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Increasing numbers of hepatitis E cases are being reported in several European countries, including Italy, but the burden of hepatitis E virus (HEV) infection is largely unknown in the latter. To gain a better understanding of HEV epidemiology at national level in Italy, we piloted a strengthened and integrated human (epidemiological and virological) and environmental HEV surveillance system between 2012 and 2016. Over the 5-year period, 169 confirmed hepatitis E cases were identified, with a national annual incidence of 0.72 cases per 1,000,000. Of 65 HEV-RNA positive samples of sufficient quality for molecular analysis, 66% were genotype HEV3, 32% HEV1 and 1% HEV4. The most frequent risk factor reported by all HEV3 infected cases, was the consumption of undercooked pork and sausage. For the environmental surveillance, 679 urban sewage samples were collected from 53 wastewater treatment plants and HEV-RNA was detected in 38/679 of the samples. Among these, 25 (66%) were genotype HEV3 and the remaining were HEV1. We demonstrate that autochthonous transmission and environmental circulation of genotype HEV3 is adding to travel-related HEV transmission in Italy. We recommend the ‘One Health’ approach to integrated surveillance, and to include HEV-related messages within health information campaigns focussing on food security.

Background Hepatitis B vaccination has proven to be very safe and highly effective. This study assessed the proportion of successfully vaccinated individuals among cases with acute hepatitis B, the proportion of preventable cases if individuals were vaccinated as recommended, and the reasons for failures. Methods We analyzed data reported to the Italian Surveillance System for Acute Viral Hepatitis from 1993 to 2014. Results A total of 362 of 11 311 (3.2%) cases with acute hepatitis B were vaccinated. Of the 277 cases for whom immunization data were available, 50 (18%) received a complete vaccination course according to the correct schedule and before exposure to hepatitis B virus. Molecular characterization of 17 of these cases showed that 6 were infected with S-gene mutants. Among the 10 949 unvaccinated cases, 213 (1.9%) escaped mandatory vaccination and 2821 (25.8%) were not vaccinated despite being at increased risk of infection. Among the latter, the most common risk factors were cohabitation with hepatitis B surface antigen (HBsAg) carriers, intravenous drug use, and homosexual/bisexual practices. Thirty-seven percent of the unvaccinated households with HBsAg carriers were aware of their risk. Lack of trust in the vaccination, negative attitude, and inaccurate beliefs followed by lack of or poor communication and low perceived severity of the disease were the most frequent reasons for vaccine hesitancy. Conclusions Development of acute disease in successfully vaccinated individuals is a rare event. Further efforts are needed to enhance the vaccine coverage rate in individuals at increased risk of infection.

This document details the operations needed for registering and maintaining domain names in accordance with synchronous registration. The synchronous system for registering and maintaining a domain name is provided by organizations (henceforth Registrars) that have an active contract with the Registry (henceforth .it Registry or Registry of the ccTLD.it), which is subordinate to an accreditation procedure. The Registrar will always be an intermediary with the Registry for all domain name registering and maintenance and also for correctly updating the Database of Assigned Names (DBNA) by using the synchronous registration system. The synchronous registration system allows Registrars to register and maintain domain names in realtime within the limits set out in the "Rules for assigning and managing domain names in the ccTLD.it" (hereafter, "Rules").

Il documento rappresenta una possibile traccia che può essere seguita dai vari registrar per implementare un proprio client EPP utilizzando la libreria client realizzata dal Registro Italiano. La libreria client implementa in linguaggio Java le seguenti funzionalità: oCreazione di una connessione HTTPS oMantenimento della sessione di lavoro oCreazione dell'XML per l'invio delle richieste Parsing delle risposte ed estrazione delle informazioni di interesse La libreria client fornisce classi e metodi sia per interagire con un generico EPP server sia per implementare le estensioni al protocollo EPP definite dal Registro Italiano.

This document outlines a method for the various registries for implementing their EPP client so that it interacts correctly with the synchronous server of the Italian registry. There are three categories of such EPP commands. Commands for: - managing sessions (login, logout, hello) - querying the server without modifying the status of the Contact and Domain objects - for modifying the status of the Contact and Domain objects For each command you will see an example of a request and how the server responds. There are also some examples of responses to errors for cases where the EPP command has not been correctly submitted or submitted in a status in which the command itself is not permitted.

Questo documento descrive le operazioni che un aspirante Registrar deve sottoporre, tramite una propria applicazione client, al server EPP (Extensible Provisioning Protocol) del Registro del ccTLD .it per effettuare la procedura tecnica di accreditamento e diventare un Registrar accreditato presso il Registro stesso. Il test permette di verificare che il client EPP utilizzato dal Registrar sia stato correttamente implementato, che esso interagisca in maniera corretta con il server EPP del Registro Italiano e che il Registrar sia in grado di effettuare le principali operazioni previste nel sistema di registrazione sincrono e definite nelle linee guida del ccTLD .it

A review of SLIT studies reveals that both cumulative dose and maintenance schedules have widely varied between the published clinical trials. Pre-co-seasonal treatment for pollen allergy seems to be better than coseasonal treatment. There is a number of studies evaluating different durations of SLIT, but the heterogeneity of the study design, allergen extracts and outcome measures make it difficult to produce a meta-analysis on SLIT efficacy according to duration. Overall,duration of both the build-up phase and the maintenance treatment does not seem to influence the effectiveness of SLIT. This suggests that the quality of the extract is more important in determining the clinical response to SLIT than duration of therapy. Further studies are warranted to establish optimal duration of SLIT treatment.

