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Assembly complexity and manufacturing costs of engineering structures can be significantly reduced by using periodic mechanical components, which are defined by combining multiple identical unit cells into a global topology. Additionally, the superior energy-absorbing properties of lattice-based periodic structures can potentially enhance the overall performance in crash-related applications. Recent research developments in periodic topology optimization (PTO) have shown its efficacy for tackling new design problems and finding advanced novel structures. However, most of these methods rely on gradient information in the optimization process, which poses difficulties for crash problems where analytical sensitivities are usually not directly applicable. In this paper, we present an effective periodic evolutionary level set method (P-EA-LSM) for the optimization of periodic structures. P-EA-LSM uses a low-dimensional level-set representation based on moving morphable components to parametrize a single unit cell, which is replicated in the design domain according to a predefined pattern. The unit cell is optimized using an evolutionary algorithm and the structural responses are calculated for the entire system. We initially assess the performance of P-EA-LSM using three 2D minimum compliance test cases with varying periodicities. Our results demonstrate that our approach produces solutions comparable to other state-of-the-art methods for PTO while keeping a low dimensionality of the optimization problem. Subsequently, we effectively evaluate the capabilities of P-EA-LSM in a crashworthiness scenario. This particular application highlights the significant potential of the method, which does not rely on analytical sensitivities. [ABSTRACT FROM AUTHOR]

Background: We assessed the clinical effectiveness of cefiderocol (CFDC) in comparison with colistin (COL) for the treatment of carbapenem-resistant Acinetobacter baumannii (CRAB) bloodstream infections (BSI). Materials/methods: Retrospective cohort study including adults with CRAB-BSI. Outcomes were mortality, clinical cure and adverse events during therapy. The average treatment effect of CFDC compared to COL was weighted with the inverse-probability treatment weight (IPTW). Results: Overall, 104 patients were included (50 CFDC, 54 COL), median age 66.5 years, median Charlson Comorbidity Index 5, septic shock in 33.6% of patients. Primary BSI accounted for 43.3% of cases, followed by ventilator-associated pneumonia (VAP) (26%), catheter-related BSI (20.2%) and hospital-acquired pneumonia (HAP) (9.6%). Although not significantly, mortality at all time points was lower for CFDC than COL, while clinical cure was higher in CFDC than COL (66% vs. 44.4%, p = 0.027). Adverse events were more frequent in COL than CFDC-group (38.8% vs. 10%, p < 0.0001), primarily attributed to acute kidney injury (AKI) in the COL group. Patients with bacteremic HAP/VAP treated with CFDC had a significant lower 30-d mortality and higher clinical cure than COL (p = 0.008 and p = 0.0008, respectively). Increment of CCI (p = 0.005), ICU (p = 0.025), SARS-CoV2 (p = 0.006) and ECMO (p < 0.0001) were independently associated with 30-d mortality, while receiving CFDC was not associated with survival. Conclusions: CFDC could represent an effective and safe treatment option for CRAB BSI, especially in patients with bacteremic HAP/VAP and frail patients where the risk of acute renal failure during therapy should be avoided. Key summary points: Increasing real-life data support the clinical effectiveness and safety of cefiderocol (CFDC) for carbapenem resistant Acinetobacter baumannii (CRAB) infections. We investigated CFDC in comparison with colistin (COL) for the treatment of CRAB bloodstream infections (BSI). Clinical cure was higher in CFDC than COL group. Patients with hospital acquired/ventilator-associated pneumonia treated with CFDC had a statistically significant lower 30-d mortality and higher clinical cure than those treated with COL. Adverse events were more frequent in COL than in CFDC-group. CFDC could be an effective and safe treatment option for CRAB BSI, especially in patients with HAP/VAP and frail patients where the risk of acute renal failure during therapy should be avoided. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) is the leading cause of lower respiratory tract infection among infants and young children, resulting in annual epidemics worldwide. Since the beginning of the COVID-19 pandemic, non-pharmacological interventions were applied, interfering with the circulation of most respiratory viruses, including RSV. The aim of this study is to analyze the RSV infection trend among hospitalized infants during the actual epidemic season (2022–2023) in comparison with the last pre-pandemic season (2018–2019), in order to outline whether significant differences emerge due to COVID-19 pandemia. We retrospectively reviewed medical data on infants hospitalized at the Bambino Gesù Children's Hospital with diagnosis of bronchiolitis in the current epidemic season and in the last pre-pandemic season, 2018–2019. RSV remains the main etiological agent of bronchiolitis in terms of frequency and severity of infections in the ongoing epidemic season. The first RSV case of the 2022–2023 season was detected at week 42 vs week 47 in the 2018–2019 season. The length of epidemic season was of 17 weeks in 2022–2023 vs 18 weeks in 2018–2019. Comparing the two seasons, age at admission was significantly higher in the current season (median age 2022–2023 65 days vs median age 2018–2019 58 days), but the disease severity was similar. Conclusions: The 2022–2023 bronchiolitis season in Italy started earlier than the usual pre-pandemic seasons but seasonality pattern may be going back to the pre-pandemic one. This season was not more severe than the previous ones. The impact of RSV disease on health care systems and costs remains a critical issue. What is Known: • RSV is one of the major leading causes of hospitalization among children aged less than 3 months. SarsCOV2 pandemic interfered with the seasonal circulation of most respiratory viruses, Including RSV. What is New: • The 2022–2023 bronchiolitis season in Italy started and peaked earlier than the usual pre-pandemic seasons but seasonality pattern may be realigning to the pre-pandemic one. The impact of RSV disease on health care systems and costs is concerning. [ABSTRACT FROM AUTHOR]

