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Vaccinating health care workers is considered to be one of the most important steps in preventing the transmission of the influenza virus to vulnerable patients. Public Health physicians are the main promoters and executors of influenza vaccination campaigns for both healthcare workers and the general population. The objective of the present survey was to analyze the knowledge, attitudes and practices regarding influenza vaccination among Hygiene and Preventive Medicine Residents. 64% of the participants had not been vaccinated against the influenza virus in the past 5 years, and 29% had been vaccinated only occasionally , with only 7.2% of the study popu-lation having been vaccinated every year. 20.3% of those surveyed were vaccinated in the 2010/2011 season. The best strategy to increase vaccination rates among health care workers according to the study participants was the participation of future public health operators to multidisciplinary training (34.8%). the main factors associated with influenza vaccination compliance were having been vaccinated in the previous season for 2011/2012 (OR [95%]: 41.14 [7.56 - 223.87]) and having received the vaccination always or occasionally during the previous 5 years for both 2010/2011 (p-value

Background: Public Health Residents (PHRs) have to be considered of relevant interest among health care workers (HCWs) since they are strongly asked to recommend and perform influenza vaccination to other HCWs and general population. Despite this consideration, Italian HCWs have influenza vaccination rates significantly below the 75% coverage proposed by International Public Health guidelines. In order to increase future coverage towards influenza vaccination, the aim of this study is to assess determinants associated with influenza vaccine uptake among Italian PHR. Methods: A survey was carried out on PHRs attending 25 out 32 Post-Graduate University training programmes on Public Health in Italy (78.1%). Each participant was interviewed through an anonymous self-administered questionnaire including questions on knowledge, attitudes and practices dealing with influenza and influenza vaccination. Each questionnaire included five sections and twenty items. The questionnaire answers were entered in a database created within EpiInfo 3.5.1 software. All the data were analyzed using the R statistical software package. Results: The response rate was 80.1% (365/456). Vaccination coverage was 22.2% for seasonal 2010-2011 influenza, 33,7% for seasonal 2011-2012 influenza. Medical residents who stated they were vaccinated against seasonal 2010-2011 influenza were significantly more likely to be vaccinated against 2011–2012 seasonal influenza (OR 42.07; 95% CI: 19,4 – 94,2). Vaccination against seasonal 2010-2011 influenza (p < 0.0001), and seasonal 2011-2012 influenza (p

Riassunto Uno studio conoscitivo condotto tra i medici in formazione specialistica in Igiene, Medicina Preventiva e Sanità Pubblica italiani è stato condotto in 25 scuole di specializzazione italiane di tale disciplina (78,1% del totale). Ciascun partecipante è stato intervistato tramite un questionario anonimo ed autosomministrato con domande riguardo attitudini, pratiche e conoscenze sull’influenza e la relativa vaccinazione. La vaccinazione contro l’influenza stagionale 2010-2011 e 2011-2012 è significativamente associata con l’essersi vaccinato almeno 3 volte nelle ultime cinque stagioni influenzali. Gli specializzandi che hanno preso parte durante il loro percorso formativo a campagne di vaccinazione nella popolazione generale sono più propensi a vaccinarsi nelle due stagioni vaccinali prese in esame. Secondo i medici in formazione in Igiene e Medicina Preventiva italiani, per implementare le coperture vaccinali e le attitudini a raccomandare la vaccinazione antinfluenzale alla popolazione generale sono necessari corsi di formazione multidisciplinari (48.2%) e una migliore formazione universitaria sull’argomento (23.3%).

The Menengai caldera is an elliptical depression with minor and major axes measuring about 8 km and 12 km respectively, located near Nakuru, Kenya's Rift Valley. Geophysical investigations (micro-seismic monitoring, gravity and MT surveys), geological surveys, geochemical surveys (fumaroles sampling, soil gas surveys) and a soil temperature survey allowed GDC to locate the first exploratory well MW-01 which intercepted a deep reservoir with temperatures exceeding 300°C, found beneath a shallower liquid-dominated reservoir at temperature in the range 190-200°C. The exploratory and development drilling campaign, which is undergoing, provided the drilling of some 20 deep wells by December 2013 aimed at characterizing the deep reservoir properties, delineate the field extension and provide additional steam for power development. The geochemical data acquired with production well testing allowed not only to characterize the chemistry of the shallow aquifer and of the deep steam-dominated reservoir, but indicates also an 'intermediate temperature zone' that could be interpreted as a 'rim' of the deep reservoir. Surface exploration surveys and the findings derived from drilling, logging and testing of geothermal wells were used to build a 3D numerical model of the geothermal system natural state by means of the TOUGH2 reservoir simulator, supported by Petrasim 5.3 graphical interface. The numerical model was intended to check the consistency of the conceptual model, give a better picture of the reservoir thermodynamic conditions, and constrain the mass and heat flows through the system. Making in numbers the idea arisen in the conceptual model, the 3D natural state has been reconstructed by simulating the heating up due to a hot intrusion in a complex system. The complexity of the system arises in a particular structure consisting in a deep vapor-dominated high temperature reservoir just on top of the hot intrusion at temperatures higher than 300°C, separated from the shallower liquid-dominated reservoir (with temperatures ranging from 130 up to 210°C) by a relatively thin impermeable layer. The model was run to steady state conditions, and calibrated against data obtained from geochemical investigations, well pressure and temperature profiles recorded under warm-up and flowing conditions, as well as available production test results. The details about the 3D model construction within TOUGH2 and Petrasim and the results of the simulated natural state are presented and discussed.

