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Little is known about the effect of using an attentional focus instruction on motor performance in people with intellectual disabilities. Therefore, this study explored the effects of different attentional focus instructions on gross motor skill performances in individuals with Down syndrome. Seven community-dwelling participants (age 25.2±3.2 yrs, height 1.70±0.04 m, body mass 72.0±6.3 kg) voluntarily participated in the study. Motor performance on 5-meter running (5m sprint), vertical jump (countermovement jump with arm swing, CMJ), broad jump (standing broad jump, SBJ), forward medball throw (FMBT) or overhead medball backward throw (OMBT) and rising-up from a chair (five repetition sit-to-stand, 5STS) were recorded while performing internal-focus (IF) or external-focus (EF) instructions. EF induced significantly (p

AimsMetabolic dysfunction Associated Steatotic Liver Disease (MASLD) outcomes such as MASH (metabolic dysfunction associated steatohepatitis), fibrosis and cirrhosis are ordinarily determined by resource-intensive and invasive biopsies. We aim to show that routine clinical tests offer sufficient information to predict these endpoints.MethodsUsing the LITMUS Metacohort derived from the European NAFLD Registry, the largest MASLD dataset in Europe, we create three combinations of features which vary in degree of procurement including a 19-variable feature set that are attained through a routine clinical appointment or blood test. This data was used to train predictive models using supervised machine learning (ML) algorithm XGBoost, alongside missing imputation technique MICE and class balancing algorithm SMOTE. Shapley Additive exPlanations (SHAP) were added to determine relative importance for each clinical variable.ResultsAnalysing nine biopsy-derived MASLD outcomes of cohort size ranging between 5385 and 6673 subjects, we were able to predict individuals at training set AUCs ranging from 0.719-0.994, including classifying individuals who are At-Risk MASH at an AUC = 0.899. Using two further feature combinations of 26-variables and 35-variables, which included composite scores known to be good indicators for MASLD endpoints and advanced specialist tests, we found predictive performance did not sufficiently improve. We are also able to present local and global explanations for each ML model, offering clinicians interpretability without the expense of worsening predictive performance.ConclusionsThis study developed a series of ML models of accuracy ranging from 71.9-99.4% using only easily extractable and readily available information in predicting MASLD outcomes which are usually determined through highly invasive means.

This research presents a comprehensive review and meta-analysis of literature to examine the impact of various leadership styles on organizational adaptive performance (AP). AP is essential for job performance, especially in environments undergoing rapid changes. Previous reviews on AP found that transformational and self-leadership had had a positive influence on job adaptivity, while the relationship between other leadership styles and AP had not been clear. First, authors outlined the theoretical framework of AP and leadership, clarifying how job adaptivity and the different leadership styles are defined and discussed in the scientific literature. Subsequently four scientific databases were explored to identify studies that investigate the Leadership and AP' relationship. 32 scientific articles and 2 conference papers were investigated for review, of which 31 were used to conduct a meta-analysis; 52 different effect sizes from 32 samples were identified for a total sample size of 11.640 people. Qualitative synthesis revealed that the influence of different leadership styles on AP depended on contextual variables and on aspects related to the nature of the work. Moreover, it was found that leadership supported AP through motivational and relational aspects. Through this meta-analysis, it was found that a significant positive relationship between leadership and AP existed (Zr = .39, SE = .04, p < .001. 95%CI [.32, .47], r = .37). However, no differences emerged from the different leadership styles examined in the studies. This review deepens the importance of leadership as organizational factor that affect the employees' likelihood of dealing with continuously emergent changes at work, extended the search to emerging leadership approaches to highlight the value of collective contributions, ethics, and moral and sustainable elements that could positively affect AP.

Processing faces accurately and efficiently is a key capability of humans and other animals that engage in sophisticated social tasks. Recent studies reported a decoupled coding for faces in the primate inferotemporal cortex, with two separate neural populations coding for the geometric position of (texture-free) facial landmarks and for the image texture at fixed landmark positions, respectively. Here, we formally assess the efficiency of this decoupled coding by appealing to the information-theoretic notion of description length, which quantifies the amount of information that is saved when encoding novel facial images, with a given precision. We show that despite decoupled coding describes the facial images in terms of two sets of principal components (of landmark shape and image texture), it is more efficient (i.e., yields more information compression) than the encoding in terms of the image principal components only, which corresponds to the widely used eigenface method. The advantage of decoupled coding over eigenface coding increases with image resolution and is especially prominent when coding variants of training set images that only differ in facial expressions. Moreover, we demonstrate that decoupled coding entails better performance in three different tasks: the representation of facial images, the (daydream) sampling of novel facial images, and the recognition of facial identities and gender. In summary, our study provides a first principle perspective on the efficiency and accuracy of the decoupled coding of facial stimuli reported in the primate inferotemporal cortex.

Coprolites contain various kinds of ancient DNAs derived from gut micro-organisms, viruses, and foods, which can help to determine the gut environment of ancient peoples. Their genomic information should be helpful in elucidating the interaction between hosts and microbes for thousands of years, as well as characterizing the dietary behaviors of ancient people. We performed shotgun metagenomic sequencing on four coprolites excavated from the Torihama shell-mound site in the Japanese archipelago. The coprolites were found in the layers of the Early Jomon period, corresponding stratigraphically to 7000 to 5500 years ago. After shotgun sequencing, we found that a significant number of reads showed homology with known gut microbe, viruses, and food genomes typically found in the feces of modern humans. We detected reads derived from several types of phages and their host bacteria simultaneously, suggesting the coexistence of viruses and their hosts. The food genomes provide biological evidence for the dietary behavior of the Jomon people, consistent with previous archaeological findings. These results indicate that ancient genomic analysis of coprolites is useful for understanding the gut environment and lifestyle of ancient peoples.

ObjectivesTo standardize the diagnosis of patent ductus arteriosus (PDA) and report its association with adverse neonatal outcomes in very low birth weight infants (VLBW, birth weight < 1500 g).Study designA multicenter prospective observational study was conducted in Emilia Romagna from March 2018 to October 2019. The association between ultrasound grading of PDA and adverse neonatal outcomes was evaluated after correction for gestational age. A diagnosis of hemodynamically significant PDA (hsPDA) was established when the PDA diameter was ≥ 1.6 mm at the pulmonary end with growing or pulsatile flow pattern, and at least 2 of 3 indexes of pulmonary overcirculation and/or systemic hypoperfusion were present.Results218 VLBW infants were included. Among infants treated for PDA closure in the first postnatal week, up to 40% did not have hsPDA on ultrasound, but experienced clinical worsening. The risk of death was 15 times higher among neonates with non-hemodynamically significant PDA (non-hsPDA) compared to neonates with no PDA. In contrast, the risk of death was similar between neonates with hsPDA and neonates with no PDA. The occurrence of BPD was 6-fold higher among neonates with hsPDA, with no apparent beneficial role of early treatment for PDA closure. The risk of IVH (grade ≥ 3) and ROP (grade ≥ 3) increased by 8.7-fold and 18-fold, respectively, when both systemic hypoperfusion and pulmonary overcirculation were present in hsPDA.ConclusionsThe increased risk of mortality in neonates with non-hsPDA underscores the potential inadequacy of criteria for defining hsPDA within the first 3 postnatal days (as they may be adversely affected by other clinically severe factors, i.e. persistent pulmonary hypertension and mechanical ventilation). Parameters such as length, diameter, and morphology may serve as more suitable ultrasound indicators during this period, to be combined with clinical data for individualized management. Additionally, BPD, IVH (grade ≥ 3) and ROP (grade ≥ 3) are associated with hsPDA. The existence of an optimal timeframe for closing PDA to minimize these adverse neonatal outcomes remains uncertain.

