Habitat characterization of the Carso Triestino on ornithological and floristic-vegetational bases

The aim of this study is to determine the correlation between nesting bird species richness in different natural habitats of the Triestine Carso and the corresponding floristic and vegetational types

pKBuS13, a KPC-2-Encoding Plasmid from Klebsiella pneumoniae Sequence Type 833, Carrying Tn4401b Inserted into an Xer Site-Specific Recombination Locus

Here, we report the first detection of a Klebsiella pneumoniae carbapenemase 2 (KPC-2)-producing Klebsiella pneumoniae strain belonging to sequence type 833 (ST833), collected in an Italian hospital from a patient coming from South America. Its bla KPC determinant was carried by a ColE1 plasmid, pKBuS13, that showed the Tn4401b::bla KPC-2 transposon inserted into the regulatory region of an Xer site-specific recombination locus. This interfered with the correct resolution of plasmid multimers into monomers, lowering plasmid stability and leading to overestimation of the number of plasmids harbored by a single host cell. Sequencing of the fragments adjacent to Tn4401b detected a region that did not have significant matches in databases other than the genome of a carbapenem-resistant Escherichia coli strain collected during the same year at a hospital in Boston. This is interesting in an epidemiologic context, as it suggests that despite the absence of tra genes and the instability under nonselective conditions, the circulation of pKBuS13 or of analogous plasmids might be wider than reported

Genome sequence analysis of the first human West Nile virus isolated in Italy in 2009.

In 2009, six new human cases of West Nile neuroinvasive disease (WNND) were identified in Veneto region, following the six cases already reported in 2008. A human West Nile virus (WNV) isolate was obtained for the first time from an asymptomatic blood donor. Whole genome sequence of the human WNV isolate showed close phylogenetic relatedness to the Italy-1998-WNV strain and to other WNV strains recently isolated in Europe, with the new acquisition of the NS3-Thr249Pro mutation, a trait associated with avian virulence, increased virus transmission, and the occurrence of outbreaks in humans

Brief intensive observation areas in the management of acute heart failure in elderly patients leading to high stabilisation rate and less admissions

Objectives. Acute heart failure is major cause of hospitalisation in Western countries. As patients with acute heart failure cannot be admitted directly to the wards, they stay in emergency rooms, causing access block. Brief Intensive Observation areas are holding units dedicated to the stabilisation of patients requiring close monitoring. However, these units have been associated with acute exacerbation of heart failure. This study aimed to evaluate the impact of Brief Intensive Observation areas on the management of acute heart failure in elderly patients. Methods. This retrospective, single-centred observational study analysed patients who presented in the emergency room with acute heart failure in 2017 and divided them into two cohorts: those treated in the Brief Intensive Observation and those who were not. The reduction of colour codes at discharge, mortality rate within the emergency rooms, hospitalisation rate, rate of transfer to less intensive facilities and readmission rate at 7, 14 and 30 days after discharge were compared. Results. Of the 694 patients, 62% were transferred to the Brief Intensive Observation for stabilisation. Age and sex between the cohorts were not significantly different. However, compared to non-Brief Intensive Observation patients, the Brief Intensive Observation patients had worse clinical conditions on arrival and longer stabilisation period. The stabilisation rate was higher in Brief Intensive Observation patients than in non-Brief Intensive Observation patients. Conclusions. Brief Intensive Observation areas allows effective stabilisation of elderly patients, better management of beds, reduced admission rates and reduced use of high intensity care unit beds

Hubble Space Telescope survey of the Perseus Cluster -III: The effect of local environment on dwarf galaxies

We present the results of a Hubble Space Telescope (HST) study of dwarf galaxies in the outer regions of the nearby rich Perseus Cluster, down to M_V = -12, and compare these with the dwarf population in the cluster core from our previous HST imaging. In this paper we examine how properties such as the colour magnitude relation, structure and morphology are affected by environment for the lowest mass galaxies. Dwarf galaxies are excellent tracers of the effects of environment due to their low masses, allowing us to derive their environmentally based evolution, which is more subtle in more massive galaxies. We identify 11 dwarf elliptical (dE) and dwarf spheroidal (dSph) galaxies in the outer regions of Perseus, all of which are previously unstudied. We measure the (V-I)_0 colours of our newly discovered dEs, and find that these dwarfs lie on the same red sequence as those in the cluster core. The morphologies of these dwarfs are examined by quantifying their light distributions using CAS parameters, and we find that dEs in the cluster outskirts are on average more disturbed than those in the core, with =0.13\pm0.09 and =0.18\pm0.08, compared to =0.02\pm0.04, =0.01\pm0.07 for those in the core. Based on these results, we infer that these objects are ``transition dwarfs'', likely in the process of transforming from late-type to early type galaxies as they infall into the cluster, with their colours transforming before their structures. When we compare the number counts for both the core and outer regions of the cluster, we find that below M_V = -12, the counts in the outer regions of the cluster exceed those in the core. This is evidence that in the very dense region of the cluster, dwarfs are unable to survive unless they are sufficiently massive to prevent their disruption by the cluster potential and interactions with other galaxies.Comment: 14 pages, 11 figures. MNRAS accepte