Purpose: To explore whether topical antibiotic prophylaxis in patients scheduled for intravitreal injections achieves surface sterility in a greater proportion of subjects as compared to povidone-iodine alone. Material and methods: A randomized, triple-blind clinical trial. Population: patients scheduled for intravitreal injections for maculopathy. Inclusion criteria: any sex and race, age 18 years and above. Subjects were randomized into 4 groups: the first group applied chloramphenicol (CHLORAM), the second netilmicin (NETILM), the third a commercial ozonized antiseptic solution (OZONE), and the fourth applied no drops (CONTROL). Outcome variable: percentage of non-sterile conjunctival swabs. Specimens were collected before and after the application of 5% povidone-iodine moments before the injection. Results: Ninety-eight subjects (33.7% females, 64.3% males), mean age: 70.2 ± 9.3 years (54–91). Before povidone-iodine, both the CHLORAM and NETILM group showed a lower percentage of non-sterile swabs (61.1% and 31.3% respectively), as compared to the OZONE (83.3%) and CONTROL (86.5%) groups (p <.04). However, this statistical difference was lost after the application of povidone-iodine for 3 min. Percentage of non-sterile swabs in each group after applying 5% povidone-iodine: CHLORAM 11.1%, NETILM 12.5%, CONTROL 15.4%, OZONE 25.0%. This was not statistically significant (p >.05). Conclusions: Topical antibiotic prophylaxis with chloramphenicol or netilmicin drops decreases the bacterial load on the conjunctiva. However, after the application of povidone-iodine, all groups showed a significant reduction in the percentage of non-sterile swabs, and this value was comparable among all groups. For this reason, authors conclude that povidone-iodine alone is sufficient and prior topical antibiotic prophylaxis is not indicated. [ABSTRACT FROM AUTHOR]

Introduction: Literature supports numerous benefits of skin-to-skin contact for neonatal adaptation to extrauterine life and bonding/attachment, but few studies explore the effects of skin-to-skin contact on maternal outcomes. This review aims to map the evidence on skin-to-skin contact in the third stage of labor for postpartum hemorrhage prevention. Methods: Scoping review, which covered stages recommended by the Institute Joanna Briggs, including studies from the PubMed, EMBASE, CINAHL, LILACS, Web of Science, and Scopus databases, using the descriptors "Postpartum hemorrhage", "Labor stages, third", "Prevention" and "Kangaroo care/Skin-to-skin". Results: 100 publications on the subject found, 13 articles met the inclusion criteria, with 10,169 dyads were assessed in all studies. Publications from 2008 to 2021 were mostly written in English and designed as a randomized controlled trial. Skin-to-skin contact was effective and significant in: reducing the duration of the third stage of labor; placenta delivery; uterine contractility and physiological involution; absence of atony, decreasing blood loss with lower rates of erythrocyte and hemoglobin drop; reducing the need for synthetic oxytocin and/or ergometrine to control bleeding; and reducing changing pads per period and length of stay. Discussion: Skin-to-skin contact was considered an effective, low-cost, and safe strategy, with positive effects already established in the literature for infants and extremely favorable results in postpartum hemorrhage prevention cases, being highly recommended in assistance for the dyad. Open Science Framework Registry (https://osf.io/n3685). [ABSTRACT FROM AUTHOR]

Classifying a weapon based on its muzzle blast is a challenging task that has significant applications in various security and military fields. Most of the existing works rely on ad-hoc deployment of spatially diverse microphone sensors to capture multiple replicas of the same gunshot, which enables accurate detection and identification of the acoustic source. However, carefully controlled setups are difficult to obtain in scenarios such as crime scene forensics, making the aforementioned techniques inapplicable and impractical. We introduce a novel technique that requires zero knowledge about the recording setup and is completely agnostic to the relative positions of both the microphone and shooter. Our solution can identify the category, caliber, and model of the gun, reaching over 90% accuracy on a dataset composed of 3655 samples that are extracted from YouTube videos. Our results demonstrate the effectiveness and efficiency of applying Convolutional Neural Network (CNN) in gunshot classification eliminating the need for an ad-hoc setup while significantly improving the classification performance. [ABSTRACT FROM AUTHOR]

Tumour cell plasticity is a major barrier to the efficacy of targeted cancer therapies but the mechanisms that mediate it are poorly understood. Here, we identify dysregulated RNA splicing as a key driver of tumour cell dedifferentiation in colorectal cancer (CRC). We find that Apc-deficient CRC cells have dysregulated RNA splicing machinery and exhibit global rewiring of RNA splicing. We show that the splicing factor SRSF1 controls the plasticity of tumour cells by controlling Kras splicing and is required for CRC invasion in a mouse model of carcinogenesis. SRSF1 expression maintains stemness in human CRC organoids and correlates with cancer stem cell marker expression in human tumours. Crucially, partial genetic downregulation of Srsf1 does not detrimentally affect normal tissue homeostasis, demonstrating that tumour cell plasticity can be differentially targeted. Thus, our findings link dysregulation of the RNA splicing machinery and control of tumour cell plasticity. The influence of mRNA splicing on colon cancer development and progression is unclear. In this study, the authors demonstrate that the SRSF1 splicing factor is essential to sustain the stem cell phenotype of WNT-activated colorectal cancers. [ABSTRACT FROM AUTHOR]