Long QT Syndrome type 8 (LQT8) is a cardiac arrhythmic disorder associated with Timothy Syndrome, stemming from mutations in the CACNA1C gene, particularly the G406R mutation. While prior studies hint at CACNA1C mutations' role in ventricular arrhythmia genesis, the mechanisms, especially in G406R presence, are not fully understood. This computational study explores how the G406R mutation, causing increased transmural dispersion of repolarization, induces and sustains reentrant ventricular arrhythmias. Using three-dimensional numerical simulations on an idealized left-ventricular model, integrating the Bidomain equations with the ten Tusscher-Panfilov ionic model, we observe that G406R mutation with 11% and 50% heterozygosis significantly increases transmural dispersion of repolarization. During S1-S4 stimulation protocols, these gradients facilitate conduction blocks, triggering reentrant ventricular tachycardia. Sustained reentry pathways occur only with G406R mutation at 50% heterozygosis, while neglecting transmural heterogeneities of action potential duration prevents stable reentry, regardless of G406R mutation presence.

[This corrects the article DOI: 10.1371/journal.pone.0279672.].

Understanding the relationship between a species feeding strategy and its environment (trophic ecology) is critical to assess environmental requirements and improve management policies. However, measuring trophic interactions remains challenging. Among the available methods, quantifying the plant composition of a species' diet indicates how species use their environment and their associated niche overlap. Nevertheless, most studies focusing on herbivore trophic ecology ignore the influence that landscape variability may have. Here, we explored how landscape variability influences diet composition through niche overlap. We used eDNA metabarcoding to quantify the diet composition of two large herbivores of the Bialowieza Forest, red deer (Cervus elaphus) and European bison (Bison bonasus) to investigate how increasing habitat quality (i.e. higher abundance of deciduous forage species) and predation risk (i.e. density of wolf in the area) influence their diet composition and niche partitioning. Our findings indicate diet composition is non-homogeneous across the landscape, both within and between species. Red deer showed greater diet variability and lower niche overlap within species compared to bison. We detected a reduction of niche overlap for red deer with increasing predation risk, leading to more dissimilar diets, suggesting their feeding behaviour is affected by wolf presence. This correlation was not found for bison, which are rarely predated by wolf. Higher habitat quality was associated with higher niche overlap only within bison, probably due to their suboptimal feeding strategy as browsers. These results show the importance of integrating environment-induced diet variation in studies aimed at determining the landscape usage or niche overlap of a species.

The Organic Cation Transporter Novel 1 (OCTN1), also known as SLC22A4, is widely expressed in various human tissues, and involved in numerous physiological and pathological processes remains. It facilitates the transport of organic cations, zwitterions, with selectivity for positively charged solutes. Ergothioneine, an antioxidant compound, and acetylcholine (Ach) are among its substrates. Given the lack of experimentally solved structures of this protein, this study aimed at generating a reliable 3D model of OCTN1 to shed light on its substrate-binding preferences and the role of sodium in substrate recognition and transport. A chimeric model was built by grafting the large extracellular loop 1 (EL1) from an AlphaFold-generated model onto a homology model. Molecular dynamics simulations revealed domain-specific mobility, with EL1 exhibiting the highest impact on overall stability. Molecular docking simulations identified cytarabine and verapamil as highest affinity ligands, consistent with their known inhibitory effects on OCTN1. Furthermore, MM/GBSA analysis allowed the categorization of substrates into weak, good, and strong binders, with molecular weight strongly correlating with binding affinity to the recognition site. Key recognition residues, including Tyr211, Glu381, and Arg469, were identified through interaction analysis. Ach demonstrated a low interaction energy, supporting the hypothesis of its one-directional transport towards to outside of the membrane. Regarding the role of sodium, our model suggested the involvement of Glu381 in sodium binding. Molecular dynamics simulations of systems at increasing levels of Na+ concentrations revealed increased sodium occupancy around Glu381, supporting experimental data associating Na+ concentration to molecule transport. In conclusion, this study provides valuable insights into the 3D structure of OCTN1, its substrate-binding preferences, and the role of sodium in the recognition. These findings contribute to the understanding of OCTN1 involvement in various physiological and pathological processes and may have implications for drug development and disease management.

ObjectiveStudies on resilience in advanced cancer caregiving typically focus on the interplay between resilience-promoting resources and coping strategies that may be associated with resilience. However, no studies have investigated the emergence of trajectories of resilience and distress in individuals confronted with a cancer diagnosis of a loved one.MethodsIdeal-type analysis, a method for constructing typologies from qualitative data, was used to identify trajectories involving resilience or the lack thereof based on fifty-four interviews conducted with seventeen partners of patients recently diagnosed with advanced cancer over a period of three years.FindingsSix trajectories could be distinguished, three of which involved resilience (rapidly adapting resilience, gradually adapting resilience, and slowly adapting resilience), while the other three trajectories (continuing distress, delayed distress, and frozen disconnection) reflected a less optimal adjustment. These different trajectories seemed to be rooted in the individual characteristics of partners, the behavior of a support network, and interactions between the two.ConclusionThe differentiation between these trajectories in partners of patients diagnosed with cancer not only furthers research on resilience in the face of adversity, but also promises to assist healthcare professionals in optimizing support for this often-neglected group of partners of patients diagnosed with cancer.

Combat sports, encompassing a range of activities from striking and grappling to mixed and weapon-based disciplines, have witnessed a surge in popularity worldwide. These sports are demanding, requiring athletes to harness energy from different metabolic pathways to perform short, high-intensity activities interspersed with periods of lower intensity. While it is established that the anaerobic alactic (ATP-PC) and anaerobic lactic systems are pivotal for high-intensity training sessions typical in combat sports, the precise contribution of these systems, particularly in varied training modalities such as single (SMT) and intermittent (IST) forms of the 30-second Wingate test, remains inadequately explored. This study aims at comparing performance outputs, physiological responses and gender differences during the SMT and IST forms of the 30-second Wingate test. Thirty-three highly trained combat sports athletes (17 women, 16 men; 10 boxing, 8 wrestling, 8 taekwondo and 7 karate) randomly performed SMT and IST. The IST consisted of three 10-second all-out attempts separated by 30 seconds of passive recovery, whereas the SMT was a single 30-second maximal effort. Resting, exercise and post-exercise oxygen uptake and peak blood lactate value were used to determine the metabolic energy demands via the PCr-LA-O2 method. The findings showed that total metabolic energy expenditure (TEE), ATP-PCr system contribution and the output of mechanical variables were higher in the IST than in the SMT form (all p0.05). In combat sports, performance is not only determined by physiological and technical skills but also by metabolic energy input and efficiency. Therefore, our results can provide a comparison regarding the effects of exercise type and gender on metabolic energy metabolism to design the training of combat sports athletes.

