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Abstract Background Maintaining people living with HIV (PLWHIV) in clinical care is a global priority. In the Metro Detroit area of Michigan, approximately 30% of PLWHIV are out of care. To re-engage lost-to-follow-up patients, Wayne Health Infectious Disease clinic launched an innovative Homecare program in 2017. In addition to home healthcare delivery, the program included links to community resources and quarterly community meetings. We aimed to evaluate Homecare’s impact on participants’ ability to stay engaged in HIV care and reach viral suppression. We included data from PLWHIV and their healthcare workers. Methods We used a convergent mixed-methods design, including first year program record review, semi-structured interviews, and a validated Likert scale questionnaire rating illness perception before and after Homecare. Interview data were collected from 15 PLWHIV in Metro Detroit and two healthcare workers responsible for program delivery. Semi-structured interviews focused on obstacles to clinic-based care, support networks, and illness perceptions. Interview data were transcribed and analyzed using a thematic approach. A fully coded analysis was used to create a conceptual framework of factors contributing to Homecare’s success. Means in eight categories of the Brief Illness Perception (IPQ) were compared using paired T-tests. Results In the first year of Homecare, 28 of 34 participants (82%) became virally suppressed at least once. The program offered (1) social support and stigma reduction through strong relationships with healthcare workers, (2) removal of physical and resource barriers such as transportation, and (3) positive changes in illness perceptions. PLWHIV worked towards functional coping strategies, including improvements in emotional regulation, acceptance of their diagnosis, and more positive perspectives of control. Brief-IPQ showed significant changes in six domains before and after Homecare. Conclusion Homecare offers an innovative system for successfully re-engaging and maintaining lost-to-follow-up PLWHIV in care. These findings have implications for HIV control efforts and could inform the development of future programs for difficult to reach populations.

Runoff containing road salt (sodium chloride, NaCl) causes the salinization of inland freshwaters, with potentially severe impacts on aquatic species. We performed a mesocosm experiment to test the effects of salinization on plankton community structure in an oligotrophic mountain lake with a limited history of elevated salt concentrations. We exposed plankton communities to a gradient of 30 salt concentrations ranging from 1 to 2900 Cl− mg L−1 for 6 weeks. Adding salt increased zooplankton biomass at concentrations < 500 mg Cl− L−1 while reducing phytoplankton biomass. Zooplankton biomass declined precipitously at higher concentrations, with phytoplankton biomass showing a mirror image increase. The initial increase in zooplankton biomass with salt addition suggests that zooplankton are salt-limited at low ionic concentrations. Additionally, the inverse response of zooplankton and phytoplankton suggests that salinity mainly affects phytoplankton biomass via changes in top-down regulation by grazers.

Abstract Large‐bodied mammals living in fragmented habitats are at higher risk of extinction, and such risk can be influenced by ecological factors such as predator–prey system dynamics. These dynamics can be particularly complex for conservation management when one endangered species preys on another endangered species in an isolated or poor‐quality habitat. Here we describe predation events observed over 19 months that involved two threatened species: the largest carnivore in Madagascar, the fosa (Cryptoprocta ferox), and three groups of diademed sifaka (Propithecus diadema) in the Betampona Strict Nature Reserve. This site is a 22 km2 low‐altitude rainforest that is surrounded by agricultural land and isolated from larger forest corridors. We aim to (1) assess the behavioral changes of P. diadema in response to fosa attacks and identify any antipredator strategies that they adopted, and (2) quantify the frequency of fosa attacks and the predation impact on the sifaka population. We report five direct observations of fosa predation attempts (one successful), the discovery of a dead sifaka with evidence of fosa predation, and the disappearance of three individuals. We describe the observed attacks and compare the sifaka activity budgets and movement patterns before and after the events. To escape the predator, sifakas fled short distances, hid, and remained vigilant. The impact of predation, combined with low reproductive rates and potentially high inbreeding of this isolated diademed sifaka population, could affect the survival of this species in Betampona. Given the compounding effects of habitat isolation and high hunting pressure, community‐specific conservation strategies should incorporate predator–prey dynamics via longitudinal monitoring of predator and prey population densities and quantifying the predation pressure between them.

