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Fingolimod is approved in Italy as a second-line therapy for relapsing–remitting multiple sclerosis (RRMS). Discontinuation of fingolimod may elevate the risk of relapses, typically manifesting after a relatively prolonged drug-free interval and often necessitating high doses of intravenous steroids for management. Similar to other viruses, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can act as a trigger for MS relapses. In this context, we present a case of rebound following fingolimod discontinuation during a SARS-CoV-2 infection. Notably, the rebound occurred shortly after stopping the medication and responded effectively to low doses of oral steroids. Our case is discussed in light of existing literature, with speculation on potential mechanisms governing this unconventional disease course rebound. We also consider the possibility that SARS-CoV-2 infection might have contributed to or even triggered the MS relapse. [ABSTRACT FROM AUTHOR]

Increasing reports on K. pneumoniae strains with antimicrobial resistance and virulence traits from food and farm animals are raising concerns about the potential role of Klebsiella spp. as a foodborne pathogen. This study aimed to report and characterize Klebsiella spp. isolates from two artisanal ready-to-eat food (soft cheese and salami) producing facilities, and to track similar genotypes in different ecological niches. Over 1170 samples were collected during the whole production chain of different food batches. The overall Klebsiella prevalence was 6%. Strains were classified into the three Klebsiella species complexes: K. pneumoniae (KpSC, n = 17), K. oxytoca (KoSC, n = 38) and K. planticola (KplaSC, n = 18). Despite high genetic diversity we found in terms of known and new sequence types (STs), core genome phylogeny revealed clonal strains persisting in the same processing setting for over 14 months, isolated from the environment, raw materials and end-products. Strains showed a natural antimicrobial resistance phenotype-genotype. K. pneumoniae strains showed the highest virulence potential, with sequence types ST4242 and ST107 strains carrying yersiniabactin ybt16 and aerobactin iuc3. The latter was detected in all K. pneumoniae from salami and was located on a large conjugative plasmid highly similar (97% identity) to iuc3+ plasmids from human and pig strains circulating in nearby regions of Italy. While identical genotypes may persist along the whole food production process, different genotypes from distinct sources in the same facility shared an iuc3-plasmid. Surveillance in the food chain will be crucial to obtain a more comprehensive picture of the circulation of Klebsiella strains with pathogenic potential. [ABSTRACT FROM AUTHOR]

Wastewater-based surveillance enabled the first detection of the mobile colistin resistance gene mcr-10 in Italy. This plasmid-borne resistance gene was found in strains of Klebsiella quasipneumoniae isolated from samples of human raw sewage collected over several months. Although the isolates were phenotypically susceptible to colistin, the emergence of mcr-10 is concerning due to the highly variable expression of the gene and the potential for horizontal transfer to other species. In addition, the strains also carried an extended-spectrum β-lactamase gene and were phenotypically resistant to several beta-lactams. This study highlights the value of wastewater-based surveillance as an effective tool to monitor the emergence of antimicrobial resistance in strains circulating in the community and the environment. [ABSTRACT FROM AUTHOR]

The present study aimed at assessing the occurrence of microbiological hazards (Listeria monocytogenes, Staphylococcus aureus, Salmonella spp. and Escherichia coli O157) in an artisanal soft cheese produced in northern Italy. In the same product total bacterial count, lactic acid bacteria and Enterobacteriaceae were enumerated, and pH and water activity measured in two batches sampled in summer and winter. Samples of raw materials, environmental swabs from the production processes and cheese during 15 days of storage at 2 and 8°C as well as dynamic temperature of 2°C for 5 days and 8°C for 10 days were collected and tested. The load of total bacterial count was significantly higher in the winter batch in comparison to the summer one, with a significant increase at the end of the storage period also noticed for lactic acid bacteria. Statistical higher values of pH were registered in raw materials and end of storage in winter batch. S. aureus was confirmed only in the winter batch within samples (n=4) of stored cheese. On plates used for E. coli O157 detection, colonies of Klebsiella pneumoniae and Klebsiella oxytoca were isolated. The results suggest that the highest bacterial population in the winter batch was associated to a higher pH in stored cheese and a higher number of biological hazards identified. Their isolation started in the maturation room suggesting this step as relevant for possible cheese contamination. [ABSTRACT FROM AUTHOR]

This study is focused on resistance to carbapenems and third-generation cephalosporins in Gram-negative microorganisms isolated from swine, whose transmission to humans via pork consumption cannot be excluded. In addition, the common carriage of carbapenem-resistant (CR) bacteria between humans and pigs was evaluated. Sampling involved 300 faecal samples collected from slaughtered pigs and 300 urine samples collected from 187 hospitalised patients in Parma Province (Italy). In swine, MIC testing confirmed resistance to meropenem for isolates of Pseudomonas aeruginosa and Pseudomonas oryzihabitans and resistance to cefotaxime and ceftazidime for Escherichia coli, Ewingella americana, Enterobacter agglomerans, and Citrobacter freundii. For Acinetobacter lwoffii, Aeromonas hydrofila, Burkolderia cepacia, Corynebacterium indologenes, Flavobacterium odoratum, and Stenotrophomonas maltophilia, no EUCAST MIC breakpoints were available. However, ESBL genes (blaCTXM-1, blaCTX-M-2, blaTEM-1, and blaSHV) and AmpC genes (blaCIT, blaACC, and blaEBC) were found in 38 and 16 isolates, respectively. P. aeruginosa was the only CR species shared by pigs (4/300 pigs; 1.3%) and patients (2/187; 1.1%). P. aeruginosa ST938 carrying blaPAO and blaOXA396 was detected in one pig as well as an 83-year-old patient. Although no direct epidemiological link was demonstrable, SNP calling and cgMLST showed a genetic relationship of the isolates (86 SNPs and 661 allele difference), thus suggesting possible circulation of CR bacteria between swine and humans. [ABSTRACT FROM AUTHOR]