BackgroundAthletes in certain sports aim to gain an advantage by competing in a lower body mass class instead of competing in their own body mass class. This study aims to reveal certain physiologic and strength changes in elite male boxers who lost body mass rapidly before the competition.Methods30 thirty boxers who were aged between 19-24 years and having a mean age of 7.4 years participated in the study. To evaluate the effect of short-term dietary intake interventions on body composition and muscle strength before the competition, boxers were divided into three groups: control (C), exercise+diet1 (E+D1) and exercise+diet2 (E+D2) groups. The dietary habits of the participants were controlled and they participated in the training program. The data of the study consisted of variables such as body mass, height, regional muscle mass, body fat percentage, biceps and femur bicondylar circumference measurements before the competitions. Isometric strength measurements of knee extensors and flexors and shoulder internal and external rotators were also recorded.ResultsPhysiologic parameters such as body mass change, BMI level, body fat percentage and leg muscle ratios of E+D2 were significantly decreased compared to C and E+D1 groups. Furthermore, submaximal and maximal strength production in knee extensors and flexors as well as shoulder internal and external rotators were significantly decreased in E+D2 compared to C and E+D1 groups.ConclusionThe tendency to lose body mass quickly in a short of time may give the desired results in terms of BMI, body mass and fat percentage, but it may cause strength losses in boxers during the competition period.

Candida albicans (C. albicans) can behave as a commensal yeast colonizing the vaginal mucosa, and in this condition is tolerated by the epithelium. When the epithelial tolerance breaks down, due to C. albicans overgrowth and hyphae formation, the generated inflammatory response and cell damage lead to vulvovaginal candidiasis (VVC) symptoms. Here, we focused on the induction of mitochondrial reactive oxygen species (mtROS) in vaginal epithelial cells after C. albicans infection and the involvement of fungal burden, morphogenesis and candidalysin (CL) production in such induction. Bioluminescent (BLI) C. albicans, C. albicans PCA-2 and C. albicans 529L strains were employed in an in vitro infection model including reconstituted vaginal epithelium cells (RVE), produced starting from A-431 cell line. The production of mtROS was kinetically measured by using MitoSOX™ Red probe. The potency of C. albicans to induced cell damage to RVE and C. albicans proliferation have also been evaluated. C. albicans induces a rapid mtROS release from vaginal epithelial cells, in parallel with an increase of the fungal load and hyphal formation. Under the same experimental conditions, the 529L C. albicans strain, known to be defective in CL production, induced a minor mtROS release showing the key role of CL in causing epithelial mithocondrial activation. C. albicans PCA-2, unable to form hyphae, induced comparable but slower mtROS production as compared to BLI C. albicans yeasts. By reducing mtROS through a ROS scavenger, an increased fungal burden was observed during RVE infection but not in fungal cultures grown on abiotic surface. Collectively, we conclude that CL, more than fungal load and hyphae formation, seems to play a key role in the rapid activation of mtROS by epithelial cells and in the induction of cell-damage and that mtROS are key elements in the vaginal epithelial cells response to C. albicans.

Semi-articulated remains of a large chelonioid turtle from the Turonian strata (Upper Cretaceous; ca. 93.9-89.8 Myr) near Sant'Anna d'Alfaedo (Verona province, northeastern Italy) are described for the first time. Together with the skeletal elements, the specimen also preserves pebbles inside the thoracic area which are lithologically distinct from the surrounding matrix. These allochthonous clasts are here interpreted as geo-gastroliths, in-life ingested stones that resided in the digestive tract of the animal. This interpretation marks the first reported evidence of geophagy in a fossil marine turtle. SEM-EDS analysis, together with macroscopic petrological characterization, confirm the presence of both siliceous and carbonatic pebbles. These putative geo-gastroliths have morphometries and size ranges more similar to those of gastroliths in different taxa (fossils and extant) than allochthonous "dropstone" clasts from the same deposit that were carried by floating vegetation A dense pitted pattern of superficial erosion is microscopically recognizable on the carbonatic gastroliths, consistent with surface etching due to gastric acids. The occurrence of a similar pattern was demonstrated by the experimental etching of carbonatic pebbles with synthetic gastric juice. Gut contents of modern green sea turtles (Chelonia mydas) were surveyed for substrate ingestion, providing direct evidence of geophagic behavior in extant chelonioids. Comparison with modern turtle dietary habits may suggests that the pebbles were ingested as a way to supplement calcium after or in preparation for egg deposition, implying that the studied specimen was possibly a gravid female.

It has been shown that observing a face being touched or moving in synchrony with our own face increases self-identification with the former which might alter both cognitive and affective processes. The induction of this phenomenon, termed enfacement illusion, has often relied on laboratory tools that are unavailable to a large audience. However, digital face filters applications are nowadays regularly used and might provide an interesting tool to study similar mechanisms in a wider population. Digital filters are able to render our faces in real time while changing important facial features, for example, rendering them more masculine or feminine according to normative standards. Recent literature using full-body illusions has shown that participants' own gender identity shifts when embodying a different gendered avatar. Here we studied whether participants' filtered faces, observed while moving in synchrony with their own face, may induce an enfacement illusion and if so, modulate their gender identity. We collected data from 35 female and 33 male participants who observed a stereotypically gender mismatched version of themselves either moving synchronously or asynchronously with their own face on a screen. Our findings showed a successful induction of the enfacement illusion in the synchronous condition according to a questionnaire addressing the feelings of ownership, agency and perceived similarity. However, we found no evidence of gender identity being modulated, neither in explicit nor in implicit measures of gender identification. We discuss the distinction between full-body and facial processing and the relevance of studying widely accessible devices that may impact the sense of a bodily self and our cognition, emotion and behaviour.

Data visualization plays a vital role in modern scientific communication across diverse domains, shaping the understanding of complex information through color choices. However, the significance of color palette selection goes beyond aesthetics and scientific communication, encompassing accessibility for all, especially individuals with color vision deficiencies. To address this challenge, we introduce "Color Quest," an intuitive Shiny app that empowers users to explore color palettes for data visualization while considering inclusivity. The app allows users to visualize palettes across various types of plots and maps envisioning how they appear to individuals with color blindness. In addition, it enables users to visualize palettes on their own custom-uploaded images. This short communication presents the app's design, interactive interface, and transformative potential in enhancing data visualization practices. Developed using open-source standards, Color Quest aligns with accessibility discussions, offering a practical tool and platform for raising awareness about inclusive design. Its open-source nature fosters transparency, community collaboration, and long-term sustainability. Color Quest's practicality renders it indispensable for scientific domains, simplifying palette selection and promoting accessibility. Its impact extends beyond academia to diverse communication settings, harmonizing information dissemination, aesthetics and accessibility for more impactful scientific communication.

Life tables are one of the most common tools to describe the biology of insect species and their response to environmental conditions. Although the benefits of life tables are beyond question, we raise some doubts about the completeness of the information reported in life tables. To substantiate these doubts, we consider a case study (Corcyra cephalonica) for which the raw dataset is available. The data suggest that the Gaussian approximation of the development times which is implied by the average and standard error usually reported in life tables does not describe reliably the actual distribution of the data which can be misleading and hide interesting biological aspects. Furthermore, it can be risky when life table data are used to build models to predict the demographic changes of the population. The present study highlights this aspect by comparing the impulse response generated by the raw data and by its Gaussian approximation based on the mean and the standard error. The conclusions of this paper highlight: i) the importance of adding more information to life tables and, ii) the role of raw data to ensure the completeness of this kind of studies. Given the importance of raw data, we also point out the need for further developments of a standard in the community for sharing and analysing data of life tables experiments.