Summary: Background: Despite the overall improvement in care, people with type 2 diabetes (T2D) experience an excess risk of end-stage kidney disease. We evaluated the long-term effectiveness of dapagliflozin on kidney function and albuminuria in patients with T2D. Methods: We included patients with T2D who initiated dapagliflozin or comparators from 2015 to 2020. Propensity score matching (PSM) was performed to balance the two groups. The primary endpoint was the change in estimated glomerular filtration rate (eGFR) from baseline to the end of observation. Secondary endpoints included changes in albuminuria and loss of kidney function. Findings: We analysed two matched groups of 6197 patients each. The comparator group included DPP-4 inhibitors (40%), GLP-1RA (22.3%), sulphonylureas (16.1%), pioglitazone (8%), metformin (5.8%), or acarbose (4%). Only 6.4% had baseline eGFR 30 mg/g. During a mean follow-up of 2.5 year, eGFR declined significantly less in the dapagliflozin vs comparator group by 1.81 ml/min/1.73 m2 (95% C.I. from 1.13 to 2.48; p

Video cameras provide vital information on volcanic plumes from explosive eruptions, such as plume height, for monitoring and research. These images must be calibrated to get accurate quantitative data. However, the presence of wind complicates any calibration as the plume may no longer lie in the image plane, i.e. a plane perpendicular to the camera’s line-of-sight. Here, we present a simple new tool to correct for the effect of wind on the position and height of a volcanic plume as determined from imagery by rotating the image plane to be in the direction of the wind. We show the importance of accounting for the effect of wind on the maximum plume height determined from videos for two case-studies; a Vulcanian explosion from Sabancaya volcano, Peru, and a sustained plume from Mount Etna, Italy. This tool can improve the accuracy of quantitative information extracted from images of volcanic plumes, and should prove useful for both research and monitoring purposes.

Although dominantly effusive, the 2021 Tajogaite eruption from Cumbre Vieja volcano (La Palma, Spain) produced a wide tephra blanket over 85 days of activity. About one month after the eruption onset, clean-up operations were implemented to mitigate the impact of tephra load on primary buildings. Here, we present a post-event impact assessment of 764 primary buildings, which expands our empirical knowledge of building vulnerability to tephra fallout to include impacts from long-lasting eruptions. Field observations are analyzed in the perspective of existing fragility curves, high-resolution satellite imagery and a reconstruction of the spatio-temporal evolution of the tephra blanket to characterize the evolution of roof collapse due to static loads over time. Thanks to a chronological correlation between the temporal evolution of tephra sedimentation and the timing of clean-up operations, we quantified their effectiveness in mitigating roof collapse. If no clean-up measures had been taken 11% of the surveyed buildings would have exceeded a 75% probability of roof collapse, while only 10 roof collapses have been observed (1.3% of the analysed buildings). This work provides key insights for further development of emergency plans for the management of long-lasting eruptions characterised by the sustained emission of tephra over weeks to months.

This contribution aims to describe the innovative experience related to the Laboratori e Tirocini di Introduzione alle Metodologie e Tecnologie Didattiche/Teaching Labs, which have been developed since A.Y. 2017/18 as part of the courses in the Department of Foreign Languages and Literatures, University of Verona. The objective of these Laboratori was to offer a preliminary teacher education experience for students interested in becoming foreign language and literature teachers. The article will first discuss the rationale at the basis of the Laboratori project, also in connection to the importance of introducing language and literature students to the teaching profession, within the strategic priorities identified by the 2021 European Resolution in the field of education and training. The structure of the Laboratori and their characteristics will then be described in detail, highlighting the innovative aspects, in particular with reference to the blended learning approach, the familiarisation with the eTwinning European project, the micro-teaching sessions, as well as the practicum in lower and upper secondary schools. Some qualitative results and future perspectives will finally be discussed, including the developments which have led to the new Teaching Lab: Methodologies, Technologies and Practicum structure.

Abstract To reduce bird collisions on wind turbines, Automatic Detection Systems have been developed to locate approaching birds and trigger turbines to slowdown to 2–3 rotations per minute (rpm). However, it is unknown whether birds can detect this reduced speed and avoid the turbine. We conducted an operant conditioning experiment on domestic doves (Streptopelia roseogrisea) and Harris's hawks (Parabuteo unicinctus) to assess their ability to discriminate between stationary and rotating miniature wind turbines, depending on the rotation speed and the contrast between the white blades and the background (only for doves for the latter). At high contrast, regardless of the speed tested, hawks were able to differentiate between the rotating and stationary turbines, while doves were not able to discriminate the slow‐rotating turbine (3 rpm) from the stationary one. The discrimination threshold increased to 8 rpm for the doves when the contrast was reduced. Our results suggest that the residual wind turbine speed of 2–3 rpm may not be detected by all bird species under all environmental conditions. Increasing the contrast between wind turbines and their environment may improve the detection of low‐speed rotation by some birds, otherwise, complete turbine shutdown should be recommended.