We assessed the bacterial agents found in 8–12-wk-old post-weaning pigs with arthritis. The bodies of 178 post-weaning pigs from 90 farms (average of 2 pigs/farm) with recurrent problems of lameness and swollen joints in a high-density breeding area were submitted for autopsy and sampled for further bacterial investigation. The most common articular gross lesions and histopathologic findings were serofibrinous (95 of 178; 53%) or serous (65 of 178; 37%) arthritis; suppurative lesions were less frequent (18 of 178; 10%). In 133 of 178 (74.7%) cases, a bacterial agent was detected in joints. Mycoplasma hyorhinis was the most common bacterium detected (82 of 133; 61.6%). Haemophilus parasuis and Streptococcus spp. were observed in 27 of 133 (20.3%) and 24 of 133 (18.0%) cases, respectively. Other bacteria in the 113 cases, considered less important, in order of their low frequency, were Mycoplasma spp. (13; 9.8%), Trueperella pyogenes (11; 8.2%), Mycoplasma hyosynoviae (4; 3.0%), Staphylococcus spp. (3; 2.2%), Escherichia coli (2; 1.5%), and Actinobacillus spp. (2; 1.5%). Our results highlight the primary role of M. hyorhinis compared to other microorganisms involved in young pigs with arthritis. [ABSTRACT FROM AUTHOR]

Introduction: Timely and accurate diagnosis of idiopathic pulmonary fibrosis (IPF) is challenging, requiring specific tests including chest high-resolution computed tomography (HRCT), and limited by access to specialist centres with a multidisciplinary team (MDT). Here we describe PerFECT 2.0, an Italian web-based platform designed to create a network between tertiary centres with an MDT (hubs) and secondary centres (spokes), aiming to facilitate the diagnosis of IPF. Methods: PerFECT 2.0 went live on 1 November 2016. Spoke centres submit anonymised documentation (HRCT images, pathological samples, clinical data) for a second opinion on the potential diagnosis of IPF from a hub centre. HRCT images are quickly uploaded, with patient-identifying information automatically removed. The hub centre views documentation online (no downloads allowed), makes any further information requests, then returns their second opinion as free text. An e-learning area contains educational material and simulated training clinical cases. Metrics were collected for 2017–2019; a user survey was conducted from 30 June–31 July 2020. Results: Ten hub centres and 137 spoke centres have registered. The requests for a second opinion numbered 251 in 2017, 270 in 2018 and 265 in 2019 (overall mean 19.9 requests per month). The proportion of requests answered was 100.0% (251) in 2017, 100.0% (270) in 2018 and 97.7% (259) in 2019. The mean response time was 15.7 days. In the user survey, of nine hub responders and 19 spoke responders, 78% and 74%, respectively, reported that the platform is easy to use, and 100% and 89%, respectively, would recommend the platform to colleagues. Conclusion: The PerFECT 2.0 web-based platform has created a network that enables secondary centres to gain quick and easy access to a second opinion from a tertiary centre with an MDT through online evaluation of anonymised documentation, thereby facilitating and supporting the timely and accurate diagnosis of IPF. [ABSTRACT FROM AUTHOR]

We assessed the causes of polyserositis in pigs, categorized by causative agents and ages of animals affected. In a 3-y study, 246 pigs from 80 different farms with recurrent problems of polyserositis, in a high-density breeding area, were submitted for autopsy; 154 pigs with typical fibrinous serosal lesions were sampled for further bacterial and viral investigation. The most common gross lesions were pleuritis and pericarditis (141 of 154; 92%). The animals most affected were weaned pigs (139 of 154; 90%). Haemophilus parasuis and Mycoplasma hyorhinis were the most common bacteria detected and were present at the same rate (85 of 154; 55%). Other bacteria isolated were Streptococcus sp. (44 of 154; 29%), Pasteurella multocida (21 of 154; 14%), Escherichia coli (19 of 154; 12%), Actinobacillus pleuropneumoniae (7 of 154; 5%), and Trueperella pyogenes (4 of 154; 3%). Porcine reproductive and respiratory syndrome virus (PRRSV; 119 of 154; 77%) predominated among the viruses detected, followed, with lesser prevalence, by porcine circovirus 2 (40 of 154; 26%) and swine influenza A virus (19 of 154; 12%). Bacterial coinfection and coinfection of bacteria and viruses were common (128 of 154; 83%). A strong positive correlation was found between coinfection by H. parasuis and M. hyorhinis and also by H. parasuis with PRRSV. [ABSTRACT FROM AUTHOR]