BackgroundFollowing the low incidence rates of non-SARS-CoV-2 respiratory viruses registered during the strict lockdown enforced in the pandemic, a resurgence of several endemic viruses in Catalonia (Spain) was noted during the early summer of 2021.ObjectivesIn this study, we investigated whether the circulation of non-SARS-CoV-2 respiratory viruses in Catalonia, assessed by Microbiological Reporting System of Catalonia (MRSC) and the Epidemiological Surveillance Network of Catalonia, was affected by the strict lockdown measures, as well as, the implication of the Coronavirus Disease 19 (COVID-19) de-escalation process in the late season outbreaks registered during the 2020-2021 season.Study designA retrospective comparison of epidemic patterns in the respiratory viruses' incidence, using regional public health surveillance data from MRSC, was performed between weeks 26/2016 to week 27/2021. Data were expressed as the weekly total number of test positivity for individual viruses. A segmented negative binomial regression model was conducted, with two parameters included (level and trend) for each segment of the time series (2020 pre-lockdown, 2020 post-lockdown and 2021). Results were reported as a unit changed in the strict lockdown.ResultsA total of 51588 confirmed cases of the different respiratory viruses were included in the analysis, the majority were influenza cases (63.7%). An immediate reduction in the weekly number of cases was observed in 2020 after the COVID-19 outbreak for human adenovirus virus (HAdV) (β2 = -2.606; P ConclusionsOur data not only provides evidence that occurrence of different respiratory virus infections was affected by the strict lockdown taken against SARS-CoV-2 but it also shows a late resurgence of seasonal respiratory viruses' cases during the 2020-2021 season following the relaxation of COVID-19-targeted non-pharmaceutical interventions.

Transthyretin amyloidosis (ATTR amyloidosis) is a progressive, multi-systemic disease with wild-type (ATTRwt) and hereditary (ATTRv) forms. Over 130 variants associated with ATTRv amyloidosis have been identified, although little is known about the majority of these genotypes. This analysis examined phenotypic characteristics of symptomatic patients with ATTRv amyloidosis enrolled in the Transthyretin Amyloidosis Outcomes Survey (THAOS) with four less frequently reported pathogenic genotypes: F64L (c.250T>C, p.F84L), I68L (c.262A>T, p.I88L), I107V (c.379A>G; p.I127V), and S77Y (c.290C>A; p.S97Y). THAOS is the largest ongoing, global, longitudinal observational study of patients with ATTR amyloidosis, including both ATTRwt and ATTRv amyloidosis. This analysis describes the baseline demographic and clinical characteristics of untreated symptomatic patients with the F64L, I68L, I107V, or S77Y genotypes at enrollment in THAOS (data cutoff date: January 4, 2022). There were 141 symptomatic patients with F64L (n = 46), I68L (n = 45), I107V (n = 21), or S77Y (n = 29) variants at the data cutoff. Most patients were male and median age at enrollment was in the sixth decade for S77Y patients and the seventh decade for the others. A predominantly neurologic phenotype was associated with F64L, I107V, and S77Y genotypes, whereas patients with the I68L genotype presented with more pronounced cardiac involvement. However, a mixed phenotype was also reported in a considerable proportion of patients in each variant subgroup. This analysis from THAOS represents the largest study of ATTRv symptomatic patients with the F64L, I68L, I107V, and S77Y genotypes. These data add to the limited knowledge on the clinical profile of patients with specific ATTRv variants and emphasize the importance of comprehensive assessment of all patients. Trial registration ClinicalTrials.gov: NCT00628745.

Whether Clonal Hematopoiesis (CH) represents a risk factor for severity of the COVID-19 disease remains a controversial issue. We report the first high- sensitivity analysis of CH in COVID-19 patients (threshold of detection at 0.5% vs 1 or 2% in previous studies). We analyzed 24 patients admitted to ICU for COVID-19 (COV-ICU) and 19 controls, including healthy subjects and asymptomatic SARS-CoV2-positive individuals. Despite the significantly higher numbers of CH mutations identified (80% mutations with

The presence of carbapenem-resistant bacteria and carbapenem resistance genes (CRGs) in livestock is increasing. To evaluate the presence of carbapenemase-producing Enterobacteriaceae (CPE) and the main CRGs along swine food chains of the Marche Region (Central Italy), samples of faeces, feed, and animal-food derived products were collected from seven small/medium, medium, and large-scale pig farms. A total of 191 samples were analysed using a culture-dependent method, with the aim of isolating CPE. Isolates were analysed for their resistance to carbapenems using a modified Hodge test and the microdilution method for the minimum inhibitory concentration (MIC) determination. Moreover, the extraction of microbial DNA from each sample was performed to directly detect selected CRGs via qPCR. Among the 164 presumptive resistant isolates, only one strain from a liver sample, identified as Aeromonas veronii, had an ertapenem MIC of 256 μg/mL and carried a carbapenemase- (cphA) and a β-lactamase- (blaOXA-12) encoding genes. A low incidence of CRGs was found; only nine and four faecal samples tested positive for blaNDM-1 and blaOXA-48, respectively. Overall, the importance of monitoring CPE and CRGs in livestock and their food chains should be stressed to control all potential non-human CPE and CRGs reservoirs and to determine safety levels for human health.

In industrialized countries, health care associated infections, the fourth leading cause of disease, are a major health issue. At least half of all cases of nosocomial infections are associated with medical devices. Antibacterial coatings arise as an important approach to restrict the nosocomial infection rate without side effects and the development of antibiotic resistance. Beside nosocomial infections, clot formation affects cardiovascular medical devices and central venous catheters implants. In order to reduce and prevent such infection, we develop a plasma-assisted process for the deposition of nanostructured functional coatings on flat substrates and mini catheters. Silver nanoparticles (Ag NPs) are synthesized exploiting in-flight plasma-droplet reactions and are embedded in an organic coating deposited through hexamethyldisiloxane (HMDSO) plasma assisted polymerization. Coating stability upon liquid immersion and ethylene oxide (EtO) sterilization is assessed through chemical and morphological analysis carried out by means of Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). In the perspective of future clinical application, an in vitro analysis of anti-biofilm effect has been done. Moreover, we employed a murine model of catheter-associated infection which further highlighted the performance of Ag nanostructured films in counteract biofilm formation. The anti-clot performances coupled by haemo- and cytocompatibility assays have also been performed.

Despite their extremely rare and fragmentary record, aquatic crocodylomorphs from the Middle to Upper Jurassic (Bajocian-Tithonian) Rosso Ammonitico Veronese (RAV) of northeastern Italy have sparked interest since the late 18th century. Among marine reptiles, Thalattosuchia is by far one of the best represented groups from the RAV units, especially in the Middle Jurassic. Although some specimens have been the subject of multiple studies in recent times, most of them still lack precise stratigraphic assignment and taphonomic assessment, while others remain undescribed. Here we provide a comprehensive revision of the thalattosuchian record from the RAV, alongside the most up-to-date age determination, by means of calcareous nannofossils, when available. Three new metriorhynchoid specimens are described for the first time from the Middle Jurassic of Asiago Plateau (Vicenza province). While the taphonomy of the newly described specimens hampers any taxonomic attribution below superfamily/family level, all three were confidently assigned to a precise interval between the upper Bajocian and the upper Bathonian. This revised record has major paleobiogeographical implications: the new specimens confirm an early origin and distribution of Metriorhynchoidea in the Tethys area and suggest a fast colonization of the open-ocean environment since the upper Bajocian.

