The role of immune suppression in COVID-19 hospitalization: clinical and epidemiological trends over three years of SARS-CoV-2 epidemic

Specific immune suppression types have been associated with a greater risk of severe COVID-19 disease and death. We analyzed data from patients >17 years that were hospitalized for COVID-19 at the “Fondazione IRCCS Ca′ Granda Ospedale Maggiore Policlinico” in Milan (Lombardy, Northern Italy). The study included 1727 SARS-CoV-2-positive patients (1,131 males, median age of 65 years) hospitalized between February 2020 and November 2022. Of these, 321 (18.6%, CI: 16.8–20.4%) had at least one condition defining immune suppression. Immune suppressed subjects were more likely to have other co-morbidities (80.4% vs. 69.8%, p < 0.001) and be vaccinated (37% vs. 12.7%, p < 0.001). We evaluated the contribution of immune suppression to hospitalization during the various stages of the epidemic and investigated whether immune suppression contributed to severe outcomes and death, also considering the vaccination status of the patients. The proportion of immune suppressed patients among all hospitalizations (initially stable at <20%) started to increase around December 2021, and remained high (30–50%). This change coincided with an increase in the proportions of older patients and patients with co-morbidities and with a decrease in the proportion of patients with severe outcomes. Vaccinated patients showed a lower proportion of severe outcomes; among non-vaccinated patients, severe outcomes were more common in immune suppressed individuals. Immune suppression was a significant predictor of severe outcomes, after adjusting for age, sex, co-morbidities, period of hospitalization, and vaccination status (OR: 1.64; 95% CI: 1.23–2.19), while vaccination was a protective factor (OR: 0.31; 95% IC: 0.20–0.47). However, after November 2021, differences in disease outcomes between vaccinated and non-vaccinated groups (for both immune suppressed and immune competent subjects) disappeared. Since December 2021, the spread of the less virulent Omicron variant and an overall higher level of induced and/or natural immunity likely contributed to the observed shift in hospitalized patient characteristics. Nonetheless, vaccination against SARS-CoV-2, likely in combination with naturally acquired immunity, effectively reduced severe outcomes in both immune competent (73.9% vs. 48.2%, p < 0.001) and immune suppressed (66.4% vs. 35.2%, p < 0.001) patients, confirming previous observations about the value of the vaccine in preventing serious disease

Stereoselective synthesis of 2-acyl-3,4-dihydro-1,4-benzothiazines

2-Benzylidene-4-methyl-3-oxo-2H-1,4-benzothiazine 2 undergoes 1,2-addition with MeMgI and allylic magnesium halides to give 2-acyl-4-methyl-3-phenyl-3,4-dihydro-2H-1,4-benzothiazines 3a-d. Lithiation of 3a and subsequent reaction with MeI and PhCH2Br leads to compounds 3e, 3f, 3h and 3i. In contrast, the reaction of lithiated 3a with benzaldehyde and 2,6-dichlorobenzaldehyde furnished compounds 3k and 3l respectively. © 1994

Gut Microbiota and Alcoholic Liver Disease

The gut-liver axis model has often explained liver disease physiopathology. Among the latter we can mention Non-Alcoholic Liver Steatosis (NAFLD), Liver Steatohepatitis (NASH), liver cirrhosis. In this frame an altered Intestinal Permeability (IP) is the gate for antigenic/toxic substances from gut lumen until target organs such as liver in NAFLD. Altered intestinal permeability was discovered almost forty years ago as consequence of acute and chronic alcohol ingestion. Alcohol Liver Disease (ALD) is a systemic pathology whose beginning and end belong to the intestine. Several recent evidences from the literature show how gut microbiota composition can be altered by alcohol, affects IP and can be modulated by several nonpharmacological and pharmacological agents, becoming the target for ALD treatment. In this review we describe the definition of ALD, gut microbiota composition in healthy and ALD, definition and role of IP in ALD physiopathology and emerging evidences on gut microbiota modulation in ALD treatment from preliminary clinical and non-clinical studies

