118 research outputs found
Pseudomonas aeruginosa (PA) resistant to colistin (CL) in Italian cystic fibrosis (CF) patients
A Stochastic Multi-scale Approach for Numerical Modeling of Complex Materials - Application to Uniaxial Cyclic Response of Concrete
In complex materials, numerous intertwined phenomena underlie the overall
response at macroscale. These phenomena can pertain to different engineering
fields (mechanical , chemical, electrical), occur at different scales, can
appear as uncertain, and are nonlinear. Interacting with complex materials thus
calls for developing nonlinear computational approaches where multi-scale
techniques that grasp key phenomena at the relevant scale need to be mingled
with stochastic methods accounting for uncertainties. In this chapter, we
develop such a computational approach for modeling the mechanical response of a
representative volume of concrete in uniaxial cyclic loading. A mesoscale is
defined such that it represents an equivalent heterogeneous medium: nonlinear
local response is modeled in the framework of Thermodynamics with Internal
Variables; spatial variability of the local response is represented by
correlated random vector fields generated with the Spectral Representation
Method. Macroscale response is recovered through standard ho-mogenization
procedure from Micromechanics and shows salient features of the uniaxial cyclic
response of concrete that are not explicitly modeled at mesoscale.Comment: Computational Methods for Solids and Fluids, 41, Springer
International Publishing, pp.123-160, 2016, Computational Methods in Applied
Sciences, 978-3-319-27994-
Local and transboundary transmission of methicillin-resistant Staphylococcus aureus sequence type 398 through pig trading
Livestock-associated methicillin-resistant Staphylococcus aureus sequence type (ST) 398 (LA-MRSA ST398) is a genetic lineage for which pigs are regarded as the main reservoir. An increasing prevalence of LA-MRSA ST398 has been reported in areas with high livestock density throughout Europe. In this study, we have investigated the drivers contributing to the introduction and spread of LA-MRSA ST398 along the pig farming system in Southern Italy. Whole-genome sequencing (WGS) of LA-MRSA ST398 isolates collected in 2018 from pigs (n=53) and employees (n=14) from 10 farms in the Calabria region were comparatively analysed with previously published WGS data from Italian ST398 isolates (n=45), an international ST398 reference collection (n=89) and isolates from Danish pigs farms (n=283), which are the main suppliers of pigs imported to Italy. Single-nucleotide polymorphisms (SNP) were used to infer isolates relatedness and, together with data from animal trading, factors contributing to LA-MRSA ST398 dissemination were identified. The analyses support the existence of two concurrent pathways for the spread of LA-MRSA ST398 in Southern Italy: i) multiple introductions of LA-MRSA ST398 through the import of colonized pigs from other European countries including Denmark and France and; ii) the spread of distinct clones dependent on local trading of pigs between farms. Phylogenetically related Italian and Danish LA-MRSA ST398 isolates shared extensive similarities including carriage of antimicrobial resistance genes. Our findings highlight the potential risk of transboundary transmission of antimicrobial-resistant bacterial clones with a high zoonotic potential when importing pigs from countries with high LA-MRSA prevalence
Italian pool of asbestos workers cohorts: asbestos related mortality by industrial sector and cumulative exposure
Objective. Italy has been a large user of asbestos and asbestos containing materials until the 1992 ban. We present a pooled cohort study on long-term mortality in exposed workers. Methods. Pool of 43 Italian asbestos cohorts (asbestos cement, rolling stock, shipbuilding, glasswork, harbors, insulation and other industries). SMRs were computed by industrial sector for the 1970-2010 period, for the major causes, using reference rates by age, sex, region and calendar period. Results. The study included 51 801 subjects (5741 women): 55.9% alive, 42.6% died (cause known for 95%) and 1.5% lost to follow-up. Asbestos exposure was estimated at the plant and period levels. Asbestos related mortality was significantly increased. All industrial sectors showed increased mortality from pleural malignancies, and most als
Emergency hernia repair in the elderly. multivariate analysis of morbidity and mortality from an Italian registry
Purpose The incidence of inguinal hernia is higher in elderly because of aging-related diseases like prostatism, bronchitis, collagen laxity. A conservative management is common in elderly to reduce surgery-related risks, however watchful waiting can expose to obstruction and strangulation. The aim of the present study was to assess the impact of emergency surgery in a large series of elderly with complicated groin hernia and to identify the independent risk factors for postoperative morbidity and mortality. The predictive performance of prognostic risk scores has been also assessed. Methods This is a prospective observational study carried out between January 2017 and June 2018 in elderly patients who underwent emergency surgery for complicated hernia in 38 Italian hospitals. Pre-operative, surgical and postoperative data were recorded for each patient. ASA score, Charlson's comorbidity index, P-POSSUM and CR-POSSUM were assessed. Results 259 patients were recruited, mean age was 80 years. A direct repair without mesh was performed in 62 (23.9%) patients. Explorative laparotomy was performed in 56 (21.6%) patients and bowel resection was necessary in 44 (17%). Mortality occurred in seven (2.8%) patients. Fifty-five (21.2%) patients developed complications, 12 of whom had a major one. At univariate and multivariate analyses, Charlson's comorbidity index >= 6, altered mental status, and need for laparotomy were associated with major complications and mortality Conclusion Emergency surgery for complicated hernia is burdened by high morbidity and mortality in elderly patients. Preoperative comorbidity played a pivotal role in predicting complications and mortality and therefore Charlson's comorbidity index could be adopted to select patients for elective operation
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