Asymptomatic patients as a source of transmission of COVID-19 in homeless shelters

Objectives: Asymptomatic carriers account for over a third of all Coronavirus Disease 19 (COVID-19) cases and are characterized by the absence of symptoms but the same infectivity as symptomatic infections. The high percentage of asymptomatic COVID-19 patients is significant in settings with specific vulnerabilities, such as homeless shelters, where the consequences of an outbreak may be dramatic. In this work, we briefly report our experience on residents and staff of homeless shelters in the City of Rome, Italy, with a particular focus on asymptomatic transmission, and compare it with the available evidence. Methods: We performed routine Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) nasopharyngeal swab tests in all residents and staff of homeless shelters managed by the Eleemosynaria Apostolica of the Vatican City State in the city of Rome, Italy, in addition to daily symptom screening, body temperature monitoring, and application of other prevention measures. Results: We evaluated 298 persons and identified twelve positive cases (4%). Most of the positive cases (75%) were asymptomatic, while only three patients reported symptoms that included fever, diarrhea, and cough. Conclusions: Our data confirm the importance of early identification of asymptomatic carriers that could, in vulnerable conditions such as homeless shelters, spread the infection and cause outbreaks with severe consequences on individual and public health

Assessment of SARS-CoV-2 infection through rapid serology testing in the homeless population in the City of Rome, Italy. Preliminary results

Background: The development of COVID-19 pandemic has affected all segments of the population; however, it had a significant impact on vulnerable subjects, such as in people experiencing homelessness. The aim of this study was to evaluate the prevalence of COVID-19 spread in homeless persons in the city of Rome, Italy.  Design and Methods: Patients included in the study underwent a clinical evaluation and rapid antibody analysis on capillary blood for the presence of immunoglobulin G (IgG) and immunoglobulin M (IgM) antibodies to SARS-CoV-2 virus. Symptomatic patients were not included in the screening and immediately referred to local hospitals for further evaluation.Results: One-hundred seventy-three patients of both sexes were tested for SARS-CoV-2 infection through rapid serological test. Age range was 8-80 years; people came from 35 different countries of origin and 4 continents. Test results were negative for most patients (170-98.2%); two patients had positive IgM (1.2%) and one patient had positive IgG (0.6%).Conclusions: Our study is the first to evaluate the prevalence of SARS-CoV-2 infection in people experiencing homelessness in the city of Rome, Italy. Most patients were negative for COVID-19, although several factors may have had an impact on this result, such as the exclusion of symptomatic patients, the limited sensitivity of rapid serological tests in the initial stage of infection and the prevention measures adopted in these populations. Larger studies on fragile populations are needed to prevent and intercept new clusters of infection in the upcoming months

Lessons learned from COVID-19 pandemic in Italy

Since the COVID-19 outbreak, Italy has been one of the most affected countries in Europe and the second for number of deaths. In this commentary, we discuss some lessons that we learned as healthcare providers working in a large public hospital during the pandemic, with a special focus on the importance of infection containment and early diagnosis, the role of swab, serological tests, home isolation and individual protection devices,  and the available therapies and management indications to better face a possible new outbreak in the near future. These comments should stimulate a more diffused, efficient and efficacious management of COVID-19 patients, also reducing the number of accesses to hospital emergency departments and the related spread of the infection

Nutritional outcomes in HIV Exposed Infants in the Mingha Program, Dschang-Cameroon (2003-2011)

Background: Prevention of Mother to Child Transmission (PMTCT) is a set of interventions that contribute in reducing the risk of HIV transmission from mother (parents) to the child. The infant feeding choice in the HIV context remains a key item of PMTCT. This study aimed at evaluating the nutritional status of children followed by the Mingha / PMTCT program in the Dschang Health District (DHD) during 09 years of activities. We used a descriptive study based on retrospective data from an intervention conducted at the DHD between 2003 and 2011 on a group of mother-child pairs in the PMTCT (Mingha/PMTCT) facilitation program. The intervention was the formula feeding given to the children from birth till 18 months. The data collected was analyzed using SPSS Version 18 software. Results: Among 328 children accessed, we had a sex ratio of 0.83 with more boys than girls. Severe wasting was found only within 11 boys (3.26%) and only <6 months old children were concerned. Moderate wasting was found among 6 girls (1.74%) and 5 boys (1.52%) and <6 months old children were highly concerned 10 (3.17%). Overweight (3.26%) was highly predominant among 8 boys (2.24%) and except those of <6 months, all the other age groups were concerned. There were no cases of obesity or stunting. Conclusions: The nutritional status of the Mingha/PMTCT program children was quite satisfactory. It characterizes the hope for a suitable nutritional follow up of children in HIV context. Therefore programs like Mingha/PMTCT should be promoted and transferred to other Health Districts and even resource-limited countries