The objective was to study ceftazidime-avibactam resistant and susceptible Klebsiella pneumoniae isolated from a patient admitted to the Policlinico Umberto I of Rome for SARS-CoV2. Data on the evolution of patient's conditions, antimicrobial therapies, and microbiological data were collected. Whole-genome sequencing performed by Illumina and Nanopore sequencing methods were used to type the strains. During the hospitalization, a SARS-CoV2-infected patient was colonized by a KPC-producing K. pneumoniae strain and empirically treated with ceftazidime-avibactam (CZA) when presenting spiking fever symptoms. Successively, ST2502 CZA-resistant strain producing the KPC-31 variant gave a pulmonary infection to the patient. The infection was treated with high doses of meropenem. The KPC-31-producing strain disappeared but the patient remained colonized by a KPC-3-producing K. pneumoniae strain. An interplay between highly conserved KPC-31- and KPC-3-producing ST2502 strains occurred in the SARS-CoV2 patient during the hospitalization, selected by CZA and carbapenem treatments, respectively. [ABSTRACT FROM AUTHOR]

Background: Little is known in distinguishing clinical features and outcomes between coronavirus disease-19 (COVID-19) and influenza (FLU). Materials/methods : Retrospective, single-centre study including patients with COVID-19 or FLU pneumonia admitted to the Intensive care Unit (ICU) of Policlinico Umberto I (Rome). Aims were: (1) to assess clinical features and differences of patients with COVID-19 and FLU, (2) to identify clinical and/or laboratory factors associated with FLU or COVID-19 and (3) to evaluate 30-day mortality, bacterial superinfections, thrombotic events and invasive pulmonary aspergillosis (IPA) in patients with FLU versus COVID-19. Results: Overall, 74 patients were included (19, 25.7%, FLU and 55, 74.3%, COVID-19), median age 67 years (58–76). COVID-19 patients were more male (p = 0.013), with a lower percentage of COPD (Chronic Obstructive Pulmonary Disease) and chronic kidney disease (CKD) (p = 0.001 and p = 0.037, respectively) than FLU. SOFA score was higher (p = 0.020) and lymphocytes were significantly lower in FLU than in COVID-19 [395.5 vs 770.0 cells/mmc, p = 0.005]. At multivariable analysis, male sex (OR 6.1, p < 0.002), age > 65 years (OR 2.4, p = 0.024) and lymphocyte count > 725 cells/mmc at ICU admission (OR 5.1, p = 0.024) were significantly associated with COVID-19, whereas CKD and COPD were associated with FLU (OR 0.1 and OR 0.16, p = 0.020 and p < 0.001, respectively). No differences in mortality, bacterial superinfections and thrombotic events were observed, whereas IPA was mostly associated with FLU (31.5% vs 3.6%, p = 0.0029). Conclusions: In critically ill patients, male sex, age > 65 years and lymphocytes > 725 cells/mmc are related to COVID-19. FLU is associated with a significantly higher risk of IPA than COVID-19. [ABSTRACT FROM AUTHOR]

Italy is the sixth most populous country in Europe and has the second highest average life expectancy, reaching 79.4 years for men and 84.5 for women. However, Italy has one of the lowest total fertility rates in the world: in 2018 it was 1.3 births per woman, with the population older than 65 comprising more than 30%, and those younger-than-19 less than 15%. Older people are the main concern of the Italian health system. Weighted coefficients for the allocation of funds favour older adults. As confirmed by our study, paediatric radiology is expensive, and the reimbursement based on Italian adult rates is not sufficient. The negative impact on the budget discourages the diffusion of paediatric radiology both in the private practices that provide services paid for by the state government and in the public hospitals. The 501 paediatric hospital units in Italy are not homogeneously distributed throughout the national territory. Furthermore, in Italy there are 12 highly specialised children's hospitals whose competences were defined in 2005 by the Ministry of Health. Paediatric radiology is not included among the highly qualified specialties. The quality gap in paediatric radiology between children's hospitals and general hospitals, the latter often without paediatric radiologists, is evident in daily practice with misdiagnoses and investigations not carried out. [ABSTRACT FROM AUTHOR]

Quantification of antibiotic utilization is an essential component of antibiotic stewardship programs. In this multicentric study, we used different metrics to evaluate inpatient antibiotic use in children. The study objectives were to describe point prevalence of antibiotic use by indication and patient characteristics, to evaluate DOTs, LOTs and PDDs, and to compare PDDs to DDDs, which assume average maintenance dose per day in adults. All children hospitalized on the days of the study were included. Trained personnel collected demographic and clinical data from patients' clinical records. We recorded information about antibiotics administered on the date of data collection, and in the previous 30 days of hospitalization. Of 810 patients, 380 (46.9%; CI 95%: 43.4–50.4) received one or more antibiotics; prevalence of use was 27.0% for prophylaxis (219/810), and 20.7% (168/810) for treatment. Overall, 587 drugs were issued to the 380 patients receiving antibiotics (1.5 antibiotic per patient). When considering treatments, DOT and LOT per 100 patient-days were 30.5 and 19.1, respectively, resulting in a DOT/LOT ratio of 1.6. PDDs increased with age and approached DDDs only in children aged ≥ 10 years; the ratio between PDDs estimated in children aged ≥ 10 years and in 0–11 month-old infants ranged from 2 for sulfamethoxazole and trimethoprim, to 25 for meropenem. Our results confirm that DOT, LOT and PDD are better alternatives to DDD in children. [ABSTRACT FROM AUTHOR]