Background: Antimicrobial resistant bacteria are emerging biological contaminants of the environment. In aquatic ecosystems, they originate mainly from hospitals, livestock manure and private households sewage water, which could contain antimicrobial agents and resistant microorganisms. Aeromonas spp. occur ubiquitously in aquatic environments and they cause disease in fish. Motile aeromonads are also associated with human gastrointestinal and wound infections and fish can act as a transmission route of antimicrobial resistance (AMR) aeromonads to humans. The environmental ubiquity, the natural susceptibility to antimicrobials and the zoonotic potential of Aeromonas spp. make them optimal candidates for studying the AMR in aquatic ecosystems. Results: The AMR patterns of 95 motile aeromonads isolated from freshwater fish during 2013 and 2016 were analyzed. All samples from fish came from farms and natural water bodies located in northern Italy, which is an area characterized by high anthropic impact on the environment. The isolates were biochemically identified as Aeromonas hydrophila, Aeromonas sobria or Aeromonas caviae and AMR was determined by the standard disk diffusion method. All isolates were resistant to cloxacillin, spiramycin and tilmicosin. High AMR frequencies (> 95%) were detected for tylosin, penicillin and sulfadiazine. AMR to danofloxacin, enrofloxacin, flumequine, ceftiofur, aminosidine, colistin, doxycycline, gentamicin, marbocyl and florfenicol was observed at low levels (< 10%). No AMR to cefquinome was found. Logistic regression showed several differences in antimicrobial activity between complexes. According to the source of aeromonads, only few differences in AMR between isolates from farmed and wild fish were observed. Conclusions: Our data revealed an increasing trend of AMR to neomycin and apramycin among Aeromonas isolates during the study period, while resistance to erythromycin, tetracycline and thiamphenicol decreased. All isolates were multidrug resistance (MDR), but A. caviae showed the highest number of MDR per isolate. In most isolates, various degrees of MDR were detected to macrolides, quinolones, fluoroquinolones, polymyxins and cephalosporins (third and fourth generations), which are listed, by the World Health Organisation, to be among the highest priority and critically important antimicrobials in human medicine. Our findings underlined that freshwater fish can act as potential source of MDR motile aeromonads. Due to their zoonotic potential, this can pose serious threat to human health. [ABSTRACT FROM AUTHOR]

Aim: The aim of the study is to compare the efficacy of two dressings for the treatment of the donor sites of split-thickness skin grafts (STSG). Method: After harvesting of the graft, the donor site was covered with a calcium sodium alginate wound dressing for haemostasis until surgery had been completed. At the end of the operation, the wound was cleaned with saline solution and either dressing based on whey extract and Polyhexanide1 or the one with Hyaluronic Acid and Silver sulphadiazine2 was applied. Then, an absorbent foam dressing and two layers of cotton gauze pads were placed onto the medicated gauzes. Moreover, in order to provide increased protection to the donor site wound, self-adhesive elastic bandages were applied on top. The primary outcomes were healing rate, time to re-epithelialisation, the quality of the scar after 3 months. Results / Discussion: 31 patients were enrolled in the randomized trial. The average time of healing was 22 days, with no statistical significance. The quality of the scar was assessed using two different scar scales: the Vancouver Scar Scale (VSS) and the Manchester Scar Scale (MSS) three months after surgery. The dressings based on whey extract yielded better scarring results. Conclusion: Both gauzes, the one with whey extract and Polyhexanide1 and the one with Hyaluronic Acid and Silver sulphadiazine2 are secure and effective for this purpose, especially to promote wound healing and scarring. They both showed interesting results but dressing with whey extract1, both as impregnated gauze and cream, demonstrated significant better scarring of the donor site in a long term follow up. 1. Fitostimoline Plus ® 2. Connettivina Plus ® [ABSTRACT FROM AUTHOR]

Aim: We present three cases of healing with antimicrobial silver dressing in polyurethane foam for the transfer of exudate produced by the blisters to a secondary dressing. This dressing adheres gently with a safetac mechanism, inactivates pathogenic bacteria, can be left in situ for up to 14 days, can be cut in areas difficult to dress and can be placed under the bandages. 1) very rare lesion caused by contrast medium outside the vein: phlycten, appearing in a few hours from extravasation of liquid necessary for angiotec, starting from the hand where the vein cannulated. There is evidence of erythema, painful phlyctenae up to 10 cm from the wrist, without an increase in the diameter of the limb and without functional limitation. Healing in 10 days without scarring. 2) young person with burns with an area greater than 47 cm² of second and third degree burns after a fall on a motorbike, due to the heat from the muffler and the weight of 100 kg of the motorbike. After debridement and reconstruction of the peripheral part with hemoglobin spray, the reconstruction of the skin is completed with the application of a silver sheath and secondary dressing which leads to healing without keloid. 3) post-covid-like burn injuries: young woman hospitalized in intensive care for COVID with the appearance of phlytene all over her body alternating with large areas of erythema healed after leaving the dressing in place for 14 days with a single change. Conclusion: This foam is a chance for all the patients acute and chronic. [ABSTRACT FROM AUTHOR]

Aim: Since April 2020 in Asl AL, vulnology has developed the "bedside vulnology" project, i.e., bringing vulnology with telemedicine to everyone fragile, chronic and bedridden of all ages, from children to adults. All structures of the hospital province, RSA / CDR, patients in adi, in palliative care and private at home have joined such projects. Methods: Through the email vulnologia.adi.aslal@aslal.it, we brought a super specialist medicine to the bedside with first visits, follow-up visits and training of the nurses who were close to the patient. In April 2021, we created a virtual medical clinic in the geographically most penalized district, that of Acqui, where patient and caregiver can go by booking to the regional CUP to perform a vulnological visit or angiological visit and take advantage of all the therapeutic and technological innovations in our possession. By associating television viewing with the photographic project with a high-resolution device, we had the possibility of acquiring high-resolution images and archiving them in a depository to be able to use them and compare them for scientific purposes. Results: Visits are around 500 in 30 months. Conclusion: Now it is a consolidated service independent of the covid peaks. [ABSTRACT FROM AUTHOR]

Objective:The purpose of this study was to examine the longitudinal relationship between Positivity (POS), defined as a stable disposition to view at experience under a positive outlook, and physical and psychological functioning in a sample of cancer patients immediately after diagnosis and one year later. Methods:A total of 110 patients (40% males) with pulmonary, colorectal and breast cancer, aged 30–75 (Mage = 59.62; SD = 10.33), have been prospectively enrolled between 2012 and 2013, at the S. Andrea Hospital in Rome. All patients were previously aware of their diagnosis. A follow-up one year after diagnosis was conducted. We used structural equation modeling in order to analyse the specific effects of POS on functioning impairment from diagnosis to follow up. Results:POS was associated with less functioning impairment both at diagnosis and follow-up assessments. Furthermore, POS level at diagnosis continued to be associated with less functioning impairment one year later, after controlling for its stability. Conclusions:Patients with higher level of POS tended to report less symptoms associated with negative affect such as anxiety and despondency and to preserve their habitual relationships and social roles. POS may act as a basic disposition that sustains patients’ efforts to deal efficaciously with severe illness, by complying with medical treatment and using cognitive strategies that enable individuals to cope with concurrent and prospective challenges of illness. [ABSTRACT FROM PUBLISHER]

