the fragmented natural and archaeological heritage. Palaeoenvironment maps and real and virtual itineraries can be consulted with the aid of a web application, more specifically web mapping, developed with free and open-source libraries. The web mapping also contains other geological, geomorphological and archaeological datasets, which allow to understand the evolution of the environment and the cultural and natural heritage of the study area. The dataset available on the web mapping is also downloadable.

Immunocastration has been pointed out as an alternative to surgical castration; though, most of the scientific studies were performed in light pig production. This study aimed to evaluate the effect of immunocastration on animal welfare in heavy pig production through the evaluation of behaviour and body lesions. A total of 188 commercial-hybrid pigs were randomly allocated into two treatment groups: surgical castration (SC) and immunocastration with Improvac® (IC). Data on behaviour, body lesions, and salivary testosterone levels were collected the day before each vaccination at 15, 22, 32, and 36 weeks of age. IC and SC pigs were slaughtered at 40 and 41 weeks of age, respectively; productive and carcass traits data were also collected. Considering productive performance, our results confirmed that IC pigs grew faster and presented a higher weight at slaughter. A critical period for pig welfare was observed before 32 weeks: testosterone concentration and body lesion score were significantly higher in IC pigs compared to SC pigs; active behaviours were significantly more frequent in IC at 15 weeks. Immunocastration may represent a suitable alternative to surgical castration with profitable productive performances, whereas the impairment of welfare during the period before the effective vaccination should be further investigated as a potential critical aspect in heavy pig production.

AimThe primary aim of this study was to assess insulin requirements and carbohydrate to insulin ratio (CHO/IR) in normal weight, overweight, and obese pregnant women with type 1 diabetes across early, middle, and late pregnancy.MethodsIn this multicenter, retrospective, observational study we evaluated 86 of 101 pregnant Caucasian women with type 1 diabetes under pump treatment. The women were trained to calculate CHO/IR daily by dividing CHO grams of every single meal by insulin units injected. Since the purpose of the study was to identify the CHO/IR able to reach the glycemic target, we only selected the CHO/IR obtained when glycemic values were at target. Statistics: SPSS 20.ResultsWe studied 45 normal weight, 31 overweight, and 10 obese women. Insulin requirements increased throughout pregnancy (p < 0.0001 and

Background Paranasal sinuses act as bacterial reservoirs and contribute to transmitting bacteria to the lower airway of patients with cystic fibrosis (CF). Also, passage of bacteria from the oral cavity to the lungs may occur. Methods We evaluated the presence of Pseudomonas aeruginosa, Staphylococcus aureus, Stenotrophomonas maltophilia, Achromobacter xylosoxidans and Serratia marcescens in sputum and nasal lavage of 59 patients with CF, and also collected saliva and used toothbrushes from 38 of them. We assessed the clonal identity of the strains isolated from the different samples by pulsed-field gel electrophoresis. Results About 80% of the patients were positive for at least one of the bacterial species examined in nasal lavage and sputum. Among the subjects with positive sputum, 74% presented the same species in the nasal lavage and saliva, and 26% on their toothbrush. S. aureus was the most abundant species in all samples. Clonal identity (≥80% similarity) of the strains isolated among the different samples from each patient was confirmed in almost all cases. Longitudinal observation helped to identify five patients who were colonised in the lower airways after an initial period of nasal or oral colonisation. Conclusion Nasal and oral sites act as bacterial reservoirs, favouring the transmission of potentially pathogenic microorganisms to the lower airway. The lack of eradication from these sites might undermine the antibiotic therapy applied to treat the lung infection, allowing the persistence of the bacteria within the patient if colonisation of these sites is not assessed, and no specific therapy is performed.

Background: Cystic fibrosis (CF) lung infection is a complex condition where opportunistic pathogens and defective immune system cooperate in developing a constant cycle of infection and inflammation. The major pathogen, Pseudomonas aeruginosa, secretes a multitude of virulence factors involved in host immune response and lung tissue damage. In this study, we examined the possible anti-inflammatory effects of molecules inhibiting P. aeruginosa virulence factors. Methods: Pyocyanin, pyoverdine and proteases were measured in bacterial culture supernatant from different P. aeruginosa strains. Inhibition of virulence factors by sub-inhibitory concentrations of clarithromycin and by protease inhibitors was evaluated. Lung inflammatory response was monitored by in vivo bioluminescence imaging in wild-type and CFTR-knockout mice expressing a luciferase gene under the control of a bovine IL-8 promoter. Results: The amount of proteases, pyocyanin and pyoverdine secreted by P. aeruginosa strains was reduced after growth in the presence of a sub-inhibitory dose of clarithromycin. Intratracheal challenge with culture supernatant containing bacteria-released products induced a strong IL-8-mediated response in mouse lungs while lack of virulence factors corresponded to a reduction in bioluminescence emission. Particularly, sole inactivation of proteases by inhibitors Ilomastat and Marimastat also resulted in decreased lung inflammation. Conclusions: Our data support the assumption that virulence factors are involved in P. aeruginosa pro-inflammatory action in CF lungs; particularly, proteases seem to play an important role. Inhibition of virulence factors production and activity resulted in decreased lung inflammation; thus, clarithromycin and protease inhibitors potentially represent additional therapeutic therapies for P. aeruginosa-infected patients.

