Search

Abstract Background Patients with hematological malignancies (HM) have a high risk of severe coronavirus disease 2019 (COVID‐19), also in the Omicron period. Material and methods Retrospective single‐center study including HM patients with severe acute respiratory syndrome Coronavirus 2 (SARS‐CoV2) infection from January 2022 to March 2023. Study outcomes were respiratory failure (RF), mechanical ventilation (MV), and COVID‐related mortality, comparing patients according to SARS‐CoV2 serology. Results Note that, 112 patients were included: 39% had negative SARS‐CoV2 serology. Seronegative were older (71.5 vs. 65.0 years, p = 0.04), had more often a lymphoid neoplasm (88.6% vs. 69.1%, p = 0.02), underwent anti‐CD20 therapy (50.0% vs. 30.9% p = 0.04) and had more frequently a severe disease (23.0% vs. 3.0%, p = 0.02) than seropositive. Kaplan‐Meier showed a higher risk for seronegative patients for RF (p = 0.014), MV (p = 0.044), and COVID‐related mortality (p = 0.021). Negative SARS‐CoV2 serostatus resulted in a risk factor for RF (hazards ratio [HR] 2.19, 95% confidence interval [CI] 1.03–4.67, p = 0.04), MV (HR 3.37, 95% CI 1.06–10.68, p = 0.04), and COVID‐related mortality (HR 4.26, 95% CI 1.09–16.71, p = 0.04). Conclusions : HM patients with negative SARS‐CoV2 serology, despite vaccinations and previous infections, have worse clinical outcomes compared to seropositive patients in the Omicron era. The use of serology for SARS‐CoV2 diagnosis could be an easy tool to identify patients prone to developing complications.

Abstract Background Acute Lymphoblastic Leukemia (ALL) is a neoplasm of the hematopoietic system characterized by a clonal expansion of abnormal lymphocyte precursor cells. ALL is the most common form of cancer in children, but despite advances in treatment, it can still be fatal. Ethnic differences influence survival rates, and genomic ancestry plays an important role, especially in mixed-race populations such as Latin America. This study aims to analyze the influence of genomic ancestry on toxicity in children with ALL in the Amazon region. Methods The study included 171 patients (protocol number 119,649/2012—Ethics Committee) with ALL treated at a pediatric treatment center in Belém do Pará, in the Brazilian Amazon. The patients were submitted to the BFM protocol of induction therapy for ALL. Toxicity was assessed based on laboratory tests and adverse events, classified according to the CTC-NCI guide. Genomic ancestry was determined using autosomal informative markers. Results The majority of children (94.74%) developed some type of toxicity during treatment, 87.04% of which were severe. Infectious toxicity was the most common, present in 84.8% of cases, 77.24% of which were severe. Amerindian ancestry showed an association with the risk of severe general toxicity and severe infectious toxicity, with a contribution of 35.0% demonstrating a significant increase in risk. In addition, post-induction refractoriness and relapse were also associated with an increased risk of death. Conclusion This study highlights the influence of Amerindian genomic ancestry on response to therapy and toxicity in children with ALL in the Amazon region. Understanding these associations can contribute to personalizing treatment and improving clinical outcomes.

Abstract The design and implementation of Philaenus spumarius control strategies can take advantage of properly calibrated models describing and predicting the phenology of vector populations in agroecosystems. We developed a temperature-driven physiological-based model based on the system of Kolmogorov partial differential equations to predict the phenological dynamics of P. spumarius. The model considers the initial physiological age distribution of eggs, the diapause termination process, and the development rate functions of post-diapausing eggs and nymphal stages, estimated from data collected in laboratory experiments and field surveys in Italy. The temperature threshold and cumulative degree days for egg diapause termination were estimated as 6.5 °C and 120 DD, respectively. Preimaginal development rate functions exhibited lower thresholds ranging between 2.1 and 5.0 °C, optimal temperatures between 26.6 and 28.3 °C, and upper threshold between 33.0 and 35 °C. The model correctly simulates the emergence of the 3rd, 4th, and 5th nymphal instars, key stages to target monitoring actions and control measures against P. spumarius. Precision in simulating the phenology of the 1st and 2nd nymphal stages was less satisfactory. The model is a useful rational decision tool to support scheduling monitoring and control actions against the late and most important nymphal stages of P. spumarius.