Purpose: To reduce intensive care unit overcrowding and optimize resources, elderly patients affected by suspected infection with declining clinical conditions could be managed in internal medicine departments with stepdown beds. However, commonly used prognostic scores, as Sequential Organ Failure Assessment (SOFA) or quick SOFA (qSOFA) have never been studied in this specific setting. The aim of this study was to evaluate the role and the accuracy of SOFA and qSOFA as prognostic scores in a population of elderly patients with suspected infection admitted to stepdown beds of two internal medicine departments. Methods: Elderly patients admitted from the emergency department in the stepdown beds of two different internal medicine departments for suspected infection were assessed with SOFA and qSOFA scores at the admission. All patients were treated according to current guidelines. Age, sex, comorbidities, Charlson comorbidity index, SOFA and qSOFA were assessed. In-hospital death and length of hospital admission were also recorded. Results: 390 subjects were enrolled. In-hospital death occurred in 144 (36.9%) patients; we observed that both SOFA (HR 1.189; 95% CI 1.128–1.253; p < 0.0001) and qSOFA (HR 1.803; 95% CI 1.503–2.164; p < 0.0001) scores were independently associated with an increased risk of in-hospital death. However, the accuracy of both SOFA (AUC: 0.686; 95% CI 0.637–0.732; p < 0.0001) and qSOFA (AUC: 0.680; 95% CI 0.641–0.735; p < 0.0001) in predicting in-hospital death was low in this population. Conclusion: Elderly patients admitted to stepdown beds for suspected infection experience a high rate of in-hospital death; both SOFA and qSOFA scores can be useful to identify a group of patients who can benefit from admission to an intermediate care environment, however their accuracy is low. [ABSTRACT FROM AUTHOR]

On 12 November 2014, the Philae lander descended towards comet 67P/Churyumov–Gerasimenko, bounced twice off the surface, then arrived under an overhanging cliff in the Abydos region. The landing process provided insights into the properties of a cometary nucleus1–3. Here we report an investigation of the previously undiscovered site of the second touchdown, where Philae spent almost two minutes of its cross-comet journey, producing four distinct surface contacts on two adjoining cometary boulders. It exposed primitive water ice—that is, water ice from the time of the comet's formation 4.5 billion years ago—in their interiors while travelling through a crevice between the boulders. Our multi-instrument observations made 19 months later found that this water ice, mixed with ubiquitous dark organic-rich material, has a local dust/ice mass ratio of 2.3 − 0.16 + 0.2 : 1 , matching values previously observed in freshly exposed water ice from outbursts4 and water ice in shadow5,6. At the end of the crevice, Philae made a 0.25-metre-deep impression in the boulder ice, providing in situ measurements confirming that primitive ice has a very low compressive strength (less than 12 pascals, softer than freshly fallen light snow) and allowing a key estimation to be made of the porosity (75 ± 7 per cent) of the boulders' icy interiors. Our results provide constraints for cometary landers seeking access to a volatile-rich ice sample. When the Philae lander bounced on the surface of comet 67P/Churyumov–Gerasimenko, it exposed primitive icy-dust material within cometary boulders; the intrinsic strength and porosity of this material is reported. [ABSTRACT FROM AUTHOR]

Procalcitonin (PCT) is a a marker of bacterial infection. Its prognostic role in the critically-ill patient, however, is still object of debate. Aim of this study was to evaluate the capacity of admission PCT (aPCT) in assessing the prognosis of the critically-ill patient regardless the presence of bacterial infection. A single-cohort, single-center retrospective study was performed evaluating critically-ill patients admitted to a stepdown care unit. Age, sex, Simplified Acute Physiology Score II (SAPS-II), shock, troponin-I, aPCT, serum creatinine, cultures and clinical endpoints (in-hospital mortality or Intensive Care Unit (ICU) transfer) were collected. Time free from adverse event (TF-AE) was defined as the time between hospitalization and occurrence of one of the clinical endpoints, and calculated with Kaplan-Meier curves. We engineered a new predictive model (POCS) adopting aPCT, age and shock.We enrolled 1063 subjects: 450 reached the composite outcome of death or ICU transfer. aPCT was significantly higher in this group, where it predicted TF-AE both in septic and non-septic patients. aPCT and POCS showed a good prognostic performance in the whole sample, both in septic and non-septic patients. aPCT showed a good prognostic accuracy, adding informations on the rapidity of clinical deterioration. POCS model reached a performance similar to SAPS-II. [ABSTRACT FROM AUTHOR]

One of the major concerns when using prepreg materials for advanced composite manufacturing is the cure advancement. Although this type of prepreg curing is usually programmed to occur at high temperatures, the exposition to environmental conditions during processing, intrinsic to the industrial production, leads to the cure advancement and, consequently, to the detriment of prepreg's processability. Therefore, techniques that provide accurate, relatively low-cost, and fast alternatives for tracking prepreg out-time are of great interest for composite industries. In this scenario, the present work aims to provide information on the use of thermal and rheological characterization techniques for monitoring the prepreg out-time. To do so, prepreg specimens were aged for pre-established periods (0 to 60 days) and characterized by differential scanning calorimetry (DSC) and dynamic shear rheometry techniques. Also, laminates were manufactured from aged prepregs, and their properties were characterized by ultrasound and volume fraction analyses and by interlaminar shear strength (ILSS) tests. The combination of the findings provides out-time tracking and properties monitoring alternatives for industries and points out to the possibility of extending prepreg out-time limits, reducing the waste on prepreg processing, one of the main challenges associated with composite manufacturing. [ABSTRACT FROM AUTHOR]