ObjectiveThis study aims to develop high-performing Machine Learning and Deep Learning models in predicting hospital length of stay (LOS) while enhancing interpretability. We compare performance and interpretability of models trained only on structured tabular data with models trained only on unstructured clinical text data, and on mixed data.MethodsThe structured data was used to train fourteen classical Machine Learning models including advanced ensemble trees, neural networks and k-nearest neighbors. The unstructured data was used to fine-tune a pre-trained Bio Clinical BERT Transformer Deep Learning model. The structured and unstructured data were then merged into a tabular dataset after vectorization of the clinical text and a dimensional reduction through Latent Dirichlet Allocation. The study used the free and publicly available Medical Information Mart for Intensive Care (MIMIC) III database, on the open AutoML Library AutoGluon. Performance is evaluated with respect to two types of random classifiers, used as baselines.ResultsThe best model from structured data demonstrates high performance (ROC AUC = 0.944, PRC AUC = 0.655) with limited interpretability, where the most important predictors of prolonged LOS are the level of blood urea nitrogen and of platelets. The Transformer model displays a good but lower performance (ROC AUC = 0.842, PRC AUC = 0.375) with a richer array of interpretability by providing more specific in-hospital factors including procedures, conditions, and medical history. The best model trained on mixed data satisfies both a high level of performance (ROC AUC = 0.963, PRC AUC = 0.746) and a much larger scope in interpretability including pathologies of the intestine, the colon, and the blood; infectious diseases, respiratory problems, procedures involving sedation and intubation, and vascular surgery.ConclusionsOur results outperform most of the state-of-the-art models in LOS prediction both in terms of performance and of interpretability. Data fusion between structured and unstructured text data may significantly improve performance and interpretability.

The purpose of this study was to investigate the effects of partial-body cryostimulation on middle-distance runners before two 3000-m tests at the speed of the first and second ventilatory threshold, and before a time to exhaustion test at 110% of the maximal aerobic speed. Twelve amateur runners (age: 46 ± 9 years; VO2max: 51.7 ± 4.9 ml·kg-1·min-1) completed six running testing sessions in a randomized counterbalanced cross-over fashion: three of them were preceded by a partial-body cryostimulation and the other three by a control condition. The testing sessions consisted of: 1) a 3000-m continuous running test at the speed of the first ventilatory threshold; 2) a 3000-m continuous running test at the speed of the second ventilatory threshold; 3) a time to exhaustion test at 110% of the maximal aerobic speed. Heart rate, ratings of perceived exertion and visual analogue scale relative to muscle pain were recorded throughout the tests. Total quality recovery was evaluated 24-48 h after the end of each test. Distance to exhaustion was higher after partial-body cryostimulation than control condition (p = 0.018; partial-body cryostimulation: 988 ± 332 m, control: 893 ± 311 m). There were differences in the ratings of perceived exertion during each split of the 3000-m continuous running test at the speed of the second ventilatory threshold (p = 0.001). Partial-body cryostimulation can be positively considered to enhance middle-distance running performance and reduce perception of effort in amateur runners.

The effects of caffeine (CAF) and music have been well documented when used separately, but their combined effects are not yet studied. Thus, the present study assessed the acute effects of combining a low dose of CAF with listening to music during warm-up on taekwondo physical performance, perceived exertion (RPE), and psychological responses during taekwondo-specific tasks in male elite athletes. In a double-blinded, randomized, placebo-controlled crossover study design, male taekwondo athletes (n = 16; age: 18.25 ± 0.75 years) performed the taekwondo-specific agility test (TSAT), 10 s frequency speed of kick test (FSKT-10s) and the multiple version of FSKT (FSKT-mult) under the following conditions: 1) CAF without music (CAF+NoM), 2) placebo (PL) without music (PL+NoM), 3) CAF with music (CAF+M), 4) PL with music (PL+M), 5) no supplement with music (NoS+M) and no supplement without music (control). RPE, feeling scale (FS), felt arousal scale (FAS) and physical enjoyment (PACES) were determined after each test. Findings showed the CAF+M condition induced better performances than other conditions for TSAT, FSKT-10s, FSKT-mult, RPE, FAS and FS and PACES post FSKT-10s (all p

The control of non-coding repeated DNA by DNA methylation plays an important role in genomic stability, contributing to health and healthy aging. Mind-body practices can elicit psychophysical wellbeing via epigenetic mechanisms, including DNA methylation. However, in this context the effects of movement meditations have rarely been examined. Consequently, the current study investigates the effects of a specifically structured movement meditation, called the Quadrato Motor Training (QMT) on psychophysical wellbeing and on the methylation level of repeated sequences. An 8-week daily QMT program was administered to healthy women aged 40-60 years and compared with a passive control group matched for gender and age. Psychological well-being was assessed within both groups by using self-reporting scales, including the Meaning in Life Questionnaire [MLQ] and Psychological Wellbeing Scale [PWB]). DNA methylation profiles of repeated sequences (ribosomal DNA, LINE-1 and Alu) were determined in saliva samples by deep-sequencing. In contrast to controls, the QMT group exhibited increased Search for Meaning, decreased Presence of Meaning and increased Positive Relations, suggesting that QMT may lessen the automatic patterns of thinking. In the QMT group, we also found site-specific significant methylation variations in ribosomal DNA and LINE-1 repeats, consistent with increased genome stability. Finally, the correlations found between changes in methylation and psychometric indices (MLQ and PWB) suggest that the observed epigenetic and psychological changes are interrelated. Collectively, the current results indicate that QMT may improve psychophysical health trajectories by influencing the DNA methylation of specific repetitive sequences.

In racehorses, the associations between physiological parameters obtained by exercise testing and racing results have been questioned. We hypothesized that fitness variables measured during a treadmill incremental test may be related with racing outcomes and lifetime career. Our study aimed to investigate the role of fitness parameters obtained during a treadmill test in performance evaluation and career prediction in poorly performing Standardbreds, through a retrospective review of the clinical records of 245 trotters that underwent an incremental treadmill test. Several fitness parameters were assessed, and their correlations with racing data (number of starts, wins and placings) in the 3 months before and 6 months after examination were evaluated; moreover their associations and predictive power for lifetime racing results and earnings were considered. The associations between fitness parameters and measures of racing performance as well as the associations between racing results over time were evaluated by Spearman's correlation in the whole population and in different age groups. Multivariate regression models predicting the total number of starts, wins and earnings based on fitness parameters were constructed, controlling for age, weight, and sex. Maximum speed and the speed at the aerobic threshold were the parameters correlated with the most racing results, in the three evaluation periods (3 months before, 6 months after, lifetime). Other parameters predictive of career outcomes were maximum blood lactate concentration and maximum hematocrit. Interestingly, in 2-year-old Standardbreds, the only parameters correlated with racing results were maximum hematocrit and minimum pH, suggesting they may reflect individual potential. Both the racing results obtained before and after examination were predictive of lifetime career, with those following hospitalization being more strongly correlated. In conclusion, parameters obtained during treadmill tests both reflect the racing outcomes and the career potential.

Sirtuin 3 (SIRT3), the main deacetylase of mitochondria, modulates the acetylation levels of substrates governing metabolism and oxidative stress. In the kidney, we showed that SIRT3 affects the proper functioning of high energy-demanding cells, such as tubular cells and podocytes. Less is known about the role of SIRT3 in regulating endothelial cell function and its impact on the progression of kidney disease. Here, we found that whole body Sirt3-deficient mice exhibited reduced renal capillary density, reflecting endothelial dysfunction, and VEGFA expression compared to wild-type mice. This was paralleled by activation of hypoxia signaling, upregulation of HIF-1α and Angiopietin-2, and oxidative stress increase. These alterations did not result in kidney disease. However, when Sirt3-deficient mice were exposed to the nephrotoxic stimulus Adriamycin (ADR) they developed aggravated endothelial rarefaction, altered VEGFA signaling, and higher oxidative stress compared to wild-type mice receiving ADR. As a result, ADR-treated Sirt3-deficient mice experienced a more severe injury with exacerbated albuminuria, podocyte loss and fibrotic lesions. These data suggest that SIRT3 is a crucial regulator of renal vascular homeostasis and its dysregulation is a predisposing factor for kidney disease. By extension, our findings indicate SIRT3 as a pharmacologic target in progressive renal disease whose treatments are still imperfect.

