Isolation and molecular typing of Leishmania infantum from Phlebotomus perfiliewi in a reemerging focus of leishmaniasis, Northeastern Italy

Visceral leishmaniasis (VL) caused by Leishmania (L.) infantum is a public health threat in the Emilia-Romagna region, northeastern Italy, but its epidemiology has not been fully elucidated in this area. The objective of this study was to characterize Leishmania infection in sand flies collected in a re-emerging focus of VL in the Bologna province. During the summer of 2016, 6114 sand flies were collected, identified, and tested for Leishmania detection. Of the identified sand flies, 96.5% were Phlebotomus (P.) perfiliewi and 3.5% were P. perniciosus. Detected parasites were characterized by biomolecular methods (multilocus microsatellite typing and characterization of repetitive region on chromosome 31), and quantified by real-time PCR. The prevalence of Leishmania infection in individually-tested P. perfiliewi sand flies varied from 6% to 10% with an increasing trend during the season. Promastigotes of L. infantum were isolated by dissection in one P. perfiliewi female; the isolated strain (Lein-pw) were closely related to Leishmania parasites from VL cases in northeastern Italy, but differed from strains isolated in dogs from the same area. Our findings strongly support the vector status of P. perfiliewi for human VL in the study area

Implementation of an enhanced recovery program after bariatric surgery: Clinical and cost-effectiveness analysis

Enhanced recovery after surgery (ERAS) programs are perioperative evidence-based interventions that have the purpose of making the perioperative pathway more efficient in safeguarding patient safety and quality of care. Recently, several ERAS components have been introduced in the setting of bariatric surgery (Enhanced Recovery After Bariatric Surgery, ERABS). The aim of the present study was to evaluate clinical efficiency and cost-effectiveness of the implementation of an ERABS program. It was a retrospective case-control study comparing a group of adult obese (body mass index >40) patients treated according to the ERABS protocol (2014-2015) with a historical control group that received standard care (2013-2014) in the General and Emergency Surgery Department, Arcispedale S. Maria Nuova Hospital, Reggio Emilia, Italy. Data on the occurrence of complications, mortality, re-admissions and re-operations were extracted retrospectively from medical case notes and emergency patient admission lists. Length of hospital stay was significantly different between the two cohort patients. In the control group, the mean length of stay was 12.6±10.9 days, whereas in the ERABS cohort it was 7.1±2.9 days (p=0.02). During hospital stay, seven patients in the control group developed surgical complications, including one patient with major complications, whereas in the ERABS group three patients developed minor complications. Economic analysis revealed a different cost distribution between the two groups. On the whole, there were significant savings for almost all the variables taken into consideration, mainly driven by exclusion of using intensive care unit, which is by far more expensive than the average cost of post-anesthesia care unit. Our study confirmed the implementation of an ERABS protocol to have shortened hospital stay and was cost-saving while safeguarding patient safety

Longitudinal study of Salmonella infection in four Italian farrow-to finish swine herds

A longitudinal study of Salmonella enterica infection was carried out in 4 Italian farrow-to-finish swine herds. In each herd 5 litters were randomly selected and in each litter 6 piglets ear tagged. Thus, on each farm 30 pigs were included in the study. Individual blood samples were collected for serologic examination at weaning from all piglets and in the same day from all sows 1n the farrowing unit. Piglets were bled again at approximately 60, 90, 150, 210 and 270 days of life with the last blood sample collected at slaughtering. In one herd, in which the duration of productive cycle was about 12 months, the last blood samples was collected at 350 days of life. 5 pen pooled faecal samples were collected from each herd for bacteriological examination with the same time schedule of blood samples. At slaughtering mesenteric lymph nodes were collected from each ear tagged pig. Sera-prevalence (cutoff S/P ratio 0,25) in sows varied from 93,8% to 100%. In all herds sera-prevalence in piglets showed a similar profile with complete decline of maternal antibodies at day 60 and clear sera-conversion between day 90 and day 150. The peak of sera-prevalence was observed between day 210 and day 270. Sera-prevalence at slaughtering varied from 66% to 100%. Salmonella was isolated from faecal samples in 3 out of 4 herds. No Salmonella was isolated from mesenteric lymph nodes at slaughter in 2 herds. Culture prevalence from mesenteric lymph nodes in the other herds was respectively 3,3% and 30%. This longitudinal study provides original information about epidemiological dynamics of Salmonella enterica infection in Italian swine herds in consideration of the typical longer fattening cycles

