Clinical peculiarities of tuberculosis

The ongoing spread of tuberculosis (TB) in poor resource countries and the recently increasing incidence in high resource countries lead to the need of updated knowledge for clinicians, particularly for pediatricians. The purpose of this article is to provide an overview on the most important peculiarities of TB in children. Children are less contagious than adults, but the risk of progression to active disease is higher in infants and children as compared to the subsequent ages. Diagnosis of TB in children is more difficult than in adults, because few signs are associated with primary infection, interferon-gamma release assays and tuberculin skin test are less reliable in younger children, M. tuberculosis is more rarely detected in gastric aspirates than in smears in adults and radiological findings are often not specific. Treatment of latent TB is always necessary in young children, whereas it is recommended in older children, as well as in adults, only in particular conditions. Antimycobacterial drugs are generally better tolerated in children as compared to adults, but off-label use of second-line antimycobacterial drugs is increasing, because of spreading of multidrug resistant TB worldwide. Given that TB is a disease which often involves more than one member in a family, a closer collaboration is needed between pediatricians and clinicians who take care of adults

Experiences from a winter school on landscape agronomy: Stakes, difficulties, perspectives

International audienceIn the latest fifteen years, agronomic research has shown a growing interest for studies which link farm or field scale to landscape scale. Thus, agronomy is called to renew its research questions and methodologies, and as well its educational programmes. In this context, some French and Italian researchers interested in these topics, coming from different scientific fields but sharing interests on landscape scale issues in research and higher education, decided to join their efforts around a common one-week educational programme on Landscape Agronomy for undergraduate and PhD students. Their aim has been to develop a new form of knowledge transfer and application on Landscape Agronomy approaches to students of SSSA-Pisa (IT) and of the PhD School of ABIES-AgroParisTech-Paris (FR). The educational programme consisted of three phases : 1) some theoretical contributions supported by presentations on : issues regarding agriculture and farming practices at landscape level, main approaches on environmental functions of agriculture, changes in farmers practices driven by environmental questions,spatial organization of agricultural activities, role of farming in ecological dynamics, identification of complementarities among agro-environmental functions, environmental impacts of cropping systems,biodiversity influence on agro-ecosystem functions and vice-versa ; 2) two case-studies: a macro level one(at landscape scale) to analyse the role of agriculture on landscape dynamics, and a micro level one (at farm scale) to analyse farming practices and their environmental impacts ; 3) a final evaluation of the educational programme based on : contents of oral presentations on fieldwork results, global evaluation of the educational programme contents by all the participants, each individual ex-post analysis of fieldwork results. The evaluation of the students and teachers underlines benefits, requests and perspectives for education in landscape agronomy. Furthermore, this experience stimulated a collective conceptual and methodological debate that confirmed the necessity to favour and organise experience exchanges on researching and learning in landscape agronomy

Don’t forget the vertical dimension: assessment of distributional dynamics of cave-dwelling invertebrates in both ground and parietal microhabitats

Biological studies on factors shaping underground communities are poor, especially those considering simultaneously organisms with different degrees of adaptation to cave life. In this study, we assessed the annual dynamics and use of both horizontal and vertical microhabitats of a whole community with the aim of understanding whether cave-dwelling organisms have a similar distribution among vertical and ground-level microhabitats and to find out which microhabitat features influence such distribution. We monthly assessed from 2017 to 2018, by direct observation combined with quadrat sampling method on the ground and transects on the walls, richness and abundance of 62 cave-dwelling species in a cave of Northern Italy. Environmental factors such as light intensity, temperature, relative humidity and mineralogical composition of the substrates were measured during each monitoring session, influencing the dynamics of the whole community and revealing significant differences between ground and wall microhabitats. A gradient of variation of the species assemblages occurred from the entrance toward inner areas, however, evidence that the dynamics of the walls are very different from those occurring at the ground independent from the distance from the surface are shown. Biodiversity indices highlighted sampling area diversity and a discrete total cave fauna biodiversity with the highest values found near the entrance and the lowest in the inner part of the cave

Dark matter electron anisotropy: a universal upper limit

We study the dipole anisotropy in the arrival directions of high energy CR electrons and positrons (CRE) of Dark Matter (DM) origin. We show that this quantity is very weakly model dependent and offers a viable criterion to discriminate among CRE from DM or from local discrete sources, like e.g. pulsars. In particular, we find that the maximum anisotropy which DM can provide is to a very good approximation a universal quantity and, as a consequence, if a larger anisotropy is detected, this would constitute a strong evidence for the presence of astrophysical local discrete CRE sources, whose anisotropy, instead, can be naturally larger than the DM upper limit. We further find that the main source of anisotropy from DM is given by the fluctuation in the number density of DM sub-structures in the vicinity of the observer and we thus devote special attention to the study of the variance in the sub-structures realization implementing a dedicated Montecarlo simulation. Such scenarios will be probed in the next years by Fermi-LAT, providing new hints, or constraints, about the nature of DM.Comment: 23 pages, 7 figure

Reconstructing the recent West Nile virus lineage 2 epidemic in Europe and Italy using discrete and continuous phylogeography

