Vaccination for seasonal influenza in patients with cancer: Recommendations of the Italian Society of Medical Oncology (AIOM)

Background: Influenza virus causes annual epidemics in the winter\u2013spring season with significant morbidity in the general population and important mortality in high-risk groups, including cancer patients. Opinions on the suitability of patients with malignancies not undergoing active treatment and in different phases of antineoplastic therapy, to receive influenza vaccination, vary considerably among oncologists, sometimes even within one center. Methods: We reviewed available data, including recommendations by national health authorities, on impact of influenza in patients with cancer and their capacity to mount protective immunological responses to vaccination, thus allowing, on behalf of Italian Association of Medical Oncology, to make suitable recommendations for the prevention and treatment of seasonal influenza. Results and discussion: Patients with cancer often have disease- or treatment-related immunosuppression, and as a consequence, they may have a suboptimal serologic response to influenza vaccination. The protective effect of the differ- ent preparations of influenza vaccines in patients with cancer has not been widely investigated, especially in adult patients harboring solid tumors. The optimal timing for administration of influenza vaccines in patients receiving chemotherapy is also not clearly defined. However, since vaccination is the most effective method, along with antiviral drugs in selected patients, for preventing influenza infection, it has to be recommended for cancer patients. Implementing vaccination of close contacts of oncology patients would be an additional tool for enhancing protection in fragile patient populations

Characterization of low pathogenic H5 subtype influenza viruses from Eurasia: Implications for the origin of highly pathogenic H5N1 viruses

Oral Presentations - Genetic and Antigenic EvolutionHighly pathogenic avian influenza (HPAI) H5N1 viruses are now endemic in many Asian countries. The immediate precursor of these HPAI viruses was recognized as A/Goose/Guangdong/1/96 (Gs/Gd)-like H5N1 HPAI viruses first detected in Guangdong in 1996. However, precursors of the Gs/GD-like viruses and their subsequent reassortants have not been fully determined. Here we characterize low pathogenic avian influenza (LPAI) H5 subtype viruses isolated from poultry and migratory birds in southern China and Europe from the 1970s to the 2000s. Phylogenetic analyses revealed that Gs/GD-like virus was likely derived from an LPAI H5 virus in migratory birds. However, its variants arose from multiple reassortments between Gs/GD-like virus and viruses from migratory birds, or with those Eurasian viruses isolated in the 1970s. It is of note that unlike HPAI H5N1 viruses, those recent LPAI H5 viruses have not become established in aquatic or terrestrial poultry. Phylogenetic analyses revealed the dynamic nature of the influenza gene pool in Eurasia with repeated transmissions between the eastern and western extremities of the continent. The data also shows reassortment between influenza viruses from domestic and migratory birds in this region that has contributed to the expanded diversity of the influenza gene pool among poultry in Eurasia ...postprin

Human and animal integrated influenza surveillance: a novel sampling approach for an additional transmission way in the aquatic bird reservoir.

Background: infectious low pathogenic avian influenza viruses (LPAIVs) have been recently detected on feathers of wild ducks. Laboratory trial results suggested that the preen oil gland secretion, covering waterbirds\u2019 feathers, may attract and concentrate virus particles from AIV-contaminated waters to birds\u2019 bodies. We evaluated whether ducks can become infected by the ingestion of preen oil-associated viral particles, experimentally smeared on their plumage. In addition, we compared virologic and serologic results obtained from mallards whose feathers were experimentally infected, with those from wild mallards naturally carrying AIVs on feathers. Methods: we experimentally coated 7 mallards (Anas plathyrynchos) using preen oil mixed with a LPAIV (H10N7 subtype), and housed them for 45 days with a control, uncoated duck. Cloacal, oropharyngeal and feather swabs were collected from all birds and examined for AIV molecular detection and isolation. Blood samples were also taken to detect influenza specific antibodies. In addition, sera from 10 wild mallards, carrying on feathers infectious LPAIV H10N7, were examined. Results: virologic and serologic results indicated that through self- and allopreening all the birds experimentally coated with the preen oil/AIV mix and the control duck ingested viruses covering feathers and became infected. Virus isolation from feathers was up to 32 days post-coating treatment. One out of 8 wild mallards showing antibodies against type A influenza virus was seropositive for H10 subtype too. Conclusions: our experimental and field results show evidences suggesting that uninfected birds carrying viruses on their feathers, including immune ones, might play an active role in spreading AIV infection in nature. For this reason, routine AIV surveillance programs, aimed at detecting intestinal and/or respiratory viruses, should include the collection of samples, such as feather swabs, enabling the detection of viruses sticky to preened birds\u2019 bodies

