Microbiological surveillance of plasmid mediated colistin resistance in human Enterobacteriaceae isolates in Romagna (Northern Italy): August 2016–July 2017

Objectives: To start a surveillance program to investigate the possible diffusion of mobilized colistin resistance genes in Enterobacteriaceae strains isolated in the Unit of Microbiology of the Great Romagna Hub Laboratory. Methods: All the colistin resistant Enterobacteriaceae, isolated from August 1st 2016 to July 31st 2017, were prospectively evaluated for mcr-1 and mcr-2. Backdated survey of mcr-3, mcr-4 and mcr-5 was performed on the same group of isolates. Species identification was achieved by Vitek MS and the antibiotic susceptibility testing was performed both with Vitek-2 and Sensititre systems. Colistin resistant isolates were screened by PCR for the presence of the plasmid-mediated colistin resistance genes and amplicons were verified by sequencing. All mcr-1 positive isolates were subjected to MLST analysis. Results: Over the total of 19053 isolates belonging to Enterobacteriaceae, 90 were colistin resistant. The presence of mcr-1 was detected in 26 Escherichia coli. The overall prevalence of mcr-1 was 0.14%. The mcr-1 positive E. coli strains were assigned to 13 distinct sequence types (STs) according to MLST. Conclusions: The prospective epidemiological survey carried out in our study gave a glimpse of the plasmid-mediated colistin resistance dissemination in Romagna. Since the prevalence rate of carbapenem resistant Enterobacteriaceae (CRE) in some hospital wards in our area is alarming, we underline the importance of a Surveillance Program to monitor the spread of the plasmid-mediated colistin resistance genes into MDR Gram-negative bacteria

Self-efficacy for coping. Utility of the Cancer behavior inventory (Italian) for use in palliative care

Background: Newer models of palliative and supportive cancer care view the person as an active agent in managing physical and psychosocial challenges. Therefore, personal efficacy is an integral part of this model. Due to the lack of instruments in Italian to assess coping self-efficacy, the present study included the translation and validation of the Italian version of the Cancer Behavior Inventory-Brief (CBI-B/I) and an initial analysis of the utility of self-efficacy for coping in an Italian sample of palliative care patients. Methods: 216 advanced cancer patients who attended palliative care clinics were enrolled. The CBI-B/I was administered along with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30), the Mini Mental Adjustment to Cancer Scale (Mini-MAC), the Cancer Concerns Checklist (CCL), and the Hospital Anxiety and Depression Scale (HADS). The Eastern Cooperative Oncology Group Performance Status (ECOG-PS) ratings of functional capacity were completed by physicians. Results: Factor analysis confirmed that the structure of the CBI-B/I was consistent with the English version. Internal consistency reliability and significant correlations with the EORTC QLQ-C30, Mini-MAC, and HADS supported the concurrent validity of the CBI-B/I. Differences in CBI-B/I scores for high versus low levels of the CCL and ECOG-PS supported the clinical utility of the CBI-B/I. Conclusions: The CBI-B/I has strong psychometric properties and represents an important addition to newer model of palliative and supportive care. In order to improve clinical practice, the CBI-B/I could be useful in identifying specific self-efficacy goals for coping in structured psychosocial intervention

How the Cathedral Embraced the Bazaar, and the Bazaar Became a Cathedral

Peer reviewe

End-to-end approach to flexible and sustainable commercial spaceflight initiatives: Evaluation of operational scenarios, safety aspects, spaceports and associated economic elements

Multiple initiatives are going on today, aimed at developing new technologies for commercial exploitation of space. The potential benefits of widening up the access to space to a broader users community affect different applications ranging from space tourism to microgravity experimentation to astronauts and pilots training; moreover, in the new space economy users communities may include parties that do not traditionally operate in the space business but can take advantage of microgravity exploitation as an opportunity to carry out experimental activities with potential more significant outcome. The present paper initially approaches commercial access to space by evaluating different mission concepts, technologies and platforms such as suborbital spaceflight, orbital spaceflight, air launch and deployment of small satellites. In order to select the most promising alternative, trade off methodologies, making use of safety, cost and complexity as figures of merit are suggested for the specific case of the suborbital flight. Moreover, the paper describes the outcome of simplified mission simulations, encompassing both suborbital vehicle as well as satellite air launch trajectories predictions. The trajectories simulations can also provide useful inputs to the vehicle design and performance analysis and are instrumental to planning air space operations after lift off from the launch site, as well as to assess logistics and operational aspects. Thus, simulations of really operating environment provide the link to the Spaceport selection process aiming at defining an adequate operating base and a set of proper ground infrastructures that efficiently support in integrated fashion the execution of the planned activities with the selected platforms. An integrated end-to-end approach is also described, that basing upon the specific users' needs identifies the appropriate platform and delivers the associated service matching the relevant goals. The paper finally discusses some economic and organizational aspects for developing a sustainable commercial spaceflight initiative. Ideas for next activities are drawn too, mainly focusing on trajectory validation simulation with real data coming from the initial test campaigns