Facebook identity management implies a selective front and backstage: users perform multiple social roles for a multiple spectator audience (boyd 2008). But as friend lists increase and the discussion about sensitive topics becomes more critical, people tend to protect their image by dealing only with content that may be interesting to all their contacts (Hogan, 2010). Starting from field research on Italian users (40 in-depth interviews with Facebook users aged 14-55), this paper discusses the idea of Facebook as a place where people are engaged in building their social relations and their self-representation by managing their online presence in a way that can be both intriguing and acceptable for most of their contacts. The paper will highlight the strategies of content homogenization and the online behavior adopted by users according to their perceptions of their «imagined audience» (Litt, 2012). The article aims at underlining that Facebook use is surprisingly consistent with mass-media and generalist-media cultural models: users seem to apply models of television spectatoriality, not only in terms of passivity (lurking), but also in terms of consumption (skipping uninteresting content) and content production performed for a generalist audience (developing a distinctive and acceptable style of interaction). [ABSTRACT FROM AUTHOR]

multi-methodical approach has been applied for characterizing the bulk and surface crystal chemical features of a high-temperature vesuvianite crystal from skarns of Mount Somma-Vesuvius Volcano (Naples, Italy). Vesuvianite belongs to the space group P4/ nnc with unit cell parameters a = 15.633(1) Å, c = 11.834(1) Å and chemical formula (Ca Na Ba K Sr □) (Al Ti Mg Mn Fe Fe Cr B) Si(O F OH). Structure refinement, which converges at R = 0.0328, demonstrates a strong positional disorder down the fourfold axes, indicating that the Y1 site is split into two positions (Y1A and Y1B) alternatively occupied. However, because of X4 proximity to Y1B and Y1A, X4 cannot be occupied if Y1B or Y1A are. Overall Y1 occupancy (Y1A + Y1B) reaches approximately 0.5, as common in vesuvianite and occupancy of Y1B site is extremely limited. Moreover, T1 position, limitedly occupied, accommodates the excess of cations generally related to Y position. A small quantity (0.202 apfu) of boron is sited at the T2 site that, like T1, is poorly occupied. The determination of the amount of each element on the (100) vesuvianite surface, obtained through X-ray photoelectron spectroscopy high-resolution spectra in the region of the Si, Al, Mg, and Ca core levels, evidences that a greater amount of aluminum and a smaller amount of calcium characterize the surface with respect to the bulk. Although both of these features require further investigation, we may consider the Al increase can be related to preferential orientation of Al-rich sites on the (100) plane. Furthermore, the surface structure of vesuvianite suggests that Al, Ca, and Mg cations maintain coordination features at the surface similar to the bulk. Silica, however, while presenting fourfold coordination, shows also a [1]-fold small coordinated component at binding energy 99.85 eV, due to broken Si-O bonds at the surface. The presence of eight- and nine-coordinated Ca cations is suggested by a large XPS feature resulting from the merging of Ca and Ca peaks at 348.45 and 352.05 eV, respectively. [ABSTRACT FROM AUTHOR]

Background: Information on the treatment of pancreatic endocrine tumours (PETs) comes mostly from small, retrospective, uncontrolled studies. Methods: Newly diagnosed, histologically proven PETs, observed from June 2004 to March 2007 in 24 Italian centres, were included in a specific dataset. Results: Three-hundred and ten patients (mean age 57.6 years, females 46.6%) were analysed. At the time of recruitment, 262 (84.5%) underwent surgery. The percentage of operated patients was 91.9% and 62.0% in surgical and non-surgical centres, respectively. A curative resection was carried out in 83.6% ( n = 219) of cases, a palliative resection (debulking) in 10.7% ( n = 28), an exploratory laparotomy in 4.6% ( n = 12), and a bypass procedure in 1.1% ( n = 3). Laparoscopy was performed in 8.0% ( n = 21) of cases. Resection consisted of a pancreatoduodenectomy in 46 cases (21.0%), a distal pancreatectomy in 95 (43.4%), an enucleation in 50 (22.8%), a middle pancreatectomy in 16 (7.3%) and a total pancreatectomy in 12 (5.5%). Liver resection was associated with pancreatic resection in 26 cases (9.9%). Post-operative mortality was 1.5% and morbidity 39.7%, respectively. A curative resection was performed more frequently in asymptomatic, small, non-metastatic, benign and at uncertain behaviour tumours, with low Ki67 values. Conclusions: This study strongly indicates the fact that surgical resection represents the cornerstone treatment of PETs. [ABSTRACT FROM AUTHOR]

Microprobe analysis, single crystal X-ray diffraction, X-ray photoelectron spectroscopy, atomic force microscopy, and X-ray absorption spectroscopy were applied on Fe-rich osumilite from the volcanic massif of Mt. Arci, Sardinia, Italy. Osumilite belongs to the space group P6/ mcc with unit cell parameters a = 10.1550(6), c = 14.306(1) Å and chemical formula (K) (Na) (Si Al) (Al Fe) (Mg Mn Fe)O. Structure refinement converged at R = 0.0201. Unit cell parameter a is related to octahedral edge length as well as to Fe content, unlike the c parameter which does not seem to be affected by chemical composition. The determination of the amount of each element on the mineral surface, obtained through X-ray photoelectron spectroscopy high-resolution spectra in the region of the Si, Al, Mg and Fe core levels, suggests that Fe presents Fe oxidation state and octahedral coordination. Two peaks at 103.1 and 100.6 eV can be related to Si and Si components, respectively, both in tetrahedral coordination. The binding energy of Al, at 74.5 eV, indicates that Al is mostly present in the distorted T2 site, whereas the Mg peak at 1,305.2 eV suggests that this cation is located at the octahedral site. X-ray absorption at the Fe L-edges confirms that iron is present in the mineral structure, prevalently in the divalent state and at the A octahedral site. [ABSTRACT FROM AUTHOR]