Effetto del sistema di prova sulla resistenza per aderenza calcestruzzo-FRP

When dealing with the strengthening of RC structures by means of FRP(Fiber Reinforced Polymer) sheets or plates, the bond between FRP and concrete is very important: the debonding is a very brittle failure mechanism and must be avoided. In the literature [1], different experimental set-ups can be found when dealing with FRP-concrete bond tests. It has been observed that different test methodologies may give different values of the debonding force [2]. For this reason, the experimental data obtained from different test campaigns are typically very scattered [3]. For this reason, the characteristic values related with given (low) levels of probability are much lower than the mean values. In the present paper, an extensive experimental campaign on FRP-concrete debonding is described: it has been carried out by five different Italian Laboratories (University of Bologna, \u201cFederico II\u201d University of Naples, University of Sannio, Politecnico of Milan and University of Calabria). The tests were devoted to the definition of a standard test procedure for the bond strength evaluation. According to the Round Robin procedure, a number of concrete prisms strengthened with CFRP plates and sheets have been prepared by the University of Bologna and supplied to the other Universities. The sets of homogeneous specimens have then been subjected to bond tests by the various partners according to different experimental procedures and using different test set-ups. From the analysis of the results, the effect of various parameters characterizing the test procedure has been studied, and some indications concerning the statistical dispersion related to each experimental procedure have been obtained. This study is part of the activities done for the definition of a standard FRP-concrete bond test to be used to evaluate the maximum transmissible force by an FRP anchorage, to be included in the new version of the Italian code for design of strengthening interventions with FRP [4]

Effetto del sistema di prova sulla resistenza per aderenza calcestruzzo-FRP

Nella presente memoria sono presentati i risultati di una campagna sperimentale relativa allo studio della perdita di aderenza tra calcestruzzo e lamine o tessuti di carbonio. Le attività hanno coinvolto cinque diversi laboratori universitari. Lo studio è stato affrontato secondo la formula del Round Robin per poter valutare l’effetto dell’adozione di diversi sistemi sperimentali sulla resistenza alla perdita di aderenza. A questo scopo, sono stati preparati dallo stesso operatore con materiali omogenei 50 provini identici, successivamente soggetti a prova di aderenza nei 5 laboratori coinvolti. Le lamine sono state strumentate mediante estensimetri ed LVDT per poter cogliere nei dettagli il comportamento d’interfaccia. Sui risultati è stata effettuata un’analisi statistica per valutare la loro dispersione e l’influenza degli specifici sistemi sperimentali adottati

Effetto del sistema di prova sulla resistenzaper aderenza calcestruzzo-FRP

Nella presente memoria sono presentati i risultati di una campagna sperimentale relativa allo studio della perdita di aderenza tra calcestruzzo e lamine o tessuti di carbonio. Le attività hanno coinvolto cinque diversi laboratori universitari. Lo studio è stato affrontato secondo la formula del Round Robin per poter valutare l’effetto dell’adozione di diversi sistemi sperimentali sulla resistenza alla perdita di aderenza. A questo scopo, sono stati preparati dallo stesso operatore con materiali omogenei 50 provini identici, successivamente soggetti a prova di aderenza nei 5 laboratori coinvolti. Le lamine sono state strumentate mediante estensimetri ed LVDT per poter cogliere nei dettagli il comportamento d’interfaccia. Sui risultati è stata effettuata un’analisi statistica per valutare la loro dispersione e l’influenza degli specifici sistemi sperimentali adottati

Experimental round robin test on FRP-concrete bonding

reserved11When dealing with the strengthening of r.c. structures by means of FRP(Fiber Reinforced Polymer) sheets or plates, the bond between FRP and concrete is very important: the debonding is a very brittle failure mechanism and must be avoided. It has been observed that different test methodologies may give different values of the debonding force. For this reason, the experimental data obtained from different test campaigns are typically very scattered. In the present paper, an extensive experimental campaign on FRP-concrete debonding is described: it has been carried out by five different Italian Laboratories (University of Bologna, “Federico II” University of Naples, University of Sannio, Politecnico di Milano and University of Calabria). The tests were devoted to the definition of a standard test procedure for the bond strength evaluation. According to the Round Robin procedure, a number of concrete prisms strengthened with CFRP plates and sheets have been prepared by the University of Bologna and supplied to the other Universities. The sets of homogeneous specimens have then been subject to bond tests by the various partners according to different experimental procedures and using different test set-ups. From the analysis of the results, the effect of various parameters characterizing the test procedure has been studied, and some indications concerning the statistical dispersion related to each experimental procedure have been obtained. This study is part of the activities performed for the definition of a standard FRP-concrete bond test to be used to evaluate the maximum transmissible force by an FRP anchorage, to be included in the new version of the Italian code for design of strengthening interventions with FRPM. Savoia ; A. Bilotta ; F. Ceroni ; M. Di Ludovico ; G. Fava ; B. Ferracuti ; C. Mazzotti ; E. Nigro ; R. Olivito ; M. Pecce ; C. PoggiM., Savoia; A., Bilotta; F., Ceroni; M., Di Ludovico; Fava, Giulia; B., Ferracuti; C., Mazzotti; E., Nigro; R., Olivito; M., Pecce; Poggi, Carl