Visual object recognition was traditionally believed to rely on a hierarchical feedforward process. However, recent evidence challenges this notion by demonstrating the crucial role of foveal retinotopic cortex and feedback signals from higher-level visual areas in processing peripheral visual information. The nature of the information conveyed through foveal feedback remains a topic of debate. To address this, we conducted a study employing a foveal mask paradigm with varying stimulus-mask onset asynchronies in a peripheral same/different task, where peripheral objects exhibited different degrees of similarity. Our hypothesis posited that simultaneous arrival of feedback and mask information in the foveal cortex would lead to neural contamination, biasing perception. Notably, when the two peripheral objects were identical, we observed a significant increase in the number of "different" responses, peaking at approximately 100 ms. Similar effect was found when the objects were dissimilar, but with an overall later timing (around 150 ms). No significant difference was found when comparing easy (dissimilar objects) and difficult trials (similar objects). The findings challenge the hypothesis that foveation planning alone accounts for the observed effects. Instead, these and previous observations support the notion that the foveal cortex serves as a visual sketchpad for maintaining and manipulating task-relevant information.

There is increasing evidence that digital technologies such as mobile phones have the potential to shape some of the United Nations (UN) Sustainable Development Goals (SDGs) such as health, education, and nutrition, even among the most resource-deprived countries and communities in the world. Nonetheless, little research has focused on the intergenerational implications of digital technologies for infant health and wellbeing. This study leverages Demographic and Health Survey (DHS) data from 29 low- and middle-income countries (LMICs) to explore associations between mothers' ownership of mobile phones and their children's health at birth, as measured by birth weight and low birth weight (LBW), i.e., weight lower than 2,500 grams. Infants born to women owning mobile phones fare consistently better in terms of birth weight, even after accounting for potential socioeconomic confounders and other sources of media or information in the household. Partly, mechanisms are consistent with the idea of broader knowledge and access to healthcare services, as associations are mediated by a higher number of antenatal visits, higher likelihood of having a birth assisted by a health professional, and by the extent to which mothers hear about family planning by text message. Associations are strongest among low-educated mothers. Also, associations are stronger in countries where infant health is poorer yet mobile-phone diffusion is higher, highlighting the comparatively higher potential of the diffusion of mobile phones for global development in poorest contexts. Our findings may be of interest to scholars and policymakers concerned with identifying relatively cheap policy levers to promote global health and wellbeing in disadvantaged contexts, particularly among women.

Machine learning tools are increasingly used to improve the quality of care and the soundness of a treatment plan. Explainable AI (XAI) helps users in understanding the inner mechanisms of opaque machine learning models and is a driver of trust and adoption. Explanation methods for black-box models exist, but there is a lack of user studies on the interpretability of the provided explanations. We used a Think Aloud Protocol (TAP) to explore oncologists' assessment of a lung cancer relapse prediction system with the aim of refining the purpose-built explanation model for better credibility and utility. Novel to this context, TAP is used as a neutral methodology to elicit experts' thought processes and judgements of the AI system, without explicit prompts. TAP aims to elicit the factors which influenced clinicians' perception of credibility and usefulness of the system. Ten oncologists took part in the study. We conducted a thematic analysis of their verbalized responses, generating five themes that help us to understand the context within which oncologists' may (or may not) integrate an explainable AI system into their working day.

ObjectivesTo investigate which infertile men with semen parameters above WHO reference limits at first semen analysis deserve a second semen test.Materials and methodsData from 1358 consecutive infertile men were analysed. Patients underwent two consecutive semen analyses at the same laboratory. Descriptive statistics and logistic regression models tested the association between clinical variables and semen parameters. A new predicting model was identified through logistic regression analysis exploring potential predictors of semen parameters below WHO reference limits after a previously normal one. Diagnostic accuracy of the new model was compared with AUA/ASRM and EAU guidelines. Decision curve analyses (DCA) tested their clinical benefit.ResultsOf 1358, 212 (15.6%) infertile men had semen parameters above WHO reference limits at first analysis. Of 212, 87 (41.0%) had a second semen analysis with results above WHO reference limits. Men with sperm parameters below reference limits at second analysis had higher FSH values, but lower testicular volume (TV) (all pConclusionsApproximately 60% of infertile men with a first semen analysis above WHO limits have a second analysis with results below limits. The newly identified risk model might be useful to select infertile men with initial semen results above WHO limits who deserve a second semen analysis.

The effects of postural training on postural stability and vestibulospinal reflexes (VSRs) were investigated in normal subjects. A period (23 minutes) of repeated episodes (n = 10, 50 seconds) of unipedal stance elicited a progressive reduction of the area covered by centre of pressure (CoP) displacement, of average CoP displacement along the X and Y axes and of CoP velocity observed in this challenging postural task. All these changes were correlated to each other with the only exception of those in X and Y CoP displacement. Moreover, they were larger in the subjects showing higher initial instability in unipedal stance, suggesting that they were triggered by the modulation of sensory afferents signalling body sway. No changes in bipedal stance occurred soon and 1 hour after this period of postural training, while a reduction of CoP displacement was apparent after 24 hours, possibly due to a beneficial effect of overnight sleep on postural learning. The same period of postural training also reduced the CoP displacement elicited by electrical vestibular stimulation (EVS) along the X axis up to 24 hours following the training end. No significant changes in postural parameters of bipedal stance and VSRs could be observed in control experiments where subjects were tested at identical time points without performing the postural training. Therefore, postural training led to a stricter control of CoP displacement, possibly acting through the cerebellum by enhancing feedforward mechanisms of postural stability and by depressing the VSR, the most important reflex mechanism involved in balance maintenance under challenging conditions.

Italy was the first European country to be significantly impacted by the COVID-19 pandemic. The lack of similar previous experiences and the initial uncertainty regarding the new virus resulted in an unpredictable health crisis with 243,506 total confirmed cases and 34,997 deaths between February and July 2020. Despite the panorama of precariousness and the impelling calamity, the country successfully managed many aspects of the early stages of the health and socio-economic crisis. Nevertheless, many disparities can be identified at the regional level. The study aims to determine which aspects of regional management were considered more important by the citizens regarding economic and health criteria. A survey was designed to gather responses from the population on the Italian regions' response and provide a ranking of the regions. The 29-item online survey was provided to 352 individuals, and the collected data were analyzed using the Analytic Hierarchy Process methodology. The results show a general agreement in considering of greater relevance the healthcare policies rather than the economic countermeasures adopted by regional governments. Our analysis associated a weight of 64% to the healthcare criteria compared to the economic criteria with a weight of 36%. In addition to the results obtained from the Analytic Hierarchy Process, the sample's composition was analyzed to provide an overall assessment of the Italian regions. To do so, we collected objective data for each region and multiplied them by the overall weight obtained for each sub-criteria. Looking at the propensity to vaccination or the belief in a relation between COVID-19 and 5G according to age and educational qualification helps understand how public opinion is structured according to cultural and anthropological differences.