During past decades, a number of ports worldwide have suffered extensive earthquake-related damage. As seaports play a key role in the world's economy, their seismic performance should be enhanced, clearly stated and reliably pursued by designers. This work focuses on seismic vulnerability of wharves in Italy. According to a recently carried out statistical study, most of the existing wharves are gravity-type, made of superimposed, dry-connected blocks, particularly in older facilities. Such technology is widely in use worldwide but it has not attracted much research interest so far. In the present study, the validity of current, simplified design approaches has been investigated by comparison with the results of inelastic dynamic time-history analyses. Permanent displacements of the wall blocks have been calculated. Available performance criteria have been reviewed. A real wharf structure in the Port of Ancona (Italy) has been studied in depth, as a methodological example. For such structure, a parametric study has been conducted with the aim of investigating the role played by different design parameters and to assess the validity of the widely in use pseudo-static method. [ABSTRACT FROM AUTHOR]

Simulating the population dynamics of a stage-structured population requires the knowledge of development, mortality and fecundity rate functions characterizing the species. In general, development and fecundity can satisfactorily be estimated starting from literature data. Unfortunately, this is often not the case for the mortality function due to the lack of experimental data. To overcome this problem, we estimate the mortality rate function from field data on the abundance of the species. The mortality is expressed as a linear combination of cubic splines and the estimation method allows to determine its coefficients taking into account the observations measurement error. Moreover, the variability in the estimate is quantified using the confidence bands for both mortality and dynamics. The presented method allows obtaining a more flexible shape for the mortality rate functions compared with previous methods applied to the same pest. The method has been applied to the case of Lobesia botrana , the main pest in the European vineyards, with abundance data collected for five consecutive years in an experimental field in the North of Italy. Data collected over three years are used to estimate the mortality and to analyse the variability in the estimate and its effects on the population dynamics, while the other two datasets are used to validate the model simulating the dynamics using the estimated mortality. • The dynamics of a population is characterized by its biodemographic functions. • An estimation method of the mortality function driven by field data is presented. • The mortality is expressed as a linear combination of cubic splines. • The method allows to obtain a flexible shape of the mortality rate function. • An application to the vineyard pest Lobesia botrana is considered. [ABSTRACT FROM AUTHOR]

Background: The natural history after surgery for chronic pancreatitis is rarely reported.Methods: Between 1970 and 1999, 174 patients underwent surgery for chronic pancreatitis and were followed until December 2006. They were divided in four groups: (1) resection 62; (2) drainage 82; (3) external drainage 7; (4) non-pancreas-directed surgery 23. A second procedure was required by 25 patients and a third by four: group 1 = 6 + 0, group 2 = 10 + 2, group 3 = 3 + 1, group 4 = 6 + 1.Results: Hospital mortality was four of 174 (2.3%). Fifty-seven patients are alive; 49 of 170 developed cancer, and 38 died: lung (22), oral, pharynx, larynx (eight), esophagus, kidney, pancreas, colon, liver (two each), breast, stomach, mediastinum, prostate, melanoma, chronic myelogenous leukemia, squamous cancer of the auricle (one each), liver metastasis from unknown primary (two). Fifteen patients died of liver cirrhosis, 13 of myocardial infarction/decompensation, six of vascular problems, five each of acute renal insufficiency or cerebral diseases, four each of acute pancreatitis, accidental trauma, complications of diabetes, bronchopneumonia, and 19 of other causes. The overall 5-, 10-, 15-, 20-, 25-, and 30-year survival rate was 84.7, 65.6, 51.6, 38.0, 28.1, and 23.5.Conclusions: Incidence of pancreatic cancer was 1.2%. The high incidence of smoking cancers (18.8%) is explained by the smoking habits of almost 100% of our patients. Eliminating smoking and increasing tests on organs at risk may prolong survival. [ABSTRACT FROM AUTHOR]

Fusarium wilt of lettuce, caused worldwide by Fusarium oxysporum f. sp. lactucae, is an emerging seed-transmitted disease on Lactuca sativa. In order to develop a molecular diagnostic tool for identifying race I (VCGO300) of the pathogen on vegetable samples, an effective technique is presented. Inter-retrotransposon amplified polymorphism polymerase chain reaction (PCR), a technique based on the amplification of genomic regions between long terminal repeats, was applied. It was shown to be useful for grouping F oxysporum f. sp. lactucae race I isolates. Inter-retrotransposon sequence-characterized amplified regions (IR-SCAR) was used to develop a specific set of PCR primers to be utilized for differentiating F oxysporum f. sp. lactucae isolates from other F oxysporum isolates. The specific primers were able to uniquely amplify fungal genomic DNA from race I isolates obtained in Italy, Portugal, the United States, Japan, and Taiwan. The primers also were specific to pathogen DNA obtained from artificially infected lettuce seed and naturally and artificially infected plants. [ABSTRACT FROM AUTHOR]