Numerical algorithm to recover contrast dynamics in 3D digital subtraction angiography data-sets: a preliminary clinical validation

Several neurosurgical procedures, such as ArteroVenous Malformations (AVMs) and StereoElectroEncephaloGraphy (SEEG) require accurate reconstruction of the cerebral vascular tree, as well as the classification of arteries and veins, to increase the safety of the intervention. We propose ART-3.5D, a novel approach to recover the dynamic information from standard Cone Beam Computed Tomography Angiography scans based on the post- processing of both the segmented angiogram and the raw data-set

Detection of specific antibodies against toscana virus among blood donors in northeastern Italy and correlation with sand fly abundance in 2014

Toscana virus (TOSV) is a Phlebovirus transmitted by phlebotomine sand flies and is an important etiological agent of summer meningitis in the Mediterranean basin. Since TOSV infection is often asymptomatic, we evaluated the seroprevalence in blood donors (BDs) in the Bologna and Ferrara provinces (Northeastern Italy)\u2014the areas with the highest and lowest numbers of TOSV neuroinvasive cases in the region, respectively. A total of 1208 serum samples from BDs were collected in April\u2013June 2014 and evaluated for the presence of specific TOSV-IgG by ELISA. The IgG-reactive samples were confirmed by indirect immunofluorescence assay (IIF) and by microneutralization test (MN). Serum samples were defined as positive for anti-TOSV IgG when reactive by ELISA and by at least one second-level test; TOSV seroprevalence was 6.8% in the Bologna province, while no circulation of TOSV was detected in the Ferrara province. Sand fly abundance in 2014 was also estimated by a geographic information system using a generalized linear model applied to a series of explanatory variables. TOSV seroprevalence rate was strongly associated with the sand fly abundance index in each municipality, pointing out the strong association between sand fly abundance and human exposure to TOSV

Antimicrobial Resistance Profile and ExPEC Virulence Potential in Commensal <i>Escherichia coli</i> of Multiple Sources.

We recently described the genetic antimicrobial resistance and virulence profile of a collection of 279 commensal E. coli of food-producing animal (FPA), pet, wildlife and human origin. Phenotypic antimicrobial resistance (AMR) and the role of commensal E. coli as reservoir of extra-intestinal pathogenic Escherichia coli (ExPEC) virulence-associated genes (VAGs) or as potential ExPEC pathogens were evaluated. The most common phenotypic resistance was to tetracycline (76/279, 27.24%), sulfamethoxazole/trimethoprim (73/279, 26.16%), streptomycin and sulfisoxazole (71/279, 25.45% both) among the overall collection. Poultry and rabbit were the sources mostly associated to AMR, with a significant resistance rate (p > 0.01) to quinolones, streptomycin, sulphonamides, tetracycline and, only for poultry, to ampicillin and chloramphenicol. Finally, rabbit was the source mostly associated to colistin resistance. Different pandemic (ST69/69*, ST95, ST131) and emerging (ST10/ST10*, ST23, ST58, ST117, ST405, ST648) ExPEC sequence types (STs) were identified among the collection, especially in poultry source. Both ST groups carried high number of ExPEC VAGs (pandemic ExPEC STs, mean = 8.92; emerging ExPEC STs, mean = 6.43) and showed phenotypic resistance to different antimicrobials (pandemic ExPEC STs, mean = 2.23; emerging ExPEC STs, mean = 2.43), suggesting their role as potential ExPEC pathogens. Variable phenotypic resistance and ExPEC VAG distribution was also observed in uncommon ExPEC lineages, suggesting commensal flora as a potential reservoir of virulence (mean = 3.80) and antimicrobial resistance (mean = 1.69) determinants

Effect of production process and high-pressure processing on viability of Listeria innocua in traditional Italian dry-cured coppa

