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Objectives: To demonstrate the effectiveness and the safety of laser thermal ablation (LTA) in patients with unresectable hepatocellular carcinoma (HCC) deemed not accessible for other percutaneous procedures (radiofrequency ablation, sclerotherapy).Methods: From September 2003 to August 2008, 140 patients with HCC nodules were treated. In 49 patients, the lesions were localized in "critical sites". A total of 29 men and 20 women (age range 51-79 years; Child-Pugh score A = 75.51%, B = 24.49%) with 52 nodules (mean diameter 2.0 +/- 1.2 cm) were treated in 95 percutaneous LTA sessions. We compared major and minor complications observed in the two groups of patients. Effectiveness was defined as the percentage of HCCs completely ablated after percutaneous LTA. Follow-up was carried out with computed tomography (CT) at 1, 3, 6, 9, and 12 months.Results: No major complications or deaths were registered. In a few patients (8.16%), minor complications were observed. No substantial differences were observed on comparing the percentage of minor and major complications in these patients with the remaining patients. A difference in terms of effectiveness was found.Conclusion: LTA can be considered a safe treatment in "critical nodules". [ABSTRACT FROM AUTHOR]

Rapid urbanization has led to negative, and sometimes unintended, consequences on biodiversity and human health. While cities offer numerous advantages in meeting the basic needs of a growing population, they also pose less apparent and longer-term health costs. To address the multifaceted impacts of urbanization, an evidence-based design framework for establishing mitigation and regeneration actions is essential. Via a "One Health" approach, this perspective provides recommendations and strategies for the urban ecosystem rehabilitation of future cities, placing biodiversity and ecosystem services at the core of designing healthy and sustainable urban spaces. The framework we propose is based on a Hub and Spoke model to integrate diverse perspectives from public and private sectors and declined in a six-building-blocks structure. This will ensure that efforts are sustainable, health-centered, socially inclusive, and grounded in high-quality data, reinforcing the essential connection between healthy environments and thriving communities., Competing Interests: M.B., B.P., and N.R. are inventors of exp-EIA© (experiential Environmental Impact Assessment) method (Patent 1: Italian Publication Number 102021000017168 - 30/06/2021; International Publication Number WO 2023/275679 A1 - 5.1.2023). M.B., L.M., B.P., and N.R. are inventors of exp-EIA© (experiential Environmental Impact Assessment) method (Patent 2: Italian Patent Publication filed Number 102024000011161 - 16.5.2024). The other authors declare no competing interests., (© 2024 The Author(s).)

West Nile disease is a vector-borne disease caused by West Nile virus (WNV), involving mosquitoes as vectors and birds as maintenance hosts. Humans and other mammals can be infected via mosquito bites, developing symptoms ranging from mild fever to severe neurological infection. Due to the worldwide spread of WNV, human infection risk is high in several countries. Nevertheless, there are still several knowledge gaps regarding WNV dynamics. Several aspects of transmission taking place between birds and mosquitoes, such as the length of the infectious period in birds or mosquito biting rates, are still not fully understood, and precise quantitative estimates are still lacking for the European species involved. This lack of knowledge affects the precision of parameter values when modelling the infection, consequently resulting in a potential impairment of the reliability of model simulations and predictions and in a lack of the overall understanding of WNV spread. Further investigations are thus needed to better understand these aspects, but field studies, especially those involving several wild species, such as in the case of WNV, can be challenging. Thus, it becomes crucial to identify which transmission processes most influence the dynamics of WNV. In the present work, we propose a sensitivity analysis to investigate which of the selected epidemiological parameters of WNV have the largest impact on the spread of the infection. Based on a mathematical model simulating WNV spread into the Lombardy region (northern Italy), the basic reproduction number of the infection was estimated and used to quantify infection spread into mosquitoes and birds. Then, we quantified how variations in four epidemiological parameters representing the duration of the infectious period in birds, the mosquito biting rate on birds, and the competence and susceptibility to infection of different bird species might affect WNV transmission. Our study highlights that knowledge gaps in WNV epidemiology affect the precision in several parameters. Although all investigated parameters affected the spread of WNV and the modelling precision, the duration of the infectious period in birds and mosquito biting rate are the most impactful, pointing out the need of focusing future studies on a better estimate of these parameters at first. In addition, our study suggests that a WNV outbreak is very likely to occur in all areas with suitable temperatures, highlighting the wide area where WNV represents a serious risk for public health., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2023 Fesce et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