Solar heating of a cometary surface provides the energy necessary to sustain gaseous activity, through which dust is removed1,2. In this dynamical environment, both the coma3,4 and the nucleus5,6 evolve during the orbit, changing their physical and compositional properties. The environment around an active nucleus is populated by dust grains with complex and variegated shapes7, lifted and diffused by gases freed from the sublimation of surface ices8,9. The visible colour of dust particles is highly variable: carbonaceous organic material-rich grains10 appear red while magnesium silicate-rich11,12 and water-ice-rich13,14 grains appear blue, with some dependence on grain size distribution, viewing geometry, activity level and comet family type. We know that local colour changes are associated with grain size variations, such as in the bluer jets made of submicrometre grains on comet Hale–Bopp15 or in the fragmented grains in the coma16 of C/1999 S4 (LINEAR). Apart from grain size, composition also influences the coma's colour response, because transparent volatiles can introduce a substantial blueing in scattered light, as observed in the dust particles ejected after the collision of the Deep Impact probe with comet 9P/Tempel 117. Here we report observations of two opposite seasonal colour cycles in the coma and on the surface of comet 67P/Churyumov–Gerasimenko through its perihelion passage18. Spectral analysis indicates an enrichment of submicrometre grains made of organic material and amorphous carbon in the coma, causing reddening during the passage. At the same time, the progressive removal of dust from the nucleus causes the exposure of more pristine and bluish icy layers on the surface. Far from the Sun, we find that the abundance of water ice on the nucleus is reduced owing to redeposition of dust and dehydration of the surface layer while the coma becomes less red. Spectral analysis of the VIRTIS dataset shows two opposite seasonal colour cycles in the coma and on the surface of comet 67P/Churyumov–Gerasimenko, indicating an orbital water-ice cycle. [ABSTRACT FROM AUTHOR]

Students' performance is a crucial aspect for university programs effectiveness and organization. In this paper, we introduce and analyze a performance index for the first-year students of a private Italian university, namely the Libera Università Maria Ss. Assunta. We use administrative data on 532 undergraduate students enrolled in any of the eight available bachelor degrees in 2015. Our aim is to improve the general understanding of performance linking it with personal student's characteristics and with degree-specific aspects. A beta inflated latent class approach is employed to identify clusters of performance establishing a link with all available explanatory variables. The empirical analysis unveils that a good and balanced degree organization may improve students' performance. The student's ability plays a crucial role in discriminating between good and bad performances, and also strongly depends on individual-specific characteristics, such as the final mark obtained at high school. [ABSTRACT FROM AUTHOR]

The worldwide consumption of dried carrot ( Daucus carota L.) is on a growing trend. Conventional methods for drying carrots include hot-water blanching followed by hot-air drying, which is usually uncontrolled and therefore prone to product quality deterioration. Thus, there is a need for innovative drying systems that yield high-value end products. In this study, the efficacy of NIR spectroscopy for the non-destructive monitoring of physicochemical changes and drying behaviour in organic carrot slices during 8-h hot-air drying at 40 °C was demonstrated using Partial least squares (PLS) regression and PLS discriminant analysis (PLS-DA). The impact of hot-water blanching pre-treatment (at 95 °C for 1.45 min) for enzyme inactivation on performances of both regression and classification models was also evaluated. PLS regression models were successfully developed to monitor changes in water activity ( R = 0.91-0.96), moisture content ( R = 0.97-0.98), total carotenoids content ( R = 0.92-0.96), lightness for unblanched carrots ( R = 0.80-0.83) and hue angle for blanched samples ( R = 0.85-0.87). Soluble solids content prediction was poor for both treatments (RMSEP = 3.43-4.40). Classification models were developed to recognise dehydration phases of carrot slices on the basis of their NIR spectral profile using K-means and PLS-DA algorithms in sequence. The performance of each PLS-DA model was defined based on its accuracy, sensitivity and specificity rates. All of the selected models provided from good (> 0.85) to excellent (> 0.95) sensitivity and specificity for the predefined drying phases. Feature selection procedures yielded both regression and classification models with performances very similar to models computed from the full spectrum. [ABSTRACT FROM AUTHOR]

Purpose: The use of surgical antibiotic prophylaxis (SAP) in children is poorly characterized. Our aim was to evaluate the effectiveness of a quality improvement (QI) intervention targeting SAP in children, by means of a multicenter prospective intervention study, with a before and after design. Methods: We prospectively investigated elective surgical procedures performed in children <18 years, prior to the QI intervention, after the intervention and at 9-month follow-up. The primary outcomes were adherence to SAP indications and SAP appropriateness, defined considering antibiotic choice, timing of first dose and duration of administration. We compared SAP adherence and appropriateness prior the QI intervention, to the post-intervention and the follow-up. We considered patient and procedure characteristics as covariates in two logistic regression models to assess the effect of the QI intervention on SAP adherence and appropriateness. Results: We collected information on 2383 procedures (pre-intervention: 784; post-intervention: 790; follow-up: 809). The QI intervention had a significant impact on the adherence to SAP indications (86.6% in the post-intervention, compared to 82.0% prior to the intervention; p < 0.05), and on its appropriateness (35.7% compared to 19.9%; p < 0.01). The impact of the intervention on SAP appropriateness was maintained at follow-up (38.3%; p < 0.01 compared to pre-intervention). All components of SAP appropriateness significantly improved after the intervention and at follow-up. The logistic regression analyses confirmed the effect of intervention in improving adherence to SAP indications and appropriateness. Conclusions: Following the QI intervention, there was a significant improvement in quality of SAP in pediatric surgery, though more efforts are needed to increase SAP appropriateness. [ABSTRACT FROM AUTHOR]