PurposeCongenital myopathies are a heterogeneous group of diseases affecting the skeletal muscles and characterized by high clinical, genetic, and histological variability. Magnetic Resonance (MR) is a valuable tool for the assessment of involved muscles (i.e., fatty replacement and oedema) and disease progression. Machine Learning is becoming increasingly applied for diagnostic purposes, but to our knowledge, Self-Organizing Maps (SOMs) have never been used for the identification of the patterns in these diseases. The aim of this study is to evaluate if SOMs may discriminate between muscles with fatty replacement (S), oedema (E) or neither (N).MethodsMR studies of a family affected by tubular aggregates myopathy (TAM) with the histologically proven autosomal dominant mutation of the STIM1 gene, were examined: for each patient, in two MR assessments (i.e., t0 and t1, the latter after 5 years), fifty-three muscles were evaluated for muscular fatty replacement on the T1w images, and for oedema on the STIR images, for reference. Sixty radiomic features were collected from each muscle at t0 and t1 MR assessment using 3DSlicer software, in order to obtain data from images. A SOM was created to analyze all datasets using three clusters (i.e., 0, 1 and 2) and results were compared with radiological evaluation.ResultsSix patients with TAM STIM1-mutation were included. At t0 MR assessments, all patients showed widespread fatty replacement that intensifies at t1, while oedema mainly affected the muscles of the legs and appears stable at follow-up. All muscles with oedema showed fatty replacement, too. At t0 SOM grid clustering shows almost all N muscles in Cluster 0 and most of the E muscles in Cluster 1; at t1 almost all E muscles appear in Cluster 1.ConclusionOur unsupervised learning model appears to be able to recognize muscles altered by the presence of edema and fatty replacement.

Compression as an accelerant of computation is increasingly recognized as an important component in engineering fast real-world machine learning methods for big data; c.f., its impact on genome-scale approximate string matching. Previous work showed that compression can accelerate algorithms for Hidden Markov Models (HMM) with discrete observations, both for the classical frequentist HMM algorithms-Forward Filtering, Backward Smoothing and Viterbi-and Gibbs sampling for Bayesian HMM. For Bayesian HMM with continuous-valued observations, compression was shown to greatly accelerate computations for specific types of data. For instance, data from large-scale experiments interrogating structural genetic variation can be assumed to be piece-wise constant with noise, or, equivalently, data generated by HMM with dominant self-transition probabilities. Here we extend the compressive computation approach to the classical frequentist HMM algorithms on continuous-valued observations, providing the first compressive approach for this problem. In a large-scale simulation study, we demonstrate empirically that in many settings compressed HMM algorithms very clearly outperform the classical algorithms with no, or only an insignificant effect, on the computed probabilities and infered state paths of maximal likelihood. This provides an efficient approach to big data computations with HMM. An open-source implementation of the method is available from https://github.com/lucabello/wavelet-hmms.

Both common pain and anxiety problems are widespread, debilitating and often begin in childhood-adolescence. Twin studies indicate that this co-occurrence is likely due to shared elements of risk, rather than reciprocal causation. A joint genome-wide investigation and pathway/network-based analysis of adolescent anxiety and pain problems can identify genetic pathways that subserve shared etiopathogenetic mechanisms. Pathway-based analyses were performed in the independent samples of: The Quebec Newborn Twin Study (QNTS; 246 twin pairs and 321 parents), the Longitudinal Study of Child Development in Quebec (QLSCD; n = 754), and in the combined QNTS and QLSCD sample. Multiple suggestive associations (p

The ergogenic effect of pre-selected warm-up music with the tempo and loudness variations on the performance of combat sports' athletes as well as the difference between sexes is not well established. The present study aimed to assess the effects of listening to music with different tempos and loudness during warm-up on perceived exertion, physical enjoyment and physical performances in young taekwondo athletes. In a randomized study design, 20 taekwondo athletes (10 males, mean ± SD: age: 17.5 ± 0.7 years, taekwondo experience: ≥ 6 year) performed the taekwondo specific agility test (TSAT) and the 10s and multiple frequency speed of kick test (FSKT-10s and FSKT-mult) after warming-up with or without music. The music was played at high (140 beats·min-1) or very high (200 beats·min-1) tempo combined with low (60 dB) or high (80 dB) loudness, resulting in four experimental and control conditions. The ratings of perceived exertion (RPE) and physical activity enjoyment scale (PACES) were assessed after each condition. After normality, homogeneity and sphericity checks, two-way (or multivariate) analysis of variance and Bonferrroni (or Friedman's and Wilcoxon's test) post-hoc test were operated when necessary. For TSAT, 140 beats·min-1+80 dB induced better performance compared with 200 beats·min-1+80 dB, 200 beats·min-1+60 dB, control and the 140 beats·min-1+60 dB conditions. For FSKT-10s, 140 beats·min-1+80 dB condition induced higher performance compared with 200 beats·min-1+60 dB, 200 beats·min-1+80 dB, 140 beats·min-1+60 dB and the control conditions. For FSKT-mult, 140 beats·min-1+80 dB induced higher number of techniques compared with 200 beats·min-1+60 dB, 140 beats·min-1+60 dB, control and the 200 beats·min-1+80 dB conditions. Moreover, 140 beats·min-1+80 dB induced lower decrement index (DI) compared with the other conditions and lower DI in 140 beats·min-1+60 dB compared with 200 beats·min-1+80 dB and control conditions. Moreover, 140 beats·min-1+80 dB resulted in greater PACES scores compared with 200 beats·min-1+80 dB and control conditions. Better performance was found for males compared with females in TSAT, FSKT-10s and FSKT-mult (i.e., techniques' number), as well as lower DI and higher RPE post-FSKT-10s. Pre-selected warm-up music played at 140 beats·min-1 and 80 dB is an efficient strategy to enhance physical activity enjoyment and specific performances in taekwondo.

IntroductionHealthcare-associated infections (HAIs) and antimicrobial resistance (AMR) are major public health threats in upper- and lower-middle-income countries. Electronic health records (EHRs) are an invaluable source of data for achieving different goals, including the early detection of HAIs and AMR clusters within healthcare settings; evaluation of attributable incidence, mortality, and disability-adjusted life years (DALYs); and implementation of governance policies. In Italy, the burden of HAIs is estimated to be 702.53 DALYs per 100,000 population, which has the same magnitude as the burden of ischemic heart disease. However, data in EHRs are usually not homogeneous, not properly linked and engineered, or not easily compared with other data. Moreover, without a proper epidemiological approach, the relevant information may not be detected. In this retrospective observational study, we established and engineered a new management system on the basis of the integration of microbiology laboratory data from the university hospital "Policlinico Tor Vergata" (PTV) in Italy with hospital discharge forms (HDFs) and clinical record data. All data are currently available in separate EHRs. We propose an original approach for monitoring alert microorganisms and for consequently estimating HAIs for the entire period of 2018.MethodsData extraction was performed by analyzing HDFs in the databases of the Hospital Information System. Data were compiled using the AREAS-ADT information system and ICD-9-CM codes. Quantitative and qualitative variables and diagnostic-related groups were produced by processing the resulting integrated databases. The results of research requests for HAI microorganisms and AMR profiles sent by the departments of PTV from 01/01/2018 to 31/12/2018 and the date of collection were extracted from the database of the Complex Operational Unit of Microbiology and then integrated.ResultsWe were able to provide a complete and richly detailed profile of the estimated HAIs and to correlate them with the information contained in the HDFs and those available from the microbiology laboratory. We also identified the infection profile of the investigated hospital and estimated the distribution of coinfections by two or more microorganisms of concern. Our data were consistent with those in the literature, particularly the increase in mortality, length of stay, and risk of death associated with infections with Staphylococcus spp, Pseudomonas aeruginosa, Klebsiella pneumoniae, Clostridioides difficile, Candida spp., and Acinetobacter baumannii. Even though less than 10% of the detected HAIs showed at least one infection caused by an antimicrobial resistant bacterium, the contribution of AMR to the overall risk of increased mortality was extremely high.ConclusionsThe increasing availability of health data stored in EHRs represents a unique opportunity for the accurate identification of any factor that contributes to the diffusion of HAIs and AMR and for the prompt implementation of effective corrective measures. That said, artificial intelligence might be the future of health data analysis because it may allow for the early identification of patients who are more exposed to the risk of HAIs and for a more efficient monitoring of HAI sources and outbreaks. However, challenges concerning codification, integration, and standardization of health data recording and analysis still need to be addressed.