Lessons learned from COVID-19 pandemic in Italy – A commentary

Since the COVID-19 outbreak, Italy has been one of the most affected countries in Europe and the second for number of deaths. In this commentary, we discuss some lessons that we learned as health-care providers working in a large public hospital during the pandemic, with a special focus on the importance of infection containment and early diagnosis, the role of swab, serological tests, home isolation and individual protection  devices, and the available therapies and management indications to better face a possible new outbreak in the near future. These comments should stimulate a more diffused, efficient, and efficacious management of COVID-19 patients, also reducing the number of admissions to hospital emergency departments and the related spread of the infection

The transcription factor LEF1 interacts with NFIX and switches isoforms during adult hippocampal neural stem cell quiescence

Stem cells in adult mammalian tissues are held in a reversible resting state, known as quiescence, for prolonged periods of time. Recent studies have greatly increased our understanding of the epigenetic and transcriptional landscapes that underlie stem cell quiescence. However, the transcription factor code that actively maintains the quiescence program remains poorly defined. Similarly, alternative splicing events affecting transcription factors in stem cell quiescence have been overlooked. Here we show that the transcription factor T-cell factor/lymphoid enhancer factor LEF1, a central player in canonical beta-catenin-dependent Wnt signalling, undergoes alternative splicing and switches isoforms in quiescent neural stem cells. We found that active beta-catenin and its partner LEF1 accumulated in quiescent hippocampal neural stem and progenitor cell (Q-NSPC) cultures. Accordingly, Q-NSPCs showed enhanced TCF/LEF1-driven transcription and a basal Wnt activity that conferred a functional advantage to the cultured cells in a Wnt-dependent assay. At a mechanistic level, we found a fine regulation of Lef1 gene expression. The coordinate upregulation of Lef1 transcription and retention of alternative spliced exon 6 (E6) led to the accumulation of a full-length protein isoform (LEF1-FL) that displayed increased stability in the quiescent state. Prospectively isolated GLAST + cells from the postnatal hippocampus also underwent E6 retention at the time quiescence is established in vivo. Interestingly, LEF1 motif was enriched in quiescence-associated enhancers of genes upregulated in Q-NSPCs and quiescence-related NFIX transcription factor motifs flanked the LEF1 binding sites. We further show that LEF1 interacts with NFIX and identify putative LEF1/NFIX targets. Together, our results uncover an unexpected role for LEF1 in gene regulation in quiescent NSPCs, and highlight alternative splicing as a post-transcriptional regulatory mechanism in the transition from stem cell activation to quiescence.Peer reviewe

Data-driven clustering of combined Functional Motor Disorders based on the Italian registry

Functional Motor Disorders (FMDs) represent nosological entities with no clear phenotypic characterization, especially in patients with multiple (combined FMDs) motor manifestations. A data-driven approach using cluster analysis of clinical data has been proposed as an analytic method to obtain non-hierarchical unbiased classifications. The study aimed to identify clinical subtypes of combined FMDs using a data-driven approach to overcome possible limits related to "a priori" classifications and clinical overlapping

A new subspecies of Dysiatus from the Sangihe and Talaud islands (Coleoptera: Cerambycidae, Prioninae)

Missori, Paolo, Ercoli, Lucia (2019): A new subspecies of Dysiatus from the Sangihe and Talaud islands (Coleoptera: Cerambycidae, Prioninae). Zootaxa 4614 (1): 195-200, DOI: https://doi.org/10.11646/zootaxa.4614.1.1

A new subspecies of Xixuthrus from Papua New Guinea (Coleoptera: Cerambycidae, Prioninae)

Missori, Paolo, Ercoli, Lucia (2018): A new subspecies of Xixuthrus from Papua New Guinea (Coleoptera: Cerambycidae, Prioninae). Zootaxa 4455 (2): 395-399, DOI: 10.11646/zootaxa.4455.2.