Abstract The three-site Pati-Salam gauge model provides a consistent description for the hints of lepton-flavor non-universality observed in B decays, connecting the present pattern of “anomalies” to the origin of the Standard Model Yukawa couplings. We present here a detailed analysis of the model predictions for a series of low-energy observables, mainly in B and τ physics. The model is in good agreement with present data and predicts a well-defined pattern of non-standard effects in low-energy observables that could allow us to test it in the near future. Particularly interesting are the predictions of large τ → μ Lepton Flavor Violating processes, such as τ → μγ, τ → 3μ, B → Kτ μ, and B s → τ μ. Also μ → 3e, μ → eγ, and K L → μe decays could be not far from the present exclusion bounds, although this conclusion is more model dependent.

Abstract Lepton Flavour Universality tests with semileptonic Λ b → Λ c * decays are important to corroborate the present anomalies in the similar ratios RD∗ $$ {R_D}_{{}^{\left(\ast \right)}} $$, and can provide complementary constraints on possible origins of these anomalies beyond the Standard Model. In this paper we provide — for the first time — all the necessary theoretical ingredients to perform and interpret measurements of RΛc* $$ {R}_{\Lambda_c^{*}} $$ at the LHCb experiment. For this, we revisit the heavy-quark expansion of the relevant hadronic matrix elements, and provide their expressions to order α s and 1/m accuracy. Moreover, we study the sensitivity to the form factor parameters given the projected size and purity of upcoming and future LHCb datasets of Λb→Λc*μν¯ $$ {\Lambda}_b\to {\Lambda}_c^{*}\mu \overline{\nu} $$ decays. We demonstrate explicitly the need to perform a simultaneous fit to both Λ c * final states. Finally, we provide projections for the uncertainty of RΛc* $$ {R}_{\Lambda_c^{*}} $$ based on the form factors analysis from semimuonic decays and theoretical relations based on the heavy-quark expansion.

We present a three-site Pati–Salam gauge model able to explain the Standard Model flavor hierarchies while, at the same time, accommodating the recent experimental hints of lepton-flavor non-universality in B decays. The model is consistent with low- and high-energy bounds, and predicts a rich spectrum of new states at the TeV scale that could be probed in the near future by the high-pT experiments at the LHC.

In the lungs of patients with cystic fibrosis (CF), the main pathogen Pseudomonas aeruginosa is often co-isolated with other microbes, likely engaging in inter-species interactions. In the case of chronic co-infections, this cohabitation can last for a long time and evolve over time, potentially contributing to the clinical outcome. Interactions involving the emerging pathogens Achromobacter spp. have only rarely been studied, reporting inhibition of P. aeruginosa biofilm formation. To evaluate the possible evolution of such interplay, we assessed the ability of Achromobacter spp. isolates to affect the biofilm formation of co-isolated P. aeruginosa strains during long-term chronic co-infections. We observed both competition and cohabitation. An Achromobacter sp. isolate secreted exoproducts interfering with the adhesion ability of a co-isolated P. aeruginosa strain and affected its biofilm formation. Conversely, a clonal Achromobacter sp. strain later isolated from the same patient, as well as two longitudinal strains from another patient, did not show similar competitive behavior against its P. aeruginosa co-isolates. Genetic variants supporting the higher virulence of the competitive Achromobacter sp. isolate were found in its genome. Our results confirm that both inter-species competition and cohabitation are represented during chronic co-infections in CF airways, and evolution of these interplays can happen even at the late stages of chronic infection.

