Hospital discharges-based search of acute flaccid paralysis cases 2007-2016 in Italy and comparison with the National Surveillance System for monitoring the risk of polio reintroduction

Background: Acute flaccid paralysis (AFP) surveillance has been adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Hereby, to evaluate the completeness of the ascertainment of AFP cases in Italy, a hospital-discharges based search was carried out. Methods: AFP cases occurring between 2007 and 2016 among children under 15 years of age were searched in the Italian Hospital Discharge Records (HDR) database using specific ICD-9-CM diagnostic codes. AFP cases identified between 2015 and 2016 were then compared with those notified to the National Surveillance System (NSS). Results: Over a 10-year period, 4163 hospital discharges with diagnosis of AFP were reported in Italy. Among these, 956 (23.0%) were acute infective polyneuritis, 1803 (43.3%) myopathy, and 1408 (33.8%) encephalitis, myelitis and encephalomyelitis. During the study period, a decreasing trend was observed for all diagnoses and overall the annual incidence rate (IR) declined from 5.5 to 4.5 per 100,000 children. Comparing NSS with HDR data in 2015-2016, we found a remarkable underreporting, being AFP cases from NSS only 14% of those recorded in HDR. In particular, the acute infective polyneuritis cases reported to NSS accounted for 42.6% of those detected in HDR, while only 0.9% of myopathy cases and 13.1% of encephalitis/myelitis/encephalomyelitis cases have been notified to NSS. The highest AFP IRs per 100,000 children calculated on HDR data were identified in Liguria (17.4), Sicily (5.7), and Veneto (5.1) Regions; regarding the AFP notified to the NSS, 11 out of 21 Regions failed to reach the number of expected cases (based on 1/100,000 rate), and the highest discrepancies were observed in the Northern Regions. Overall, the national AFP rate was equal to 0.6, therefore did not reach the target value. Conclusions: AFP surveillance data are the final measure of a country's progress towards polio eradication. The historical data obtained by the HDR have been useful to assess the completeness of the notification data and to identify the Regions with a low AFP ascertainment rate in order to improve the national surveillance system

Driving of Outer Belt Electron Loss by Solar Wind Dynamic Pressure Structures : Analysis of Balloon and Satellite Data

We present observations of similar to 10-60 min solar wind dynamic pressure structures that drive large-scale coherent similar to 20-100 keV electron loss from the outer radiation belt. A combination of simultaneous satellite and Balloon Array for Radiation-belt Relativistic Electron Losses (BARREL) observations on 11-12 January 2014 shows a close association between the pressure structures and precipitation as inferred from BARREL X-rays. Specifically, the structures drive radial ExB transport of electrons up to 1 Earth radii, modulating the free electron energy available for low-frequency plasmaspheric hiss growth, and subsequent hiss-induced loss cone scattering. The dynamic pressure structures, originating near the Sun and commonly observed advecting with the solar wind, are thus able to switch on scattering loss of electrons by hiss over a large spatial scale. Our results provide a direct link between solar wind pressure fluctuations and modulation of electron loss from the outer radiation belt and may explain long-period modulations and large-scale coherence of X-rays commonly observed in the BARREL data set. Plain Language Summary The Earth's low-density magnetosphere is a region of enclosed magnetic field lines that contains energetic electrons ranging from eV to MeV energies. These populations can be greatly enhanced in response to solar driving. Following enhancements, energetic electron populations are depleted on timescales of hours to days by various processes. One important depletion process occurs when an electromagnetic plasma wave called plasmaspheric hiss, which exists within a high plasma density region called the plasmasphere and its (occasional) radial extension called the plume, scatters energetic electrons into the atmosphere. In this paper, we show that these hiss waves can be switched on by compressions of the magnetosphere which occur in response to similar to 1 hr long pressure structures in the solar wind. These structures originate at or near the Sun and are very common in the solar wind at 1 AU. The newly excited hiss waves scatter electrons into the atmosphere where they are observed on balloon-borne X-ray detectors. Our results suggest that magnetospheric models that predict the loss of electrons from hiss waves may be improved by consideration of solar wind pressure-driven dynamics.Peer reviewe

Bright light exposure reduces TH-positive dopamine neurons: Implications of light pollution in Parkinson\u27s disease epidemiology

This study explores the effect of continuous exposure to bright light on neuromelanin formation and dopamine neuron survival in the substantia nigra. Twenty-one days after birth, Sprague–Dawley albino rats were divided into groups and raised under different conditions of light exposure. At the end of the irradiation period, rats were sacrificed and assayed for neuromelanin formation and number of tyrosine hydroxylase (TH)-positive neurons in the substantia nigra. The rats exposed to bright light for 20 days or 90 days showed a relatively greater number of neuromelanin-positive neurons. Surprisingly, TH-positive neurons decreased progressively in the substantia nigra reaching a significant 29% reduction after 90 days of continuous bright light exposure. This decrease was paralleled by a diminution of dopamine and its metabolite in the striatum. Remarkably, in preliminary analysis that accounted for population density, the age and race adjusted Parkinson's disease prevalence significantly correlated with average satellite-observed sky light pollution

Bright light exposure reduces TH-positive dopamine neurons: implications of light pollution in Parkinson's disease epidemiology.