Contrary to common believing, the prevalence of the intolerance to food additives in the general population is rather low. Nowadays many doubts persist with regard both to the pathogenetic mechanisms and to the clinical and diagnostic aspects in this field. Symptoms due to, or exacerbated from, food additives usually involve non-IgE-mediate mechanisms (pseudo-allergic reactions, PAR) and are usually less severe of those induced by food allergy. The most frequent clinical feature of the intolerance to food additives still remains the urticaria-angioedema syndrome, although these substances are really involved only in a minority of patients. Other possible clinical features include anaphylaxis, atopic eczema, behaviour disturbances, asthma and non-allergic rhinitis. The diagnostic approach consists in diary cards, reporting symptoms and food habits, elimination diet and double blinded placebo-controlled oral challenge with suspected additives. However, such procedure still remains poorly standardized and numerous uncertainties persist with regard to optimal conditions for performing and interpret the challenge results. The therapeutic approach consists in the exclusion of foods and products containing the additive involved, and, in patients not compliant to the diet, in treatment with symptomatic drugs.

Clinical non-instrumental evaluation plays an important role in the assessment of the dysphagic patient. This evaluation, called “ bedside examination” , aims to establish whether dysphagia is present, evaluating severity, determining the alterations which cause it, planning rehabilitation, testing outcome of treatment. The assessment takes into consideration anamnesis regarding the swallowing problem, evaluation of the anatomy and functionality, of sensitivity and the reflexes, of the swallowing apparatus. Finally, the oral feeding test is performed, which evaluates the oral and pharyngeal phases of swallowing. The examination performed in the neurologic patient is different from that performed in the patient submitted to ENT or maxillo-facial surgery.

Slicing technique is considered as a valid help in many software engineering activities. Traditional slicing is made on programs, however, slicing all over legacy systems cannot be limited only to programs because part of the system logic is implemented at the JCL layer so we would distinguish two different slicing phases: slicing in-the-small at the program layer and slicing in-the-large at the JCL layer. In this work, the authors propose a two-level static slicing to provide a more effective approach to slice legacy systems. Both slicing in-the-small and slicing in-the-large is based on dependence graphs. Control and data dependencies are extended to model all code patterns. OSK tool implements the entire process.

An abstract is not available.

An abstract is not available.

L'attività di misurazione è ormai considerata uno strumento indispensabile per ottenere il pieno controllo e la certificazione ISO 9000 dei sistemi informativi. Finora, in ambito software, tale attività è stata maggiormente rivolta alla valutazione degli attributi interni dei prodotti, sia perchè questi sono direttamente misurabili, sia per la convinzione comprovata che la bontà di un sistema dipenda da una sua certa strutturazione interna. A partire dalla prima ed empirica metrica LOC, le metriche si sono sempre più specializzate palesando, di fatto, l'inefficacia del calcolo di un unico valore monolitico nel quantificare la qualità di un componente software. Ciò risulta particolarmente evidente allorchè, provando a definire il concetto di complessità del codice sorgente, ci accorgiamo che vari domini intuitivamente ortogonali devono essere presi in considerazione per fornire una valutazione completa di questa proprietà. Dopo un'introduzione di carattere generale alle tematiche trattate, il presente lavoro affronta il problema della determinazione dei domini di complessità ortogonali nel codice sorgente e illustrala proposta di una metrica di complessità vettoriale basata sul PDG. In seguito, la bontà di tale metrica viene valutata applicandola ad un semplice, ma significativo, caso di studio ed eseguendo un'analisi statistica sui dati raccolti. Infine, viene brevemente illustrato l'ambiente di manutenzione TROOP che ha supportato l'attività di analisi dei programmi, di costruzione di rappresentazioni diagrammatiche e di raccolta di metriche.

The Aquarelle system is a distributed multimedia information system, offering access to information describing and documenting the European cultural heritage. Yhe Aquarelle system provides access to existing archives, which supply raw data, taht can be pointed by folders. This document (Deliverable D5.1) defines the technical specifications for the Z39.50-SQL gateways. It has been generated within Task 5.1 (interface tools for archive servers) of Workpackage 5 (archive servers) of the Aquarelle project (IE2005). These specifications are based on the architecture for the Aquarelle system, that was defined during Task 3.1. This document discusses the problems raised by the need of accessing a relational database using the Z39.50 protocol, presents the architecture of the Z39.50-SQL gateway and defines the components of the gateway and the interfaces between those components.

The most significant advantage offered by hypermedia is the possibility of implementing a large variety of cognitive paths, using links to represent both extensional and intensional associative aspects. Authority files and thesauri can act as the most appropriate tools to build the cognitive layer of hypermedia, a twofold role: to formulate the query using a normalised language and to exploit the power of the cognitive layer as a large set of semantically rich links the user will activate according to higher specific interests. In this paper, we present the use of an authority file on authors and the ICONCLASS classification system to implement the cognitive layer of hypermedia and enhance user's search and navigation capabilities.