Abstract Objective We investigated, using population-based data, whether worse autonomic function, estimated from lower 24-hour heart rate variability (HRV), was associated with beta cell function, assessed from beta cell response during an oral glucose tolerance test (OGTT). Research design and methods We used cross-sectional data from The Maastricht Study, a population-based cohort study (N = 2,007; age, mean ± SD:60 ± 8 years; 52% men; and 24% with type 2 diabetes). We used linear regression analyses with adjustment for potential confounders (demographic, cardiovascular, and lifestyle factors) to study the associations of time- and frequency-domain HRV (composite scores) with overall beta cell response (estimated from a composite score calculated from: C-peptidogenic index, overall insulin secretion, beta cell glucose sensitivity, beta cell potentiation factor, and beta cell rate sensitivity). In addition, we tested for interaction by sex and glucose metabolism status. Results After full adjustment, lower time- and frequency-domain HRV was significantly associated with lower overall beta cell response composite score (standardized beta, -0.055 [-0.098; -0.011] and − 0.051 [-0.095; -0.007], respectively). These associations were not modified by sex and there was no consistent pattern of interaction by glucose metabolism status. Conclusion The present etiological study found that worse autonomic function, estimated from lower HRV, was associated with worse beta cell function, estimated from a composite score in a population-based sample which covered the entire spectrum of glucose metabolism. Hence, autonomic dysfunction may contribute to beta cell dysfunction and, ultimately, to the alteration of glucose metabolism status from normal glucose metabolism to prediabetes and type 2 diabetes.

Quality of life can be generally defined as people’s satisfaction with their lives and personal wellbeing. Contemporary literature agrees that dimensions such as health, education, employment, leisure, social relations, security, environment, landscape, and cultural heritage should be considered. Tourism serves as a stimulus for rural development, and assessing residents’ and tourists’ quality of life is relevant for local administrators of a tourist destination. Given the absence of quality-of-life models for individual municipalities, the research questions were aimed at the mapping of quality-of-life frameworks and the construction of a set of quality-of-life indicators for Alagna Valsesia. This research was conducted in 2023. The results of the research showed the possibility of constructing a modular model of indicator sets aimed particularly at decision making by territorial policymakers. The limitations of the research are related to the difficulty of finding different indicators in public platforms and, in the future, we would like to build a synthetic indicator replicable in other Piedmontese and Italian municipalities.

Abstract Runoff containing road salt (sodium chloride, NaCl) causes the salinization of inland freshwaters, with potentially severe impacts on aquatic species. We performed a mesocosm experiment to test the effects of salinization on plankton community structure in an oligotrophic mountain lake with a limited history of elevated salt concentrations. We exposed plankton communities to a gradient of 30 salt concentrations ranging from 1 to 2900 Cl− mg L−1 for 6 weeks. Adding salt increased zooplankton biomass at concentrations

Abstract The most frequent volcanic eruptions are of low-intensity and small magnitude. They produce abundant ash-sized (