The Tendaho geothermal system is characterized by the presence of a 50 km wide graben trending NW- SE, dissected on its turn by a series of normal faults which form a sequence of secondary horst and graben. The graben basement is composed of fissural basalts with minor rhyolite of the Afar Stratoid Series, overlain by a 1,200-1,400 m thick sedimentary sequence, consisting of clastic products (mostly siltstone with some sandstone) and intercalated basalt lenses. The occurrence within the graben of continental crust thinning and opening phenomena, accompanied by upward mass and heat transfer, represents a favourable element for the development of important thermal anomalies. According to surface exploration surveys performed during the 1970s and early 1980s, exploration drilling was carried out in the Tendaho Rift, in Central Afar (Ethiopia), from October 1993 to June 1995. Three deep and three shallow wells were drilled in the central part of the Northern Tendaho Rift to prove the existence of a geothermal reservoir and its possible use for electric power generation. The project was jointly financed by the Ethiopian Ministry of Mines and Energy and the Italian Ministry for Foreign Affairs. Project activities were performed by the Ethiopian Institute of Geological Surveys and Aquater S.p.A. In this work, a review and reinterpretation of the available fluid inclusion and isotopic data is presented, fostered by the recent Feasibility Study of Dubti prospect (2013) and by the current developments of the scientific investigation and integrated interpretation of Dubti-Ayrobera geothermal fields and by the renewed interest in the Tendaho basin. Data are mostly from core-drilled samples of wells TD1-4, and after having recomputed their isochrones with a new interpretation taking into account the scientific development occurred after the first work in 1999, they provide an insight into the two reservoir model (shallow and deep) with fault-driven circulation. The possible existence of a double reservoir system was proposed by Battistelli et al. (2002), with an hypothesized deep contributing geofluid. Waters discharged from wells TD-1, TD-2 and TD-4 are low salinity, sodium-chloride geothermal types, with reservoir temperature ranging from 220°C to 270°C. Fluid inclusion data, compared with present-day measured temperatures, indicate either heating (well TD-1) or cooling (well TD-3, Gianelli et al. (1998)) and are used in the present work to reconstruct the thermal history of this reservoir. R/Ra ratios of geothermal fluids discharged from fumaroles, geothermal wells and those trapped in fluid inclusions, suggest a supply of mantle 3He to the geothermal fluids, a mixing between mantle 3He and He of crustal (and/or upper mantle) origin. The 4He/20Ne ratios indicated a moderate or very low input of atmospheric He, except for one sample from Tendaho with the lowest 4He/20Ne ratio both from present-day fluids and paleo-fluids extracted from inclusion in hydrothermal minerals. This low ratio indicates input of atmospheric He from infiltrating water at shallow depths (Ruggieri et al., 1999). In particular, the isotopic signature results support a fault driven circulation model, adding some information on the contributing deep geofluid.

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infects host cells following binding with the cell surface ACE2 receptors, thereby leading to coronavirus disease 2019 (COVID-19). SARSCoV-2 causes viral pneumonia with additional extrapulmonary manifestations and major complications, including acute myocardial injury, arrhythmia, and shock mainly in elderly patients. Furthermore, patients with existing cardiovascular comorbidities, such as hypertension and coronary heart disease, have a worse clinical outcome following contraction of the viral illness. A striking feature of COVID-19 pandemics is the high incidence of fatalities in advanced aged patients: this might be due to the prevalence of frailty and cardiovascular disease increase with age due to endothelial dysfunction and loss of endogenous cardioprotective mechanisms. Although experimental evidence on this topic is still at its infancy, the aim of this position paper is to hypothesize and discuss more suggestive cellular and molecular mechanisms whereby SARS-CoV-2 may lead to detrimental consequences to the cardiovascular system. We will focus on aging, cytokine storm, NLRP3/inflammasome, hypoxemia, and air pollution, which is an emerging cardiovascular risk factor associated with rapid urbanization and globalization. We will finally discuss the impact of clinically available CV drugs on the clinical course of COVID-19 patients. Understanding the role played by SARS-CoV2 on the CV system is indeed mandatory to get further insights into COVID-19 pathogenesis and to design a therapeutic strategy of cardio-protection for frail patients.

Background I dati sugli effetti della terapia sostitutiva con ormone somatotropo (GH) sull’insulino-sensibilità sono variabili e talora discordanti tra loro e per gran parte ricavati dall’utilizzo di indici surrogati basali, come Homa-IR, o derivati dall’OGTT, come ISI Matsuda. Scopo Valutare la variazione dell’insulino-sensibilità in un gruppo di pazienti affetti da deficit di GH (GHD) pediatrico confrontando i suddetti indici con il clamp euglicemico iperinsuliemico. Materiali e Metodi In 20 bambini affetti da GHD idiopatico isolato alla diagnosi e dopo 12 mesi di terapia con GH e in 10 controlli con bassa statura costituzionale, oltre ai classici parametri clinico-auxologici (statura, BMI, CV), sono stati valutati glicemia e insulinemia a digiuno e durante OGTT, HbA1c, HomaIR, ISI e M-value clamp-derivato. Risultati: In baseline i bambini GHD, rispetto ai controlli, presentavano valori significativamente più bassi di velocità di crescita staturale (p=0.002), picco di GH dopo i 2 test di stimolo (entrambe p