Abstract We analyse the rare processes $$K\rightarrow \pi \nu \bar{\nu }$$ K → π ν ν ¯ in view of the recent hints of violations of lepton-flavour universality (LFU) observed in B meson decays. If, as suggested by present data, the new interactions responsible for LFU violations couple mainly to the third generation of left-handed fermions, $$K\rightarrow \pi \nu \bar{\nu }$$ K → π ν ν ¯ decays turn out to be particularly interesting: these are the only kaon decays with third-generation leptons (the $$\tau $$ τ neutrinos) in the final state. In order to relate B-physics anomalies and K decays we adopt an effective field theory approach, assuming that the new interactions satisfy an approximate $$U(2)_q\times U(2)_\ell $$ U ( 2 ) q × U ( 2 ) ℓ flavour symmetry. In this framework we show that O(1) deviations from the Standard Model predictions in $$K\rightarrow \pi \nu \bar{\nu }$$ K → π ν ν ¯ branching ratios, closely correlated to similar effects in $$B\rightarrow K^{(*)}\nu \bar{\nu }$$ B → K ( ∗ ) ν ν ¯ , are naturally expected. The correlation of $$\mathcal {B}(K \rightarrow \pi \nu \bar{\nu })$$ B ( K → π ν ν ¯ ) , $$\mathcal {B}(B\rightarrow K^{(*)}\nu \bar{\nu })$$ B ( B → K ( ∗ ) ν ν ¯ ) , and the LFU violations in B decays would provide a very valuable tool to shed more light on this interesting phenomenon.

Objective The aim of the analysis is to assess the organisational and economic consequences of adopting an early discharge strategy for the treatment of acute bacterial skin and skin structure infection (ABSSSI) and osteomyelitis within infectious disease departments.Setting Infectious disease departments in Greece, Italy and Spain.Participants No patients were involved in the analysis performed.Interventions An analytic framework was developed to consider two alternative scenarios: standard hospitalisation care or an early discharge strategy for patients hospitalised due to ABSSSI and osteomyelitis, from the perspective of the National Health Services of Greece, Italy and Spain. The variables considered were: the number of annual hospitalisations eligible for early discharge, the antibiotic treatments considered (ie, oral antibiotics and intravenous long-acting antibiotics), diagnosis-related group (DRG) reimbursements, number of days of hospitalisation, incidence and costs of hospital-acquired infections, additional follow-up visits and intravenous administrations. Data were based on published literature and expert opinions.Primary and secondary outcome measures Number of days of hospitalisation avoided and direct medical costs avoided.Results The total number of days of hospitalisation avoided on a yearly basis would be between 2216 and 5595 in Greece (−8/−21 hospital beds), between 15 848 and 38 444 in Italy (−57/−135 hospital beds) and between 7529 and 23 520 in Spain (−27/−85 hospital beds). From an economic perspective, the impact of the early discharge scenario is a reduction between €45 036 and €149 552 in Greece, a reduction between €182 132 and €437 990 in Italy and a reduction between €292 284 and €884 035 in Spain.Conclusions The early discharge strategy presented would have a positive organisational impact on National Health Services, leading to potential savings in beds, and to a reduction of hospital-acquired infections and costs.

Recent findings indicate that the oral cavity acts as a bacterial reservoir and might contribute to the transmission of bacteria to the lower airways. Control of a potentially pathogenic microbiota might contribute to prevent the establishment of chronic infection in cystic fibrosis. We evaluated the presence of CF microorganisms in saliva and toothbrushes of CF patients and verify their possible transmission to lower airways. Methods: We assessed the presence of P. aeruginosa, S. aureus, S. maltophilia, A. xylosoxidans, S. marcescens, and yeasts in saliva, toothbrushes and sputum of 38 CF patients and assessed the clonal identity of the strains occurring contemporary in multiple sites by PFGE. Results: At least one of the investigated species was isolated from 60 saliva samples and 23 toothbrushes. S. aureus was the most abundant species, followed by Candida spp. 31 patients contemporary had the same species in sputum and saliva/toothbrush: in most cases, clonal identity of the strains among the different sites was confirmed. Conclusion: Toothbrushes may be sources of oral contamination and might act as reservoirs favoring transmission of potentially pathogenic microorganisms from the environment to the oral cavity and eventually to the LAW. Oral hygiene and toothbrush care are important strategies to prevent CF lung infections.

I review the parametrisation of the full set of Λb→Λ*(1520) form factors in the framework of Heavy Quark Expansion, including next-to-leading-order O(αs) and, for the first time, next-to-leading-power O(1/mb) corrections. The unknown hadronic parameters are obtained by performing a fit to recent lattice QCD calculations. I investigate the compatibility of the Heavy Quark Expansion and the current lattice data, finding tension between these two approaches in the case of tensor and pseudo-tensor form factors, whose origin could come from an underestimation of the current lattice QCD uncertainties and higher order terms in the Heavy Quark Expansion.

