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Intravenous administration of zidovudine (ZDV) during labour is a key step for vertical HIV transmission (VT) prevention, but there is no evidence of benefit when maternal HIV-RNA at delivery is50 copies/mL. The aim of this study is evaluating the appropriateness of intrapartum ZDV use in Italy.Observational study including mother-infant pairs with perinatal HIV exposure during 2002-2019, enrolled in the Italian Register for HIV Infection in Children. Univariable and multivariable logistic regression were used to evaluate factors associated with VT.A total of 3,861 infants, born from 3,791 pregnancies were included. The frequency of ZDV use was 79.9%, 92.1%, 93.7% and 92.8% when HIV-RNA was not available, ≥400 copies, between 50 and 399 copies, and50 copies/mL. Thirty-three out of 3861 (0.85%) infants were subsequently diagnosed with HIV, 25/3861 (0.6%) of them born to mothers receiving intrapartum ZDV, and 31 (93.9%) to mothers with HIV-RNA ≥50 copies/mL or not available. In women with HIV-RNA50 copies/mL, ART discontinuation during pregnancy was the strongest risk factor for VT (odds ratio, OR, 23.1, 95%CI 2.4-219.3), while a higher gestational age (OR 0.6, 95%CI 0.4-0.8) and PEP administration to the newborn (aOR 0.004, 95%CI0.0001-0.4) were protective factors. Intrapartum ZDV administration did not influence the final outcome in this group.In ART era, more transmission events may occur in utero, limiting value of intrapartum ZDV, particularly for women with suppressed HIV-RNA load. More attention to the HIV-RNA testing of mothers before delivery may avoid unnecessary ZDV use.

Management of iron deficiency (ID) and iron deficiency anemia (IDA) is primarily focused to remove, when possible, the underlying cause of ID; subsequently its treatment is primary focused on iron stores repletion. Ferrous sulphate (FS) remains the mainstay of treatment and it is recommended as the first-line treatment of ID and IDA in children as in adults by all guidelines of scientific societies. However the effectiveness of FS is largely compromised by increased adverse effects, poor compliance and discontinuation of treatment. A new oral iron source named FERALGINE™ (FBC-A) has been recently developed. This new molecule is a patented co-processed one-to-one ratio compound between Ferrous Bysglicinate Chelate (FBC) and Sodium Alginate (AA), obtained by using a spray drying technology. The data presented in this short review highlight the efficacy and safety of the treatment with FBC-A and support its use in adult patients with IDA. Furthermore the present review also provides preliminary evidence to suggest FBC-A as first-line treatment for ID/IDA in patients with celiac disease (CD) or inflammatory bowel diseases (IBD).

Cloud segmentation of remotely sensed multispectral images is an important topic not only for weather forecast but, more in general, for establishing when the sensed data actually relate to the soil so that can be reliably used for some monitoring purpose. In this work, leveraging on the capability of convolutional neural networks to accurately approximate complex relationships between raw data and higher-level products, we propose a U-Net-like solution conceived for Sentinel-2 images. In order to face the scarsity of training data, a proper domain adaptation strategy has been pursued, which resorts to a labeled Landsat-8 dataset. Preliminary results show a consistent improvement over standard tools.

The iron absorption process developsmainly in the proximal duodenum. This portion of the intestine is typically destroyed in celiac disease (CD), resulting in a reduction in absorption of iron and subsequent iron deficiency anemia (IDA). In fact, the most frequent extra-intestinal manifestation (EIM) of CD is IDA, with a prevalence between 12 and 82% (in relation with the various reports) in patients with new CD diagnosis. The primary treatment of CD is the gluten-free diet (GFD), which is associated with adequate management of IDA, if present. Iron replacement treatment historically has been based on oral products containing ferrous sulphate (FS). However, the absorption of FS is limited in patients with active CD and unpredictable in patients on a GFD. Furthermore, a poor tolerability of this kind of ferrous is particularly frequent in patients with CD or with other inflammatory bowel diseases. Normalization from anemic state typically occurs after at least 6 months of GFD, but the process can take up to 2 years for iron stores to replenish.

