Il servizio WCTS del Geoportale Nazionale

The 2007/2/CE INSPIRE directive requires every Member State to implement a set of services to facilitate the interchange of spatial data; the Coordinate Transformation Service (CTS) is one of the geometric transformation services required by the directive. The Italian National Geoportal (GN) has recently published a new set of public access services that enable the users to transform and convert the coordinate reference system of geographic data within the Italian territory using the high-accuracy correction data provided by the Istituto Geografico Militare Italiano (IGM). This article will illustrate these newly published services: a browser-based web application to transform raster and vector files or sets of coordinates and an OGC-compliant Web Coordinate Transformation Service (WCTS) that performs on the fly transformation of GML (Geography Markup Language) data

Acute decompensated heart failure in the emergency department: Identification of early predictors of outcome

Identification of clinical factors that can predict mortality and hospital early readmission in acute decompensated heart failure (ADHF) patients can help emergency department (ED) physician optimize the care-path and resource utilization.We conducted a retrospective observational study of 530 ADHF patients evaluated in the ED of an Italian academic hospital in 2013.Median age was 82 years, females were 55%; 31.1% of patients were discharged directly from the ED (12.5% after short staying in the observation unit), while 68.9% were admitted to a hospital ward (58.3% directly from the ED and 10.6% after a short observation). At 30 days, readmission rate was 17.7% while crude mortality rate was 9.4%; this latter was higher in patients admitted to a hospital ward in comparison to those who were discharged directly from the ED (12.6% vs. 2.4%, P\u200a 104\u200amm Hg, POS\u200a>\u200a94%, may guide the ED physician to identify low-risk patients who can be safely discharged directly from the emergency room or after observation unit stay

Growth of a sinkhole in a seismic zone of the northern Apennines (Italy)

Sinkhole collapse is a major hazard causing substantial social and economic losses. However, the surface deformations and sinkhole evolution are rarely recorded, as these sites are known mainly after a collapse, making the assessment of sinkhole-related hazard challenging. Furthermore, more than 40% of the sinkholes of Italy are in seismically hazardous zones; it remains unclear whether seismicity may trigger sinkhole collapse. Here we use a multidisciplinary data set of InSAR, surface mapping and historical records of sinkhole activity to show that the Prà di Lama lake is a long-lived sinkhole that was formed in an active fault zone and grew through several events of unrest characterized by episodic subsidence and lake-level changes. Moreover, InSAR shows that continuous aseismic subsidence at rates of up to 7.1mmyr-1occurred during 2003-2008, between events of unrest. Earthquakes on the major faults near the sinkhole do not trigger sinkhole activity but low-magnitude earthquakes at 4-12 km depth occurred during sinkhole unrest in 1996 and 2016. We interpret our observations as evidence of seismic creep at depth causing fracturing and ultimately leading to the formation and growth of the Prà di Lama sinkhole

Runx2 stimulates neoangiogenesis through the Runt domain in melanoma

Runx2 is a transcription factor involved in melanoma cell migration and proliferation. Here, we extended the analysis of Runt domain of Runx2 in melanoma cells to deepen understanding of the underlying mechanisms. By the CRISPR/Cas9 system we generated the Runt KO melanoma cells 3G8. Interestingly, the proteome analysis showed a specific protein signature of 3G8 cells related to apoptosis and migration, and pointed out the involvement of Runt domain in the neoangiogenesis process. Among the proteins implicated in angiogenesis we identified fatty acid synthase, chloride intracellular channel protein-4, heat shock protein beta-1, Rho guanine nucleotide exchange factor 1, D-3-phosphoglycerate dehydrogenase, myosin-1c and caveolin-1. Upon querying the TCGA provisional database for melanoma, the genes related to these proteins were found altered in 51.36% of total patients. In addition, VEGF gene expression was reduced in 3G8 as compared to A375 cells; and HUVEC co-cultured with 3G8 cells expressed lower levels of CD105 and CD31 neoangiogenetic markers. Furthermore, the tube formation assay revealed down-regulation of capillary-like structures in HUVEC co-cultured with 3G8 in comparison to those with A375 cells. These findings provide new insight into Runx2 molecular details which can be crucial to possibly propose it as an oncotarget of melanoma

Contributi alla flora vascolare di Toscana. VII (357-439)

New localities and/or confirmations concerning 83 specific and subspecific plant taxa of Tuscan vascular flora, belonging to 71 genera and 33 families are presented: Carpobrotus (Aizoaceae), Alternanthera (Amaranthaceae), Leucojum (Amaryllidaceae), Anacyclus, Andryala, Carduus, Centaurea, Cichorium, Erigeron, Helichrysum, Helminthotheca, Hieracium, Limbarda, Pilosella, Scolymus, Sonchus, Tagetes, Urospermum, Xanthium (Asteraceae), Mahonia (Berberidaceae), Myosotis (Boraginaceae), Biscutella, Ionopsidium, Raphanus, Rapistrum (Brassicaceae), Buxus (Buxaceae), Vaccaria (Caryophyllaceae), Cistus (Cistaceae), Calystegia, Cuscuta (Convolvulaceae), Cymodocea (Cymodoceaceae), Cyperus (Cyperaceae), Amorpha, Emerus, Lathyrus, Lotus, Ononis, Trifolium, Vicia (Fabaceae), Quercus (Fagaceae), Geranium (Geraniaceae), Myriophyllum (Haloragaceae), Malva (Malvaceae), Epipogium, Himantoglossum (Orchidaceae), Orobanche (Orobanchaceae), Osyris (Santalaceae), Oxalis (Oxalidaceae), Pinus (Pinaceae), Anisantha, Avellinia, Avena, Corynephorus, Crypsis, Cutandia, Elytrigia, Lolium, Panicum, Polypogon, Sporobolus (Poaceae), Rumex (Polygonaceae), Lysimachia (Primulaceae), Eranthis, Ranunculus (Ranunculaceae), Rubus (Rosaceae), Crucianella, Galium (Rubiaceae), Verbascum (Scrophulariaceae), Solanum (Solanaceae), Tamarix (Tamaricaceae), Viola (Violaceae). In the end, the conservation status of the units and eventual protection of the cited biotopes are discussed

