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Background: In last years the diffusion of carbapenem resistance in Gram-negative bacteria (CR-GNB) is increasing worldwide, mainly due to the expression of carbapenemases. Cefiderocol has molecular characteristics that ideally confers activity against all CR-GNB, but resistant strains have already been identified. We describe cefiderocol susceptibility profile among multi-drug resistant Gram-negative isolated from pediatric patients. Methods: Prospective, single pediatric center study, 1st January 2020–15th June 2023. All GNB carbapenemases producers or phenotypically carbapenem-resistant isolated in the study period were tested for cefiderocol susceptibility. Clinical and microbiological data were collected. A descriptive analysis was performed, comparing the groups of cefiderocol-resistant vs. cefiderocol-susceptible Enterobacterales and non-fermenting Gram-negative bacteria (NF-GNB). Results: Forty-seven GNB were tested for cefiderocol susceptibility; 38% were cefiderocol-resistant: 16/30 (52%) among Enterobacterales and 2/17 (12%) among NF-GNB. None of the patients were previously exposed to cefiderocol. Looking at Enterobacterales, resistance to ceftazidime/avibactam was higher among cefiderocol-resistant vs. cefiderocol-susceptible strains (62% vs 36%, respectively), as MBL expression (67% vs. 36%, respectively). Too few NF-GNB were cefiderocol-resistance to draw any conclusion. No difference in ICU admission and mortality was identified comparing cefiderocol-resistant vs. susceptible strains. Patients colonized/infected by cefiderocol-resistant strains had been previously hospitalized more frequently. Conclusion: In our cohort cefiderocol resistance was mostly registered among Enterobacterales, and especially among MBL producers’ strains (that were alongside resistant to ceftazidime/avibactam). This could be explained by the known possible cross resistance mechanism among ceftazidime/avibactam and cefiderocol. Also, correlation of cefiderocol-resistance with previous hospitalization could be associated with horizontal resistance transmission. Looking at our data, we believe that cefiderocol should be use cautiously, especially empirically and in monotherapy, due to the high resistance rate.

BackgroundEchocardiography is essential in cardiovascular medicine for screening, diagnosis, and monitoring. Artificial intelligence (AI) has the potential to improve echocardiography by reducing variability and analysis time. While 3D echocardiography is becoming more accurate, 2D imaging still dominates clinical care. We aimed to evaluate agreement in measures of left ventricular (LV) volumes and function between human readers, a fully automated AI 2D algorithm, and the 3D Heart Model.MethodsA retrospective analysis was conducted on 109 patients who underwent 2D and 3D transthoracic echocardiography. LV end-diastolic and end-systolic volumes (LVEDV, LVESV) and ejection fraction (LVEF) were measured by two operators, a commercially available AI algorithm (US2ai), and the 3D Heart Model. Global longitudinal strain (GLS) was measured by the integrated semi-automated software and the AI algorithm. Outcomes included measures of agreement [bias, limit of agreement and Pearson's correlation (R)]ResultsFor LV volume measurements, the AI algorithm was strongly correlated with the average of the human operators (r = 0.89 for LVEDV and r = 0.92 for LVESV), which was higher than between the operators (r = 0.74 and r = 0.84, respectively, p

Abstract Background Guidelines about febrile neutropenia in paediatric patients are not homogeneous; the best empiric treatment of this condition should be driven by local epidemiology. The Weighted-Incidence Syndromic Combination Antibiogram (WISCA) addresses the need for disease-specific local susceptibility evidence that could guide empiric antibiotic prescriptions based on outcome estimates of treatment regimens obtained as a weighted average of pathogen susceptibilities. This study developed a WISCA model to inform empirical antibiotic regimen selection for febrile neutropenia (FN) episodes in onco-haematological paediatric patients treated at two Italian paediatric tertiary centres. Methods We included blood cultures from patients with a bloodstream infection and neutropenia admitted to the Paediatric Haematology-Oncology wards in Padua and Genoa Hospitals from 2016 to 2021. WISCAs were developed by estimating the coverage of 20 antibiotics as monotherapy and of 21 combined regimens with a Bayesian probability distribution. Results We collected 350 blood cultures, including 196 g-negative and 154 g-positive bacteria. Considering the most used antibiotic combinations, such as piperacillin–tazobactam plus amikacin, the median coverage for the pool of bacteria collected in the study was 78%. When adding a glycopeptide, the median coverage increased to 89%, while the replacement of piperacillin–tazobactam with meropenem did not provide benefits. The developed WISCAs showed that no monotherapy offered an adequate coverage rate for the identified pathogens. Conclusions The application of WISCA offers the possibility of maximizing the clinical utility of microbiological surveillance data derived from large hospitals to inform the choice of the best empiric treatment while contributing to spare broad-spectrum antibiotics.