From 2002 to 2004, wilted plants of different species of rocket ( Eruca vesicaria and Diplotaxis spp.) were found for the first time in Europe, in greenhouse cultivations in Piedmont and Lombardy, northern Italy. The causal agent of the disease was found to be Fusarium oxysporum. Vegetative compatibility analysis was carried out on 46 isolates of the fungus, 41 of them obtained from wilted rocket ( E. vesicaria and D. tenuifolia) and five reference strains, in order to increase the knowledge on the causal agent of recent epidemics of Fusarium wilt on rocket in Italy. The analysis showed the presence of two vegetative compatibility groups (VCGs) (VCG 0101 and VCG 0220) pathogenic on both kinds of rocket. The two VCG populations, which were classified as formae speciales conglutinans and raphani, respectively, are spread in the area of epidemics but are not related to the host species from which they were isolated ( D. tenuifolia or E. vesicaria). This finding shows the heterogeneity of the causal agent of Fusarium wilt on rocket in Italy. [ABSTRACT FROM AUTHOR]

The article presents a critical analysis of the development of digital interactive television services in Italy. In the 1990s, the Italian television broadcasting system has seen a period characterized by unequal development, which has forcefully introduced different time and modality zones for its diverse components to come into action, for example, network, technology, market, regularization, and social uses. The introduction of new digital interactive television services in Italy have brought about a revolution in the television broadcasting industry. The recognition of the actual offer of interactive TV seems in the first place, about confirming the models of development and configuration already outlined in the first phase of experimentation and orientations on the selection of additional contents and on interaction in the form of surveys and games.

The article analyses social discourses about the Internet in Italy from the mid-1990s onwards, taking its examples from advertising. Beyond the individual campaigns and their subjects there have been two distinct trends in Internet advertising. The first has made an effort to build the Internet as a cognitive object, the second has presented the Internet as a 'possible world'. The article aims to account for the ways in which the Web has been thematized in Italy: its fields of reference, and how its possible social and personal uses have been anticipated. [ABSTRACT FROM AUTHOR]

Investigates the prevalence of yeasts and bacteria in milk samples from dairy cows of Umbria, Italy and the effect on mammary glands in terms of somatic cell count. Species of yeast and bacterial commonly encountered; Pathogens contributing to bovine mastitis; Implementation of epidemiological and sanitary correlation.

OBJECTIVE-- Wolfram syndrome is an autosomal recessive neurodegenerative disorder characterized by diabetes insipidus, diabetes (nonautoimmune), optic atrophy, and deafness (a set of conditions referred to as DIDMOAD). The WFS1 gene is located on the short arm of chromosome 4. Wolfram syndrome prevalence is 1 in 770,000 live births, with a 1 in 354 carrier frequency. RESEARCH DESIGN AND METHODS-- We evaluated six Italian children from five unrelated families. Genetic analysis for Wolfram syndrome was performed by PCR amplification and direct sequencing. RESULTS-- Mutation screening revealed five distinct variants, one novel mutation (c.1346C>T; p.T449I) and four previously described, all located in exon 8. CONCLUSIONS-- Phenotype-genotype correlation is difficult, and the same mutation gives very different phenotypes. Severely inactivating mutations result in a more severe phenotype than mildly inactivating ones. Clinical follow-up showed the progressive syndrome's seriousness. [ABSTRACT FROM AUTHOR]

Data on antimicrobial use (AMU) in heavy pig production (>150 kg) are limited. The aim of this study was to investigate the AMU in this production. Data from 2015 were collected for 143 fattening farms. The AMU was estimated through a treatment index per 100 days (TI100) using the defined daily dose animal for Italy (DDDAit). When possible, a comparison with the European Medicines Agency's defined daily doses for animals (DDDvet) was performed. The median TI100 was 10.7 (range, 0.2–49.5). Group treatments represented 94.6% of overall consumption. The AMU calculated using DDDAit and DDDvet were strongly correlated (ρ = 0.976; p < 0.001). The AMU was negatively correlated with injectables use (ρ = −0.46, p < 0.001) and positively correlated with oral products (ρ = 0.21, p = 0.014), premixes (ρ = 0.26, p = 0.002), and mortality (ρ = 0.18; p = 0.027). Farm size was negatively correlated with AMU (ρ = −0.29, p < 0.001). Smaller farms were more frequently above the median TI100 (odds ratio = 2.3, 95% confidence interval = 1.2–4.7), suggesting that they may have lower biosecurity and management standards. The results of this study should provide useful insights for the development of an Italian monitoring system. [ABSTRACT FROM AUTHOR]

Deoxynivalenol (DON) is the most frequently detected mycotoxin in beer. This study represents a comprehensive assessment of DON occurrence in beers from the Italian market. Seventy-two craft and industrial beer samples were tested using the RIDASCREEN DON® ELISA method. DON was found in all samples. The average DON contamination was 34.3 !g/L (range: 6.1 - 111.2 !g/L). The highest contamination level was found in a wheat-based sample. Our study determined that wheat-based beers have a higher DON contamination than barley-based beers. Further studies are needed to verify the role of single ingredients on the risk of DON accumulation in beers. [ABSTRACT FROM AUTHOR]

