Translational Research in the Era of Precision Medicine: Where We Are and Where We Will Go

The advent of Precision Medicine has globally revolutionized the approach of translational research suggesting a patient-centric vision with therapeutic choices driven by the identification of specific predictive biomarkers of response to avoid ineffective therapies and reduce adverse effects. The spread of "multi-omics" analysis and the use of sensors, together with the ability to acquire clinical, behavioral, and environmental information on a large scale, will allow the digitization of the state of health or disease of each person, and the creation of a global health management system capable of generating real-time knowledge and new opportunities for prevention and therapy in the individual person (high-definition medicine). Real world data-based translational applications represent a promising alternative to the traditional evidence-based medicine (EBM) approaches that are based on the use of randomized clinical trials to test the selected hypothesis. Multi-modality data integration is necessary for example in precision oncology where an Avatar interface allows several simulations in order to define the best therapeutic scheme for each cancer patient

ECMO for COVID-19 patients in Europe and Israel

Since March 15th, 2020, 177 centres from Europe and Israel have joined the study, routinely reporting on the ECMO support they provide to COVID-19 patients. The mean annual number of cases treated with ECMO in the participating centres before the pandemic (2019) was 55. The number of COVID-19 patients has increased rapidly each week reaching 1531 treated patients as of September 14th. The greatest number of cases has been reported from France (n = 385), UK (n = 193), Germany (n = 176), Spain (n = 166), and Italy (n = 136) .The mean age of treated patients was 52.6 years (range 16–80), 79% were male. The ECMO configuration used was VV in 91% of cases, VA in 5% and other in 4%. The mean PaO2 before ECMO implantation was 65 mmHg. The mean duration of ECMO support thus far has been 18 days and the mean ICU length of stay of these patients was 33 days. As of the 14th September, overall 841 patients have been weaned from ECMO support, 601 died during ECMO support, 71 died after withdrawal of ECMO, 79 are still receiving ECMO support and for 10 patients status n.a. . Our preliminary data suggest that patients placed on ECMO with severe refractory respiratory or cardiac failure secondary to COVID-19 have a reasonable (55%) chance of survival. Further extensive data analysis is expected to provide invaluable information on the demographics, severity of illness, indications and different ECMO management strategies in these patients

Neutralizing antibodies to Omicron after the fourth SARS-CoV-2 mRNA vaccine dose in immunocompromised patients highlight the need of additional boosters

IntroductionImmunocompromised patients have been shown to have an impaired immune response to COVID-19 vaccines.MethodsHere we compared the B-cell, T-cell and neutralizing antibody response to WT and Omicron BA.2 SARS-CoV-2 virus after the fourth dose of mRNA COVID-19 vaccines in patients with hematological malignancies (HM, n=71), solid tumors (ST, n=39) and immune-rheumatological (IR, n=25) diseases. The humoral and T-cell responses to SARS-CoV-2 vaccination were analyzed by quantifying the anti-RBD antibodies, their neutralization activity and the IFN-γ released after spike specific stimulation.ResultsWe show that the T-cell response is similarly boosted by the fourth dose across the different subgroups, while the antibody response is improved only in patients not receiving B-cell targeted therapies, independent on the pathology. However, 9% of patients with anti-RBD antibodies did not have neutralizing antibodies to either virus variants, while an additional 5.7% did not have neutralizing antibodies to Omicron BA.2, making these patients particularly vulnerable to SARS-CoV-2 infection. The increment of neutralizing antibodies was very similar towards Omicron BA.2 and WT virus after the third or fourth dose of vaccine, suggesting that there is no preferential skewing towards either virus variant with the booster dose. The only limited step is the amount of antibodies that are elicited after vaccination, thus increasing the probability of developing neutralizing antibodies to both variants of virus.DiscussionThese data support the recommendation of additional booster doses in frail patients to enhance the development of a B-cell response directed against Omicron and/or to enhance the T-cell response in patients treated with anti-CD20

