Co-haplotyping symbiont and host to unravel invasion pathways of the exotic pest Halyomorpha halys in Italy

The brown marmorated stink bug Halyomorpha halys (Stål) is a globally invasive species that harbors a primary bacterial symbiont ‘Candidatus Pantoea carbekii’. In this work, P. carbekii was used here as another genetic marker to investigate the biodiversity and biogeographical patterns of this important pest, in native and newly invaded areas, especially in Italy. The correlation between the genetic structure of the symbiont and that of its host was studied through the analyses of one bacterial and one host marker, the putative pseudogene ΔybgF and the mitochondrial gene COI, respectively. As a result, five new P. carbekii haplotypes were identified, and an association pattern between host-symbiont haplotypes was observed. Host species showed higher haplotype diversity than symbiont, which can be expected in a long term host-symbiont association. Populations from the north-eastern Italy showed the highest values of genetic diversity for both markers, highlighting that this particular Italian area could be the result of multiple ongoing introductions. Moreover, some of the symbiont-host haplotypes observed were shared only by populations from north-eastern Italy and native areas, especially Japan, suggesting further introductions from this native country to Italy. Overall, our findings improve the understanding of the potential origin of multiple accidental introductions of H. halys in Italy

Validation of the Italian version of wisconsin stone quality of life (WISQOL): a prospective Italian multicenter study

Urolithiasis is a worldwide spread condition that affects patients' Health-Related Quality of Life (HRQOL), which measurement is an important tool for routine clinical and research practice. Disease-specific HRQOL measures demonstrated to perform better in assessing the effects of specific conditions. A disease-specific questionnaire for kidney stones, the WISQOL, has been validated in different languages, but an Italian version is still missing. Our aim is to produce and validate the Italian version of WISQOL (IT-WISQOL). Patients undergoing any elective treatment for upper urinary tract stones were enrolled. A multi-step process with forward- and back-translation was used to translate WISQOL into Italian. Patients were evaluated within 15 days pre-operatively and then at 30-, 90 days post-operatively and administered both IT-WISQOL and SF-36v2. Post-operative data such as 30 days postoperative complications, late stone-related events, successful status, and stone complexity were collected. Cronbach's α was used to evaluate the internal consistency of IT-WISQOL, while Spearman's rho was used for item and inter-domain correlations and IT-WISQOL with SF-36v2 correlation. We found excellent internal consistency across all domains (α ≥ 0.88), particularly when the total score is considered (α = 0.960). Test-retest reliability showed excellent results for the total questionnaire (Pearson correlation value: 0.85). The Inter-domain association ranged from 0.497 to 0.786. Convergent validity was confirmed by a good correlation with subdomains of the SF-36v2 measures. IT-WISQOL is a reliable tool to measure HRQOL in stone patients. It shows analog characteristics if compared to English WISQOL

How to communicate with families living in complete isolation

The global emergency caused by the SARS-CoV-2 pandemic has suddenly changed how we communicate with families in all the CoViD19 care settings, on account of the need to maintain complete social isolation. Far-reaching mental suffering manifests itself in widespread anxiety. Health workers are isolated from their families, and must manage the consequences of this isolation just like the patients under their care. Patients and their families perceive not only the clinical results but also the personal attitudes, closeness and psychological support from the care teams. This perception of genuine participation by the health worker in the course of the treatment is especially important when a patient dies, and may influence the whole process of grief

La pandemia da COVID-19: mutamento e persistenze

L’analisi dei documenti prodotti in Italia sul tema dell’accesso alle terapie intensive durante la pandemia da COVID-19 indica che la riflessione sulle questioni di accesso alle risorse drammaticamente limitate nel nostro Paese è ancora molto acerba e meriterebbe lavori di indagine più accurata e approfondita con un contributo multidisciplinare. Bioetica. Rivista interdisciplinare ha contribuito alla maturazione e alla crescita delle conoscenze in questo ambito, con la pubblicazione di diversi articoli. Tale apertura verso i temi di giustizia distributiva mostra la capacità della rivista di cogliere e affrontare i temi emergenti nel dibattito bioetico italiano, mostra il suo sapere essere “giovane”, nonostante la sua lunga storia editoriale, ovvero la sua capacità di rinnovarsi e rispondere a esigenze nuove.The review of documents released in Italy on the issue of access to intensive care units during the COVID-19 pandemic suggests that the discussion on the issues of access to dramatically limited resources in our country is still immature and deserves an in-depth investigation with a multidisciplinary contribution. Bioetica. Rivista interdisciplinare has contributed to the growth of knowledge in this field, with the publication of several articles. This openness to the issues of distributive justice shows the magazine’s ability to grasp and address emerging issues in the Italian bioethical debate, it shows its ability to be “young”, despite its long publishing history, namely its ability to renew itself and respond to new needs