This study explores the effect of continuous exposure to bright light on neuromelanin formation and dopamine neuron survival in the substantia nigra. Twenty-one days after birth, Sprague-Dawley albino rats were divided into groups and raised under different conditions of light exposure. At the end of the irradiation period, rats were sacrificed and assayed for neuromelanin formation and number of tyrosine hydroxylase (TH)-positive neurons in the substantia nigra. The rats exposed to bright light for 20 days or 90 days showed a relatively greater number of neuromelanin-positive neurons. Surprisingly, TH-positive neurons decreased progressively in the substantia nigra reaching a significant 29% reduction after 90 days of continuous bright light exposure. This decrease was paralleled by a diminution of dopamine and its metabolite in the striatum. Remarkably, in preliminary analysis that accounted for population density, the age and race adjusted Parkinson's disease prevalence significantly correlated with average satellite-observed sky light pollution

Counseling in fetal medicine: Congenital cytomegalovirus infection.

Although the clinical work-up of CMV in pregnancy has gradually become more accurate, counseling for CMV is still challenging. Despite the potential feasibility of universal prenatal serological screening, its introduction in prenatal diagnosis continues to raise concerns related to its real cost-effectiveness. Contextually, anticipating the confirmation of fetal infection earlier in pregnancy is one of the most pressing issues to reduce the parental psychological burden. Amniocentesis is still the gold standard and recent data have demonstrated that it could be performed before 20 weeks of gestation, provided that at least 8 weeks have elapsed from the presumed date of maternal seroconversion. New approaches, such as chorionic villus sampling (CVS) and virome DNA, even if not yet validated as confirmation of fetal infection, have been studied alternatively to amniocentesis to reduce the time-interval from maternal seroconversion and the amniocentesis results. Risk stratification for sensorineural hearing loss (SNHL) and long-term sequelae should be provided according to the prognostic predictors. Nevertheless, in the era of valacyclovir, maternal high-dose therapy, mainly for first trimester infections, can reduce the risk of vertical transmission and increase the likelihood of asymptomatic newborns, but it is still unclear whether valacyclovir continues to exert a beneficial effect on fetuses with positive amniocentesis. This review provides updated evidence-based key counseling points with GRADE recommendations

DART Impact Ejecta Plume Evolution: Implications for Dimorphos

The NASA Double Asteroid Redirection Test (DART) spacecraft impacted the moon Dimorphos of the [65803] Didymos binary system and changed the binary orbit period, demonstrating asteroid deflection by a kinetic impact and indicating that more momentum was transferred to Dimorphos by escaping impact ejecta than was incident with DART. Images of the DART impact ejecta plume were obtained by the Light Italian cubesat for Imaging of Asteroids (LICIACube) in the first few minutes after the DART impact. The ejecta plume imaged by LICIACube 158 s after the DART impact prior to closest approach shows no evidence for plume clearing at low altitude. The ejecta plume imaged 175 s after the DART impact is optically thick up to projected altitudes of 200 m above the surface of Dimorphos. These observations are compared with models of the impact ejecta plume optical depth, structure, and evolution, which are developed from point-source scaling models fitted to numerical simulations of the DART impact into a rubble pile Dimorphos with different material strengths. The observations of the impact plume optical depth and the high momentum transfer from the DART impact are not consistent with impact and ejecta plume models assuming the Dimorphos cohesive strength to be as high as 5000 Pa. Models with 5 and 50 Pa Dimorphos cohesive strength provide the overall best consistency with plume opacity observations and high momentum transfer

Hospital discharges-based search of acute flaccid paralysis cases 2007-2016 in Italy and comparison with the National Surveillance System for monitoring the risk of polio reintroduction

Background: Acute flaccid paralysis (AFP) surveillance has been adopted globally as a key strategy for monitoring the progress of the polio eradication initiative. Hereby, to evaluate the completeness of the ascertainment of AFP cases in Italy, a hospital-discharges based search was carried out. Methods: AFP cases occurring between 2007 and 2016 among children under 15 years of age were searched in the Italian Hospital Discharge Records (HDR) database using specific ICD-9-CM diagnostic codes. AFP cases identified between 2015 and 2016 were then compared with those notified to the National Surveillance System (NSS). Results: Over a 10-year period, 4163 hospital discharges with diagnosis of AFP were reported in Italy. Among these, 956 (23.0%) were acute infective polyneuritis, 1803 (43.3%) myopathy, and 1408 (33.8%) encephalitis, myelitis and encephalomyelitis. During the study period, a decreasing trend was observed for all diagnoses and overall the annual incidence rate (IR) declined from 5.5 to 4.5 per 100,000 children. Comparing NSS with HDR data in 2015-2016, we found a remarkable underreporting, being AFP cases from NSS only 14% of those recorded in HDR. In particular, the acute infective polyneuritis cases reported to NSS accounted for 42.6% of those detected in HDR, while only 0.9% of myopathy cases and 13.1% of encephalitis/myelitis/encephalomyelitis cases have been notified to NSS. The highest AFP IRs per 100,000 children calculated on HDR data were identified in Liguria (17.4), Sicily (5.7), and Veneto (5.1) Regions; regarding the AFP notified to the NSS, 11 out of 21 Regions failed to reach the number of expected cases (based on 1/100,000 rate), and the highest discrepancies were observed in the Northern Regions. Overall, the national AFP rate was equal to 0.6, therefore did not reach the target value. Conclusions: AFP surveillance data are the final measure of a country's progress towards polio eradication. The historical data obtained by the HDR have been useful to assess the completeness of the notification data and to identify the Regions with a low AFP ascertainment rate in order to improve the national surveillance system

