Dr. Favalli, et al. reply

We thank Dr. So, et al1 for the interest in our letter2 and for sharing the results about the coronavirus disease 2019 (COVID-19) in patients with systemic lupus erythematosus (SLE) in Hong Kong1 We agree that the quantification of the risk of infection with severe acute respiratory coronaviruses-2 (SARS-CoV-2) in patients with SLE is a major concern

Reply to the Comment on “Lost tsunami by M.T.Pareschi et al.”, by Luigi Vigliotti

No abstrac

Topographic control on lava flow paths at Mt. Etna (Italy): implications for hazard assesment

Assessment of the hazard from lava flow inundation at the active volcano of Mt. Etna (Italy) was performed by calculating the probability of lava flow inundation at each position on the volcano. A probability distribution for the formation of new vents was calculated using geological and volcanological data from past eruptions. The simulated lava flows from these vents were emplaced using a maximum expected flow length derived from geological data on previous lava flows. Simulations were run using DOWNFLOW, a DEM-based model designed to predict lava flow paths. Different eruptive scenarios were simulated by varying the elevation and probability distribution of eruptive points. Inundation maps show that the city of Catania and the coastal zone may only be impacted by flows erupted from low-altitude vents (< 1500 m elevation), and that flank eruptions at elevations > 2000 m preferentially inundate the northeast and southern sectors of the volcano as well as the Valle del Bove. Eruptions occurring in the summit area (> 3000 m elevation) pose no threat to the local population. Discrepancies between the results of simple, hydrological models and those of the DOWNFLOW model show that hydrological approaches are inappropriate when dealing with Etnean lava flows. Because hydrological approaches are not designed to reproduce the full complexity of lava flow spreading, they underestimate the catchment basins when the fluid has a complex rheology

TINITALY/01: a new Triangular Irregular Network of Italy

A new Digital Elevation Model (DEM) of the natural landforms of Italy is presented. A methodology is discussed to build a DEM over wide areas where elevation data from non-homogeneous (in density and accuracy) input sources are available. The input elevation data include contour lines and spot heights derived from the Italian Regional topographic maps, satellite-based global positioning system points, ground based and radar altimetry data. Owing to the great heterogeneity of the input data density, the DEM format that better preserves the original accuracy is a Triangular Irregular Network (TIN). A Delaunay-based TIN structure is improved by using the DEST algorithm that enhances input data by evaluating inferred break-lines. Accordingly to this approach, biased distributions in slopes and elevations are absent. To prevent discontinuities at the boundary between regions characterized by data with different resolution a cubic Hermite blending weight S-shaped function is adopted. The TIN of Italy consists of 1.39×109 triangles. The average triangle area ranges from 12 to about 13000 m2 accordingly to different morphologies and different sources. About 50% of the model has a local average triangle area <500 m2. The vertical accuracy of the obtained DEM is evaluated by more than 200000 sparse control points. The overall Root Mean Square Error (RMSE) is less than 3.5 m. The obtained national-scale DEM constitutes an useful support to carry out accurate geomorphological and geological investigations over large areas. The problem of choosing the best step size in deriving a grid from a TIN is then discussed and a method to quantify the loss of vertical information is presented as a function of the grid step. Some examples of DEM application are outlined. Under request, an high resolution stereo image database of the whole Italian territory (derived from the presented DEM) is available to browse via internet

The combined use of VIGl@ct (R) (bioMerieux) and fluorescent amplified length fragment polymorphisms in the investigation of potential outbreaks

Even with good surveillance programmes, hospital-acquired infections (HAls) are not always recognized and this may lead to an outbreak. In order to reduce this risk, we propose a model for prompt detection of HAls, based on the use of a real-time epidemiological information system called VIGI@ct (R) (bioMerieux, Las Balmas, France) and on the rapid confirmation or exclusion of the genetic relationship among pathogens using fluorescent amplified length fragment polymorphism (f-AFLP) microbial fingerprinting. We present the results of one year's experience with the system, which identified a total, of 306 suspicious HAls. Of these, 281 (92%) were 'confirmed' by clinical evidence, 16 (5%) were considered to be simple colonization and the tatter nine (3%) were archived as 'not answered' because of the absence of the physician's cooperation. There were seven suspected outbreaks; of these, f-AFLP analysis confirmed the clonal relationship among the isolates in four cases: outbreak 1 (four isolates of Pseudomonas aeruginosa), outbreak 2 (three Escherichia coli isolates), outbreak 6 (two Candida parapsilosis isolates) and outbreak 7 (30 ESPL-producing Klebsiella pneumoniae subsp. pneumoniae). Based on our results, we conclude that the combination of VIGI@ct (R) and f-AFLP is useful in the rapid assessment of an outbreak due to Gram-positive or Gramnegative bacteria and yeasts. (C) 2007 The Hospital Infection Society. Published by Elsevier Ltd. All rights reserved

hla typing in systemic sclerosis

Objective: the aim of the study was to investigate the relationship between Systemic Sclerosis (SSc) and HLA antigens, and to correlate these antigens with the clinical manifestations of the disease. Materials and methods: 55 patients were stratified according a) to the cutaneous involvement b) to the positivity of Scl- 70 and anticentromere antibody and c) to the internal organ involvement, in particular we used HRCT to demonstrate lung fibrosis, echocardiography for the diagnosis of pulmonary hypertension, blood creatinine, urinalysis and arterial hypertension to demonstrate renal failure, and esophagus double-countrast barium swallow for the diagnosis of esophagopathy. The control group consisting of 2000 healthy Caucasian subjects was recruited from the same population. Results: the frequency of the antigens A23 (p=0.003, RR=3.69), B18 (p<0.0001, RR=3.57), and DR11 (p<0.0001, RR=6.18) was statistically increased in the patients population compared with the healthy controls. Although there is no any significant correlation between HLA antigens and different clinical subsets of scleroderma, antigens B18 and DR11 could be associated with more severe clinical features. Conclusions: the presence of a significant association between SSc and specific HLA antigens (A23, B18, and DR11) could link the HLA system with SSc