Resumo: Este artigo busca analisar o conhecimento de alunos do ensino médio sobre a história do esporte. Elaborou-se um questionário sobre a temática, respondido por 148 discentes de escolas públicas do noroeste do Paraná, cujos dados foram analisados à luz da teoria crítica da sociedade. Os alunos participantes indicaram rupturas entre as diferentes manifestações corporais, de períodos históricos distintos, acerca das regras, técnicas corporais, níveis de violência física e sentidos e significados dessas práticas, com predomínio da associação do esporte à Antiguidade, sem o reconhecimento deste como um fenômeno contemporâneo. Esse entendimento, influenciado pela indústria cultural, dificulta a reflexão sobre as manifestações corporais violentas como reprodução da própria dominação social.

Abstract Background In Italy, malaria was endemic until the 1970s, when it was declared eradicated by WHO. Nowadays, with the persistence of competent mosquito populations, the effect of climate change, and increased possibility of importing malaria parasites from endemic counties due to growing migration, a malaria resurgence in Italy has become more likely. Hence, enhancing the understanding of the current distribution of the Anopheles maculipennis complex and the factors that influence the presence of this malaria vector is crucial, especially in Northern Italy, characterised by a high density of both human population and livestock. Methods To assess the presence and abundance of malaria vectors, a 4-year field survey in the plain areas of Lombardy and Emilia-Romagna region in Italy was conducted. Every sampling point was characterised in space by the land use in a 500-m radius and in time considering meteorological data collected in the short and long time periods before sampling. We combined the results of a linear regression model with a random forest analysis to understand the relative importance of the investigated niche dimensions in determining Anopheles mosquito presence and abundance. Results The estimated normalised variable importance indicates that rice fields were the most important land use class explaining the presence of Anopheles, followed by transitional woodlands and shrubland. Farm buildings were the third variable in terms of importance, likely because of the presence of animal shelters, followed by urbanised land. The two most important meteorological variables influencing the abundance of Anopheles in our study area were mean temperature in the 24 h before the sampling date and the sum of degree-days with temperature between 18 °C and 30 °C in the 14 days before the sampling date. Conclusions The results obtained in this study could be helpful in predicting the risk of autochthonous malaria transmission, based on local information on land cover classes that might facilitate the presence of malaria vectors and presence of short- and medium-term meteorological conditions favourable to mosquito development and activity. The results can support the design of vector control measures through environmental management. Graphical Abstract

In the advanced cancer setting, low psychological functioning is a common symptom and its deleterious impact on health outcomes is well established. Yet, the beneficial role of positive psychological well-being (PPWB) on several clinical conditions has been demonstrated. Early palliative care (EPC) is a recent value-based model consisting of the early integration of palliative care into standard care for solid tumors and hematologic malignancies. While the late palliative care primary offers short-term interventions, predominantly pharmacological in nature and limited to physical symptom reduction, EPC has the potential to act over a longer term, enabling specific interventions aimed at promoting PPWB. This narrative review examines nine English studies retrieved from MEDLINE/PubMed, published up to October 2023, focusing on EPC and three dimensions of PPWB: hope, gratitude, and death acceptance. These dimensions consistently emerge in our clinical experience within the EPC setting for advanced cancer patients and appear to contribute to its clinical efficacy. The choice of a narrative review reflects the novelty of the topic, the limited existing research, and the need to incorporate a variety of methodological approaches for a comprehensive exploration.

Objectives: The consumption of whole grains is widely recognised as healthy and included in several national dietary guidelines. Despite that, the consumption of whole grain products remains sub-optimal. Methods: We developed a questionnaire investigating perceptions of price, taste, positive and negative health effects, sustainability and versatility of whole grains and the consumption frequency of whole grain food products. This questionnaire was administered to a sample of 1,014 individuals in Northern Italy. Results: We observed an overall positive attitude towards whole grain products, especially in relation to positive health effects, versatility and taste, that resulted in strong drivers for whole grain consumption. Age, gender and educational level were identified as influences on whole grain perceptions, especially for taste and positive health effects. Respondents were clustered according to the attitudes they expressed. Conclusion: The characteristics of these clusters could be used to customise future nutritional education programmes.