Abstract In less than half a century, allergy, originally perceived as a rare disease, has become a major public health threat, today affecting the lives of more than 60 million people in Europe, and probably close to one billion worldwide, thereby heavily impacting the budgets of public health systems. More disturbingly, its prevalence and impact are on the rise, a development that has been associated with environmental and lifestyle changes accompanying the continuous process of urbanization and globalization. Therefore, there is an urgent need to prioritize and concert research efforts in the field of allergy, in order to achieve sustainable results on prevention, diagnosis and treatment of this most prevalent chronic disease of the 21st century. The European Academy of Allergy and Clinical Immunology (EAACI) is the leading professional organization in the field of allergy, promoting excellence in clinical care, education, training and basic and translational research, all with the ultimate goal of improving the health of allergic patients. The European Federation of Allergy and Airways Diseases Patients’ Associations (EFA) is a non-profit network of allergy, asthma and Chronic Obstructive Pulmonary Disorder (COPD) patients’ organizations. In support of their missions, the present EAACI Position Paper, in collaboration with EFA, highlights the most important research needs in the field of allergy to serve as key recommendations for future research funding at the national and European levels. Although allergies may involve almost every organ of the body and an array of diverse external factors act as triggers, there are several common themes that need to be prioritized in research efforts. As in many other chronic diseases, effective prevention, curative treatment and accurate, rapid diagnosis represent major unmet needs. Detailed phenotyping/endotyping stands out as widely required in order to arrange or re-categorize clinical syndromes into more coherent, uniform and treatment-responsive groups. Research efforts to unveil the basic pathophysiologic pathways and mechanisms, thus leading to the comprehension and resolution of the pathophysiologic complexity of allergies will allow for the design of novel patient-oriented diagnostic and treatment protocols. Several allergic diseases require well-controlled epidemiological description and surveillance, using disease registries, pharmacoeconomic evaluation, as well as large biobanks. Additionally, there is a need for extensive studies to bring promising new biotechnological innovations, such as biological agents, vaccines of modified allergen molecules and engineered components for allergy diagnosis, closer to clinical practice. Finally, particular attention should be paid to the difficult-to-manage, precarious and costly severe disease forms and/or exacerbations. Nonetheless, currently arising treatments, mainly in the fields of immunotherapy and biologicals, hold great promise for targeted and causal management of allergic conditions. Active involvement of all stakeholders, including Patient Organizations and policy makers are necessary to achieve the aims emphasized herein.

Penguins are the only extant family of flightless diving birds. They currently comprise at least 18 species, distributed from polar to tropical environments in the Southern Hemisphere. The history of their diversification and adaptation to these diverse environments remains controversial. We used 22 new genomes from 18 penguin species to reconstruct the order, timing, and location of their diversification, to track changes in their thermal niches through time, and to test for associated adaptation across the genome. Our results indicate that the penguin crown-group originated during the Miocene in New Zealand and Australia, not in Antarctica as previously thought, and that Aptenodytes is the sister group to all other extant penguin species. We show that lineage diversification in penguins was largely driven by changing climatic conditions and by the opening of the Drake Passage and associated intensification of the Antarctic Circumpolar Current (ACC). Penguin species have introgressed throughout much of their evolutionary history, following the direction of the ACC, which might have promoted dispersal and admixture. Changes in thermal niches were accompanied by adaptations in genes that govern thermoregulation and oxygen metabolism. Estimates of ancestral effective population sizes (N e ) confirm that penguins are sensitive to climate shifts, as represented by three different demographic trajectories in deeper time, the most common (in 11 of 18 penguin species) being an increased N e between 40 and 70 kya, followed by a precipitous decline during the Last Glacial Maximum. The latter effect is most likely a consequence of the overall decline in marine productivity following the last glaciation.

Long-lasting eruptions are of complex characterization and are typically associated with challenging risk assessment and crisis management due to the usual occurrence of multiple interacting hazards evolving at different temporal and spatial scales (e.g., lava, tephra, and gas). The 2021 Tajogaite eruption of Cumbre Vieja (La Palma) demonstrated how even hybrid events that are mostly effusive can be associated with widespread and impacting tephra deposits as a result of a complex interplay among gas flux, conduit geometry, and magma feeding rate. In this novel study, direct observations, syn-eruptive and post-eruptive sampling, and statistical analysis of pulsatory activity have been combined to provide new insights into eruption dynamics. They show how rapid gas segregation and high magma ascent rate modulated the gas flux at multiple vents, resulting in short-time fluctuations among the different explosive styles (ash-poor gas puffing, Strombolian, violent Strombolian, and lava fountaining) and unsteady tephra ground accumulation. Various size-selective sedimentation processes were also observed, including particle aggregation and ash fingers, which have impacted the overall tephra dispersal. In fact, even though both local and total grainsize distributions of selected layers, units, and of the whole tephra blanket are unimodal with a low fine-ash content, grainsize analysis of 154 samples suggests no correlation of particles