To investigate the activity of regorafenib in advanced solitary fibrous tumour (SFT). An Italian monocentric investigator-initiated exploratory single-arm Phase II trial was conducted of regorafenib in adult patients with advanced and progressive SFT, until progression or limiting toxicity. Prior treatment with antiangiogenics was allowed. Primary and secondary end-points were: overall response rate (ORR) by Choi criteria, and ORR by RECIST, progression-free survival (PFS), overall survival (OS). From January 2016 to February 2021, 18 patients were enroled [malignant-SFT = 13; dedifferentiated-SFT (D -SFT) = 4; typical-SFT (T-SFT) = 1]. Fourteen patients were pre-treated, in 12 cases with antiangiogenics (median [m-] lines of treatment = 3). Sixteen patients were evaluable for response (one screening failure; one early discontinuation). Six/16 (35.2%) required a definitive dose reduction. ORR by Choi was 37.5% (95% CI: 15.2–64.6), with 6/16 (37.5%) partial responses (PR), 6/16 (37.5%) stable disease (SD) and 4/16 (25%) progressions; 5/6 responses occurred in patients pre-treated with antiangiogenics. No responses were detected in D -SFT. Best RECIST responses were: 1/16 (6.2%) PR, 12/16 (75%) SD, 3/16 (18.8%) progressions. At 48.4 month m-FU, m-PFS by Choi was 4.7 (inter-quartile range: 2.4–13.1) months, with 31.2% patients progression-free at 1 year. Regorafenib showed activity in SFT, with 30% patients free-from-progression at one year. Responses were observed also in patients pretreated and refractory to another antiangiogenic agents. However, ORR and m-PFS were lower than reported with other antiangiogenics, and this was possibly due to discrepancies in the patient population and the high-rate of dose reductions. • Regorafenib (R) is active in advanced, progressive solitary fibrous tumour (SFT). • R activity was seen in typical-/malignant-SFT but not in dedifferentiated-SFT. • R was effective also in cases refractory to previous antiangiogenic agents. [ABSTRACT FROM AUTHOR]

Klebsiella pneumoniae is the most common Klebsiella species infecting animals and is one of the causing agents of mastitis in cows. The rise of antimicrobial resistance in K. pneumoniae , particularly in strains producing extended-spectrum β-lactamases (ESBLs) and/or carbapenemases, is of concern worldwide. Recently (Regulation UE No 2022/1255), carbapenems and cephalosporins in combination with β-lactamase inhibitors have been reserved only to human treatments in the European Union. The aim of this study was to investigate the role of cattle as carrier of human pathogenic carbapenem-resistant (CR) and ESBL-producing K. pneumoniae. On this purpose, a study involving 150 dairy farms in Parma province (Northern Italy) and 14 non replicate K. pneumoniae isolates from patients admitted at Parma University-Hospital was planned. Four multidrug resistant (MDR) K. pneumoniae strains were detected from 258 milk filters collected between 2019 and 2021. One carbapenemase KPC-3-positive K. pneumoniae ST307 (0.4 %; 95 % CI – 0.07 - 2.2) was detected in milk filters. The isolate also harboured OXA-9, CTX-M-15 and SHV-106 determinants, together with genes conferring resistance to aminoglycosides (aac(3′)-IIa, aph (3″)-Ib, aph (6)-Id), fluoroquinolones (oqxA, oqxB, qnrB1), phosphonic acids (fosA6), sulphonamides (sul2), tetracyclines (tet(A)6) and trimethoprim (dfrA14). One KPC-3-producing K. pneumoniae ST307 was identified also among the human isolates, thus suggesting a possible circulation of pathogens out of the clinical settings. The remaining three bovine isolates were MDR ESBL-producing K. pneumoniae characterized by different genomic profiles: CTX-M-15, TEM-1B and SHV-187 genes (ST513); CTX-M-15 and SHV-145 (ST307); SHV-187 and DHA-1 (ST307). Occurrence of ESBL-producing K. pneumoniae in milk filters was 1.2 % (95 % CI 0.4–3.4). All the isolates showed resistance to aminoglycosides, 3rd-generation cephalosporins, and fluoroquinolones. Among the human isolates, two multidrug resistant ESBL-producing K. pneumoniae ST307 were found, thus confirming the circulation of this high-risk lineage between humans and cattle. Our findings suggest that food-producing animals can carry human pathogenic microorganisms harboring resistance genes against carbapenems and 3rd-generation cephalosporins, even if not treated with such antimicrobials. Moreover, on the MDR K. pneumoniae farms, the antimicrobial use was much higher than the Italian median value, thus highlighting the importance of a more prudent use of antibiotics in animal productions. • First report of KPC-3-producing and ESBL- K. pneumoniae ST307 in bulk milk in Italy • Carbapenem- and ESBL-resistant K. pneumoniae detected in milk of non-treated cows. • Prudent use of antibiotics on farms could prevent increase in multidrug resistance. [ABSTRACT FROM AUTHOR]

• Allele-specific RT-qPCR assay for quantitative detection of the Omicron variant. • Assay validated against 10-month longitudinal wastewater treatment plant samples. • SARS-CoV-2 RNA concentrations and variant frequencies in wastewater agree with clinical data. • Assays reveal the rapid displacement of the Delta variant by the Omicron variant. • Assays derived enable accurate tracking of the dynamics of variant displacement. On November 26, 2021, the B.1.1.529 COVID-19 variant was classified as the Omicron variant of concern (VOC). Reports of higher transmissibility and potential immune evasion triggered flight bans and heightened health control measures across the world to stem its distribution. Wastewater-based surveillance has demonstrated to be a useful complement for clinical community-based tracking of SARS-CoV-2 variants. Using design principles of our previous assays that detect SARS-CoV-2 variants (Alpha and Delta), we developed an allele-specific RT-qPCR assay which simultaneously targets the stretch of mutations from Q493R to Q498R for quantitative detection of the Omicron variant in wastewater. We report their validation against 10-month longitudinal samples from the influent of a wastewater treatment plant in Italy. SARS-CoV-2 RNA concentrations and variant frequencies in wastewater determined using these variant assays agree with clinical cases, revealing rapid displacement of the Delta variant by the Omicron variant within three weeks. These variant trends, when mapped against vaccination rates, support clinical studies that found the rapid emergence of SARS-CoV-2 Omicron variant being associated with an infection advantage over Delta in vaccinated persons. These data reinforce the versatility, utility and accuracy of these open-sourced methods using allele-specific RT-qPCR for tracking the dynamics of variant displacement in communities through wastewater for informed public health responses. [Display omitted] [ABSTRACT FROM AUTHOR]