The SSDC Role in the LICIACube Mission: Data Management and the MATISSE Tool

Light Italian Cubesat for Imaging of Asteroids (LICIACube) is an Italian mission managed by the Italian Space Agency (ASI) and part of the NASA Double Asteroid Redirection Test (DART) planetary defense mission. Its main goals are to document the effects of the DART impact on Dimorphos, the secondary member of the (65803) Didymos binary asteroid system, characterizing the shape of the target body and performing dedicated scientific investigations on it. Within this framework, the mission Science Operations Center will be managed by the Space Science Data Center (ASI-SSDC), which will have the responsibility of processing, archiving, and disseminating the data acquired by the two LICIACube onboard cameras. In order to better accomplish this task, SSDC also plans to use and modify its scientific webtool Multi-purpose Advanced Tool for Instruments for the solar system Exploration (MATISSE), making it the primary tool for the LICIACube data analysis, thanks to its advanced capabilities for searching and visualizing data, particularly useful for the irregular shapes common to several small bodies

Energetic electron precipitation driven by electromagnetic ion cyclotron waves from ELFIN's low altitude perspective

We review comprehensive observations of electromagnetic ion cyclotron (EMIC) wave-driven energetic electron precipitation using data from the energetic electron detector on the Electron Losses and Fields InvestigatioN (ELFIN) mission, two polar-orbiting low-altitude spinning CubeSats, measuring 50-5000 keV electrons with good pitch-angle and energy resolution. EMIC wave-driven precipitation exhibits a distinct signature in energy-spectrograms of the precipitating-to-trapped flux ratio: peaks at 0.5 MeV which are abrupt (bursty) with significant substructure (occasionally down to sub-second timescale). Multiple ELFIN passes over the same MLT sector allow us to study the spatial and temporal evolution of the EMIC wave - electron interaction region. Using two years of ELFIN data, we assemble a statistical database of 50 events of strong EMIC wave-driven precipitation. Most reside at L=5-7 at dusk, while a smaller subset exists at L=8-12 at post-midnight. The energies of the peak-precipitation ratio and of the half-peak precipitation ratio (our proxy for the minimum resonance energy) exhibit an L-shell dependence in good agreement with theoretical estimates based on prior statistical observations of EMIC wave power spectra. The precipitation ratio's spectral shape for the most intense events has an exponential falloff away from the peak (i.e., on either side of 1.45 MeV). It too agrees well with quasi-linear diffusion theory based on prior statistics of wave spectra. Sub-MeV electron precipitation observed concurrently with strong EMIC wave-driven 1MeV precipitation has a spectral shape that is consistent with efficient pitch-angle scattering down to 200-300 keV by much less intense higher frequency EMIC waves. These results confirm the critical role of EMIC waves in driving relativistic electron losses. Nonlinear effects may abound and require further investigation

Momentum transfer from the DART mission kinetic impact on asteroid Dimorphos

The NASA Double Asteroid Redirection Test (DART) mission performed a kinetic impact on asteroid Dimorphos, the satellite of the binary asteroid (65803) Didymos, at 23:14 UTC on 26 September 2022 as a planetary defence test1. DART was the first hypervelocity impact experiment on an asteroid at size and velocity scales relevant to planetary defence, intended to validate kinetic impact as a means of asteroid deflection. Here we report a determination of the momentum transferred to an asteroid by kinetic impact. On the basis of the change in the binary orbit period2, we find an instantaneous reduction in Dimorphos’s along-track orbital velocity component of 2.70 ± 0.10 mm s−1, indicating enhanced momentum transfer due to recoil from ejecta streams produced by the impact3,4. For a Dimorphos bulk density range of 1,500 to 3,300 kg m−3, we find that the expected value of the momentum enhancement factor, β, ranges between 2.2 and 4.9, depending on the mass of Dimorphos. If Dimorphos and Didymos are assumed to have equal densities of 2,400 kg m−3, β=3.61−0.25+0.19(1σ). These β values indicate that substantially more momentum was transferred to Dimorphos from the escaping impact ejecta than was incident with DART. Therefore, the DART kinetic impact was highly effective in deflecting the asteroid Dimorphos