Effect of Lactoferrin on Clinical Outcomes of Hospitalized Patients with COVID-19: The LAC Randomized Clinical Trial

: As lactoferrin is a nutritional supplement with proven antiviral and immunomodulatory abilities, it may be used to improve the clinical course of COVID-19. The clinical efficacy and safety of bovine lactoferrin were evaluated in the LAC randomized double-blind placebo-controlled trial. A total of 218 hospitalized adult patients with moderate-to-severe COVID-19 were randomized to receive 800 mg/die oral bovine lactoferrin (n = 113) or placebo (n = 105), both given in combination with standard COVID-19 therapy. No differences in lactoferrin vs. placebo were observed in the primary outcomes: the proportion of death or intensive care unit admission (risk ratio of 1.06 (95% CI 0.63-1.79)) or proportion of discharge or National Early Warning Score 2 (NEWS2) ≤ 2 within 14 days from enrollment (RR of 0.85 (95% CI 0.70-1.04)). Lactoferrin showed an excellent safety and tolerability profile. Even though bovine lactoferrin is safe and tolerable, our results do not support its use in hospitalized patients with moderate-to-severe COVID-19

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 ± 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys

Fatality rate and predictors of mortality in an Italian cohort of hospitalized COVID-19 patients

Clinical features and natural history of coronavirus disease 2019 (COVID-19) differ widely among different countries and during different phases of the pandemia. Here, we aimed to evaluate the case fatality rate (CFR) and to identify predictors of mortality in a cohort of COVID-19 patients admitted to three hospitals of Northern Italy between March 1 and April 28, 2020. All these patients had a confirmed diagnosis of SARS-CoV-2 infection by molecular methods. During the study period 504/1697 patients died; thus, overall CFR was 29.7%. We looked for predictors of mortality in a subgroup of 486 patients (239 males, 59%; median age 71 years) for whom sufficient clinical data were available at data cut-off. Among the demographic and clinical variables considered, age, a diagnosis of cancer, obesity and current smoking independently predicted mortality. When laboratory data were added to the model in a further subgroup of patients, age, the diagnosis of cancer, and the baseline PaO2/FiO2 ratio were identified as independent predictors of mortality. In conclusion, the CFR of hospitalized patients in Northern Italy during the ascending phase of the COVID-19 pandemic approached 30%. The identification of mortality predictors might contribute to better stratification of individual patient risk

"Delirium Day": A nationwide point prevalence study of delirium in older hospitalized patients using an easy standardized diagnostic tool

Background: To date, delirium prevalence in adult acute hospital populations has been estimated generally from pooled findings of single-center studies and/or among specific patient populations. Furthermore, the number of participants in these studies has not exceeded a few hundred. To overcome these limitations, we have determined, in a multicenter study, the prevalence of delirium over a single day among a large population of patients admitted to acute and rehabilitation hospital wards in Italy. Methods: This is a point prevalence study (called "Delirium Day") including 1867 older patients (aged 65 years or more) across 108 acute and 12 rehabilitation wards in Italian hospitals. Delirium was assessed on the same day in all patients using the 4AT, a validated and briefly administered tool which does not require training. We also collected data regarding motoric subtypes of delirium, functional and nutritional status, dementia, comorbidity, medications, feeding tubes, peripheral venous and urinary catheters, and physical restraints. Results: The mean sample age was 82.0 \ub1 7.5 years (58 % female). Overall, 429 patients (22.9 %) had delirium. Hypoactive was the commonest subtype (132/344 patients, 38.5 %), followed by mixed, hyperactive, and nonmotoric delirium. The prevalence was highest in Neurology (28.5 %) and Geriatrics (24.7 %), lowest in Rehabilitation (14.0 %), and intermediate in Orthopedic (20.6 %) and Internal Medicine wards (21.4 %). In a multivariable logistic regression, age (odds ratio [OR] 1.03, 95 % confidence interval [CI] 1.01-1.05), Activities of Daily Living dependence (OR 1.19, 95 % CI 1.12-1.27), dementia (OR 3.25, 95 % CI 2.41-4.38), malnutrition (OR 2.01, 95 % CI 1.29-3.14), and use of antipsychotics (OR 2.03, 95 % CI 1.45-2.82), feeding tubes (OR 2.51, 95 % CI 1.11-5.66), peripheral venous catheters (OR 1.41, 95 % CI 1.06-1.87), urinary catheters (OR 1.73, 95 % CI 1.30-2.29), and physical restraints (OR 1.84, 95 % CI 1.40-2.40) were associated with delirium. Admission to Neurology wards was also associated with delirium (OR 2.00, 95 % CI 1.29-3.14), while admission to other settings was not. Conclusions: Delirium occurred in more than one out of five patients in acute and rehabilitation hospital wards. Prevalence was highest in Neurology and lowest in Rehabilitation divisions. The "Delirium Day" project might become a useful method to assess delirium across hospital settings and a benchmarking platform for future surveys