Comparison of four commercial screening assays for the detection of blakpc, blandm, blaimp, blavim, and blaoxa48 in rectal secretion collected by swabs

The spread of carbapenem-resistant Enterobacteriaceae (CRE) has been enabled by the lack of control measures directed at carriers of multidrug-resistant organisms in healthcare settings. Screening patients for asymptomatic colonization on the one hand, and implementation of contact precautions on the other hand, reduces patient-to-patient transmission. Screening plates represents a relatively low-cost method for isolating CRE from rectal swabs; however, molecular assays have become widely available. This study compared the performance of four commercial molecular platforms in detecting clinically significant carbapenemase genes versus routine screening for CRE. A total of 1015 non-duplicated rectal swabs were cultured on a chromogenic carbapenem-resistant selective medium. All growing Enterobacteriaceae strains were tested for carbapenemase-related genes. The same specimens were processed using the following molecular assays: Allplex\u2122 Entero-DR, Amplidiag\uae CarbaR + MCR, AusDiagnostics MT CRE EU, and EasyScreen\u2122 ESBL/CPO. The prevalence of Klebsiella pneumoniae carbapenemase (KPC)-producing Enterobacteriaceae detected by swab culture was 2.2%, while organisms producing oxacillinase (OXA)-48 and metallo-\u3b2-lactamases were infrequent. The cost of CRE-related infection control precautions, which must be kept in place while waiting for screening results, are significant, so the molecular tests could become cost-competitive, especially when the turnaround time is decreased dramatically. Molecular assays represent a powerful diagnostic tool as they allow the rapid detection of the most clinically relevant carbapenemases

Mixing enhancement induced by viscoelastic micromotors in microfluidic platforms

Fine manipulation of fluid flows at the microscale has a tremendous impact on mass transport phenomena of chemical and biological processes inside microfluidic platforms. Fluid mixing in the laminar flow regime at low Reynolds number is poorly effective due to the inherently slow diffusive mechanism. As a strategy to enhance mixing and prompt mass transport, here, we focus on polyelectrolyte multilayer capsules (PMCs), embodying a catalytic polyoxometalate, as microobjects to create elastic turbulence and as micromotors to generate chaotic flows by fuel-fed propulsions. The effects of the elastic turbolence and of the artificial propulsion on some basic flow parameters, such as pressure and volumetric flow rate, are studied by a microfluidic set-up including pressure and flow sensors. Numerical-handling and physical models of the experimental data are presented and discussed to explain the measured dependence of the pressure drop on the flow rate in presence of the PMCs. As a practical outcome of the study, a strong decrease of the mixing time in a serpentine microreactor is demonstrated. Unlike our previous reports dealing with capillarity flow studies, the present paper relies on hydrodynamic pumping experiments, that allow us to both develop a theoretical model for the understanding of the involved phenomena and demonstrate a successful microfluidic mixing application. All of this is relevant in the perspective of developing microobject-based methods to overcome microscale processes purely dominated by diffusion with potential improvements of mass trasport in microfluidic platforms. \ua9 2019 Elsevier B.V