Analysis of Oscillations and Defect Measures for the Quasineutral Limit in Plasma Physics

We perform a rigorous analysis of the quasineutral limit for a hydrodynamical model of a viscous plasma represented by the Navier Stokes Poisson system in $3-D$. We show that as $\lambda\to 0$ the velocity field $u^{\lambda}$ strongly converges towards an incompressible velocity vector field $u$ and the density fluctuation $\rho^{\lambda}-1$ weakly converges to zero. In general the limit velocity field cannot be expected to satisfy the incompressible Navier Stokes equation, indeed the presence of high frequency oscillations strongly affects the quadratic nonlinearities and we have to take care of self interacting wave packets. We shall provide a detailed mathematical description of the convergence process by using microlocal defect measures and by developing an explicit correctors analysis. Moreover we will be able to identify an explicit pseudo parabolic pde satisfied by the leading correctors terms. Our results include all the previous results in literature, in particular we show that the formal limit holds rigorously in the case of well prepared data.Comment: Submitted pape

PERFORMANCE ASSESSMENT OF A LARGE INTERNAL COMBUSTION ENGINE DUE TO INLET AIR COOLING AND DEHUMIDIFICATION: GT-POWER SOFTWARE SIMULATION

Large internal combustion engines (ICEs) performance is limited by knocking phenomenon due to harsh ambient conditions such as hot temperature and excessive humidity. The performance of these engines can be enhanced by cooling and dehumidifying the inlet air on turbocharger upstream under safe operation conditions through a cooling coil heat exchanger, hence, increasing the power output as well as reducing the brake specific fuel consumption and pollutant specific emissions. Analysis have been performed in the GT-POWER software through a 1-D thermodynamic modelling of the Wärtsilä W20V34SG engine, making it possible to verify the influence of cooled and dehumidified ambient air, considering a temperature range from 9.5°C (282.7 K) to 15.5°C (288.7 K), while keeping 1 bar for pressure and relative humidity of 100%. Furthermore, the brake mean effective pressure (BMEP) has been set from 20 to 23.45 bar with a step of 1.15 bar. Such simulations are aimed to find the maximum air temperature at the cooling coil outlet in which the average of maximum cylinder pressures does not exceed the safety limit pressure of 186 bar while maintaining control on the wastegate valve. As a result, it was possible to evaluate that the maximum temperature to be chosen, under the conditions already mentioned, should be lower than 13.8°C (287 K)