Since the discovery that rhythmic abilities are universal in humans, temporal features of vocal communication have greatly interested researchers studying animal communication. Rhythmic patterns are a valuable tool for species discrimination, mate choice, and individual recognition. A recent study showed that bird songs and human music share rhythmic categories when a signal's temporal intervals are distributed categorically rather than uniformly. Following that study, we aimed to investigate whether songs of indris (Indri indri), the only singing lemur, may show similar features. We measured the inter-onset intervals (tk), delimited by the onsets of two consecutive units, and the rhythmic ratios between these intervals (rk), calculated by dividing an interval by itself plus its adjacent, and finded a three-cluster distribution. Two clusters corresponded to rhythmic categories at 1:1 and 1:2, and the third approached a 2:1 ratio. Our results demonstrated for the first time that another primate besides humans produces categorical rhythms, an ability likely evolved convergently among singing species such as songbirds, indris, and humans. Understanding which communicative features are shared with other species is fundamental to understanding how they have evolved. In this regard, thanks to the simplicity of data processing and interpretation, our study relied on an accessible analytical approach that could open up new branches of the investigation into primate communication, leading the way to reconstruct a phylogeny of rhythm abilities across the entire order.

Evacuation planning and management represent a key aspect of volcanic crises because they can increase people's protection as well as minimize potential impacts on the economy, properties and infrastructure of the affected area. We present an agent-based simulation tool that assesses the effectiveness of different evacuation scenarios using the small island of Vulcano (southern Italy) as a case study. Simulation results show that the overall time needed to evacuate people should be analysed together with the percentage of people evacuated as a function of time and that a simultaneous evacuation on Vulcano is more efficient than a staged evacuation. For example, during the touristic (high) season between July and August, even though the overall duration is similar for both evacuation strategies, after ∼ 6 h about 96 % of people would be evacuated with a simultaneous evacuation, while only 86 % would be evacuated with a staged evacuation. We also present a model to assess the economic impact of evacuation as a function of evacuation duration and of the starting period with respect to the touristic season. It reveals that if an evacuation lasting 3 to 6 months was initiated at the beginning or at the end of the touristic season (i.e. June or November), it would cause a very different economic impact on the tourism industry (about 78 %–88 % and 2 %–7 % of the total annual turnover, respectively). Our results show how the assessment of evacuation scenarios that consider human and economic impact carried out in a pre-disaster context helps authorities develop evacuation plans and make informed decisions outside the highly stressful time period that characterizes crises.

Abstract Characterizing the size and settling velocity of pyroclastic fragments injected into the atmosphere during volcanic eruptions (i.e., tephra) is crucial to the forecasting of plume and cloud dispersal. Optical disdrometers have been integrated into volcano monitoring networks worldwide in order to best constrain these parameters in real time. Nonetheless, their accuracy during tephra fallout still needs to be assessed. A significant complication is the occurrence of particle aggregates that modify size and velocity distributions of falling tephra. We made the first use of the Thies Clima Laser Precipitation Monitor (LPM) for tephra-fallout detection at Sakurajima volcano (Japan), which is characterized by a lower size detection window with respect to more commonly used disdrometers (e.g., Parsivel2) and can more easily distinguish different falling objects. For the first time, individual particles have been distinguished from most aggregates based on disdrometer data, with the potential to provide useful grain-size information in real time. In case of negligible aggregation, LPM and collected sample-based estimates are in agreement for both grain-size and sedimentation rate. In case of significant aggregation, particle shape analyses and a dedicated drag equation are used to filter out aggregates from LPM data that also provide good agreement with collected tephra samples.

Tephra dispersal and fallout resulting from explosive activity of Mt. Etna (Italy) represent a significant threat to the surrounding inhabited areas as well as to aviation operations. An early-warning system aimed at foreseeing the onset of paroxysmal activity has been developed, combining a thermal infrared camera, infrasonic network, and a weather radar. In this way, it is possible to identify the onset of a lava fountain as well as to determine the associated mass eruption rate (MER) and top plume height (HTP). The new methodology, defined as the paroxysmal early-warning (PEW) alert system, is based on the analysis of some explosive eruptions that occurred between 2011 and 2021 at Etna, simultaneously observed by the thermal camera and infrasound systems dislocated around the summit eruptive craters, and by the weather radar, located at about 32 km from the summit craters. This work represents an important step towards the mitigation of the potential impact associated with the tephra dispersal and fallout during paroxysms at Etna, which can be applied to other volcanoes with similar activity and monitoring strategies.