Colorectal Cancer Stage at Diagnosis Before vs During the COVID-19 Pandemic in Italy

IMPORTANCE Delays in screening programs and the reluctance of patients to seek medical attention because of the outbreak of SARS-CoV-2 could be associated with the risk of more advanced colorectal cancers at diagnosis. OBJECTIVE To evaluate whether the SARS-CoV-2 pandemic was associated with more advanced oncologic stage and change in clinical presentation for patients with colorectal cancer. DESIGN, SETTING, AND PARTICIPANTS This retrospective, multicenter cohort study included all 17 938 adult patients who underwent surgery for colorectal cancer from March 1, 2020, to December 31, 2021 (pandemic period), and from January 1, 2018, to February 29, 2020 (prepandemic period), in 81 participating centers in Italy, including tertiary centers and community hospitals. Follow-up was 30 days from surgery. EXPOSURES Any type of surgical procedure for colorectal cancer, including explorative surgery, palliative procedures, and atypical or segmental resections. MAIN OUTCOMES AND MEASURES The primary outcome was advanced stage of colorectal cancer at diagnosis. Secondary outcomes were distant metastasis, T4 stage, aggressive biology (defined as cancer with at least 1 of the following characteristics: signet ring cells, mucinous tumor, budding, lymphovascular invasion, perineural invasion, and lymphangitis), stenotic lesion, emergency surgery, and palliative surgery. The independent association between the pandemic period and the outcomes was assessed using multivariate random-effects logistic regression, with hospital as the cluster variable. RESULTS A total of 17 938 patients (10 007 men [55.8%]; mean [SD] age, 70.6 [12.2] years) underwent surgery for colorectal cancer: 7796 (43.5%) during the pandemic period and 10 142 (56.5%) during the prepandemic period. Logistic regression indicated that the pandemic period was significantly associated with an increased rate of advanced-stage colorectal cancer (odds ratio [OR], 1.07; 95%CI, 1.01-1.13; P = .03), aggressive biology (OR, 1.32; 95%CI, 1.15-1.53; P < .001), and stenotic lesions (OR, 1.15; 95%CI, 1.01-1.31; P = .03). CONCLUSIONS AND RELEVANCE This cohort study suggests a significant association between the SARS-CoV-2 pandemic and the risk of a more advanced oncologic stage at diagnosis among patients undergoing surgery for colorectal cancer and might indicate a potential reduction of survival for these patients

Mapping genomic loci implicates genes and synaptic biology in schizophrenia

Schizophrenia has a heritability of 60-80%1, much of which is attributable to common risk alleles. Here, in a two-stage genome-wide association study of up to 76,755 individuals with schizophrenia and 243,649 control individuals, we report common variant associations at 287 distinct genomic loci. Associations were concentrated in genes that are expressed in excitatory and inhibitory neurons of the central nervous system, but not in other tissues or cell types. Using fine-mapping and functional genomic data, we identify 120 genes (106 protein-coding) that are likely to underpin associations at some of these loci, including 16 genes with credible causal non-synonymous or untranslated region variation. We also implicate fundamental processes related to neuronal function, including synaptic organization, differentiation and transmission. Fine-mapped candidates were enriched for genes associated with rare disruptive coding variants in people with schizophrenia, including the glutamate receptor subunit GRIN2A and transcription factor SP4, and were also enriched for genes implicated by such variants in neurodevelopmental disorders. We identify biological processes relevant to schizophrenia pathophysiology; show convergence of common and rare variant associations in schizophrenia and neurodevelopmental disorders; and provide a resource of prioritized genes and variants to advance mechanistic studies