Cluster of legionnaires’ disease in an Italian prison

Background: Legionella pneumophila (Lp) is the most common etiologic agent causing Legionnaires’ Disease (LD). Water systems offer the best growth conditions for Lp and support its spread by producing aerosols. From 2015 to 2017, the Regional Reference Laboratory of Clinical and Environmental Surveillance of Legionellosis of Palermo monitored the presence of Lp in nine prisons in Western Sicily. During this investigation, we compared Lp isolates from environmental samples in a prison located in Palermo with isolates from two prisoners in the same prison. Methods: We collected 93 water samples from nine Sicilian prisons and the bronchoalveolar lavages (BALs) of two prisoners considered cases of LD. These samples were processed following the procedures described in the Italian Guidelines for the Prevention and Control of Legionellosis of 2015. Then, genotyping was performed on 19 Lp colonies (17 from water samples and 2 from clinical samples) using the Sequence-Based Typing (SBT) method, according to European Study Group for Legionella Infections (ESGLI) protocols. Results: Lp serogroup (sg) 6 was the most prevalent serogroup isolated from the prisons analyzed (40%), followed by Lp sg 1 (16%). Most of all, in four penitentiary institutions, we detected a high concentration of Lp >104 Colony Forming Unit/Liter (CFU/L). The environmental molecular investigation found the following Sequence Types (STs) in Lp sg 6: ST 93, ST 292, ST 461, ST 728, ST 1317 and ST 1362, while most of the isolates in sg 1 belonged to ST 1. We also found a new ST that has since been assigned the number 2451 in the ESGLI-SBT database. From the several Lp sg 1 colonies isolated from the two BALs, we identified ST 2451. Conclusions: In this article, we described the results obtained from environmental and epidemiological investigations of Lp isolated from prisons in Western Sicily. Furthermore, we reported the first cluster of Legionnaires’ in an Italian prison and the molecular typing of Lp sg 1 from one prison’s water system and two BALs, identified the source of the contamination, and discovered a new ST

Detection potential to point-like neutrino sources with the NEMO-km3 telescope

The NEMO Collaboration is conducting an R&D activity towards the construction of a Mediterranean km3 neutrino telescope. In this work, we present the results of Monte Carlo simulation studies on the capability of the proposed NEMO telescope to detect and identify point-like sources of high energy muon neutrinos.Comment: To be published on BCN06 proceedings (Barcelona, July 4-7, 2006

Seismic potential in the Italian Peninsula from integration and comparison of seismic and geodetic strain rates.

Seismological and geodetic data provide key information about the kinematics and active tectonics of plate margins. Focal solutions enable determining the directions in which the current tectonic stress acts when fault rupturing occurs; GPS measurements provide information on the crustal velocity field and on current interseismic strain rates. The comparison of the strain rates resulting from the two datasets provides further insight into how large an area is affected by aseismic deformation, which is a valuable indicator for seismic hazard mitigation and estimating the seismic potential. In this work, we investigate both seismic and geodetic strain rates and the combined field resulting from the joint inversion of the geodetic and seismic datasets, providing a picture of the overall deformation field and its variation during the last decades. In this way, we seek to give an overview of the seismic potential distribution across the Apennines and southern Italy, as a qualitative analysis of space-time variations in the released seismic strain rate, compared to the space-time distribution of the cumulated geodetic strain rate. The results show a variable distribution of the seismic efficiency over the peninsula. The Southern Apennines shows the greatest seismic potential, highlighting a significantly lower seismicity in the last two decades over an area affected by the highest total strain rates. The Messina Straits and eastern Sicily have a significant seismic potential, together with the Calabrian arc (from the Tindari-Letojanni and central Aeolian islands to the Mt. Pollino area), as a result of seismic gaps with respect to the combined strain rates in the investigated period. This long gap highlights the longer recurrence periods for the strongest earthquakes on this area. The central-northern Apennines and off-shore northern Sicily, show a lower seismic potential than central-southern Apennines, probably due to the more recent seismicity affecting these areas

Smoking ban : a long-term analysis of the Malta paradox in a population of over 400,000 subjects

Objectives: The introduction of laws that make indoor public areas and workplaces smoke-free has resulted in a significant reduction in the incidence of acute coronary syndromes (ACS). Malta was the second European country to introduce the smoking ban legislation in April 2004. The purpose of the study was to investigate the impact of the smoking ban in Malta on ACS morbidity and mortality. Methods: The number of ACS hospital admissions and the number of cardiovascular deaths were retrospectively analysed. The annual data for 5 years prior to and following the introduction of the Tobacco Act were obtained according to age-groups for both genders. Poisson regression analyses were performed to assess for decline in ACS admission and cardiovascular death. Results: The ACS admission rate increased throughout the 5 years following the introduction of the smoking ban. There was no change in mortality rate in the 5 years following the legislation, except in 2007 when a small but significant decline was noted. Conclusions: The Malta smoking ban did not have a significant impact on cardiovascular mortality and ACS admissions rates, indicating the need for proper enforcement of the public smoking ban and increase in public awareness regarding the adverse effects of smoking.peer-reviewe