Objetivando-se avaliar os efeitos do calcário e do gesso e suas interações nas propriedades químicas de alguns solos e na produtividade agrícola da cana-de-açúcar, foram instalados quatro experimentos em unidades sucro-alcooleiras do Estado de São Paulo, sendo dois com aplicação destes insumos em pré-plantio e dois em soqueiras da cultura. Um dos experimentos em condição de pré-plantio foi instalado em março/abril de 1988 no município de Guariba, Usina Bonfim, Fazenda Santo Antonio da Estiva em um Latossolo Vermelho Escuro distrófico textura argilosa (LEd). O outro foi instalado em maio de 1989 no município de Olímpia, Usina Cruz Alta, Fazenda Momplazier em um Podzólico Vermelho Amarelo distrófico textura média/argilosa (PVm/arg). Os dois experimentos de soqueiras foram instalados em 1989, no município de Lençóis Paulista, Usina Barra Grande, sendo um em Latossolo Vermelho Amarelo Podzólico álico (LVp) e outro em Latossolo Roxo álico (LRa). Foram adotadas doses e combinações de calcário e gesso, em pré-plantio e soqueiras, cujos níveis variaram desde quantidades abaixo das recomendadas usualmente, para a cana-de-açúcar, até quantidades consideradas muito elevadas. Os resultados obtidos indicaram, para os solos estudados, efeito altamente benéfico, tanto do calcário como do gesso, nos atributos químicos e parâmetros de fertilidade analisados. O gesso mostrou-se bastante eficiente em promover, num menor período de tempo, melhor distribuição de cálcio e magnésio nos perfis de solos, enquanto que os maiores efeitos do calcário restringiram-se às camadas da superfície. A combinação de ambos proporcionou os melhores resultados de distribuição dos nutrientes nos perfis. A maior rapidez na modificação dos atributos químicos dos solos, verificada para o gesso, proporcionou, a curto e médio prazos (12-30 meses), incrementos na produtividade agrícola da cana-de-açúcar, tanto para aplicação em pré-plantio como para aplicação em soqueiras, respectivamente para o LEd e para o LRa. Paralelamente, o calcário, quando aplicado em pré-plantio ou em soqueiras, apresentou efeitos altamente benéficos na produtividade agrícola a médio e longo prazos (24-36 meses), para os dois latossolos argilosos citados, complementando, desta forma, os efeitos do gesso. Apesar das modificações benéficas proporcionadas pelo gesso nos atributos químicos do PVm/arg, o mesmo apresentou efeitos depreciativos na produtividade agrícola da cana-de-açúcar cultivada no sol o em questão. Verificou-se, neste caso, apenas influência benéfica do calcário. A utilização de gesso em doses bastante elevadas não provocou modificações drásticas nos atributos químicos dos solos, nem refletiu em decréscimos da produtividade agrícola da cana-de-açúcar, indicando que existe limite de solubilidade imposto pelo próprio gesso e influenciado pela forma de aplicação e incorporação, além de condições edafoclimáticas. Four experirnents where conducted in sugar cane mills in São Paulo State (Brazil) with the purpose of evaluating the effect of lime and phosphogypsum and its interaction on chemical properties of some soils on crop productivity of sugar cane. Two experiments were with pre-planting application and two with ratoon application. One of the pre-planting experiments began in March/April 1988 in Guariba, São Paulo State, at the Bonfim sugar cane mill, on a clayey Latossolo Vermelho Escuro Distrófico, LEd, (Typic Haplorthox), and the other one in May 1989 in Olímpia, São Paulo State, at the Cruz Alta sugar cane mill, on a medium/clayey textured Podzólico Vermelho Amarelo Distrófico, PVm/arg, (Typic Paleudult). The two ratoon application experiments began in 1989 in Lençóis Paulista at the Usina Barra Grande, one on a Latossolo Vermelho Amarelo Podzólico Alico (Quartzipsammentic Haplorthox) and the other on a Latossolo Roxo Alico (Typic Haplorthox). The rates of lime and phosphogypsum application and its combinations in pre-planting and ratoon application varied from very low, beneath usually recommended quantities, to very high rates. The results indicated a very beneficial effect of lime and phosphogypsum on soil chemical attributes and on the fertility parameters analyzed. Phosphogypsum showed to be very efficient in promoting in a short time a better distribution of Ca and Mg in soil profile, and on the other hand, lime effects were restricted to the surface layer. The combination of both yielded the best result s in nutriente distribution in the soil profile. The more rapid effects of phosphogypsum on soil chemical attributes, provided a fast increase in sugar cane crop productivity on pre-planting and ratoon application, i.e. 12 months for the LEd and 30 months for the LRd. On the other hand, lime, when applied in pre-planting or on ratoon, showed benefits on crop productivity on the longer term, i.e. 24 and 36 months for the two previous soils, completing, in this way the effect of phosphogypsum. Despite the beneficial effect of phosphogypsum on soil chemical propert ies of the PVm/arg there was no effect on crop productivity. In this case only lime increased productivity. The use of phosphogypsum in very high rates did not provoke drastic changes on soil chemical attributes, neither decreased crop productivity, indicating that there is a solubility limit from the own product, influenced by the way of application and incorporation and by soil and climate conditions.