Several strategies have been in place in food animal production to reduce the unnecessary use of antimicrobial agents. Beyond the monitoring of their use, the evaluation of the effect of these strategies on the occurrence and types of antimicrobial resistance (AMR) associated genes is crucial to untangle the potential emergence and spread of AMR to humans through the food chain. In the present study, the occurrence of these genes was evaluated in commensal Escherichia coli isolated from broiler carcasses "produced without the use of antibiotics" in 3 antibiotic-free (AB -free) farms in Italy in 2019. Sequenced data were analyzed along with publicly available genomes of E. coli collected in Italy from the broiler food chain from previous years (2017–2018). The genetic relationships among all 93 genomes were assessed on de novo assemblies by in silico MLST and SNP calling. Moreover, the resistomes of all genomes were investigated. According to SNP calling, genomes were gathered in three clades. Clade A encompassed, among others, ST117, ST8070, and ST1011 genomes. ST10 belonged to clade B, whereas Clade C included ST58, ST297, ST1101, and ST23 among others. Regarding the occurrence of AMR genes, a statistically significant lower occurrence of these genes in the genomes of this study in comparison to the public genomes was observed considering the whole group of genes as well as genes specifically conferring resistance to aminoglycosides, β-lactams, phenicols, trimethoprim, and lincosamides. Moreover, significant reductions were observed by comparing the whole group of AMR associated mutations, as well as those specifically for fluoroquinolones and fosfomycin resistance. Although the identification of 3° generation cephalosporin resistance associated genes in AB-free E. coli is a concern, this study provides a first indication of the impact of a more prudent use of antimicrobial agents on the occurrence of AMR genes in Italian broiler production chain. More studies are needed in next years on a higher number of genomes to confirm this preliminary observation. [ABSTRACT FROM AUTHOR]

Objective: To evaluate serum total inhibin (the sum of precursors, subunits, and mature molecules of inhibin) along with inhibin A and inhibin B in a large sample of women with polycystic ovary syndrome (PCOS) and to investigate whether these parameters differ between lean and overweight PCOS patients. Design: Cross-sectional, controlled study. Setting: Academic health centers in Siena and Bologna, Italy. Patient(s): A group of women with PCOS (n = 145) was divided according to body mass index (BMI) into “lean PCOS” (BMI 19–25 kg/m2, n = 52) and “overweight PCOS” (BMI 26–51 kg/m2, n = 93). A group of healthy women (n = 90) with BMI 19–24 kg/m2 and a history of regular menstrual cycles and normal results on physical examination served as controls. Intervention(s): Blood samples were drawn between cycle days 3 and 5 in PCOS patients and controls. Main Outcome Measure(s): Serum concentrations of total inhibin, inhibin A, inhibin B, FSH, and LH were measured using commercially available immunoassays. Result(s): Women with PCOS had serum total inhibin levels twice as high as in the control group (median = 115 vs. 47 pg/mL). Dimeric inhibin A concentration was lower in the PCOS group compared with controls (10 vs. 25 pg/mL), whereas inhibin B concentration did not differ significantly between PCOS and control groups. There was no difference of either total inhibin or inhibin A levels between lean and overweight women with PCOS, whereas the inhibin B level was higher in the lean PCOS subgroup compared with the overweight PCOS subgroup. Total inhibin did not show any linear correlation with inhibin B, inhibin A, or serum gonadotropins. Conclusion(s): Women with PCOS have high serum concentration of total inhibin but not of inhibin A or inhibin B, thus suggesting that PCOS women have an impaired processing of α-inhibin precursor proteins. [Copyright &y& Elsevier]

Abstract: GCK gene analysis in an Italian MODY patient revealed a novel synonymous substitution in exon 4 (c.459T>G; p.Pro153Pro) resulting in an aberrant transcript lacking the last eight codons of the same exon. Our findings emphazise the importance of not underestimating synonymous variations when screening for disease-causing mutations. [Copyright &y& Elsevier]

Objective: The objective of this study was to replicate an association study on a newly collected Italian autism spectrum disorder (ASD) cohort by studying the genetic markers associated with ASDs from recent genome-wide and candidate gene association studies., Methods: We have genotyped 746 individuals from 227 families of the Italian Autism Network using allelic discrimination TaqMan assays for seven common single-nucleotide polymorphisms: rs2292813 (SLC25A12 gene), rs35678 (ATP2B2 gene), rs4307059 (between CDH9 and CDH10 genes), rs10513025 (between SEMA5A and TAS2R1 genes), rs6872664 (PITX1 gene), rs1861972 (EN2 gene), and rs4141463 (MACROD2 gene). A family-based association study was conducted., Results: A significant association was found for two of seven markers: rs4307059 T allele (odds ratio: 1.758, SE=0.236; P-value=0.017) and rs35678 TC genotype (odds ratio: 0.528, SE=0.199; P-value=0.0013)., Conclusion: A preferential allele transmission of two markers located at loci previously associated with social and verbal communication skill has been confirmed in patients of a new ASD family sample.

Deaths caused by pulmonary thromboembolism (PTE) are often of forensic interest, due to the frequent preexistence of a traumatic event the suddeness of death, and possible professional responsibility. Early diagnosis of vein thromboembolism is often difficult. Fatal PTE usually presents itself on an unexpected and large scale, chronologically occurring shortly before death and thus irreconcilable with any consequent efficacious therapy. Pharmacological prophylaxis, aiming at reducing the state of blood hypercoagulability, is the elective therapeutic strategy for vein thromboembolism. These are the premises for this work which, after a brief pharmacological and clinical description of heparin prophylaxis and a review of data emerging from a sample of 24 deaths due to PTE, makes some considerations regarding professional responsibility.