West Nile virus lineage 2 (WNV-2) was mainly confined to sub-Saharan Africa until the early 2000s, when it was identified for the first time in Central Europe causing outbreaks of human and animal infection. The aim of this study was to reconstruct the origin and dispersion of WNV-2 in Central Europe and Italy on a phylodynamic and phylogeographical basis. To this aim, discrete and continuous space phylogeographical models were applied to a total of 33 newly characterised full-length viral genomes obtained from mosquitoes, birds and humans in Northern Italy in the years 2013-2015 aligned with 64 complete sequences isolated mainly in Europe. The European isolates segregated into two highly significant clades: a small one including three sequences and a large clade including the majority of isolates obtained in Central Europe since 2004. Discrete phylogeographical analysis showed that the most probable location of the root of the largest European clade was in Hungary a mean 12.78 years ago. The European clade bifurcated into two highly supported subclades: one including most of the Central/East European isolates and the other encompassing all of the isolates obtained in Greece. The continuous space phylogeographical analysis of the Italian clade showed that WNV-2 entered Italy in about 2008, probably by crossing the Adriatic sea and reaching a central area of the Po Valley. The epidemic then spread simultaneously eastward, to reach the region of the Po delta in 2013, and westward to the border area between Lombardy and Piedmont in 2014; later, the western strain changed direction southward, and reached the central area of the Po valley once again in 2015. Over a period of about seven years, the virus spread all over an area of northern Italy by following the Po river and its main tributaries

Proposal for a New Diagnostic Histopathological Approach in the Evaluation of Ki-67 in GEP-NETs

Abstract Introduction: Studies have shown that the Ki-67 index is a valuable biomarker for the diagnosis, and classification of gastro-entero-pancreatic neuroendocrine tumors (GEP-NETs). We re-evaluated the expression of Ki-67 based on the intensity of the stain, basing our hypothesis on the fact that the Ki-67 protein is continuously degraded. Background: The aim was to evaluate whether a new scoring method would be more effective in classifying NETs by reducing staining heterogeneity. Methods: Patients with GEP-NET (n = 87) were analyzed. The classification difference between the two methods was determined. Results: The classification changed significantly when the Ki-67 semiquantal index was used. The percentage of G1 patients increased from 18.4% to 60.9%, while the G2 patients decreased from 66.7% to 29.9% and the G3 patients also decreased from 14.9% to 9.2%. Moreover, it was found that the traditional Ki-67 was not significantly related to the overall survival (OS), whereas the semiquantal Ki-67 was significantly related to the OS. Conclusions: The new quantification was a better predictor of OS and of tumor classification. Therefore, it could be used both as a marker of proliferation and as a tool to map tumor dynamics that can influence the diagnosis and guide the choice of therapy

Software Challenges For HL-LHC Data Analysis

The high energy physics community is discussing where investment is needed to prepare software for the HL-LHC and its unprecedented challenges. The ROOT project is one of the central software players in high energy physics since decades. From its experience and expectations, the ROOT team has distilled a comprehensive set of areas that should see research and development in the context of data analysis software, for making best use of HL-LHC's physics potential. This work shows what these areas could be, why the ROOT team believes investing in them is needed, which gains are expected, and where related work is ongoing. It can serve as an indication for future research proposals and cooperations

Role of Narrow Band Imaging Technology in the Diagnosis and Follow up of Laryngeal Lesions: Assessment of Diagnostic Accuracy and Reliability in a Large Patient Cohort

BACKGROUND: The aim of this study was to assess diagnostic accuracy and reliability of narrow band imaging (NBI) in the differential diagnosis of laryngeal premalignant lesion, early cancers and recurrences.MATERIAL AND METHODS: We enrolled 231 patients who underwent endoscopic examination with white light endoscopy (WLE) + NBI and divided them into two groups, group A, without previous radiochemotherapy and group B, with previous radiochemotherapy. When indicated, we performed surgical biopsies to evaluate sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), accuracy and likelihood of endoscopic examination comparing WLE alone and WLE + NBI.RESULTS: A positive NBI lesion, compared with a negative NBI lesion, had a 29.68 (group A) and 13.96 (group B) times higher probability to be histologically positive (i.e., confirmed) compared with WLE alone improving the diagnostic accuracy. In group A, the NBI mode showed excellent sensitivity (95.0%), which was higher than WLE 2 mode (77.5%). However, the greatest differences were recorded regarding specificity (96.8% vs. 40.6%). In group B, both NBI alone and WLE + NBI mode showed a 94.1% specificity compared with WLE alone, which had a maximum specificity of 85.3%. The mode comparison between NBI and WLE in both groups showed a statistically significant difference, with p-values <0.0001.CONCLUSIONS: NBI represents a reliable technology in challenging situations, especially in the context of post-radiotherapy or post-surgical mucosal changes showing a high NPV. NBI could reduce the number of unnecessary biopsies related to increased microvascular anomaly revelation, which could help to identify early-stage lesions suitable for minimally invasive surgery and, consequently, decrease hospital admissions