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The COVID‐19 pandemic has induced significant impairments, including sleep disturbances. The present study aimed to explore the impact of fear in relation to stress on sleep disorders among Italian adults and older participants in the second phase of the EPICOVID19 web‐based survey (January‐February 2021). Sleep disturbances during the pandemic were evaluated using the Jenkins Sleep Scale, perceived stress through the 10‐item Perceived Stress Scale and fear of contagion and about economic and job situation with four ad hoc items. The strength of the pathways between stress, sleep disturbances and fear was explored using structural equation modelling, hypothesising that stress was related to sleep disturbances and that fear was associated with both stress and sleep problems. Out of 41,473 participants (74.7% women; mean age 49.7 ± 13.1 years), 8.1% reported sleep disturbances and were more frequently women, employed in a work category at risk of infection or unemployed, and showed higher deprivation scores. Considering an a priori hypotheses model defining sleep and stress scores as endogenous variables and fear as an exogenous variable, we found that fear was associated with sleep problems and stress, and stress was associated with sleep problems; almost half of the total impact of fear on sleep quality was mediated by stress. The impact of stress on sleep quality was more evident in the younger age group, among individuals with a lower socioeconomic status and healthcare workers. Fear related to COVID‐19 seem to be associated with sleep disturbances directly and indirectly through stress. [ABSTRACT FROM AUTHOR]

Introduction Since antiretroviral therapy must be taken lifelong, persistence and safety have become the goals to achieve. Protease inhibitors, in particular atazanavir (ATV) with or without ritonavir (r), represent a highly prescribed class in real life long-term treatment. Methods We conducted a retrospective cohort study in HIV-1-positive patients who were followed at the Infectious Diseases Unit, DIBIC Luigi Sacco, University of Milan. Data regarding viral load, CD4 lymphocytes and the mean blood chemistry parameters were collected at baseline, first, third, sixth months from the beginning of therapy and then every six months. Factors related to persistence of therapy with ATV and time-dependent probability to reach a CD4 cells count >500 cells/µL were evaluated with Kaplan-Meier curve and Cox model. Results A total of 1030 patients were evaluated: 183 received therapy with ATV/r as naïve, 653 switched to ATV/r as a second or following line and 194 switched to unboosted ATV from previous ATV-free regimens. A total of 138 patients shifted to unboosted ATV from a previous ATV/r regimen (17 from naïve ATV/r and 121 from experienced ATV/r). The median duration of therapy was 38 months (95% CI 29-73) in ATV/r naïve patients, 36 months (95% CI 23-53) in unboosted ATV group and 35 months (95% CI 31-43) in patients switched to ATV/r. We observed no significant difference in the persistence of the three regimens (p=0.149). Female (HR=1.317; 95% CI 1.073-1.616 p=0.008) and patients with CD4<200 cells/µL at baseline (HR=1.433 95% CI 1.086-1.892 p=0.011) were at increased risk of regimen interruption, whereas starting therapy with a backbone containing abacavir (HR=0.725; 95% CI 0.533-0.987 p=0.041) resulted protective. In multivariate analysis no significant difference between the three regimens was observed regarding reaching a count of CD4 cells >500 cells/µL. Factors associated to a poor CD4 gain were each extra Log of viral load at baseline (HR=0.915; 95% CI 0.852-0.982 p=0.014) and CD4<200 cells/µL at ATV start (HR=0.197; 95%CI 0.138-0.281 p<0.0001); conversely, females (HR=1.262; 95%CI 1.032-1.543 p=0.023) had a higher probability of CD4 recovery. Conclusions Antiretroviral regimens containing atazanavir with or without ritonavir were durable and well tolerated, an elevated viral load and CD4 <200 cells/µL at baseline resulted related to regimen discontinuation and reduced CD4 recovery. [ABSTRACT FROM AUTHOR]

HCV point of care screening in people tested for SARS-CoV-2 in a social-housing neighbourhood of Milan, Italy Keywords: awareness; COVID-19; diagnosis; elimination strategy; hepatitis C; rapid test EN awareness COVID-19 diagnosis elimination strategy hepatitis C rapid test 251 255 5 01/04/23 20230101 NES 230101 Key points In our study, we assessed the antibody positivity for hepatitis C using point-of-care-testing in subjects undergoing COVID-19 screening in the San Siro social-housing neighbourhood of Milan which is characterized by a multi-ethnical population and low socio-economic status. Milestones to reach hepatitis C virus (HCV) elimination in Italy: from free-of-charge screening to regional roadmaps for an HCV-free nation. [Extracted from the article]

Artificial light at night (ALAN) is one of the most recently recognized sources of anthropogenic disturbance, with potentially severe effects on biological systems that are still to be fully explored. Among marine ecosystems, high‐shore habitats are those more likely to be impacted by ALAN, due to a more intense exposition to outdoor nocturnal lightings (mostly from lamps along coastal streets and promenades, or within harbours, ports and marinas).By performing in situ nocturnal manipulations of a direct source of white LED light and presence of herbivores in a Mediterranean high‐shore habitat, we assessed the interactive effects of light pollution and grazing on two key functional components of the epilithic microbial community (the cyanobacteria, as the main photoautotrophic component, and the other bacteria, mainly dominated by heterotrophs) developing on rocky shores.Results showed an unexpected increase in the diversity of epilithic bacterial biofilm at unlit sites in the presence of grazers, that was more evident on the other (mainly heterotrophic) bacterial component, when giving weight to more abundant families. This effect was likely related to the mechanical removal of dead cells through the grazing activity of consumers. ALAN significantly modified this scenario, by reducing the density of grazers and thus erasing their effects on bacteria, and by increasing the diversity of more abundant cyanobacterial families.Overall, direct and indirect effects on ALAN resulted in a significant increase in the diversity of the photoautotrophic component and a decrease in the heterotrophic one, likely affecting key ecosystem functions acting on rocky shore habitats.ALAN may represent a threat for natural systems through the annihilation of positive interactions across trophic levels, potentially impairing the relationship between biodiversity and functioning of ecosystems and interacting with other global and local stressors currently impinging on coastal areas. A free Plain Language Summary can be found within the Supporting Information of this article. [ABSTRACT FROM AUTHOR]

Dear Editor, We read with interest the letter by Aldinio et al[1] in which the authors, in response to our previous report[2] regarding an opportunistic HCV and SARS-CoV-2 co-screening, reported their experience of HCV point-of-care testing offered to the general population during the 2022 Open Day of the University of Milan, with most participants (217/292) born >1989. HCV point of care screening in people tested for SARS-CoV-2 in a social-housing neighbourhood of Milan, Italy [published online ahead of print, 2022 Jul 22]. [Extracted from the article]

Distributed hydrologic models are an integral component of spatial decision support systems for watershed management. At these basin (and larger) scales, a common problem in hydrology and other environmental sciences arises from the need to cope with the increasingly sophisticated models and software tools that are used in the management, processing, and analysis of large volumes of data collected from advanced in situ and remote monitoring instruments. The diversity of these tools, and the need for experts and non-experts alike to be able to easily use them, suggests a non-trivial integration problem of building customized systems from disparate (and in many cases proprietary) components. In this paper we address the systems integration problem within the context of a study of surface-subsurface-atmosphere interactions involving soil moisture remote sensing and hydrologic simulation. The simple early steps that were taken highlight the role of the different components and tools in the integration effort. An alternative approach is presented for creating an integrated system, based on a data flow model with the modular components linked within a flexible framework. An example is developed based on established systems integration techniques from the field of computer aided design. [ABSTRACT FROM AUTHOR]