Assessment of the Air Pollution Level in the City of Rome (Italy)

Exposure to pollutants is usually higher in cities than in the countryside. Generally, in the urban areas pollution sources as traffic, power generator and domestic heating system are more intense and spatially distributed. The pollutants can be classified as a function of long-term toxicological effects due to an exposure and inhalation. In the present work, several kinds of pollutants concentration generated in Rome during 2015 have been analyzed applying different advanced post-processing technique. In particular, statistic and cross-statistic have been computed in time and phase space domain. As main result, it is observed, as expected, that all the pollutant concentrations increase during the winter season into a couple of time ranges despite of [O3] that has high values in summer. It can be clearly concluded that Rome has a strongly unsteady behaviour in terms of a family of pollutant concentration, which fluctuate significantly. It is worth noticing that there is a strong linear dependence between [C6H6] and [NO] and a more complex interdependence of [O3] and [C6H6]. Qualitatively is provided that, to a reduction of [C6H6] under a certain threshold level corresponds an increase of [O3]

Analysis of Two Models for Evaluating the Energy Performance of Different Buildings

Nowadays it is possible to employ several software packages to evaluate building’s energy performance, each of them based on a different calculation code, with different boundary conditions in terms of environmental temperature, solar radiation, wind velocity and relative humidity. In this contribution, a comparison between two calculation codes, taking into account different types of buildings, has been carried out. In particular, a semi-stationary calculation code and a dynamic one have been employed to determine energy demands of three different building’s types: an old building, a house and a flat. Analyzing semi-stationary conditions (consequently simplified environmental conditions), a software which applies the UNI TS 11300 standard has been considered. This standard defines the procedures for the national implementation of the UNI EN ISO 13790. Furthermore, in order to consider the environmental conditions variation, a well-known dynamic software has been used

Buildings Energy Efficiency: Interventions Analysis under a Smart Cities Approach

Most of the world’s population lives in urban areas and in inefficient buildings under the energy point of view. Starting from these assumptions, there is the need to identify methodologies and innovations able to improve social development and the quality of life of people living in cities. Smart cities can be a viable solution. The methodology traditionally adopted to evaluate building energy efficiency starts from the structure’s energy demands analysis and the demands reduction evaluation. Consequently, the energy savings is assessed through a cascade of interventions. Regarding the building envelope, the first intervention is usually related to the reduction of the thermal transmittance value, but there is also the need to emphasize the building energy savings through other parameters, such as the solar gain factor and dye solar absorbance coefficients. In this contribution, a standard building has been modeled by means of the well-known dynamic software, TRNSYS. This study shows a parametrical analysis through which it is possible to evaluate the effect of each single intervention and, consequently, its influence on the building energy demand. Through this analysis, an intervention chart has been carried out, aiming to assess the intervention efficiency starting from the percentage variation of energy demands

Influence of the Thermal Inertia in the European Simplified Procedures for the Assessment of Buildings’ Energy Performance

This study aims to highlight the importance of thermal inertia in buildings. Nowadays, it is possible to use energy analysis software to simulate the building energy performance. Considering Italian standards, these analyses are based on the UNI TS 11300 that defines the procedures for the national implementation of the UNI EN ISO 13790. These standards require an energy analysis under steady-state condition, underestimating the thermal inertia of the building. In order to understand the inertial behavior of walls, a cubic Test-Cell was modelled through the dynamic calculation code TRNSYS and three different wall types were tested. Different stratigraphies, characterized by the same thermal transmittance value, composed by massive elements and insulating layers in different order, were simulated. Through TRNSYS, it was possible to define maximum surface temperatures and to calculate thermal lag between maximum values, both external and internal. Moreover, the attenuation between external surface temperatures and internal ones during summer (July) was calculated. Finally, the comparison between Test-Cell’s annual energy demands, performed by using a commercial code based on the Italian standard UNITS 11300 and the dynamic code, TRNSYS, was carried out