In this study the effect of the application of High Pressure Treatment (HPP) combined with four different manufacturing processes on the inactivation of Listeria innocua, used as a surrogate for L. monocytogenes, in artificially contaminated coppa samples was evaluated in order to verify the most suitable strategy to meet the Listeria inactivation requirements needed for the exportation of dry-cured meat in the U.S. Fresh anatomical cuts intended for coppa production were supplied by four different delicatessen factories located in Northern Italy. Raw meat underwent experimental contamination with Listeria innocua using a mixture of 5 strains. Surface contamination of the fresh anatomical cuts was carried out by immersion into inoculum containing Listeria spp. The conditions of the HPP treatment were: pressure 593 MPa, time 290 seconds, water treatment temperature 14\ub0C. Listeria innocua was enumerated on surface and deep samples post contamination, resting, ripening and HPP treatment. The results of this study show how the reduction of the microbial load on coppa during the production process did not vary among three companies (P&gt;0.05) ranging from 3.73 to 4.30 log CFU/g, while it was significantly different (P&lt;0.01) for the fourth company (0.92 log CFU/g). HPP treatment resulted in a significant (P&lt;0.01) deep decrease of L. innocua count with values ranging between 1.63-3.54 log CFU/g with no significant differences between companies. Regarding superficial contamination, HPP treatment resulted significant (P&lt;0.01) only in Coppa produced by two companies. The results highlight that there were processes less effective to inhibit the pathogen; in particular for company D an increase of L. innocua count was shown during processing and HPP alone cannot be able to in reaching the Listeria inactivation requirements needed for exportation of dry-cured meat in the U.S. According to the data reported in this paper, HPP treatment increases the ability of the manufacturing process of coppa in reducing Listeria count with the objective of a lethality treatment

Effect of production process and high-pressure processing on viability of Salmonella spp. in traditional Italian dry-cured coppa

The aim of the study was to investigate the combined effect of the manufacturing process followed by HPP treatment on the inactivation of Salmonella spp. in artificially contaminated coppa samples, in order to verify the ability of the combined processes to achieve the objective of a 5-log reduction of Salmonella spp. needed for exportation to the U.S. Fresh anatomical cuts intended for coppa production were supplied by four different delicatessen factories located in Northern Italy. Raw meat underwent experimental contamination with Salmonella spp. using a mixture of 3 strains. Surface contamination of the fresh anatomical cuts was carried out by immersion into inoculum containing Salmonella spp. The conditions of the HPP treatment were: pressure 593 MPa, time 290 seconds, water treatment temperature 14\ub0C. Surface and deep samples were performed post contamination (T0), end of the cold phase (T1), end of process (Tend), and after HPP treatment (postHPP) and Salmonella spp. Enumerated. The results of this study show a significant reduction of Salmonella spp. all through the production process (P&lt;0.01) for all companies, followed by an additional reduction of bacterial counts due to HPP treatment (P&lt;0.01), both in superficial and deep contaminations (P&lt;0.01). The superficial overall reduction resulted of 1.58 to 5.04 log CFU/g during the production process. HPP treatment resulted in a significant (P&lt;0.01) superficial and deep decrease in Salmonella spp. enumeration varying from 0.61 to 4.01 log and from 1.49 to 4.13 log. According to the data presented in this study, only the combined approach of coppa manufacturing process followed by HPP treatment always led to a 5-log reduction of Salmonella spp. required by USDA/FSIS guidelines

Tsunami evacuation times and routes to safe zones: a GIS-based approach to tsunami evacuation planning on the island of Stromboli, Italy

Funder: IDEX-ISITE initiative16-IDEX-0001 (CAP 20-25)AbstractWhile a landslide at the volcanic island of Stromboli (Aeolian Islands, Italy) in December 2002 created a tsunami with a run-up of 10.9 m, two paroxysmal eruptions in the summer of 2019 caused a tsunami with an amplitude of 40 to 20 cm. All three events required rapid, spontaneous emergency evacuations of the beach zone as the time between tsunami generation and impact is around 4 min. These conditions thus require a special consideration of the issue of evacuation capabilities on the island in the event of a volcanogenic tsunami. The purpose of this paper is thus to (i) determine pedestrian evacuation times from high-risk coastal areas to safe zones, (ii) to assess building evacuation ease, and (iii) determine emergency evacuation plans (for buildings and coastal zones). For this purpose, we created a GIS-based risk analysis/mapping tool that also allowed macroscopic evacuation modelling. In our case, the high-risk zone to be evacuated involves an area extending to 10 m a.s.l. and involving 123 individual buildings over an area of 0.18 km2. The results show that 33% of the buildings can be evacuated in 4 min, and that a 10-min warning time is required for a complete and well-distributed evacuation whereby the population is evenly distributed between all evacuation exits to avoid the potential for congestion. Initial interviews of residents in the at-risk zone reveal a high level of awareness and a desire for personalized evacuation scenarios.</jats:p