Knowledge of epidemiology is essential for guiding correct antibiotic prescription, reducing bacteremia-associated mortality, and implementing targeted infection control programs. However, only a few studies have reported on the epidemiology of bloodstream infections (BSIs) in pediatrics. We performed a retrospective analysis of all BSIs (excluding those caused by common skin contaminants) diagnosed from 2006 to 2022 in patients younger than 18 years who were treated at an Italian pediatric tertiary care hospital. Overall, 2395 BSIs were recorded, including 2207 (92.15%) due to bacteria and 188 (7.85%) due to fungi. The incidence rate (BSIs/10,000 hospital discharges, IR) of bacterial BSIs significantly increased during the study period. In particular, BSIs caused by S. aureus (including MRSA), Enterobacterales (including ESBL and AmpC producers), Enterococcus spp., and P. aeruginosa became more common. The frequency of carbapenem-resistant strains was S. pneumoniae. The BSIs were stratified by patient age, and S. aureus was the most frequent cause of BSIs in all age groups, while E. coli was the most frequent in the Enterobacterales family. S. agalactiae was the third most frequent cause of neonatal early-onset BSIs. The prevalence of Enterococcus spp. increased in the subgroups from 8 days to 5 years of age, while P. aeruginosa became more prevalent in children over 5 years of age. S. aureus was also the most frequent isolate in both community- and hospital-onset BSIs, followed by E. coli. The prevalence of multidrug-resistant (MDR) pathogens was very low. It was C. albicans was the most frequently isolated strain, followed by C. parapsilosis. Notably, the IR of fungemia did not change significantly during the study period, in spite of an increase in the absolute number of events. The continuous monitoring of local epidemiology is essential to identify changes in the IRs of pathogens and antibiotic susceptibility and to guide antibiotic treatments, especially in the phase when antibiograms are not yet available.

This paper analyses one of the most successful historical shows broadcasted on the Italian networks, Passato e presente. The essay focuses on how this broadcast declines historical narration and how it constructs, through the language of television, its dimension as an enunciative vector. By outlining the characteristics of its mise-en-scene and narrative, the essay demonstrates the degree of sophistication and innovation of Passato e presente in the Italian panorama, but also the persisting limitations in understanding the specificities of the audiovisual medium for the dissemination of history.

Vegetation models for climate adaptation and mitigation strategies require spatially high-resolution climate input data in which the error with respect to observations has been previously corrected. To quantify the impact of bias correction, we examine the effects of quantile-mapping bias correction on the climate change signal (CCS) of climate, extremes, and biological variables from the convective regional climate model COSMO-CLM and two dynamic vegetation models (LPJ-GUESS and CARAIB). COSMO-CLM was driven and analyzed at 3 km horizontal resolution over Central Europe (CE) and the Iberian Peninsula (IP) for the transient period 1980–2070 under the RCP8.5 scenario. Bias-corrected and uncorrected climate simulations served as input to run the dynamic vegetation models over Wallonia. Main result of the impact of bias correction on the climate is a reduction of seasonal absolute precipitation by up to −55% with respect to uncorrected simulations. Yet, seasonal climate changes of precipitation and also temperature are marginally affected by bias correction. Main result of the impact of bias correction on changes in extremes is a robust spatial mean CCS of climate extreme indices over both domains. Yet, local biases can both over- and underestimate changes in these indices and be as large as the raw CCS. Changes in extremely wet days are locally enhanced by bias correction by more than 100%. Droughts in southern IP are exacerbated by bias correction, which increases changes in consecutive dry days by up to 14 days/year. Changes in growing season length in CE are affected by quantile mapping due to local biases ranging from 24 days/year in western CE to −24 days/year in eastern CE. The increase of tropical nights and summer days in both domains is largely affected by bias correction at the grid scale because of local biases ranging within ±14 days/year. Bias correction of this study strongly reduces the precipitation amount which has a strong impact on the results of the vegetation models with a reduced vegetation biomass and increases in net primary productivity. Nevertheless, there are large differences in the results of the two applied vegetation models.

Titanium dioxide nanotubes (TNT) have been extensively studied because of their unique properties, which make such systems ideal candidates for biomedical application, especially for the targeted release of drugs. However, knowledge about the properties of TiO2 nanotubes with typical dimensions of the order of the nanometer is limited, especially concerning the adsorption of molecules that can be potentially loaded in actual devices. In this work, we investigate, by means of simulations based on hybrid density functional theory, the adsorption of Vitamin C molecules on different nanotubes through a comparative analysis of the properties of different structures. We consider two different anatase TiO2 surfaces, the most stable (101) and the more reactive (001)A; we evaluate the role of the curvature, the thickness and of the diameter as well as of the rolling direction of the nanotube. Different orientations of the molecule with respect to the surface are studied in order to identify any trends in the adsorption mechanism. Our results show that there is no preferential functional group of the molecule interacting with the substrate, nor any definite spatial dependency, like a rolling orientation or the concavity of the nanotube. Instead, the adsorption is driven by geometrical factors only, i.e., the favorable matching of the position and the alignment of any functional groups with undercoordinated Ti atoms of the surface, through the interplay between chemical and hydrogen bonds. Differently from flat slabs, thicker nanotubes do not improve the stability of the adsorption, but rather develop weaker interactions, due to the enhanced curvature of the substrate layers.