The rise of deep learning has impacted profoundly all aspects of image processing and remote sensing. Following this trend, in the last few years, a large number of data-driven methods have been proposed also for SAR image despeckling. However, in spite of this large effort, only limited performance gains have been observed. We believe this is mostly due to the use of training sets that are only partially fit to the task, and sometimes plain wrong. In this work we assess experimentally the impact of training set design on the performance of SAR image despeckling with the goal of highlighting solid guidelines for sensible training.

Objectives The study evaluates the trend over time and the results of serological screening for hepatitis C infection in pregnancy and obstetric and neonatal outcomes. Study design It is a retrospective observational study of all pregnant women delivered in maternity units in Trento province, North East Italy, between 2009-2018. Serological screening data for hepatitis C virus were collected through the birth attendance certificate that is the mandatory tool in Italy for the birth report and the monitoring of the pregnancy, childbirth and health of the newborn. We also used the informations collected in the Hospital information system in order to get, for confirmed positive cases, the data of the entire serological profile. On this basis, we calculated the coverage of serological screening, the seroprevalence of the infection and the obstetric and neonatal outcomes. Results A total of 45,493 pregnant women were analysed, 75.5% Italians and 24.5% foreigners. The mean coverage for serological HCV screening in pregnancy was 99.4%. 177 women tested positive for HCV antibodies (107 Italian and 70 foreign women). Mean overall seroprevalence in pregnant women was 3.9‰ (95% CI: 3.8-4.0); amongst Italians it was 3.2‰ (95% CI: 3.0-3.4) and amongst foreigners it was 6.1‰ (95% CI: 5.9-6.2). The highest seroprevalence was recorded in mothers coming from Asian countries. HCV positive mothers present an excess risk for intrahepatic cholestasis and gestational diabetes compared to HCV negative mothers. The neonatal outcomes considered bring to light a statistically significant increase in preterm births, low birth weight, elective Caesarean births, hospitalisation at birth and bottle- or mixed-feeding vs breast-only feeding. There are differences in obstetric and neonatal outcomes in relation to the HCV positive subgroup of the mother defined in particular by exposure to smoke and/or opioids. Conclusions The availability and integration of current information sources allows you to verify compliance with national recommendations on the serological screening of hepatitis C virus infection, to determine infection seroprevalence, the characteristics of the cases and the obstetric and neonatal outcomes. Only part of the maternal and neonatal outcomes studied can be attributed to the presence of HCV.

The COVID-19 outbreak is having a significant impact on both cardiac rehabilitation (CR) inpatient and outpatient healthcare organization. The variety of clinical and care scenarios we are observing in Italy depends on the region, the organization of local services and the hospital involved. Some hospital wards have been closed to make room to dedicated beds or to quarantine the exposed health personnel. In other cases, CR units have been converted or transformed into COVID-19 units. The present document aims at defining the state of the art of CR during COVID-19 pandemic, through the description of the clinical and management scenarios frequently observed during this period and the exploration of the future frontiers in the management of cardiac rehabilitation programs after the COVID-19 outbreak.

