Lopinavir/Ritonavir and Darunavir/Cobicistat in Hospitalized COVID-19 Patients: Findings From the Multicenter Italian CORIST Study

Background: Protease inhibitors have been considered as possible therapeutic agents for COVID-19 patients. Objectives: To describe the association between lopinavir/ritonavir (LPV/r) or darunavir/cobicistat (DRV/c) use and in-hospital mortality in COVID-19 patients. Study Design: Multicenter observational study of COVID-19 patients admitted in 33 Italian hospitals. Medications, preexisting conditions, clinical measures, and outcomes were extracted from medical records. Patients were retrospectively divided in three groups, according to use of LPV/r, DRV/c or none of them. Primary outcome in a time-to event analysis was death. We used Cox proportional-hazards models with inverse probability of treatment weighting by multinomial propensity scores. Results: Out of 3,451 patients, 33.3% LPV/r and 13.9% received DRV/c. Patients receiving LPV/r or DRV/c were more likely younger, men, had higher C-reactive protein levels while less likely had hypertension, cardiovascular, pulmonary or kidney disease. After adjustment for propensity scores, LPV/r use was not associated with mortality (HR = 0.94, 95% CI 0.78 to 1.13), whereas treatment with DRV/c was associated with a higher death risk (HR = 1.89, 1.53 to 2.34, E-value = 2.43). This increased risk was more marked in women, in elderly, in patients with higher severity of COVID-19 and in patients receiving other COVID-19 drugs. Conclusions: In a large cohort of Italian patients hospitalized for COVID-19 in a real-life setting, the use of LPV/r treatment did not change death rate, while DRV/c was associated with increased mortality. Within the limits of an observational study, these data do not support the use of LPV/r or DRV/c in COVID-19 patients

The rapid spread of SARS-COV-2 Omicron variant in Italy reflected early through wastewater surveillance

The SARS-CoV-2 Omicron variant emerged in South Africa in November 2021, and has later been identified worldwide, raising serious concerns. A real-time RT-PCR assay was designed for the rapid screening of the Omicron variant, targeting characteristic mutations of the spike gene. The assay was used to test 737 sewage samples collected throughout Italy (19/21 Regions) between 11 November and 25 December 2021, with the aim of assessing the spread of the Omicron variant in the country. Positive samples were also tested with a real-time RT-PCR developed by the European Commission, Joint Research Centre (JRC), and through nested RT-PCR followed by Sanger sequencing. Overall, 115 samples tested positive for Omicron SARS-CoV-2 variant. The first occurrence was detected on 7 December, in Veneto, North Italy. Later on, the variant spread extremely fast in three weeks, with prevalence of positive wastewater samples rising from 1.0% (1/104 samples) in the week 5–11 December, to 17.5% (25/143 samples) in the week 12–18, to 65.9% (89/135 samples) in the week 19–25, in line with the increase in cases of infection with the Omicron variant observed during December in Italy. Similarly, the number of Regions/Autonomous Provinces in which the variant was detected increased fromone in the first week, to 11 in the second, and to 17 in the last one. The presence of the Omicron variant was confirmed by the JRC real-time RT-PCR in 79.1% (91/115) of the positive samples, and by Sanger sequencing in 66% (64/97) of PCR amplicons

The rapid spread of SARS-COV-2 Omicron variant in Italy reflected early through wastewater surveillance

The SARS-CoV-2 Omicron variant emerged in South Africa in November 2021, and has later been identified worldwide, raising serious concerns. A real-time RT-PCR assay was designed for the rapid screening of the Omicron variant, targeting characteristic mutations of the spike gene. The assay was used to test 737 sewage samples collected throughout Italy (19/21 Regions) between 11 November and 25 December 2021, with the aim of assessing the spread of the Omicron variant in the country. Positive samples were also tested with a real-time RT-PCR developed by the European Commission, Joint Research Centre (JRC), and through nested RT-PCR followed by Sanger sequencing. Overall, 115 samples tested positive for Omicron SARS-CoV-2 variant. The first occurrence was detected on 7 December, in Veneto, North Italy. Later on, the variant spread extremely fast in three weeks, with prevalence of positive wastewater samples rising from 1.0% (1/104 samples) in the week 5-11 December, to 17.5% (25/143 samples) in the week 12-18, to 65.9% (89/135 samples) in the week 19-25, in line with the increase in cases of infection with the Omicron variant observed during December in Italy. Similarly, the number of Regions/Autonomous Provinces in which the variant was detected increased from one in the first week, to 11 in the second, and to 17 in the last one. The presence of the Omicron variant was confirmed by the JRC real-time RT-PCR in 79.1% (91/115) of the positive samples, and by Sanger sequencing in 66% (64/97) of PCR amplicons. In conclusion, we designed an RT-qPCR assay capable to detect the Omicron variant, which can be successfully used for the purpose of wastewater-based epidemiology. We also described the history of the introduction and diffusion of the Omicron variant in the Italian population and territory, confirming the effectiveness of sewage monitoring as a powerful surveillance tool

