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The fast diffusion of the SARS-CoV-2 pandemic have called for an equally rapid evolution of the therapeutic options.The Human recombinant monoclonal antibodies (mAbs) have recently been approved by the Food and Drug Administration (FDA) and by the Italian Medicines Agency (AIFA) in subjects aged ≥12 with SARS-CoV-2 infection and specific risk factors.Currently the indications are specific for the use of two different mAbs combination: Bamlanivimab+Etesevimab (produced by Eli Lilly) and Casirivimab+Imdevimab (produced by Regeneron).These drugs have shown favorable effects in adult patients in the initial phase of infection, whereas to date few data are available on their use in children.AIFA criteria derived from the existing literature which reports an increased risk of severe COVID-19 in children with comorbidities. However, the studies analyzing the determinants for progression to severe disease are mainly monocentric, with limited numbers and reporting mostly generic risk categories.Thus, the Italian Society of Pediatrics invited its affiliated Scientific Societies to produce a Consensus document based on the revision of the criteria proposed by AIFA in light of the most recent literature and experts' agreement.This Consensus tries to detail which patients actually have the risk to develop severe disease, analyzing the most common comorbidities in children, in order to detail the indications for mAbs administration and to guide the clinicians in identifying eligible patients., (© 2022. The Author(s).)

Healthcare workers (HCWs) play a central role in handling the ongoing coronavirus disease 2019 (COVID-19) pandemic. Monitoring HCWs, both symptomatic and asymptomatic, through screening programs, are critical to avoid the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in the hospital environment to rapidly identify and isolate infected individuals and to allow their prompt return to work as soon as necessary. We aim to describe our healthcare surveillance experience (April 2-May 6, 2020) based on a combined screening consisting of real-time PCR (RT-PCR) on nasopharyngeal (NP) swabs and rapid serologic tests (RST) for SARS-CoV-2 in all HCWs of Meyer Children's University Hospital in Florence. Among the analyzed workers, 13/1690 (0.8%), all of them without clinical manifestations, was found positive for SARS-CoV-2 by using RT-PCR on NP swab: 8/1472 (0.5%) were found positive during the screening, 1/188 (0.5%) during contact with a positive individual ( p > 0.05 vs. screening group), while 4/30 (13.3%) were found positive on the day of re-admission at work after an influenza-like-illness ( p < 0.05). Concerning working areas, the majority of RT-PCR positivity (12/13) and serologic positivity (34/42) was found in non-COVID-19 dedicated areas ( p > 0.05 vs. COVID-19 dedicated areas). No cases were registered among non-patients-facing workers ( p = 0.04 vs. patient-facing group). Nurses and residents represented, respectively, the working role with the highest and lowest percentage of RT-PCR positivity. In conclusion, accurate surveillance is essential to reduce virus spread among HCWs, patients, and the community and to limit the shortage of skilled professionals. The implementation of the surveillance system through an efficient screening program was offered to all professionals, regardless of the presence of clinical manifestations and the level of working exposure risk, maybe wise and relevant., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Guarnieri, Moriondo, Giovannini, Lodi, Ricci, Pisano, Barbacci, Bini, Indolfi, Zanobini and Azzari.)

The Severe Acute Respiratory Syndrome CoronaVirus type 2 (SARS-CoV-2) pandemic impacted the organization of paediatric hospitals. This study aimed to evaluate the preparedness for the pandemic among a European network of children's hospitals and to explore the strategies to restart health care services. A cross-sectional, web-based survey was distributed in May 2020 to the 13 children's tertiary care hospitals belonging to the European Children's Hospitals Organisation. Responses were obtained from eight hospitals (62%). Significant reductions were observed in accesses to the emergency departments (41.7%), outpatient visits (35.7%), intensive and non-intensive care unit inpatient admissions (16.4 and 13%, respectively) between February 1 and April 30, 2020 as compared with the same period of 2019. Overall, 93 children with SARS CoV-2 infection were admitted to inpatient wards. All the hospitals created SARS-CoV-2 preparedness plans for the diagnosis and management of infected patients. Routine activities were re-scheduled. Four hospitals shared their own staff with adult units, two designated bed spaces for adults and only one admitted adults to inpatient wards. The three main components for the resumption of clinical activities were testing, source control, and reorganization of spaces and flows. Telemedicine and telehealth services were used before the SARS-CoV-2 pandemic by three hospitals and by all the hospitals during it. Conclusion: The present study provides a perspective on preparedness to SARS-CoV-2 pandemic among eight large European children's hospitals, on the impact of the pandemic on the hospital activities and on the strategies adopted to restart clinical activities., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2021 Indolfi, Stivala, Lenge, Diaz Naderi, McIntosh, Llandrich, Gannon, McGreevy, Trapani, Miettinen, Lahdenne, Desborough, Pavare, van Rossum, Zyska, Resti and Zanobini.)

