Increasing Number of Cases Due to Candida auris in North Italy, July 2019–December 2022

Candida auris is an emerging fungus that represents a serious health threat globally. In Italy, the first case was detected in July 2019. Then, one case was reported to the Ministry of Health (MoH) on January 2020. Nine months later, a huge number of cases were reported in northern Italy. Overall, 361 cases were detected in 17 healthcare facilities between July 2019 and December 2022 in the Liguria, Piedmont, Emilia-Romagna, and Veneto regions, including 146 (40.4%) deaths. The majority of cases (91.8%) were considered as colonised. Only one had a history of travel abroad. Microbiological data on seven isolates showed that all but one strain (85.7%) were resistant to fluconazole. All the environmental samples tested negative. Weekly screening of contacts was performed by the healthcare facilities. Infection prevention and control (IPC) measures were applied locally. The MoH nominated a National Reference Laboratory to characterise C. auris isolates and store the strains. In 2021, Italy posted two messages through the Epidemic Intelligence Information System (EPIS) to inform on the cases. On February 2022, a rapid risk assessment indicated a high risk for further spread within Italy, but a low risk of spread to other countries

Uric acid relationships with lipid profile and adiposity indices: Impact of different hyperuricemic thresholds

Abstract Previous studies focused on the relationships between Serum Uric Acid (SUA) and lipids have found an association mainly with triglycerides. Furthermore, previous studies on adiposity indices have been focused on the evaluation of the Visceral Adiposity Index (VAI). The present study was aimed at providing within the same population a systematic evaluation of lipids and adiposity indices with SUA, employing both the classic cutoff for hyperuricemia and the newly one identified by the Uric Acid Right for Heart Health (URRAH) study. We analyzed data collected in 1892 subjects of the Pressioni Arteriose Monitorate E loro Associazioni (PAMELA) study with available SUA, lipid profile and variables necessary to calculate VAI, Cardio‐Metabolic Index (CMI) and Lipid Accumulation Product (LAP). At linear regression model (corrected for confounders) SUA correlated with all the lipids values (with the strongest β for triglycerides) and adiposity indices. When the two different cutoffs were compared, the URRAH one was significantly related to atherogenic lipids profile (OR 1.207 for LDL and 1.33 for non‐HDL, P < 0.001) while this was not the case for the classic one. Regarding adiposity indices the classic cutoff displays highest OR as compared to the URRAH one. In conclusions, newly reported URRAH cutoff for hyperuricemia better relate to atherogenic lipoprotein (LDL and non‐HDL) when compared to the classic one. The opposite has been found for adiposity indexes where the classic cut‐off seems to present highest performance. Among adiposity indexes, LAP present the highest OR for the relationship with hyperuricemia

Cleaning of the eddy current effects from magnetic diagnostics

The plasma configuration in tokamaks is created and controlled by magnetic fields generated by the external coils. Similarly, plasma macroscopic parameters are determined using sensors measuring magnetic field or magnetic flux. Some algorithms require separation of the plasma contribution from the contribution of poloidal field coils and currents induced in passive structures. In this paper, an efficient, real-time applicable method is introduced. The method is based on the identification of a state-space model in vacuum shots using both experimental and finite-element model data. The tests were performed for ISTTOK and RFX-mod. In Section II, a simple method for plasma position determination for ISTTOK is proposed. We show that the centroid position measurement by magnetic diagnostics is feasible using our algorithm for separation of the plasma signal. The correctness of the resulting method is proven by comparison with the results of the heavy-ion beam

Simultaneous Care in Oncology: A 7-Year Experience at ESMO Designated Centre at Veneto Institute of Oncology, Italy

Benefits of early palliative care referral in oncology are well-validated. At the Veneto Institute of Oncology-IRCCS, a simultaneous-care outpatient clinic (SCOC) has been active since 2014, where patients with advanced cancer are evaluated by an oncologist together with a palliative care team. We prospectively assessed SCOC patients’ characteristics and SCOC outcomes through internal procedure indicators. Data were retrieved from the SCOC prospectively maintained database. There were 753 eligible patients. The median age was 68 years; primary tumor sites were gastrointestinal (75.2%), genitourinary (15.0%) and other sites (9.8%). Predominant symptoms were psychological issues (69.4%), appetite loss (67.5%) and pain (65.9%). Dyspnea was reported in 53 patients (7%) in the referral form, while it was detected in 226 patients (34.2%) during SCOC visits (p < 0.0001). Median survival of patients after the SCOC visit was 7.3 months. Survival estimates by the referring oncologist were significantly different from the actual survival. Psychological intervention was deemed necessary and undertaken in 34.6% of patients, and nutritional support was undertaken in 37.9% of patients. Activation of palliative care services was prompted for 77.7% of patients. Out of 357 patients whose place of death is known, 69.2% died at home, in hospice or residential care. With regard to indicators’ assessment, the threshold was reached for 9 out of 11 parameters (81.8%) requested by the procedure. This study confirmed the importance of close collaboration between oncologists and palliative care teams in responding properly to cancer patients’ needs. The introduction of a procedure with indicators allowed punctual assessment of a team’s performance

Ecosystem vulnerability to alien and invasive species: a case study on marine habitats along the Italian coast

1. Spread of alien species (AS) is a serious threat to marine habitats and analysis of principal descriptors of their occurrence is pivotal to set reliable conservation strategies. 2. In order to assess the susceptibility of marine habitats to biological invasions, a dataset was gathered of the occurrence of 3899 species from 29 phyla, taken from 93 marine sites located along the Italian coast in the period 2000\u20132012. 3. In total, 61 AS belonging to 11 phyla have been recorded. Invertebrates were the most represented (63%). Alien species were found in all the habitats examined (EUNIS, level 2), although they showed highest abundance in benthic habitats. Most of the AS were associated with a single EUNIS habitat, while some of them were present in more than one habitat. Trans-habitat occurrence suggests the potential invasiveness of AS. 4. According to statistical analysis, AS recorded could have been more numerous, since some of the marine habitats seemed to be still unsaturated. The model that best describes the spread of AS takes account of both native species richness (Rn) and EUNIS habitat type as explanatory variables. The number of observed AS was directly related to Rn and it was highest in rocky circalittoral and infralittoral habitats. 5. The results of this macro-ecological study focus on the importance of performing large-scale studies, since adopting ecosystem approaches to marine invasion management seems especially fruitful. 6. The results, moreover, highlight the importance of AS monitoring of different habitats, from those subjected to anthropogenic pressure, historically considered to be hubs of introduction of AS, to the most biologically rich and diverse marine habitats. Indeed, it is necessary to set monitoring strategies to detect the introduction, the distribution and persistence of AS over time. These recommendations are especially significant in the light of the strategic plans currently under formulation in Mediterranean countries with regard to AS monitorin