Published on behalf of the European Society of Cardiology. All rights reserved. © The Author(s) 2020. For permissions, please email: journals.permissions@oup.com., This Delphi consensus by 28 experts from the European Association of Preventive Cardiology (EAPC) provides initial recommendations on how cardiovascular rehabilitation (CR) facilities should modulate their activities in view of the ongoing coronavirus disease 2019 (COVID-19) pandemic. A total number of 150 statements were selected and graded by Likert scale [from -5 (strongly disagree) to +5 (strongly agree)], starting from six open-ended questions on (i) referral criteria, (ii) optimal timing and setting, (iii) core components, (iv) structure-based metrics, (v) process-based metrics, and (vi) quality indicators. Consensus was reached on 58 (39%) statements, 48 'for' and 10 'against' respectively, mainly in the field of referral, core components, and structure of CR activities, in a comprehensive way suitable for managing cardiac COVID-19 patients. Panelists oriented consensus towards maintaining usual activities on traditional patient groups referred to CR, without significant downgrading of intervention in case of COVID-19 as a comorbidity. Moreover, it has been suggested to consider COVID-19 patients as a referral group to CR per se when the viral disease is complicated by acute cardiovascular (CV) events; in these patients, the potential development of COVID-related CV sequelae, as well as of pulmonary arterial hypertension, needs to be focused. This framework might be used to orient organization and operational of CR programmes during the COVID-19 crisis.

Strategies for prevention of HIV-1 mother-to-child transmission (PMTCT) have been continuously optimized. However, cases of vertical transmission continue to occur in high-income countries.To investigate changes in PMTCT strategies adopted by Italian clinicians over time and to evaluate risk factors for transmission.Data from mother-child pairs prospectively collected by the Italian Register, born in Italy in 1996-2016, were analyzed. Risk factors for MTCT were explored by logistic regression analyses.Six thousand five hundred three children (348 infections) were included. In our cohort, the proportion of children born to foreign mothers increased from 18.3% (563/3078) in 1996%-2003% to 66.2% (559/857) in 2011-2016 (P0.0001). Combination neonatal prophylaxis use significantly (P0.0001) increased over time, reaching 6.3% (56/857) after 2010, and it was largely (4.2%) adopted in early preterm infants. The proportion of vaginal deliveries in women with undetectable viral load (VL) increased over time and was 9.9% (85/857) in 2011-2016; no infection occurred among them. In children followed up since birth MTCT, rate was 3.5% (96/2783) in 1996-2003; 1.4% (36/2480) in 2004-2010; and 1.1% (9/835) in 2011-2016. At a multivariate analysis, factors associated with MTCT were vaginal delivery with detectable or missing VL or nonelective caesarean delivery, prematurity, breastfeeding, lack of maternal or neonatal antiretroviral therapy, detectable maternal VL, and age at first observation. Previously described increased risk of offspring of immigrant women was not confirmed.Risk of MTCT in Italy is ongoing, even in recent years, underling the need for implementation of the current screening program in pregnancy. Large combination neonatal prophylaxis use in preterm infants was observed, even if data on safety and efficacy in prematures are poor.

In this work, we face the problem of forest mapping from TanDEM-X data by means of Convolutional Neural Networks (CNNs). Our study aims to highlight the relevance of domain-related features for the extraction of the information of interest thanks to their joint nonlinear processing through CNN. In particular, we focus on the main InSAR features as the backscatter, coherence, and volume decorrelation, as well as the acquisition geometry through the local incidence angle. By using different state-of-the-art CNN architectures, our experiments consistently demonstrate the great potential of deep learning in data fusion for information extraction in the context of synthetic aperture radar signal processing and specifically for the task of forest mapping from TanDEM-X images. We compare three state-of-the-art CNN architectures, such as ResNet, DenseNet, and U-Net, obtaining a large performance gain over the baseline approach for all of them, with the U-Net solution being the most effective one.