Experimental Round Robin test on FRP-concrete bonding

In the present paper, an extensive experimental campaign on FRP-concrete debonding is described: it has been carried out by five different Italian Laboratories (University of Bologna, \u201cFederico II\u201d University of Naples, University of Sannio, Politecnico of Milan and University of Calabria). The tests were devoted to the definition of a standard test procedure for the bond strength evaluation. According to the Round Robin procedure, a number of concrete prisms strengthened with CFRP plates and sheets have been prepared by the University of Bologna and supplied to the other Universities. The sets of homogeneous specimens have then been subjected to bond tests by the various partners according to different experimental procedures and using different test set-ups. From the analysis of the results, the effect of various parameters characterizing the test procedure has been studied, and some indications concerning the statistical dispersion related to each experimental procedure have been obtained. This study is part of the activities done for the definition of a standard FRP-concrete bond test to be used to evaluate the maximum transmissible force by an FRP anchorage, to be included in the new version of the Italian code for design of strengthening interventions with FRP [4]

Risultati di un round robin sperimentale su prove di aderenza calcestruzzo-FRP

Nel rinforzo di elementi in c.a. mediante lamine o tessuti in materiale composito (Fiber Reinforced Polymer), il problema dell’aderenza tra calcestruzzo e composito è estremamente importante in quanto la delaminazione (perdita di aderenza) è un meccanismo di crisi fragile e deve essere assolutamente evitato. Il meccanismo di aderenza è complesso in quanto dipende dalle proprietà del calcestruzzo, del composito e della colla. Una sua corretta definizione è quanto mai indispensabile per la valutazione, attraverso l’uso di leggi di interfaccia, della resistenza ultima nei confronti della delaminazione. In letteratura [1], le prove di delaminazione FRP-calcestruzzo sono state condotte adottando diversi setup di prova. E’ stato osservato che diverse metodologie di prova possono condurre a valori di forze di delaminazione significativamente diversi fra loro. Per tale motivo, molti dati sperimentali disponibili in letteratura non sono fra loro direttamente confrontabili. Nel presente studio, è documentato lo svolgimento di un’estesa campagna sperimentale, condotta da diversi laboratori universitari (Università di Bologna, Università Federico II di Napoli, Università del Sannio, Politecnico di Milano e Università della Calabria), allo scopo di definire una metodologia standard di prova di delaminazione. A tal fine, seguendo la metodologia del Round Robin, è stata preparata presso l’Università di Bologna una serie di provini in calcestruzzo rinforzati sia con lamine che con tessuti in CFRP. Gruppi di provini omogenei sono stati sottoposti a prova di delaminazione utilizzando apparecchiature, metodologie e procedure differenti. Ogni laboratorio ha eseguito 12 prove di delaminazione su provini con lunghezze di ancoraggio diverse ed ogni tipologia di prova è stata ripetuta tre volte da ogni laboratorio. L’analisi dei risultati ha consentito di valutare l’effetto sulla forza di delaminazione dei parametri caratterizzanti le diverse modalità di prova; sono state ottenute, inoltre, indicazioni sulla dispersione statistica dei risultati legata alla metodologia sperimentale adottata. Tale studio dovrebbe condurre alla definizione di una prova di delaminazione standard, la quale sarà indicata nelle nuove istruzioni CNR DT200 [2] per la caratterizzazione dell’interfaccia calcestruzzo-FRP