Clinical Features, Cardiovascular Risk Profile, and Therapeutic Trajectories of Patients with Type 2 Diabetes Candidate for Oral Semaglutide Therapy in the Italian Specialist Care

Introduction: This study aimed to address therapeutic inertia in the management of type 2 diabetes (T2D) by investigating the potential of early treatment with oral semaglutide. Methods: A cross-sectional survey was conducted between October 2021 and April 2022 among specialists treating individuals with T2D. A scientific committee designed a data collection form covering demographics, cardiovascular risk, glucose control metrics, ongoing therapies, and physician judgments on treatment appropriateness. Participants completed anonymous patient questionnaires reflecting routine clinical encounters. The preferred therapeutic regimen for each patient was also identified. Results: The analysis was conducted on 4449 patients initiating oral semaglutide. The population had a relatively short disease duration (42%  60% of patients, and more often than sitagliptin or empagliflozin. Conclusion: The study supports the potential of early implementation of oral semaglutide as a strategy to overcome therapeutic inertia and enhance T2D management

Influenza dei parametri idrogeologici nei processi di contaminazione del sottosuolo imputabili a rilasci accidentali di idrocarburi

Il presente lavoro di tesi si propone di esaminare i processi di contaminazione del suolo e delle acque sotterranee conseguenti ad un fenomeno di “oil spill”: con tale termine si vuole intendere un fenomeno di rilascio accidentale di sostanze chimiche, come il benzene, dovuto al danneggiamento di lunghe condotte onshore realizzate per trasferire, tali sostanze, anche per distanze di centinaia di chilometri. Sebbene le basse frequenze incidentali confermino che il trasporto in condotta rappresenta la modalità di movimentazione via terra più sicura per fluidi chimici, bisogna tuttavia tener presente che i quantitativi di sostanze che possono essere rilasciate da questi impianti sono molto elevati.In questo lavoro, si è partiti con l’esaminare un caso studio riportato in letteratura, relativo alla valutazione quantitativa del rischio ambientale legato a fenomeni di oil spill da condotte onshore [Bonvicini et al., 2014]. Si è considerato, in particolare, un singolo tratto di una lunga condotta industriale, in corrispondenza del quale si è ipotizzato il verificarsi di una rottura, con conseguente rilascio di contaminante nel sottosuolo. L’impianto in questione è finalizzato al trasporto di benzene (LNAPL), idrocarburo aromatico cancerogeno, fortemente pericoloso per l’ambiente e per l’uomo

Sustainability Assessment of Urban Water Use from Building to Urban Scale in the GST4Water Project

The present paper illustrates some of results obtained in the GST4Water project concerning the development of appropriate metrics, methods and tools for the assessment of economic and environmental sustainability of urban water systems at different scales for a variety of stakeholders. At the household scale and based on data and algorithms to represent residential water demand, we reconstruct the behavior of domestic users and develop a suite of indicators accounting for consumption performances and sustainability, and a software tool geared at the needs of water consumers. Considering multiple scales ranging from household to urban, we develop a model based on urban metabolism, able to evaluate several performance indicators for both sustainability assessment and benchmark, comparing the impact of different management options for water demand and reuse

Green Smart Technology for Water (GST4Water): Life Cycle Analysis of Urban Water Consumption

The increasing scarcity of water is encouraging strategies in water saving and urban water management systems devoted to reducing natural resource consumption and environmental impact. At household and urban scales, there is an increasing interest in onsite greywater and non-potable water reuse systems in order to improve water availability. In this framework, the project GST4Water funded by the European Union (EU) under the POR-FESR 2014⁻2020 Program of Emilia-Romagna Region, has been developed with the aim to implement water consumption monitoring systems, to define solutions for greywater reuse, and to develop tools for environmental sustainability evaluation applied to water systems. The present study focuses on this last goal, performing a life cycle assessment of the solutions optimized at a district level. In particular, six different scenarios are compared, starting from two models considering traditional water supply together with or without energy consumption related to hot water generation, and five additional models related with different assumptions in terms of greywater recovery systems, and energy and hot water production, at varying percentages of renewable and photovoltaic energy supply. Finally, an evaluation of the return time of environmental investment is carried out, based on the results obtained through the scenario analysis