Lava flow hazard at Fogo Volcano, Cabo Verde, before and after the 2014–2015eruption

Abstract. Lava flow simulations help to better understand volcanic hazards and may assist emergency preparedness at active volcanoes. We demonstrate that at Fogo Volcano, Cabo Verde, such simulations can explain the 2014–2015 lava flow crisis and therefore provide a valuable base to better prepare for the next inevitable eruption. We conducted topographic mapping in the field and a satellite-based remote sensing analysis. We produced the first topographic model of the 2014–2015 lava flow from combined terrestrial laser scanner (TLS) and photogrammetric data. This high-resolution topographic information facilitates lava flow volume estimates of 43.7 ± 5.2 × 106 m3 from the vertical difference between pre- and posteruptive topographies. Both the pre-eruptive and updated digital elevation models (DEMs) serve as the fundamental input data for lava flow simulations using the well-established DOWNFLOW algorithm. Based on thousands of simulations, we assess the lava flow hazard before and after the 2014–2015 eruption. We find that, although the lava flow hazard has changed significantly, it remains high at the locations of two villages that were destroyed during this eruption. This result is of particular importance as villagers have already started to rebuild the settlements. We also analysed satellite radar imagery acquired by the German TerraSAR-X (TSX) satellite to map lava flow emplacement over time. We obtain the lava flow boundaries every 6 to 11 days during the eruption, which assists the interpretation and evaluation of the lava flow model performance. Our results highlight the fact that lava flow hazards change as a result of modifications of the local topography due to lava flow emplacement. This implies the need for up-to-date topographic information in order to assess lava flow hazards. We also emphasize that areas that were once overrun by lava flows are not necessarily safer, even if local lava flow thicknesses exceed the average lava flow thickness. Our observations will be important for the next eruption of Fogo Volcano and have implications for future lava flow crises and disaster response efforts at basaltic volcanoes elsewhere in the world

Structures of the lamin A/C R335W and E347K mutants: implications for dilated cardiolaminopathies

Dilated cardiomyopathy (DCM) is a condition whereby the normal muscular function of the myocardium is altered by specific or multiple aetiologies. About 25-35% of DCM patients show familial forms of the disease, with most mutations affecting genes encoding cytoskeletal proteins. Most of the DCM-related mutations fall in the Lamin AC gene, in particular in the Coil2B domain of the encoded protein. In this context, we focussed our studies on the crystal structures of two lamin Coil2B domain mutants (R335W and E347K). Both R335 and E347 are higly conserved residues whose substitution has little effects on the Coil2B domain three-dimensional structure; we can thus hypothesize that the mutations may interfere with the binding of components within the nuclear lamina, or of nuclear factors, that have been proposed to interact/associate with lamin A/C

Factors Predicting Early Failure of Etanercept in Rheumatoid Arthritis: An Analysis From the Gruppo Italiano di Studio sulla Early Arthritis (Italian Group for the Study of Early Arthritis) Registry

Objectives: This study aims to investigate the factors associated with early discontinuation (within one year) of etanercept (ETA) in rheumatoid arthritis (RA) patients who began ETA as first biologic disease-modifying antirheumatic drug (bDMARD) and who were entered into the Gruppo Italiano di Studio sulla Early Arthritis (Italian Group for the Study of Early Arthritis; GISEA) registry.Patients and methods: This registry-based cohort study included 477 RA patients (95 males, 382 females; median age 53 years; range 18 to 83 years) who began ETA as first bDMARD. Patient demographics, disease features and drugs were re-evaluated after 12 months. Baseline predictors of ETA discontinuation were estimated by univariate and multivariate analyses using Cox regression model.Results: Seventy patients (14.7%) discontinued ETA during the first year (for inefficacy in 55.8%, adverse events in 28.6%, and other reasons in 6.5%). Concurrent conventional synthetic DMARDs (csDMARDs) were reported in 54.3% of patients, mainly methotrexate (MTX), while 52.4% of subjects took low doses of glucocorticoids. Patients stopping ETA more frequently showed one or more comorbidities, mainly cardiovascular diseases (28.6% vs. 15.7% in patients stopping and continuing ETA, respectively, p=0.009). The presence of comorbidities and a combination therapy with csDMARDs other than MTX were independent factors associated with early discontinuation of ETA at multivariate Cox analysis.Conclusion: Although ETA demonstrated a high persistence in biologic-naive RA patients, about 15% of patients discontinued the treatment within 12 months. The presence of comorbidities and a combination therapy with csDMARDs other than MTX were the main factors for an early withdrawal of the drug