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Background: Disorders of consciousness (DoC) refers to a group of clinical conditions of altered consciousness. To improve their diagnosis and prognosis, multimodal assessment can be of great importance. Informal caregivers of people with DoC who are confronted with new technologies as such can benefit from interventions to expand their health literacy, i.e., the ability to use information to make health decisions for oneself and others. Methods: We developed an information brochure on multimodal assessment for DoC in a participatory process, with decisions made by a steering group. The process was based on a methodological framework for the development of patient decision aids that built on the International Patient Decision Aid Standards (IPDAS). Results: On the background of a broad variety of needs, the priority was to focus on the explanation of multimodal testing and provide information about its uncertainty. Its development aimed at enhancing informal caregivers' understanding of implications of results from multimodal assessment and its relevance for prognosis. It should avoid the portrayal of information that could lead to the impression of false hope or suboptimal rehabilitation care. Informal caregivers rated its usability and acceptability highly, though they preferred less technical language. Conclusion: The participatory process was crucial to the project. Future studies should investigate the effectiveness of the brochure in fostering informal caregivers' health literacy. Patient or Public Contribution: Informal caregivers of people with DoC were deliberately included in the steering group and they participated in a field test of the prototype brochure. [ABSTRACT FROM AUTHOR]

The response of the San Pietro monumental bell-tower located in Perugia, Italy, to the 2016 Central Italy seismic sequence is investigated, taking advantage of the availability of field data recorded by a vibration-based SHM system installed in December 2014 to detect earthquake-induced damages. The tower is located about 85 km in the NW direction from the epicenter of the first major shock of the sequence, the Accumoli Mw6.0 earthquake of August 24th, resulting in a small local PGA of about 30 cm/s, whereby near-field PGA was measured as 915.97 cm/s (E-W component) and 445.59 cm/s (N-S component). Similar PGA values also characterized the two other major shocks of the sequence (Ussita Mw5.9 and Norcia Mw6.5 earthquakes of October 26th and 30th, respectively). Despite the relatively low intensity of such earthquakes in Perugia, the analysis of long-term monitoring data clearly highlights that small permanent changes in the structural behavior of the bell-tower have occurred after the earthquakes, with decreases in all identified natural frequencies. Such natural frequency decays are fully consistent with what predicted by non-linear finite element simulations and, in particular, with the development of microcracks at the base of the columns of the belfry. Microcracks in these regions, and in the rest of tower, are however hardly distinguishable from pre-existing ones and from the physiological cracking of a masonry structure, what validates the effectiveness of the SHM system in detecting earthquake-induced damage at a stage where this is not yet detectable by visual inspections. [ABSTRACT FROM AUTHOR]

In Italy fluoroquinolones (FQs) are extensively prescribed in empirical therapy of uncomplicated urinary tract infection (UTI) despite recommendations in national guidelines and widespread antibiotic resistance in community. To survey the dissemination of plasmid-mediated quinolone resistance in a peak area of FQs consumption, E. coli strains from 154 community and 41 local hospital patients were collected; low level ciprofloxacin resistance qnrA, qnrB, qnrS, and aac(6)′-Ib-cr genes were screened by PCR and patterns of transferable resistances were determined. Clinical ciprofloxacin resistance in hospital doubled community value, while overall rates of FQ resistance genes were similar (31.6% and 27.8%). Prevalence of aac(6′)-Ib-cr gene was 11% in outpatients (21%, inpatients) and risk of harbouring this variant was significantly associated with gentamicin resistance; linkage to ceftazidime resistance was significant ( P = 0.001) and six out of eight strains produced CTX-M-15 and TEM-1 beta lactamases. In transconjugants, the unique pattern ampicillin/kanamycin-gentamicin/ ESBL + was associated with aac(6′)-Ib-cr gene presence and with an increase of ciprofloxacin MIC value. Data highlight the need to monitor the resistance risk factors in the local community to provide clinicians with well-grounded guidelines for UTI therapy. [ABSTRACT FROM AUTHOR]