I argue that recognizing a human right to adequate food and enforcing it as a legal right is an important way to promote and ensure sustainable food security. I consider objections that have been raised against subsistence rights and socio-economic rights, including the argument that such rights are not feasible, that they are not justiciable, and that they are too amorphous-that it is not clear what is required to fulfill these rights and by whom. I defend the right to adequate food against these objections by considering how this right has been interpreted and applied in international law and how it has been protected in other domestic legal systems. I analyze different dimensions of the right to adequate food and I apply these to recent issues concerning sustainable food security in the United States, such as food deserts. [ABSTRACT FROM AUTHOR]

Observations of cometary nuclei have revealed a very limited amount of surface water ice, which is insufficient to explain the observed water outgassing. This was clearly demonstrated on comet 9P/Tempel 1, where the dust jets (driven by volatiles) were only partially correlated with the exposed ice regions. The observations of 67P/Churyumov-Gerasimenko have revealed that activity has a diurnal variation in intensity arising from changing insolation conditions. It was previously concluded that water vapour was generated in ice-rich subsurface layers with a transport mechanism linked to solar illumination, but that has not hitherto been observed. Periodic condensations of water vapour very close to, or on, the surface were suggested to explain short-lived outbursts seen near sunrise on comet 9P/Tempel 1. Here we report observations of water ice on the surface of comet 67P/Churyumov-Gerasimenko, appearing and disappearing in a cyclic pattern that follows local illumination conditions, providing a source of localized activity. This water cycle appears to be an important process in the evolution of the comet, leading to cyclical modification of the relative abundance of water ice on its surface. [ABSTRACT FROM AUTHOR]

Purpose: Surgical antibiotic prophylaxis (SAP) in children is poorly characterized. We investigated SAP for children undergoing elective surgical procedures. Methods: We prospectively investigated elective surgical procedures performed in children <18 years, from November 2012 to February 2013, in three tertiary-care children's hospitals in Italy. Data were derived from clinical records. Antibiotics were considered prophylactic if given by parenteral route during the same day of the procedure. SAP indication was defined according to international guidelines. Whenever SAP was indicated, it was defined appropriate if antibiotic choice was different from third-/fourth-generation cephalosporins, carbapenems, or piperacillin/tazobactam; timing of first dose was within 60 min before incision; and duration of administration was ≤24 h. Multivariable logistic regression model was used to assess independent predictors of adherence to SAP administration, for procedures with SAP indication performed in all hospitals. Results: Data on 765 procedures were collected. SAP was administered in 81 % of 206 procedures with SAP indication and in 18 % of 559 procedures with no indication. Type of procedure and hospital were significantly associated with adherence of administration to SAP indication. In the 206 procedures where SAP was indicated, overall appropriateness of antibiotic choice, timing, and duration was 8 %. Conclusions: The SAP rate observed in procedures with SAP indication and the appropriateness of drug choice, timing, and duration are reasons of concern. Quality improvement interventions for implementing SAP recommendations in children are strongly needed, and their impact should be evaluated at hospital level. [ABSTRACT FROM AUTHOR]

Potential clinical significance of CD34 expression in acute promyelocitic leukemia (APL) has not been deeply investigated. We hereby analyzed the clinico-biological features and treatment outcome of APL patients in relation to CD34 expression, even when expressed in a small subpopulation: 114 APL patients homogeneously treated with the AIDA schedule were included in the study and prognostic correlation with respect to CD34 expression, both when expressed in association with CD2 and as isolated expression (cutoff ≥2 to <10 % or ≥10 %), were investigated. CD34 was associated to CD2 in 30 patients and was isolated in 19 patients. When compared to the CD34-negative population, CD34/CD2 expression identified a subgroup with characteristic features: M3 variant subtype (26 vs 7 % in the negative group, p = 0.02), bcr3 transcript subtype (73 vs 32 %, p = 0.001), high risk according to the risk of relapse (66 vs 17 %, p = 0.002), high incidence of differentiation syndrome (26 vs 12 %, p = 0.01), lower overall survival (88 vs 95 %), and a significantly higher rate of relapse (22 vs 13.8 %, p = 0.05). We then evaluated the prognostic value of isolated CD34 expression: it was detected in nine patients with a cutoff of expression ≥10 % and in 10 patients with a cutoff ≥2 but <10 %. Isolated CD34 positivity identified a subgroup with a classic morphology (79 %), bcr1 prevalence (53 %), higher rate of relapse (37 vs 13.8 % in the negative group, p = 0.002), higher incidence of differentiation syndrome (55 vs 12 %, p = 0.03), and lower overall survival (60 vs 95 %, p = 0.001). The results of our study confirm that CD34/CD2 expression characterizes a subset of APL with a high WBC count and a variant morphological subtype, associated with an unfavorable clinical course. We also show that the isolated expression of CD34, even at a low cutoff, identifies a group of classic APL with a negative prognosis. Further studies aimed at identifying other molecular signatures in CD34-positive patients are needed in order to optimize the therapeutic strategy for this subset of patients. [ABSTRACT FROM AUTHOR]

This paper deals with the topic of revisions in macroeconomic Italian data with the aim of investigating whether consecutive vintages published by the National Statistical Institute contain useful information for economic analysis and forecasting. The rationality of the revisions process is tested considering the complete history of data and an application to show the usefulness of revisions for improving the precision of forecasts is proposed. The results on Italian GDP show that embedding the revision process in a dynamic factor model helps to reduce the forecast error in the short term. [ABSTRACT FROM AUTHOR]