The sample collection procedure for SARS-CoV-2 has a strong impact on diagnostic capability, contact tracing approach, ultimately affecting the infection containment performance. This study demonstrates that self-collected nasal-swab has shown to be a valid and well tolerated procedure to SARS-CoV-2 surveillance in a healthcare system. More significantly, no performance adequacy difference was detected in self-administered swabs between healthcare worker (HCW) and non-HCW which allows to speculate that this procedure could be successfully extended to the entire population for mass screening.

Background: The Region of Tuscany Health Department was included as an associated member in WP7 "Healthcare" of the European Partnership for Action Against Cancer (EPAAC), initiated by the EU Commission in 2009., Aims: The principal aim was to map centres across Europe prioritizing those that provide public health services and operating within the national health system in integrative oncology (IO)., Methods: A cross-sectional descriptive survey design was used to collect data. A questionnaire was elaborated concerning integrative oncology therapies to be administered to all the national health system oncology centres or hospitals in each European country. These institutes were identified by convenience sampling, searching on oncology websites and forums. The official websites of these structures were analysed to obtain more information about their activities and contacts., Results: Information was received from 123 (52.1 %) out of the 236 centres contacted until 31 December 2013. Forty-seven out of 99 responding centres meeting inclusion criteria (47.5 %) provided integrative oncology treatments, 24 from Italy and 23 from other European countries. The number of patients seen per year was on average 301.2 ± 337. Among the centres providing these kinds of therapies, 33 (70.2 %) use fixed protocols and 35 (74.5 %) use systems for the evaluation of results. Thirty-two centres (68.1 %) had research in progress or carried out until the deadline of the survey. The complementary and alternative medicines (CAMs) more frequently provided to cancer patients were acupuncture 26 (55.3 %), homeopathy 19 (40.4 %), herbal medicine 18 (38.3 %) and traditional Chinese medicine 17 (36.2 %); anthroposophic medicine 10 (21.3 %); homotoxicology 6 (12.8 %); and other therapies 30 (63.8 %). Treatments are mainly directed to reduce adverse reactions to chemo-radiotherapy (23.9 %), in particular nausea and vomiting (13.4 %) and leucopenia (5 %). The CAMs were also used to reduce pain and fatigue (10.9 %), to reduce side effects of iatrogenic menopause (8.8 %) and to improve anxiety and depression (5.9 %), gastrointestinal disorders (5 %), sleep disturbances and neuropathy (3.8 %)., Conclusions: Mapping of the centres across Europe is an essential step in the process of creating a European network of centres, experts and professionals constantly engaged in the field of integrative oncology, in order to increase, share and disseminate the knowledge in this field and provide evidence-based practice.

Little has been published in the scientific literature on the distribution of pathogenic viruses and on their removal in the different treatment phases in wastewater treatment plants in Italy. Recent advances in molecular biology have reduced analytic costs and allowed the detection of virus directly in the environment. This study evaluates the presence of enteric viruses and their removal in three treatment plants of different sizes and which use different treatment methods. Overall 92 samples were collected during three seasonal campaigns (winter, spring-summer, and autumn). Samples were collected at different phases of the treatment process. Chemical and microbiological analyses were performed. Samples were concentrated by ultrafiltration and tested for the presence of hepatitis A virus, adenovirus, rotavirus, astrovirus, norovirus and enteroviruses. All viruses, excluding the Enteroviruses were detected through biomolecular testing. Enteroviruses, were isolated on BGM cells and subsequently genotyped at the VP1 region. Sixty-two of the 92 samples tested positive for viruses; of these, 21 tested positive for HAV, 4 for adenovirus, 9 for rotavirus, 21 for astrovirus, and 7 for norovirus. Enteroviruses were present on average in 44% of samples collected during the three sampling campaigns. Hepatitis A virus was isolated during the spring-summer period while Astroviruses were identified in all three sampling campaigns. Different enteroviruses were isolated, including four types of Coxsackie B virus variably isolated in all three campaigns, and type 1 Echovirus isolated in the second and third campaigns. All detected polioviruses were of the vaccine-type and were identified as types 1 and 3. Both viral genotypes of Norovirus were identified. Adenoviruses were only sporadically isolated and rotaviruses were identified as type A. As expected, results show a greater prevalence of Enteroviruses and this reflects viral circulation in the population. Regarding the efficacy of the different treatment stages, primary treatment was found to remove only small percentages of viruses, while activated sludge e subsequent sedimentation were found to be more effective.