Abstract: A novel technique for monitoring of submarine groundwater discharge (SGD) in coastal zones based on an in situ underwater gamma-ray spectrometry of radon-decay products is described. Several sites were visited during the IAEA’2002 expedition offshore Donnalucata in the south-eastern Sicily. Continuous monitoring of 222Rn in the beach spring at Donnalucata has shown variable 222Rn activity concentrations in groundwater (from 12 to ), depending inversely on water levels during tide. Spatial variations of SGD have been observed in the Donnalucata boat basin. Average 222Rn activity concentrations in seawater varied from to , showing an inverse relationship with salinity. A continuous monitoring carried out at the site closest to the coast has also revealed an inverse relationship of 222Rn activity concentration on tide and salinity. The 222Rn concentrations in seawater varied from during high tides to during low tides, confirming the tidal influence on SGD. [Copyright &y& Elsevier]

We report clinical and molecular findings in 14 patients with cleidocranial dysplasia (CCD), a well defined skeletal disorder with characteristic clinical findings and autosomal dominant inheritance. We identified ten heterozygous base changes in the RUNX2 gene, including six novel mutations [c.522insA, c.389G>A (W130X), c.662T>G (V221G), IVS2+T>A, c.1111underscore;1129del19, and c.873underscore;874delCA]. We did not establish a clear correlation between clinical features and genotype, the phenotypes of all patients analyzed falling within the range of variation described in CCD without an effect related to the length of the predicted protein. In two cases, however, a limb‐girdle myopathy affecting the shoulder muscles was also identified. Our data add new variants to the repertoire of RUNX2 mutations in CCD. © 2003 Wiley‐Liss, Inc. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to produce a cross-cultural adaptation in Italian of the Agitated Behavior Scale (ABS), originally developed in English, as the first of two stages that also include cross-cultural validation and allow a clinical scale to be used in the proper setting such as rehabilitation units., Methods: In order to adapt the ABS scale to a different cultural environment, five consecutive steps were performed: (1) forward translations (n = 8), (2) synthesis of the 8 forward translations to obtain a first shared italian version (ABS_I_trial), (3) back translations (n = 3), (4) creation of an expert committee to evaluate forward and back translations and finally (5) the cognitive debriefing., Results: After the five steps, including forward translations and back translations, the process of committee verification and judgement and the evaluative step of cognitive debriefing, high comprehensibility of all items was found, resulting in an Italian translation version of ABS suitable for application in a clinical setting., Conclusion: ABS translation was produced by means of a standardized procedure aimed at minimizing cross-cultural gaps. The expert committee evaluated the version produced as highly understandable in Italian. Further steps, such as the subsequent validation of its psychometric properties, are needed to employ this translation in a clinical setting.

Purpose : SARS-CoV-2 infection can cause the coronavirus disease (COVID), ranging from flu-like symptoms to interstitial pneumonia. Mortality is high in COVID pneumonia and it is the highest among the frailest. COVID could be particularly serious in patients with severe acquired brain injury (SABI), such as those with a disorder of consciousness. We here describe a cohort of patients with a disorder of consciousness exposed to SARS-CoV-2 early after their SABI. Materials and methods : The full cohort of 11 patients with SABI hospitalized in March 2020 in the IRCCS Fondazione Don Gnocchi rehabilitation (Milan, Italy) was recruited. Participants received SARS-CoV-2 testing and different clinical and laboratory data were collected. Results : Six patients contracted SARS-CoV-2 and four of them developed the COVID. Of these, one patient had ground-glass opacities on the chest CT scan, while the remaining three developed consolidations. No patient died and the overall respiratory involvement was mild, requiring in the worst cases low-flow oxygen. Conclusions : Here we report the clinical course of a cohort of patients with SABI exposed to SARS-CoV-2. The infection spread among patients and caused COVID in some of them. Unexpectedly, COVID was moderate, caused at most mild respiratory distress and did not result in fatalities.

Prevalence, genetic characteristics, and EcoRI cleavage analysis of plasmids identified in clinical strains of Salmonella wien isolated in recent years showed that the plasmid content in this serotype has remained uniform and stable over more than a decade and also late in the epidemic history. No correlation between decrease in S. wien isolations and naturally occurring systematic changes in the DNA of its most common FIme plasmid was structurally detectable.