The present study investigated the effectiveness of a mindfulness-based pain management program developed to increase accessibility and acceptability for a severe chronic pain population seeking help in two tertiary level hospital pain clinics. Sixty chronic pain patients completed a 12-week Mindfulness-Based Chronic Pain Management program, while 59 individuals on the waiting list served as a control group. Ages ranged from 32 to 79 (mean age 52), and classes contained a mix of on-site and distant-site participants connected via a telemedicine link. Quality of life, pain catastrophizing, usual pain levels, and pain-related suffering were measured at two points during the study period. Program participants showed significant improvements in mental health, pain catastrophizing, and suffering levels, while the controls remained relatively unchanged. Neither group showed significant changes in the physical quality of life measures or usual pain levels. The present study lends support for the effectiveness of mind-body interventions in improving mental health and suffering in chronic pain sufferers seeking help in tertiary pain clinic settings. It also provides evidence for the usefulness of a mindfulness-based program modified specifically for the chronic pain population, and supports its delivery through telemedicine. [ABSTRACT FROM AUTHOR]

The capacity to imagine oneself experiencing future events has important implications for effective daily living but investigation of this ability in autism spectrum disorder (ASD) is limited. This study investigated future thinking in 30 children with high functioning ASD (IQ > 85) and 30 typically developing children. They completed the Adapted Autobiographical Interview, a measure which required participants to describe personal past events (indexing episodic memory) and plausible future events (indexing episodic future thinking). The results showed that there are ASD-related deficits in future thinking, and also provided preliminary evidence regarding cognitive mechanisms that may (and may not) contribute to these difficulties. The theoretical and practical implications of these results are discussed. [ABSTRACT FROM AUTHOR]

We evaluated matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) Biotyper as a tool for the identification of anaerobic bacteria compared with 500 base-pair (bp) 16S ribosomal ribonucleic acid (rRNA) gene sequencing analysis, which is considered to be the 'gold standard' method. A total of 484 anaerobic bacteria were retrieved from the clinical specimens of 318 pediatric patients. Molecular identification resulted in 18 genera and 51 species. The most prevalent genus was Clostridium (76.85 %), with 70 % C. difficile isolates. The concordance and sensitivity determined by MALDI-TOF MS for C. difficile, the most prevalent species isolated, was 94.08 %, whereas the specificity was 100 %. For the other anaerobes, the sensitivity and specificity were 94.07 % and 81.82 %, respectively, with a concordance of 93.15 %. Low performance was observed for Propionibacterium acnes and Fusobacterium nucleatum, for which a dedicated pretreatment procedure should likely be set up. MALDI-TOF MS was shown to be a valid alternative for the fast and reliable identification of the most clinically relevant anaerobic bacteria; moreover, it is less time-consuming, the cost for reagents is minimized, and it does not require dedicated personnel. [ABSTRACT FROM AUTHOR]

To assess the possible role of hyperhomocysteinemia (HyHcy) in delaying recovery after acute vestibular neuritis. In our retrospective study, 90 subjects were evaluated within 7 days from the beginning of an acute vertigo. All subjects had high plasma levels of homocysteine (Hcy). 46 patients were treated with homocysteine lowering therapy and betahistine for 1 month, while 44 subjects received only betahistine. Subjective symptoms were evaluated with the Dizziness Handicap Inventory (DHI) questionnaire, administered 7 days after the beginning of vertigo and again after 1 month. Moreover, postural control performed at 1 month' control was studied with static stabilometry in a subgroup of 21 non-treated and 20 treated patients. DHI total score decreased significantly more in the subgroup of subjects treated with homocysteine lowering therapy. Moreover, posturographic data were significantly increased in non-treated compared with treated subjects. Our data support the possibility of a role of HyHcy in preventing recovery after a recent vestibular neuritis. A microvascular disorder or the neurotoxic effect of HyHcy have been considered as possible causal factors. Although not conclusive, our data are not inconsistent with the hypothesis of a poorer adaptation in patients with untreated HyHcy. [ABSTRACT FROM AUTHOR]

The total solar irradiance varies over a solar cycle of 11 years and maybe over cycles of longer periods. Is the solar diameter variable over time too? A discussion of the solar diameter and its variations must be linked to the limb darkening function (LDF). We introduce a new method to perform high-resolution astrometry of the solar diameter from the ground, through the observations of eclipses, using the luminosity evolution of Baily's bead and the profile of the lunar edge available from satellite data. This approach unifies the definition of the solar limb with the inflection point of LDF for eclipses and drift-scan or heliometric methods. The method proposed is applied for the videos of the eclipse on 15 January 2010 recorded in Uganda and in India. The result suggests reconsidering the evaluations of the historical eclipses observed with the naked eye. [ABSTRACT FROM AUTHOR]