A correct evaluation of the colour vision is important to make decisions concerning the recruitment in numerous occupations that require colour discrimination. In order to identify valid pre-employment colour vision testing methods, tests actually used and in particular the Ishihara test are considered. After a careful examination we conclude that candidates who pass the Ishihara test have sufficient colour perception to meet ordinary needs and further trade test are not necessary. Nevertheless we do not consider sufficient to rely on the Ishihara test alone to reject a candidate. The diagnostic algorihm proposed is recommended in pre-employment medical examinations for distinguishing people with normal colour vision, slight or sever colour deficiency.

Many researches have shown the role of some bivalent ions on the structure and function of alkaline phosphatase. For this reason we considered interesting to assay the effect of Zn++ and Mg++, at various concentrations, on the activity of alkaline phosphatase (APase) from different sources. The isoenzymes of alkaline phosphatase used for the experiments were from rat kidney and bone, from calf intestinal mucosa and from Escherichia coli. In order to investigate the effect of Zn++ and Mg++ on the enzyme activity, the two ions were removed using EDTA as chelating agent. The residual enzymatic activity was measured after having preincubated for 15 min the enzyme with EDTA at a final concentration of 0.05 mM, 0.1 mM, 0.5 mM, 5 mM, 25 mM. The reactivation of the enzyme was studied using as reference a sample, in which the final concentration of EDTA was 5 mM. In these series of experiments the enzymatic activity was assayed after a preincubation of the reaction mixture with ZnCl2 10 mM, MgCl2 10 mM and ZnCl2 +MgCl2 10 mM. The inactivation in the time of the enzyme by 5 mM EDTA was also studied. The results obtained show that APase from intestinal mucosa maintained, at the lower concentrations of EDTA (0.05, 0.1 and 0.5 mM), a residual activity higher than that of the enzymes of other source. Moreover, whilst the activity of the mucosal enzyme was completely restored by the addition of Zn++, the complete reactivation of the other enzyme activities was obtained only by the addition of Zn++ and Mg++ together. Concerning the inactivation by EDTA during the time, it was shown that APase from calf intestinal mucosa was inactivated after 60 min of incubation, while the enzymes from other sources lost completely their activity after 10 min.

Mice fed a sorbitol-enriched diet show measurable increases of alkaline phosphatase, glucose-6-phosphatase, and glucose-6-phosphate in the liver. The increases are positively correlated with duration of the sorbitol feeding program. The results could imply that sorbitol promotes glycogen synthesis.

The activity of sorbitol dehydrogenase purified from sheep liver has been measured in the presence of some sugars and polyols. Of these, xylitol exerts an inhibition on SDH activity about four times greater than the others. Since either sorbitol or xylitol significantly influences carbohydrate interconversion, the inhibition type and the inhibition constant for xylitol were determined.

Previous researches carried out on the metabolism of sorbitol in the rat showed the influence of this polyalcohol on the activity of some dehydrogenases NAD and NADP-dependent and on lacate/pyruvate, NADH/NAD and NADPH/NADP ratios. Since sorbitol dehydrogenase (SDH, EC 1.1.1.14) is an enzyme with a great affinity for sorbitol, it seemed interesting to investigate the effect of a sorbitol-enriched diet on SDH activity in the rat liver after different periods of dietary treatment (20, 40, 60 days). SDH was assayed by a continuous optical test according to Bücher et al. The data obtained show a repressive action on SDH activity by a sorbitol-enriched diet. In fact, whilst after 20 days of treatment SDH activity decreased of about 18% in respect of the controls, after 60 days a decrease of 80% was observed. This result is so interesting to stimulate other investigations in vitro on the kinetics of such metabolic reaction in the attempt to explain the relation between the enzyme and its substrate.

The effect of 1-propanol, 2-propanol, n-butanol, ethanol and methanol an sorbitol dehydrogenase activity was assayed. The inhibition type was also investigated and results obtained are reported.

Phytase has been purified from intestinal mucosa of rats fed on a phytic acid-enriched diet. The purification consisted of four steps: homogenate preparation, ultrafiltration procedure, DEAE cellulose chromatography, and Sephadex G-100 chromatography. The enzyme was purified 828-fold, as can be seen from the polyacrylamide gel electrophoresis pattern.

The high level of lipids in seeds of some species of conifers suggested that the glyoxylate cycle might have a role in conifer seed metabolism.Six species (Pinus pinea, Pinus pinaster, Pinus canariensis, Pinus strobus, Abies alba, and Cupressus sempervirens) were investigated for their lipid content and malate synthase and isocitrate lyase level. The fatty acid composition of the triglyceride fraction was also investigated. The correlation between lipid content of germinating seed with the presence of the cycle was confirmed. The enzymes of the glyoxylate cycle were not detected in Cupressus sempervirens where the lipid content is very low.