SARS-CoV-2 Translocate from Nasopharyngeal to Bronchoalveolar Site: A Case Presentation

The nasopharyngeal swab is commonly used for the diagnosis of SARS-CoV-2 infection. Since the swab is performed in this site, of course, it cannot detect the presence of the virus in other tissue districts such as the lung, brain, or bowel. In the present case report, the nasopharyngeal swab was negative twice. From this, the patient discontinued antiviral therapy. Nasopharyngeal swabs were maintained negative until five days later, when we recorded a severe impairment of the patient’s clinical condition. At this time, the bronchoalveolar lavage was positive for SARS-CoV-2. The purpose of the case herein described is to suggest paying attention to the nasopharyngeal swab result. A negative detection in nasopharyngeal swab could not be indicative of COVID-19 recovery

A discussion of the links between solar variability and high-storm-surge events in Venice

This study explores the long-term frequency variability of high-surge events (HSEs) in the North Adriatic, the so-called acqua alta, which, particularly during autumn, cause flooding of the historical city center of Venice. The period 1948-2008, when hourly observations of sea level are available, is considered. The frequency of HSEs is correlated with the 11 year solar cycle, solar maxima being associated with a significant increase in the October-November-December HSE frequency. The seasonal geopotential height pattern at 1000 hPa (storm surge pattern; SSP) associated with the increased frequency of HSEs is identified for the whole time period and found to be similar to the positive phase of the main variability mode of the regional atmospheric circulation (empirical orthogonal function 1; EOF1). However, further analysis indicates that solar activity modulates the spatial patterns of the atmospheric circulation (EOF) and the favorable conditions for HSE occurrence (SSP). Under solar maxima, the occurrence of HSEs is enhanced by the main mode of regional atmospheric variability, namely, a large-scale wave train pattern that is symptomatic of storm track paths over northern Europe. Solar minima reveal a substantially different and less robust SSP, consisting of a meridionally oriented dipole with a preferred southward path of storm track activity, which is not associated with any dominant mode of atmospheric variability during low-solar periods. It is concluded that solar activity plays an indirect role in the frequency of HSEs by modulating the spatial patterns of the main modes of atmospheric regional variability, the favorable patterns for HSE occurrence, and their mutual relationships, so that constructive interaction between them is enhanced during solar maxima and inhibited in solar minima

Restoring tactile sensations via neural interfaces for real-time force-and-slippage closed-loop control of bionic hands

Despite previous studies on the restoration of tactile sensation to the fingers and the hand, there are no examples of use of the routed sensory information to finely control a prosthestic hand in complex grasp and manipulation tasks. Here, it is shown that force and slippage sensations can be elicited in an amputee by means of biologically inspired slippage detection and encoding algorithms, supported by a stick-slip model of the performed grasp. A combination of cuff and intraneural electrodes was implanted for 11 weeks in a young woman with hand amputation and was shown to provide close-to-natural force and slippage sensations, paramount for substantially improving manipulative skills with the prosthesis. Evidence is provided about the improvement of the participant's grasping and manipulation capabilities over time resulting from neural feedback. The elicited tactile sensations enabled the successful fulfillment of fine grasp and manipulation tasks with increasing complexity. Grasp performance was quantitatively assessed by means of instrumented objects and a purposely developed metrics. Closed-loop control capabilities enabled by the neural feedback were compared with those achieved without feedback. Further, the work demonstrates that the described amelioration of motor performance in dexterous tasks had as central neurophysiological correlates changes in motor cortical plasticity and that such changes were not of purely motor origin, but were the effect of a strong and persistent drive of the sensory feedback. \ua9 2019 The Authors, some rights reserved

Introduction

The heterogeneous nature of the Mediterranean environment, combined with a wide diversity of socio-economic and cultural identities, make this region particularly amenable to integrated research on climate change impacts, vulnerabilities, and adaptive response. Eleven case-study locations have been strategically selected to represent three generic Mediterranean environments (urban, rural and coastal). While each case study location comprises a unique and complex set of climate-related issues, the range and scope of the case studies allows identification of common lessons and messages for the wider Mediterranean region. The aim is to perform an integrated assessment of climate impacts, vulnerability and adaptation at a regional to local scale. A risk-based \u2018bottom up\u2019 approach (based on regional stakeholder dialogue) is combined with a \u2018top down\u2019 case-study indicator assessment focused on a common conceptual and methodological framework

Past and Current Climate Changes in the Mediterranean Region

Mediterranean climate change during the last 60 years is based on homogenized daily temperature and quality controlled precipitation observational data and gridded products. The estimated changes indicate statistically significant Mediterranean summer temperature increase and a reduction in winter precipitation in specific areas. Reconstructions of Mediterranean sea level suggest a rise of some 150 mm since the beginning of the nineteenth century. A 20 years long reanalysis (1985–2007) was produced, showing long term temperature variability and a positive salinity trend in the ocean layers from the surface to 1,500 m depth. A prominent increase in summer temperature extremes is found in the whole Mediterranean region, while warm bias in the mid twentieth century station data is removed by homogenization. No basin-wide trends in precipitation and droughts are found for the second half of the twentieth century, while trends in extreme winds are largely negative, as are those of the related cyclones and cut-off-lows. The role of large scale pressure patterns like the NAO for variabilities and trends is discussed for the different parameters considered

Adherence to antibiotic treatment guidelines and outcomes in the hospitalized elderly with different types of pneumonia

Background: Few studies evaluated the clinical outcomes of Community Acquired Pneumonia (CAP), Hospital-Acquired Pneumonia (HAP) and Health Care-Associated Pneumonia (HCAP) in relation to the adherence of antibiotic treatment to the guidelines of the Infectious Diseases Society of America (IDSA) and the American Thoracic Society (ATS) in hospitalized elderly people (65 years or older). Methods: Data were obtained from REPOSI, a prospective registry held in 87 Italian internal medicine and geriatric wards. Patients with a diagnosis of pneumonia (ICD-9 480-487) or prescribed with an antibiotic for pneumonia as indication were selected. The empirical antibiotic regimen was defined to be adherent to guidelines if concordant with the treatment regimens recommended by IDSA/ATS for CAP, HAP, and HCAP. Outcomes were assessed by logistic regression models. Results: A diagnosis of pneumonia was made in 317 patients. Only 38.8% of them received an empirical antibiotic regimen that was adherent to guidelines. However, no significant association was found between adherence to guidelines and outcomes. Having HAP, older age, and higher CIRS severity index were the main factors associated with in-hospital mortality. Conclusions: The adherence to antibiotic treatment guidelines was poor, particularly for HAP and HCAP, suggesting the need for more adherence to the optimal management of antibiotics in the elderly with pneumonia