Single base substitutions can lead to missense mutations, silent mutations or intronic mutations, whose significance is uncertain. Aberrant splicing can occur due to mutations that disrupt or create canonical splice sites or splicing regulatory sequences. The assessment of their pathogenic role may be difficult, and is further complicated by the phenomenon of alternative splicing. We describe an HNPCC patient, with early-onset colorectal cancer and a strong family history of colorectal and breast tumors, who harbours a germ line MLH1 intronic variant (IVS9 c.790 +4A>T). The proband, together with 2 relatives affected by colorectal-cancer and 1 by breast cancer, have been investigated for microsatellite instability, immunohistochemical MMR protein staining, direct sequencing and Multiplex Ligation-dependent Probe Amplification. The effect of the intronic variant was analyzed both by splicing prediction software and by hybrid minigene splicing assay. In this family, we found a novel MLH1 germline intronic variant (IVS9 c.790 +4A>T) in intron 9, consisting of an A to T transversion, in position +4 of the splice donor site of MLH1. The mutation is associated with the lack of expression of the MLH1 protein and MSI in tumour tissues. Furthermore, our results suggest that this substitution leads to a complete skip of both exon 9 and 10 of the mutant allele. Our findings suggest that this intronic variant plays a pathogenic role. [ABSTRACT FROM AUTHOR]

Purpose: Farnesyltransferase (Ftase) was identified by gene-expression profiling and by preclinical evaluation in in vitro and in vivo mantle cell lymphoma (MCL) models as a rational therapeutic target in MCL, one of the most refractory B-cell lymphomas. We conducted a multicenter phase II study of a potent Ftase inhibitor, tipifarnib, in patients with relapsed or refractory MCL.Methods: Tipifarnib was administered at 300 mg orally twice daily for the first 21 days of each 28-day cycle for 4 cycles, and in case of response for 6 cycles. Study endpoints were objective response at 4 and 6 cycles, progression free survival (PFS), overall survival, and toxicity. Prediction of response was retrospectively evaluated in the initial tumor biopsy by the RASGRP1/APTX gene expression ratio, and the AKAP13 expression level.Results: Eleven patients (median age, 71 years) were enrolled. Patients received a median number of three prior therapies (range 1-11). Nine patients completed at least 3 cycles of tipifarnib. No grade III-IV hematological toxicities were recorded. One patient presented a complete response (CR) after 4 and a persistent CR at 6 cycles (ORR = 9%). Median PFS was 3 months (range 0.7-14.2). The RASGRP1/APTX gene expression ratio was higher in the responder (n = 1) while the AKAP13 expression was higher in the non-responders (n = 2). This corresponds to the expected result for predicting response to tipifarnib.Conclusion: Treatment with tipifarnib relapsed or refractory MCL is associated with low response rates. Limited gene expression studies suggest that response may be associated with molecular targets. [ABSTRACT FROM AUTHOR]

An artificial capillary culture/transduction technique has been developed for application in a phase I gene therapy clinical trial for HIV. The trial protocol involves isolation of CD4+ T-lymphocytes from a genetically matched HIV negative twin, retroviral transduction of equal numbers of cells with the ribozyme therapeutic and control genes, and expansion in Cellmax artificial capillary modules. Preclinical studies showed transduction efficiencies in the range of 3–30%, with preferential expansion of CD4+ lymphocytes over a culture period of 10–14 days. Over this time period, an average yield of 1.7 × 109 lymphocytes was readily attainable from 5 × 107 CD8-depleted lymphocytes. In addition, a sensitive and reliable quantitative competitive PCR method was developed to assess the levels of transduction before infusion into the recipient. The transduction data suggest that the efficiency of retroviral transduction was affected by the presence of inhibitory factors present in the virus preparations or generated as a result of the transduction process itself. It is hypothesised that the method of transduction could significantly affect the extent of this inhibition, and thus impact on clinical efficacy of retrovirus mediated gene therapy. [ABSTRACT FROM AUTHOR]

The balance of proinflammatory and antiinflammatory cytokines, their correlation with endotoxin levels and mortality rate after lethal challenge of Escherichia coli was investigated in mice immunized weekly for 8 weeks with formalin-killed E. coli either untreated or treated with 0.5×minimal inhibitory concentration of aztreonam. Control mice treated in parallel with saline, died within 24 h after challenge with 100× lethal dose (LD50) of viable E. coli O6:K–. Mice immunized with antibiotic-treated bacteria showed a significantly higher survival than mice immunized with untreated E. coli. Cytokines were not detected in the sera of control mice during the entire period of immunization. At 90 min after immunization, mice immunized with antibiotic-treated E. coli showed tumor necrosis factor- α (TNF- α) levels significantly lower and interleukin (IL)-6 levels significantly higher ( P<0.05) than mice immunized with untreated E. coli, while comparable levels of interferon- γ (IFN- γ) were measured in both groups. TNF- α and IL-10 levels measured 90 min after lethal challenge correlated with the mortality rate observed in each group ( r=0.96 for TNF- α and 0.94 for IL-10). IL-6 levels correlated with survival ( r = 0.95), while IFN- γ serum levels did not differ in the two immunized groups, but were significantly higher than those measured in the control mice. IL-4 was detected only after challenge of mice immunized with antibiotic-treated bacteria. Comparable levels of circulating endotoxin were measured after lethal challenge in both control and immunized mice. These data showed that in the presence of a protective immune response the survival of immunized mice was correlated with an early alteration of cytokine expression pattern including enhanced secretion of IL-4, IL-6 and IFN- γ, and reduced secretion of TNF- α and IL-10. [ABSTRACT FROM AUTHOR]

The problem of the HLA association of Type 1 (insulin-dependent) diabetes was re-examined by testing Class II antigenic specificities detectable by radioimmunoassay. Established (DRw53, DQwl, DQw2, DQw3) as well as newly described (DC5, DCalpha3) specificities were typed. The data obtained suggest that the association with DR3 and DR4 is secondary to that with DQ specificities in linkage disequilibrium with DR3 and DR4. [ABSTRACT FROM AUTHOR]