Catalytic oxygen production mediated by smart capsules to modulate elastic turbulence under a laminar flow regime

none11Liquid flow in microchannels is completely laminar and uniaxial, with a very low Reynolds number regime and long mixing lengths. To increase fluid mixing and solubility of reactants, as well as to reduce reaction time, complex three-dimensional networks inducing chaotic advection have to be designed. Alternatively, turbulence in the liquid can be generated by active mixing methods (magnetic, acoustic waves, etc.) or adding small quantities of elastic materials to the working liquid. Here, polyelectrolyte multilayer capsules embodying a catalytic polyoxometalate complex have been suspended in an aqueous solution and used to create elastic turbulence and to propel fluids inside microchannels as an alternative to viscoelastic polymers. The overall effect is enhanced and controlled by feeding the polyoxometalate-modified capsules with hydrogen peroxide, H2O2, thus triggering an on-demand propulsion due to oxygen evolution resulting from H2O2 decomposition. The quantification of the process is done by analysing some structural parameters of motion such as speed, pressure, viscosity, and Reynolds and Weissenberg numbers, directly obtained from the capillary dynamics of the aqueous mixtures with different concentrations of H2O2. The increases in fluid speed as well as the capsule-induced turbulence effects are proportional to the H2O2 added and therefore dependent on the kinetics of H2O2 dismutation.Zizzari A.; Bianco M.; Miglietta R.; del Mercato L. L.; Carraro M.; Soraru A.; Bonchio M.; Gigli G.; Rinaldi R.; Viola I.; Arima, V.Zizzari, A.; Bianco, M.; Miglietta, R.; del Mercato, L. L.; Carraro, M.; Soraru, A.; Bonchio, M.; Gigli, Giuseppe; Rinaldi, Rosaria; Viola, I.; Arima, V

Myeloid Diagnostic and Prognostic Markers of Immune Suppression in the Blood of Glioma Patients.

Although gliomas are confined to the central nervous system, their negative influence over the immune system extends to peripheral circulation. The immune suppression exerted by myeloid cells can affect both response to therapy and disease outcome. We analyzed the expansion of several myeloid parameters in the blood of low- and high-grade gliomas and assessed their relevance as biomarkers of disease and clinical outcome. Methods: Peripheral blood was obtained from 134 low- and high-grade glioma patients. CD14+, CD14+/p-STAT3+, CD14+/PD-L1+, CD15+ cells and four myeloid-derived suppressor cell (MDSC) subsets, were evaluated by flow cytometry. Arginase-1 (ARG1) quantity and activity was determined in the plasma. Multivariable logistic regression model was used to obtain a diagnostic score to discriminate glioma patients from healthy controls and between each glioma grade. A glioblastoma prognostic model was determined by multiple Cox regression using clinical and myeloid parameters. Results: Changes in myeloid parameters associated with immune suppression allowed to define a diagnostic score calculating the risk of being a glioma patient. The same parameters, together with age, permit to calculate the risk score in differentiating each glioma grade. A prognostic model for glioblastoma patients stemmed out from a Cox multiple analysis, highlighting the role of MDSC, p-STAT3, and ARG1 activity together with clinical parameters in predicting patient's outcome. Conclusions: This work emphasizes the role of systemic immune suppression carried out by myeloid cells in gliomas. The identification of biomarkers associated with immune landscape, diagnosis, and outcome of glioblastoma patients lays the ground for their clinical use

Effects of different mineral supplementations in sheep grazing in Caatinga ecosystem: methane emission.

Abstract: The objective of this study was to evaluate the effects of different mineral supplements on methane emission of sheep grazing in Caatinga ecosystem. An experiment in a completely randomized design, in which 15 Santa Inês crossbred sheep (19.3 kg) were randomly assigned to one of three treatments: mineral salt for sheep (control; SALTMC), mineral salt with addition of 750 ppm of zinc per animal (SALTMZn) and mineral salt supplied with 2.5 ml of propylene glycol per kg of metabolic body weight (BW0.75; SALTMPeg). Methane emission (CH4) was performed by technique of sulfur hexafluoride tracer gas (SF6). Treatments did not affect (P>0.05) the intakes (in g/d and g/kgBW0.75) of dry matter (DM) and organic matter (OM). Methane emission, in g/d and g/kg of MO ingested, was significantly affected (P0,05) para consumos de matéria seca (MS) e matéria orgânica (MO) em g/dia e em g/kgPV0,75 para os tratamentos. Para emissão de CH4 em g/dia, g/kgMS e em g/kgMO ingerida, houve efeito (P<0,05) para tratamento e período. Os animais do tratamento SALTMZn emitiram menor quantidade de CH4, principalmente durante os meses de abril a junho. Para emissão de CH4 durante todo o período experimental, foi observado menor emissão pelos animais do tratamento SALTMZn (P<0,05). O uso do sal mineral adicionado de zinco contribui para diminuição da emissão de CH4 por ovinos terminados em pastagem nativa da Caatinga