The following paper contributes to interdisciplinary debates at the intersection of informal sport/leisure, migration and urban studies. It does so by drawing on an ethnographic research with young men of migrant origins in Turin, Italy, and by addressing the relevance of parkour in the participants' experiences and negotiations of 'what it means to (not) belong' in urban spaces. The focus on parkour provides a unique entry point to address the politics of belonging that unfold in urban spaces as contested sites where competing images of the city, the nation and of who belongs to them converge, clash and overlap. This is particularly relevant, though not limited to the Italian context, where political narratives and realities still legally and socially define the children of migration as alien bodies in the nation, while Turin's urban leaderships portray youth cultures and multicultural diversity as assets for the city's symbolic, cultural and financial regeneration. As the intersection of such discourses shapes the manifold ways through which post-migrant urban subjects become essentialised, valorised and pathologised in Turin, the paper's findings foreground the relevance of informal sports as entry points to (re)consider discussions on citizenship, conviviality and rights (to the city) in contemporary urban contexts. [ABSTRACT FROM AUTHOR]

Abstract We discuss two separate realizations of the diffeomorphism group for metric gravity, which give rise to theories that are classically equivalent, but quantum mechanically distinct. We renormalize them in $$d=2+\epsilon $$ d = 2 + ϵ dimensions, developing a new procedure for dimensional continuation of metric theories and highlighting connections with the constructions that previously appeared in the literature. Our hope is to frame candidates for ultraviolet completions of quantum gravity in $$d>2$$ d > 2 and give some perturbative mean to assess their existence in $$d=4$$ d = 4 , but also to speculate on some potential obstructions in the continuation of such candidates to finite values of $$\epsilon $$ ϵ . Our results suggest the presence of a conformal window in d which seems to extend to values higher than four.

Abstract We report the study of two-dimensional graphitic carbon nitride (GCN) functionalized with copper single atoms as a catalyst for the reduction of CO2 (CO2RR). The correct GCN structure, as well as the adsorption sites and the coordination of the Cu atoms, was carefully determined by combining experimental techniques, such as X-ray diffraction, transmission electron microscopy, X-ray absorption, and X-ray photoemission spectroscopy, with DFT theoretical calculations. The CO2RR products in KHCO3 and phosphate buffer solutions were determined by rotating ring disk electrode measurements and confirmed by 1H-NMR and gas chromatography. Formate was the only liquid product obtained in bicarbonate solution, whereas only hydrogen was obtained in phosphate solution. Finally, we demonstrated that GCN is a promising substrate able to stabilize metal atoms, since the characterization of the Cu-GCN system after the electrochemical work did not show the aggregation of the copper atoms.

Knowledge of epidemiology is essential for guiding correct antibiotic prescription, reducing bacteremia-associated mortality, and implementing targeted infection control programs. However, only a few studies have reported on the epidemiology of bloodstream infections (BSIs) in pediatrics. We performed a retrospective analysis of all BSIs (excluding those caused by common skin contaminants) diagnosed from 2006 to 2022 in patients younger than 18 years who were treated at an Italian pediatric tertiary care hospital. Overall, 2395 BSIs were recorded, including 2207 (92.15%) due to bacteria and 188 (7.85%) due to fungi. The incidence rate (BSIs/10,000 hospital discharges, IR) of bacterial BSIs significantly increased during the study period. In particular, BSIs caused by S. aureus (including MRSA), Enterobacterales (including ESBL and AmpC producers), Enterococcus spp., and P. aeruginosa became more common. The frequency of carbapenem-resistant strains was <1% and stable over time. Conversely, there was a significant reduction in the incidence of BSIs due to S. pneumoniae. The BSIs were stratified by patient age, and S. aureus was the most frequent cause of BSIs in all age groups, while E. coli was the most frequent in the Enterobacterales family. S. agalactiae was the third most frequent cause of neonatal early-onset BSIs. The prevalence of Enterococcus spp. increased in the subgroups from 8 days to 5 years of age, while P. aeruginosa became more prevalent in children over 5 years of age. S. aureus was also the most frequent isolate in both community- and hospital-onset BSIs, followed by E. coli. The prevalence of multidrug-resistant (MDR) pathogens was very low. It was <5% for both Gram-positive (i.e., MRSA and VRE) and Gram-negative (ESBL, AmpC, and carbapenem-resistant) pathogens, and MDR pathogens were almost exclusively detected in hospital-onset BSIs. Fungi accounted for just under 8% of BSIs. C. albicans was the most frequently isolated strain, followed by C. parapsilosis. Notably, the IR of fungemia did not change significantly during the study period, in spite of an increase in the absolute number of events. The continuous monitoring of local epidemiology is essential to identify changes in the IRs of pathogens and antibiotic susceptibility and to guide antibiotic treatments, especially in the phase when antibiograms are not yet available. [ABSTRACT FROM AUTHOR]