BACKGROUND: Hepatitis C Virus (HCV) infection represents a global health problem, leading to chronic cirrhosis, hepatocellular carcinoma (HCC), hepatic decompensation and liver transplant. The aim of the study was the evaluation of the impact on the budget of the Italian National Health Service (INHS) of the use of Daclatasvir (DCV) for the treatment of HCV genotype 3 in patients with advanced fibrosis. METHODS: An analytical decision model with a five year time horizon was implemented. Two scenarios were considered: a. 100% of market share for Interferon (INF-α)+Ribavirin (RBV)+Sofosbuvir (SOF) for 12 weeks; b. SOF+DCV+RBV for 24 weeks with annual market shares of 50% in 2015 and 2016, 55% in 2017 and 2018, 60% in 2019, and INF-α+RBV+SOF for 12 weeks with the remaining market shares. Every annual cycle a percentage of patients equal to the effectiveness of the antiviral treatment reach a sustained virologic response and during the first year of treatment patients may experience treatment related adverse events. The costs considered (2015) are those of the antiviral therapy, and direct medical costs for health state and adverse events management. Univariate and multivariate sensitivity analyses were performed. RESULTS: DCV would lead to an increase of the costs for the INHS (year 1 +21.31 millions, year 2 +21.35 millions, year 3 + 23.37 millions, year 4 + 23.26 millions and year 5 +16.37 millions). The sensitivity analysis confirmed the robustness of the results. CONCLUSIONS: The use of DCV is likely to have a short term impact on the INHS budget increasing resources use compared to the sole use of INF-α+RBV+SOF. However, a trend of reduction of the costs increase is observed due to the management of health states and adverse events which may lead to the possibility to reduce costs in the long term.

This study focused on loin quality in Italian heavy pigs intended for the production of PDOs (Protected Designation of Origin) products, and investigated the pre-slaughter factors which negatively affect the quality of fresh meat. Data were collected on 44 shipments (loads) of pigs. Shipments were carried out under commercial conditions. Several pre-slaughter parameters were recorded within the entire process (on-farm, during transport, and at the slaughterhouse). On a subset of pigs (10 animals from every load, N = 440), serum cortisol and creatine kinase were measured and loin samples were analyzed for pH, instrumental color, drip loss, cooking loss, shear force, and sensory quality. Cluster analysis of the instrumentally-assessed meat quality parameters allowed the categorization of the shipments into two clusters: lower quality (LQ) and higher quality (HQ). Our results showed that the factors with significant differences between the two clusters were journey duration, ambient temperature, distance traveled, and irregular behaviors (slipping, falling, and overlapping) at unloading (all greater in LQ, p < 0.05). The pre-slaughter conditions associated with lower loin quality were ambient temperatures above 22 °C, distance traveled above 26 km, travel duration between 38–66 min, more than 5.9% of animals showing irregular behaviors at unloading.

This study aimed at identifying possible pre-slaughter indicators and/or indexes to be used to predict pig stress response and meat quality variation. Data were collected on 44 shipments (loads) of Italian heavy pigs. For each shipment, several pre-slaughter parameters were recorded on farm, during transport, and at the slaughterhouse. Blood and meat samples were taken from 10 pigs from every of the 44 loads included in the study (N = 440). Blood samples were used to assess cortisol and creatine kinase levels, whereas meat samples were used to assess meat quality (pH, instrumental color, tenderness, water-holding capacity, and sensory analysis). Cluster analysis of blood parameters allowed the categorization of the shipments into two main clusters: Lower Stress (LS) and Higher Stress (HS). The variables/indexes statistically differing between the two clusters were: average vehicle speed during transport, welfare index at slaughter (i.e., “slaughter score”), overall transport and slaughter welfare index (TSWI), distance travelled, and behaviors (slips, falls, overlaps) during unloading, which appeared to be the best descriptors of the welfare conditions experienced by Italian heavy pigs during pre-slaughter handling. No consistent effects of the stress level experienced on meat quality was detected, which warrants the need for further studies conducted under more variable pre-slaughter conditions, with the aim of simplifying and improving the TSWI.