Sewage sludge (biosolids) management represents a worldwide issue. Due to its valuable properties, approximately one half of the EU production is recovered in agriculture. Nevertheless, growing attention is given to potential negative effects deriving from the presence of harmful pollutants. It is recognized that a (even very detailed) chemical characterization is not able to predict ecotoxicity of a mixture. However, this can be directly measured by bioassays. Actually, the choice of the most suitable tests is still under debate. This paper presents a multilevel characterization protocol of sewage sludge and other organic residues, based on bioassays and chemical-physical-microbiological analyses. The detailed description of the experimental procedure includes all the involved steps: the criteria for selecting the organic matrices to be tested and compared; the sample pre-treatment required before the analyses execution; the chemical, physical and microbiological characterisation; the bioassays, grouped in three classes (baseline toxicity; specific mode of action; reactive mode of action); data processing. The novelty of this paper lies in the integrated use of advanced tools, and is based on three pillars: • the direct ecosafety assessment of the matrices to be reused. • the adoption of innovative bioassays and analytical procedures. • the original criteria for data normalization and processing.

Introduzione Survey intersocietaria SICP-SIMIT-FADOI-SIMG La febbre in un contesto clinico di fine vita Peculiarità dei principali setting di cura Principali quadri sindromici nei pazienti a fine vita e indicazioni terapeutiche Antibiotici in infusione continua endovena o per via sottocutanea Bibliografia

ObjectiveWe investigated the performance of enzyme linked immunospot (ELISpot) assay for the diagnosis of invasive aspergillosis (IA) in high-risk patients with hematologic malignancies.MethodsWe prospectively enrolled two cohorts of patients undergoing intensive myelosuppressive or immunosuppressive treatments at high risk for IA. ELISpot was performed to detect Aspergillus-specific T cells producing Interleukin-10.ResultsIn the discovery cohort, a derived cut-off of 40 spot forming cells (SFCs)/106 PBMCs has shown to correctly classify IA cases with a sensitivity and specificity of 89.5% and 88.6%, respectively. This cut-off is lowered to 25 SFC when considering the subset of possible IA patients, with sensitivity and specificity of 76% and 93%, respectively. The application of the 40 SFCs cut-off to the validation cohort resulted in a positivity rate of 83.3% in proven/probable cases and a negativity rate of 92.5% in possible/non-IA cases. Adopting the 25 SCFs cut-off, the assay resulted positive in 83.3% of proven/probable cases while it resulted negative in 66.7% of possible/non-IA cases.ConclusionsELISpot shows promises in the diagnosis of IA and the possibility to use two distinct cut-offs with similar diagnostic performances according to patients' different pre-test probability of infection can widen its use in patients at risk.

Background of the Study. Nonalcoholic fatty liver disease (NAFLD) is the most common liver disease in western countries. Lifestyle interventions are recommended as the primary therapy for NAFLD. Methodology. In this clinical trial, NAFLD patients were enrolled in a 12-month dietary intervention aimed to improve their eating habits according to the Mediterranean pattern, with scheduled appointments every three months. After the exclusion of steatosis, healthy subjects were recruited and received general advice based on current Italian food-based dietary guidelines. Results. One hundred and fifty five subjects aged 20–59 years underwent (i) liver ultrasound (US), (ii) clinical and anthropometric evaluations, (iii) blood tests, and (iv) assessment of dietary habits. According to US evaluation, 73 of them had severe, moderate, or mild liver steatosis (NAFLD patients) and 82 had no liver steatosis (healthy controls). Fifty-eight NAFLD patients and 73 controls completed the study. Among NAFLD patients, 26 (45%) downgraded steatosis severity, 12 of which achieved complete steatosis regression (21%). Three of the healthy controls developed NAFLD. The NAFLD patients improved their dietary habits and reduced BMI and waist circumference, during the study period, more than healthy controls. Liver steatosis remission/regression was independent of changes in BMI or liver enzymes and was more frequent among patients with mild steatosis at baseline. Conclusions. Mediterranean dietary advices, without a personalised meal planning, were efficient in reducing/remitting NAFLD, especially among patients with mild disease, which argues in favour of early identification and lifestyle intervention. This trial is registered with NCT03300661.