Multidirectional jumping and repeated sprint ability are crucial performance factors in basketball. The main aim of this investigation was to examine the neuromuscular performance and body balance adaptations following basketball-specific combined training programs based on drop jump and multidirectional repeated sprint versus multidirectional plyometric training. Forty-two professional basketball male players participated in the current investigation and were randomly assigned to three groups: a combined group (COMB; n = 14), a multidirectional jump group (MJG; n = 14) and an active control group (CON; n = 14). The COMB and the MJG groups completed the 8-week training programs with two weekly sessions while the CON continued their usual training. The static and dynamic balance tests, the repeated sprint ability test (IRSA5COD), the T-change of direction (CoD) test, the vertical jump tests, the five time-jump test (FJT) were performed by participants before and after the intervention period. The results showed a significant main effect of time with remarkable improvements at the end of the intervention (P < 0.001, effect size small/moderate) except the physiological parameters for IRSA5COD. Only, significant group × time interactions for body balance, T-CoD test, IRSA5COD (total time and best time), and jump tests were found (P < 0.001, effect size from trivial to moderate). Bonferroni corrected post-hoc tests revealed significantly greater improvement in favor of COMB compared to MJG for body balance, CoD and IRSA5COD (P < 0.005, effect size small/moderate). Otherwise, no significant differences between COMB and MJG concerning jump performances were found. Combined drop jump and multidirectional repeated sprint training program lead to significantly better neuromuscular performance, body balance and CoD in professional basketball players when compared with an usual training.

Knowledge of the reproductive strategy is a key prerequisite to predict population dynamics and potential invasiveness of both native and non-indigenous outbreak-forming species. In 2014 the Lessepsian upside-down jellyfish Cassiopea andromeda reached the harbor of Palermo (NW Sicily, Thyrrenian Sea), to date its established westernmost outpost in the Mediterranean Sea. To predict C. andromeda reproductive success in its novel habitat, gonad histology was carried out to record the number and size of mature and immature oocytes. Both male and female simultaneously presented gametes at all stages of development suggesting an asynchronous, yet apparently continuous, reproduction strategy. Indeed, oogenesis was observed throughout the year from pre-vitellogenic, vitellogenetic, and late-vitellogenetic to mature oocytes suggesting multiple reproductive events, as known in other Mediterranean Rhizostomeae. Oocytes were found from May to December, with two seasonal peaks of abundance (late spring = 392 and autumn = 272), suggesting imminent spawning events. Further, jellyfish size varied significantly throughout the year, with maximum diameter (up to 24 cm) in summer, and minimum diameter (6 cm) in winter. Small-sized jellyfish in winter belong to the new cohort, most probably arising from intense summer strobilation of polyps. Late spring fertilization, planula development, and metamorphosis, followed by polyp strobilation in the summer months, may explain the late appearance of a new jellyfish cohort, likely coincident with that recorded throughout winter.

In insects, the biogenic amines octopamine (OA) and tyramine (TA) are involved in controlling several physiological and behavioural processes. OA and TA act as neurotransmitters, neuromodulators or neurohormones, performing their functions by binding to specific receptors belonging to the G protein-coupled receptor (GPCR) superfamily. OA and TA along with their receptors are involved in reproduction, smell perception, metabolism, and homeostasis. Moreover, OA and TA receptors are targets for insecticides and antiparasitic agents, such as the formamidine Amitraz. In the dengue and yellow fever vector, Aedes aegypti, limited research has been reported on their OA or TA receptors. Here, we identify and molecularly characterize the OA and TA receptors in A. aegypti. Bioinformatic tools were used to identify four OA and three TA receptors in the genome of A. aegypti. The seven receptors are expressed in all developmental stages of A. aegypti; however, their highest transcript abundance is observed in the adult. Among several adult A. aegypti tissues examined, including the central nervous system, antennae and rostrum, midgut, Malpighian tubules, ovaries, and testes, the type 2 TA receptor (TAR2) transcript is most abundant in the ovaries and the type 3 TA receptor (TAR3) is enriched in the Malpighian tubules, leading us to propose putative roles for these receptors in reproduction and diuresis, respectively. Furthermore, a blood meal influenced OA and TA receptor transcript expression patterns in adult female tissues at several time points post blood meal, suggesting these receptors may play key physiological roles associated with feeding. To better understand OA and TA signalling in A. aegypti, the transcript expression profiles of key enzymes in their biosynthetic pathway, namely tyrosine decarboxylase (Tdc) and tyramine β-hydroxylase (Tβh), were examined in developmental stages, adult tissues, and brains from blood-fed females. These findings provide information for better understanding the physiological roles of OA, TA, and their receptors in A. aegypti, and additionally, may help in the development of novel strategies for the control of these human disease vectors.

The aim of the present study was to investigate the effect of a short-term (4 weeks) non-soccer-specific training programme based on speed, agility and quickness (SAQ) and a soccer-specific training programme based on small-sided games (SSG) on cognitive and physical performance in preadolescent soccer players. Twenty-one participants were randomly assigned to SAQ group (n = 11) or SSG group (n = 10). They were tested pre and post interventions on physical (5 m sprint, 20 m sprint and sprint with turns of 90°) and cognitive (inhibitory control by means of the Flanker task and perceptual speed by means of the visual search task) performances. Although no significant time x group interactions were observed, the main effect of time was significant for cognitive performance and 5 m and 20 m sprint, showing improvements after both SAQ and SSG. These findings highlight that 4 weeks of SAQ training programme induced comparable improvements in cognitive and physical performance with respect to a soccer-specific training programme based on SSG in preadolescent soccer players. Non-sport-specific activities targeting speed, agility and quickness combined with cognitive engagement (i.e., SAQ) should be useful strategies as soccer-specific activities to be included within a soccer training programme for promoting both physical and cognitive domain in preadolescent individuals.

The correlation between immune responses and protection from SARS-CoV-2 infections and its duration remains unclear. We performed a sanitary surveillance at the European Institute of Oncology (IEO) in Milan over a 17 months period. Pre-vaccination, in 1,493 participants, we scored 266 infections (17.8%) and 8 possible reinfections (3%). Post-vaccination, we identified 30 infections in 2,029 vaccinated individuals (1.5%). We report that the probability of infection post-vaccination is i) significantly lower compared to natural infection, ii) associated with a significantly shorter median duration of infection than that of first infection and reinfection, iii) anticorrelated with circulating antibody levels.