The construction industry, particularly the public sector, started drawing attention towards containing costs and increasing performance. This is why several public entities worldwide are promoting new strategies and adopted innovating approaches such as the Building Information Modelling (BIM). Countries like the UK, Germany, France and Spain are working on it through investments in the industry digitalization. In Italy, despite the fact that the growing implementation of information-based technologies is not supported by a governmental strategy, public calls for tender requiring BIM have been set up. In addition, in order to benefit from a BIM-based approach, cooperating processes are being arranged to involve several parties from the very first stages of the project itself. This way flaws will be sorted out in advance and out of the construction site, and at the same time ideal solutions will be identified for the entire building lifecycle. Within the BIM methodology, a key role is played by Model Checking, which enables verification and validation of all projects, not only in the design phase, but also throughout the process phases. In order to guarantee reliable results, an initial pre-check should be carried out, the so called BIM Validation. This validates the data content of the Information Model and subsequently carries out analyses such as Clash Detection and Code Checking. The Information Model must come out of a meticulous modelling phase, in order to validate its geometric and alphanumeric content and ensure reliable results first, and then proceed with subsequent BIM-based analyses.

L’industria delle costruzioni, e in particolar modo il settore pubblico, ha iniziato a porre più attenzione al contenimento dei costi e all’aumento delle prestazioni. Per questo motivo diversi enti pubblici in tutto il mondo stanno promuovendo nuove strategie adottando approcci innovativi come il Building Information Modelling (BIM). Paesi come Regno Unito, Germania, Francia e Spagna stanno lavorando in questa direzione investendo nella digitalizzazione del settore. Anche in Italia, sebbene l’implementazione, sempre più diffusa, delle tecnologie information-based non sia accompagnata da una strategia governativa, sono stati pubblicati bandi pubblici che richiedono l’uso del BIM. Inoltre, al fine di trarre maggiori vantaggi da un approccio BIM-based, si stanno diffondendo processi collaborativi che prevedono un coinvolgimento dei diversi attori fin dalle prime fasi del progetto. In questo modo è possibile anticipare la risoluzione di eventuali criticità prima di entrare in cantiere, individuando nello stesso tempo soluzioni ottimali per l’intero ciclo di vita di un fabbricato. All’interno della metodologia BIM, un ruolo chiave è rivestito dal Model Checking grazie al quale è possibile verificare e validare i progetti non solo in fase progettuale, ma anche durante tutte le fasi del processo. Per garantire risultati affidabili, il controllo deve partire da un’iniziale pre-check, definito BIM Validation, che validi il contenuto informativo dell’Information Model per poi procedere ad ulteriori analisi quali Clash Detection e Code Checking. L’Information Model deve essere il risultato di un’accurata fase di modellazione per poterne validare il contenuto geometrico e alfanumerico garantendo risultati affidabili per procedere, poi, con successive analisi BIM-based.

Los parques urbanos son elementos de la infraestructura verde que deben contribuir a mejorar la calidad de vida y el bienestar ciudadano. En este trabajo se presentan los resultados de la aplicación de un novedoso índice que estima la alergenicidad potencial de las zonas verdes urbanas. Este índice, que contempla parámetros biológicos y biométricos intrínsecos a las especies arbóreas existentes en los parques, genera un resultado cuyo valor está comprendido entre 0 y 1 según el potencial alergénico del parque sea nulo o de riesgo alto para la población. En una primera fase el índice se ha aplicado a parques de diferente tipología, diseño, tamaño, riqueza específica y biodiversidad ubicados en 20 ciudades españolas. Los resultados han mostrado que algunos de los parques estudiados registran un valor de índice superior a 0.30, umbral suficiente para causar síntomas de alergia a la población expuesta, y por tanto, de riesgo moderado o alto. Por el contrario, en la mayoría de los parques se obtuvo un valor inferior a este umbral. También es posible conocer cuáles son las especies que más contribuyen al valor resultante, que son aquellas con estrategia de polinización anemófila, periodos de oración extensos y alta alergenicidad referenciada. Estos requisitos los cumplen todas las especies de las familias Betuláceas, Cupresáceas y Moráceas, y en menor extensión, Oleáceas y Platanáceas. Puede concluirse que el desarrollo de un índice de estimación de alergenicidad de espacios verdes urbanos constituye una herramienta de utilidad para minimizar el impacto de la alergia polínica en la población.

Insulin therapy is still the gold standard in diabetic pregnancy. Insulin lispro protamine suspension is an available basal insulin analogue. Aim. To study pregnancy outcomes of women with type 2 and gestational diabetes mellitus when insulin lispro protamine suspension or human NPH insulin was added to medical nutrition therapy and/or short-acting insulin. Methods. In this retrospective study, for maternal outcome we recorded time and mode of delivery, hypertension, glycaemic control (fasting blood glucose and HbA1c), hypoglycemias, weight increase, and insulin need. For neonatal outcome birth weight and weight class, congenital malformations was recorded and main neonatal complications. Two-tail Student's t-test and chi-square test were performed when applicable; significant P