Radiotherapy is focused on the tumor but also reaches healthy tissues, causing toxicities that are possibly related to genomic factors. In this context, radiogenomics can help reduce the toxicity, increase the effectiveness of radiotherapy, and personalize treatment. It is important to consider the genomic profiles of populations not yet studied in radiogenomics, such as the indigenous Amazonian population. Thus, our objective was to analyze important genes for radiogenomics, such as ATM, TGFB1, RAD51, AREG, XRCC4, CDK1, MEG3, PRKCE, TANC1, and KDR, in indigenous people and draw a radiogenomic profile of this population. The NextSeq 500® platform was used for sequencing reactions; for differences in the allelic frequency between populations, Fisher’s Exact Test was used. We identified 39 variants, 2 of which were high impact: 1 in KDR (rs41452948) and another in XRCC4 (rs1805377). We found four modifying variants not yet described in the literature in PRKCE. We did not find any variants in TANC1—an important gene for personalized medicine in radiotherapy—that were associated with toxicities in previous cohorts, configuring a protective factor for indigenous people. We identified four SNVs (rs664143, rs1801516, rs1870377, rs1800470) that were associated with toxicity in previous studies. Knowing the radiogenomic profile of indigenous people can help personalize their radiotherapy.

In the present work a validated numerical approach has been used in order to build a robust and reliable FE model of the impact of a NATO 7.62 mm ball bullet, against an aluminium transmission shaft. The bullet is a full metal jacket type, with a lead alloy core and a brass jacket. Target shaft is made by an Al6061-T6 aluminium alloy. According to the soft core (lead alloy) of the bullet, most effort has been spent in order to evaluate the effect of bullet materials mechanical properties on the numerical results. Numerical analyses, carried out using the non-linear dynamic finite element solver Abaqus∖Explicit 6.10, have been performed focusing on core and jacket material behaviour (target material, Al6061-T6, has been previously calibrated by the authors). Thus numerical analyses have been performed considering for the mechanical behaviour of the bullet both a simplified approach (as reported in literature) and new material data (with strain rate effect) obtained by means of experimental tests on the two materials (lead and brass) with specimens cut directly from the bullet. Finally the results of the analyses have been compared with real experimental ballistic tests.

Relapse within acute myeloid leukaemia may be driven by the presence of leukaemia stem cells. Here, the authors use single cell RNA-seq seq to characterise leukemia stem cells, and show miR-126 as a potential marker of resistance.

Na atual fase pandêmica da COVID-19, quase todas as instituições de ensino foram forçadas a passar por uma transformação abrupta de ensino presencial para ensino remoto geralmente fundamentado na adoção e uso de novas tecnologias educacionais. Especificamente, no contexto dos estudantes com autismo, entende-se como pertinente analisar estudos relacionados a possibilidades destas tecnologias no âmbito da melhoria (ou não) da compreensão conceitual destes estudantes. Neste contexto, o presente trabalho tem como objetivo levantar, analisar e discutir práticas de uso de laboratórios remotos e seu impacto na aprendizagem de estudantes autista, à luz da Teoria da Distância Transacional. Para tal, foi feita uma revisão de narrativa de literatura. Foram examinados 32 artigos encontrados nas bases de dados Google Scholar, IEEE Xplore, Wiley InterScience e Science Direct–Elsevier. Como resultado, as evidências demonstraram que, no contexto da Teoria Transacional, os laboratórios remotos tendem a potencializar a efetividade dos métodos de ensino e melhorias na aprendizagem dos estudantes com transtorno do espectro autista.

Breast cancer (BCa) is the most common cancer and leading cause of cancer death among women globally. This can be explained by the genetic factor of this disease. This article aims to correlate the epidemiological data, worldwide incidence, and mortality of BCa with the Single-Nucleotide Polymorphisms (SNPs) associated with the susceptibility and severity in different populations. Two hundred and forty genetic variants associated with BCa susceptibility/severity were selected from the literature through Genome-Wide Association Studies (GWAS). The allele frequencies were obtained from the 1000 Genomes Project, and the epidemiological data were obtained from the World Health Organization (WHO). The BCa incidence, mortality rates, and allele frequencies of the variants were evaluated using Pearson’s correlation. Our study demonstrated that 11 SNPs (rs3817578, rs4843437, rs3754934, rs61764370, rs780092, rs2290203, rs10411161, rs6001930, rs16886165, rs8051542 and rs4973768) were significantly correlated with the epidemiological data in different ethnic groups. Seven polymorphisms (rs3817578, rs3754934, rs780092, rs2290203, rs10411161, rs6001930 and rs16886165) were inversely correlated with the incidence rate and four polymorphisms (rs4843437, rs61764370, rs8051542 and rs4973768) were directly correlated with the incidence rate. African and South-East Asian populations have a lower risk of developing BCa when evaluated in terms of genetic factors since they possess variants characterized as protective, as their higher incidence is associated with a lower frequency of BCa cases. The genetic variants investigated here are likely to predispose individuals to BCa. The genetic study described here is promising for implementing personalized strategies to screen for breast cancer in diverse populations.