Dynamic interactions between coastal storms and salt marshes: A review

This manuscript reviews the progresses made in the understanding of the dynamic interactions between coastal storms and salt marshes, including the dissipation of extreme water levels and wind waves across marsh surfaces, the geomorphic impact of storms on salt marshes, the preservation of hurricanes signals and deposits into the sedimentary records, and the importance of storms for the long term survival of salt marshes to sea level rise. A review of weaknesses, and strengths of coastal defences incorporating the use of salt marshes including natural, and hybrid infrastructures in comparison to standard built solutions is then presented. Salt marshes are effective in dissipating wave energy, and storm surges, especially when the marsh is highly elevated, and continuous. This buffering action reduces for storms lasting more than one day. Storm surge attenuation rates range from 1.7 to 25 cm/km depending on marsh and storms characteristics. In terms of vegetation properties, the more flexible stems tend to flatten during powerful storms, and to dissipate less energy but they are also more resilient to structural damage, and their flattening helps to protect the marsh surface from erosion, while stiff plants tend to break, and could increase the turbulence level and the scour. From a morphological point of view, salt marshes are generally able to withstand violent storms without collapsing, and violent storms are responsible for only a small portion of the long term marsh erosion. Our considerations highlight the necessity to focus on the indirect long term impact that large storms exerts on the whole marsh complex rather than on sole after-storm periods. The morphological consequences of storms, even if not dramatic, might in fact influence the response of the system to normal weather conditions during following inter-storm periods. For instance, storms can cause tidal flats deepening which in turn promotes wave energy propagation, and exerts a long term detrimental effect for marsh boundaries even during calm weather. On the other hand, when a violent storm causes substantial erosion but sediments are redistributed across nearby areas, the long term impact might not be as severe as if sediments were permanently lost from the system, and the salt marsh could easily recover to the initial state

Efficient CSL Model Checking Using Stratification

For continuous-time Markov chains, the model-checking problem with respect to continuous-time stochastic logic (CSL) has been introduced and shown to be decidable by Aziz, Sanwal, Singhal and Brayton in 1996. Their proof can be turned into an approximation algorithm with worse than exponential complexity. In 2000, Baier, Haverkort, Hermanns and Katoen presented an efficient polynomial-time approximation algorithm for the sublogic in which only binary until is allowed. In this paper, we propose such an efficient polynomial-time approximation algorithm for full CSL. The key to our method is the notion of stratified CTMCs with respect to the CSL property to be checked. On a stratified CTMC, the probability to satisfy a CSL path formula can be approximated by a transient analysis in polynomial time (using uniformization). We present a measure-preserving, linear-time and -space transformation of any CTMC into an equivalent, stratified one. This makes the present work the centerpiece of a broadly applicable full CSL model checker. Recently, the decision algorithm by Aziz et al. was shown to work only for stratified CTMCs. As an additional contribution, our measure-preserving transformation can be used to ensure the decidability for general CTMCs.Comment: 18 pages, preprint for LMCS. An extended abstract appeared in ICALP 201

Submucosal Tunnel Endoscopic Resection of Gastric Lesion Before Obesity Surgery: a Case Series

Background: Submucosal tumors (SMTs) of the gastrointestinal tract are a rare pathological entity comprising a wide variety of neoplastic and non-neoplastic lesions. Even if most SMTs are benign tumors (e.g., leiomyomas), a smaller portion may have a malignant potential (e.g., gastrointestinal stromal tumor (GIST)). Preoperative diagnosis of SMT in bariatric patients may arise challenging clinical dilemmas. Long-term surveillance may be difficult after bariatric surgery. Moreover, according to SMT location, its presence may interfere with planned surgery. Submucosal tunneling endoscopic resection (STER) has emerged as an effective approach for minimally invasive en bloc excision of SMTs. This is the first case series of STER for SMTs before bariatric surgery. Methods: Seven female patients underwent STER for removal of SMTs before bariatric surgery. All lesions were incidentally diagnosed at preoperative endoscopy. STER procedural steps comprised mucosal incision, submucosal tunneling, lesion enucleation, and closure of mucosal defect. Results: En bloc removal of SMT was achieved in all cases. Mean procedural time was of 45 min (SD 18.6). No adverse event occurred. Mean size of the lesions was 20.6 mm (SD 5.8). Histological diagnoses were 5 leyomiomas, 1 lipoma, and 1 low grade GIST. Bariatric procedure was performed after a mean period of 4.1 months (SD 1.6) from endoscopic resection. Conclusion: STER is a safe and effective treatment for the management of SMT even in bariatric patients awaiting surgery. Preoperative endoscopic resection of SMTs has the advantages of reducing the need for surveillance and removing lesions that could interfere with planned surgery. STER did not altered accomplishment of bariatric procedures