Difficulties reporting system in intensive care

In 2005, Belluno Health Authority’s Resuscitation Unit took part in a regional project coordinated by Veneto Regional Health and Social Services to test an incident re p o rting system. The main aims were to experiment an electronic incident rep o rting sheet and the relative computerised procedure for data e n t ry and analysis with the aim of developing an incident rep o rting system. The Australian Incident Monitoring System (AIMS) was designed to obtain information about the event, the context and concomitant causes. We observed 58 anonymous incident reports over a six-month period. The main incidents include issues relating to the management of medication, the a i rways, catheters and equipment. Most incidents had modest consequences or led to temporary disability and they often caused longer hospitalisation or further treatment and investigations. Communication problems, inadequate superv i s i o n , poor teamwork and difficulties in applying procedures and protocols were the contributory factors most frequently identified as the concomitant causes of the incidents. The report sheet and experience as a whole were evaluated favourably by the operators involved. This reporting system does not provide the real frequency of the adverse events, but it does provide useful information for improving patient safety

Highly doped Tm³⁺ tellurite glasses for 2 µm laser source

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The SARS-CoV-2 pandemic as a source of unprecedented bioethical and biolaw issues: lessons for intensivists

Abstract The following article presents the relevant and unprecedented bioethical and biolaw issues posed by the SARS-COV-2 pandemic and summarizes the initiatives adopted by the Italian Society of Anesthesia and Resuscitation (SIAARTI) as well as by the Veneto Region ICU Network. Since the initial phase of the pandemic, in March 2020, there has been a strong appeal from both SIAARTI and the Veneto Region ICU Network to consider “the appropriate intensive treatment.” During the pandemic, the principle of proportionality must be applied, in compliance with the main principle in bioethics. This encompasses the concept of clinical appropriateness, based on the efficacy of the treatment in specific case and context, as well as the concept of ethical appropriateness, which refers to ethical and juridical principles of acceptance of health care. The “appropriate treatment” must never interfere with the withdrawal of patients, who are not eligible for intensive treatments since they would not benefit from them and who are eligible for ordinary treatments that must be maintained, and, where necessary, palliative treatments were initiated. On the other hand, it must not encroach on unreasonable obstinacy. At the end of 2020, the SIAARTI-SIMLA (Italian Society of Insurance and Legal Medicine) document provides healthcare professionals with a tool for responding appropriately to the emergency of the pandemic, in the event of an imbalance between healthcare demand and available resources. The document states that the ICU triage should be based on global evaluation of each patient, taking into account well-defined parameters and stresses that each person potentially eligible for intensive care should have a shared care planning (SCP) stipulated, and, when necessary, a proxy should be nominated. This has illustrated how the biolaw issues encountered by intensivists during the pandemic, such as those relating to consent and refusal to medical treatment, even when it is lifesaving, as well as requests for treatment of unproven clinical efficacy, were subject to appropriate guidelines and solutions through the application of Law 219/2017 (provisions for informed consent and advance directives treatment). Communication with family members and the management of sensitive personal data; the evaluation of “legal capacity” of comprehension and informed decision-making regarding the proposed treatment plan; and the need for emergency medical intervention in the absence of consent are all addressed in light of the relevant regulations and the particular conditions of social isolation induced by the pandemic. The collaborative ICUs network sustained by the Veneto Region has given great prominence to clinical bioethics issues, and as a result, multidisciplinary integration with the help of legal and juridical experts was developed. This has led to an increase in skills in the bioethical field, as well as providing a valuable lesson for the improvement of therapeutic relationships with critically ill patients and their families