IntroductionEarly palliative care (EPC) improves the quality of life (QoL) of advanced cancer patients and their caregivers. The increasingly widespread use of this care model requires the development of measures supporting its interventions. Although the construct of patient’s QoL has been extensively investigated and several QoL measures have been further validated, there is a paucity of data concerning the QoL of the caregiver. In 2018, McDonald and colleagues addressed this issue by interviewing 23 primary caregivers of advanced cancer patients who participated in an EPC randomized clinical trial to understand their perspective on the QoL construct. The Authors identified six major dimensions associated with the construct of caregiver’s QoL. The present retrospective study aimed to validate these dimensions on a larger sample and in a real-life EPC setting.MethodsPreviously collected reports from 137 primary caregivers of advanced cancer patients on EPC answering questions about their experience with this care model were qualitatively analyzed through a deductive, thematic approach to identify and confirm the six dimensions constituting the construct of interest based on McDonald’s and colleagues’ results.ResultsThe six dimensions (“living in the patient’s world”, “burden of illness and caregiving”, “assuming the caregiver role”, “renegotiating relationships”, “confronting mortality”, and “maintaining resilience”) were consistently found in the reports from primary caregivers in a real-life EPC setting, confirming to be significant themes associated to their QoL.ConclusionA definite and recurrent construct of primary caregiver’s QoL as described by McDonald and colleagues was also found in a larger sample and in a real-life EPC setting. Thus it may lay the groundwork for the development of a dedicated questionnaire.

IntroductionPain plays a fundamental role in the well-being of the individual, and its semantic content may have specific properties compared to other negative domains (i.e., fear and anger) which allows the cognitive system to detect it with priority. Considering the influence of the affective context in which stimuli (targets) are evaluated, it is possible that their valence could be differentially processed if preceded by negative stimuli (primes) associated with pain than negative stimuli not associated with pain. Thus, the present study aims to investigate the electrophysiological correlates of the implicit processing of words with pain content by using an affective priming paradigm.MethodsEvent-related potentials (ERPs) were recorded while participants were presented with positive and negative word targets (not associated with pain) that were preceded by positive, negative (not associated with pain), and pain word primes. Participants were asked to judge the valence of the target word.ResultsResults showed faster reaction times (RTs) in congruent conditions, especially when the negative target was preceded by a pain prime rather than a positive one. ERPs analyses showed no effect of pain at an early-stage processing (N400), but a larger waveform when the pain prime preceded the positive prime on the LPP.DiscussionThese results reaffirm the importance that valence has in establishing the priority with which stimuli are encoded in the environment and highlight the role that pain has in the processing of stimuli, supporting the hypothesis according to which the valence and the semantics of a stimulus interact with each other generating a specific response for each type of emotion.

Este artigo tem como objetivo refletir sobre o caráter formativo que está na base da Teoria Crítica, especialmente no pensamento de Max Horkheimer, cujas análises voltam-se para os fatores sociais, políticos, econômicos e culturais que, perpassados pelo conceito de racionalidade burguesa, inspiram a irracionalidade da dinâmica produtiva e político-cultural do início do século XX. Nesse sentido, a crítica sobre a razão que se faz instrumento do domínio da sociedade industrial desenvolvida, sobre a cultura que se reifica em produtos do consumo e sobre a subjetividade moldada por fatores psicossociais do processo civilizatório é basilar do projeto de Horkheimer. A análise da racionalidade positiva eleva o projeto à delimitação das fronteiras entre a teoria tradicional e a teoria crítica e possibilita denunciar os limites da razão que se mitifica. Nesse aspecto, Horkheimer procura fundamentar o caráter crítico da racionalidade, no sentido de superar a cegueira histórica a que se deixou submeter.