North American raccoons (Procyon lotor) have been introduced to several European countries, where they may represent a sanitary threat as hosts of several pathogens such as the zoonotic ascarid Baylisascaris procyonis. We carried out parasitological analysis on raccoons introduced to Italy to verify whether the species had carried along B. procyonis or any other gastro-intestinal helminths that may threaten humans, livestock or native wildlife. We examined 64 raccoons culled in Northern Italy during control activities and 3 roadkills opportunistically sampled from a separate population located in central Italy. Helminths were collected from the gastro-intestinal tract through standard parasitological techniques and identified based on a combination of morphology and molecular methods. Overall, examined raccoons showed a poor parasitic fauna, with almost 30% of individuals free of any helminth infection. The most prevalent species were the nematodes Strongyloides procyonis (26.9%), Aonchotheca putorii (25.4%) and Porrocaecum sp. (19.4%). Plagiorchis sp. trematodes were also common (13.4%), whereas cestodes were scarcely represented. With the exception of S. procyonis introduced from North America, all the other identified taxa have either a Eurasian or a wide Holarctic distribution. Despite not finding any B. procyonis in the examined raccoons, passive surveillance for this parasite should be implemented, especially in Tuscany, since the limited host sample examined in the present survey does not allow to exclude its presence., (Copyright © 2021 Elsevier B.V. All rights reserved.)

During the last century, emerging diseases have increased in number, posing a severe threat for human health. Zoonoses, in particular, represent the 60% of emerging diseases, and are a big challenge for public health due to the complexity of their dynamics. Mathematical models, by allowing an a priori analysis of dynamic systems and the simulation of different scenarios at once, may represent an efficient tool for the determination of factors and phenomena involved in zoonotic infection cycles, but are often underexploited in public health. In this context, we developed a deterministic mathematical model to compare the efficacy of different intervention strategies aimed at reducing environmental contamination by macroparasites, using raccoons (Procyon lotor) and their zoonotic parasite Bayilsascaris procyonis as a model system. The three intervention strategies simulated are raccoon depopulation, anthelmintic treatment of raccoons and faeces removal. Our results show that all these strategies are able to eliminate the parasite egg population from the environment, but they are effective only above specific threshold coverages. Host removal and anthelmintic treatment showed the fastest results in eliminating the egg population, but anthelmintic treatment requires a higher effort to reach an effective result compared to host removal. Our simulations show that mathematical models can help to shed light on the dynamics of communicable infectious diseases, and give specific guidelines to contain B. procyonis environmental contamination in native, as well as in new, areas of parasite emergence. In particular, the present study highlights that identifying in advance the appropriate treatment coverage is fundamental to achieve the desired results, allowing for the implementation of cost- and time-effective intervention strategies., Competing Interests: The authors have declared that no competing interests exist.

Aims: To measure patients' satisfaction after endoscopic retrograde cholangiopancreatography (ERCP) for biliary stones in a large number of unselected endoscopy units., Methods: A prospective study using a questionnaire (Group Health Association of America-9 [GHAA-9], modified) was administered 24 h and 30 days after the procedure. Patients undergoing endoscopy for biliary stones for the first time were enrolled in a large number of endoscopy units, regardless of their size and workload., Results: In all, 700 patients were enrolled in 15 units. A high proportion of patients expressed satisfaction (80%). Satisfaction was less extensive for pain control and the quality of information provided before the procedure. There were no differences in the replies to questionnaires at 24 h and 30 days., Conclusion: It is feasible to record patients' satisfaction and in this series most patients were very satisfied. Criticisms concerned pain control and explanations provided before the procedure.