Bridging the productivity gap between different areas in the UK

An economic strategy that helps the UK respond to change and tackle stagnant living standards and weak productivity will need to address stubborn spatial disparities in economic performance across the UK. Addressing these disparities requires a good understanding of their extent, causes and consequences. Paul Brandily, Mimosa Distefano, Hélène Donnat, Immanuel Feld, Henry G. Overman, and Krishan Shah outline what is known about disparities in productivity across the country, the factors that determine them, and the changes that would be needed to reduce them

Epidermal growth factor, oestrogen and progesterone receptor expression in primary ovarian cancer: correlation with clinical outcome and response to chemotherapy.

The expression of epidermal growth factor receptor (EGFR), oestrogen receptor (ER) and progesterone receptor (PR) was assayed by a radioreceptor method in 117 primary ovarian cancers. EGFR was not significantly related to any of the clinicopathological parameters examined. In patients with stage II-IV disease who underwent second-look surgery after primary chemotherapy, a significant correlation between high EGFR levels and poor response to chemotherapy was demonstrated (P = 0.031). Moreover, post-operative residual tumour showed an independent role in predicting chemotherapy response (P = 0.0007) and EGFR status showed a borderline significance (P = 0.052) in the multivariate analysis. No correlation between steroid hormone receptors and clinicopathological parameters was observed. Whereas a significant relationship was shown between EGFR positivity and a shorter overall survival (OS) (P = 0.0022) and progression-free survival (PFS) (P = 0.0033), patient survival was not related to steroid hormone receptor status. Among the parameters tested only stage, ascites and EGFR status retained an independent prognostic value in the multivariate analysis

Prognostic significance of epidermal growth factor receptor in laryngeal squamous cell carcinoma.

Epidermal growth factor receptor (EGFR) content was determined by a radioligand receptor assay in 140 primary laryngeal squamous cell carcinomas (median value of 8.4 fmol mg-1 protein, range 0-169.9 fmol mg-1 protein). Cox univariate regression analysis using EGFR as a continuous variable showed that EGFR levels are directly associated with the risk of death (chi 2 = 14.56, P-value = 0.0001) and relapse (chi 2 = 7.77, P-value = 0.0053). A significant relationship between EGFR status and survival was observed at the different arbitrary cut-off values chosen (8, 16 and 20 fmol mg-1 protein). The cut-off value of 20 fmol mg-1 protein was the best prognostic discriminator. In fact, the 5 year survival was 81% for patients with EGFR- tumours compared with 25% for patients with EGFR+ tumours (P < 0.0001). The 5 year relapse-free survival was 77% for patients with EGFR- tumours compared with 24% for patients with EGFR+ tumours (P < 0.010). When clinicopathological parameters and EGFR status were examined in the multivariate analysis, T classification and EGFR status retained an independent prognostic value. In this study we demonstrated that high EGFR levels single out patients with poor prognosis in laryngeal cancer

Physiological and driving behaviour changes associated to different road intersections

Road traffic injuries claim more than 1.2 million lives each year in the world and have a huge impact on health and development. It is commonly acknowledged that the human factor and the interaction between the human factor and the road environment are among the most common causes of road accidents. Intersections are among the most complex road environments: their geometric and traffic characteristics weigh the driver workload, affecting the driving behaviour and consequently the risk of accident. This study intends therefore to contribute for a better understanding of the relationship between different types of intersection and the human factor. The ultimate aim is to understand how at grade intersections affect the driving behaviour by comparing the drivers’ stress level for roundabouts and standard intersections. Electrodermal activity can provide a real-time assessment of the driver's stress level. Electrodermal activity was therefore collected continuously during a driving study which took place on a test environment based at Cranfield University and surrounding roads. Twenty participants were involved within the study. The analysis focused on four crossing manoeuvres on three at grade intersections (two T-junctions and a roundabout) situated on the study location. Results showed that the number of SCR peaks as well as the amplitude of the peaks are overall higher for the two manoeuvres on the roundabout. The stress level induced by each type of intersection was evaluated through an Electrodermal Impact Index which takes into account both the number and the amplitude of SCR peaks. Results suggested that the stress level induced by roundabouts is more than double that induced by standard intersections