Sorveglianza delle gastroenteriti da Norovirus in Italia: comparsa e diffusione della nuova variante GII.4 Sydney 2012

In the 2012-2013 winter season, global surveillance for norovirus circulation evidenced the onset of a new norovirus GII.4 variant, termed Sydney 2012. In Italy, ISGEV hospital-based surveillance revealed that this variant already circulated at low frequency in the winter season 2011-2012 and emerged definitively only in the late 2012. This lag-time pattern mirrors the findings reported elsewhere and suggests that the novel variant circulated at low prevalence before spreading globally

The Physical Attributes Most Required in Professional Ballet: A Delphi Study

Background It is commonly accepted that dancers are undoubtedly athletes, with ballet perhaps the most demanding dance form. No previous study has sought to define the physical attributes most desired for classical ballet by professional companies and vocational schools. These are likely to include both aesthetic features and attributes that reduce the risk of injury as well as enhance performance. Method An initial survey question using the modified Delphi technique was sent using Opinio Survey Software to a selected international expert panel. This was drawn both from those involved in selection of elite professional ballet dancers, and the international medical professionals involved in the care of dancers. The first questionnaire was open-ended to scope for all the physical attributes most favoured by the professional experts. Results There were 148 responses from the panel of international experts. In total 34 physical attributes were suggested. The 2 most recommended physical criteria for selection into the profession were overall flexibility and overall strength. These results are discussed in the context of the published literature on the mechanics, anatomy and physiology of ballet. Conclusion Flexibility and strength are the 2 features most sought after in elite ballet dancers

Epidemiological and virological investigation of a Norovirus outbreak in a resort in Puglia, Italy

<p>Abstract</p> <p>Background</p> <p>This paper describes the third large outbreak of Norovirus (NoV) gastroenteritis reported in the Southern Italy region of Puglia.</p> <p>Methods</p> <p>A matched case control study was conducted, on 19 July 2005, for investigating risk factors, using a structured questionnaire on food consumption. A multivariate analysis was conducted to estimate the adjusted Odds Ratios. Laboratory and environmental investigation were also performed.</p> <p>Results</p> <p>On the day of the study 41 cases were identified and 41 controls were enrolled. Controls were matched for age and gender. The mean age of the cases was 26 years old, and 58% were female. The clinical pattern of the disease was characterised by the presence of diarrhoea (95%), vomiting (70%), abdominal pain (51%) and fever (32%). Of the 41 cases included in the study, the majority (65%) were residents of Northern Italian regions. No food samples were available for testing. The matched univariate analysis revealed that cases were more likely to have consumed raw mussels, eggs or ice cubes made of tap water than controls. In the multivariate conditional logistic regression analysis, having eaten raw mussels or ice became more strongly associated with illness.</p> <p>All of the 20 faecal samples collected were tested for NoVs. Eighteen stools (90% of total examined) were positive by RT-PCR, and sequence analysis performed onto 3 samples confirmed the presence of a GGII NoV. No test specific for NoV was performed on water or food samples.</p> <p>Conclusion</p> <p>The most likely hypothesis supported by the findings of the epidemiological investigation was that illness was associated with raw mussels and ice, made with tap water. These hypothesis could not be confirmed by specific microbiologic testing for NoV in food or ice. The lack of clear knowledge of NoV as a major causative agent of epidemic outbreaks of gastroenteritis in Italy is due to the absence of timely reporting of the cases to the local public health offices and the uncommon practice of saving clinical samples for virological analysis after bacteriological testing.</p

Of gastro and the gold standard: evaluation and policy implications of norovirus test performance for outbreak detection

<p>Abstract</p> <p>Background</p> <p>The norovirus group (NVG) of caliciviruses are the etiological agents of most institutional outbreaks of gastroenteritis in North America and Europe. Identification of NVG is complicated by the non-culturable nature of this virus, and the absence of a diagnostic gold standard makes traditional evaluation of test characteristics problematic.</p> <p>Methods</p> <p>We evaluated 189 specimens derived from 440 acute gastroenteritis outbreaks investigated in Ontario in 2006–07. Parallel testing for NVG was performed with real-time reverse-transcriptase polymerase chain reaction (RT²-PCR), enzyme immunoassay (EIA) and electron microscopy (EM). Test characteristics (sensitivity and specificity) were estimated using latent class models and composite reference standard methods. The practical implications of test characteristics were evaluated using binomial probability models.</p> <p>Results</p> <p>Latent class modelling estimated sensitivities of RT²-PCR, EIA, and EM as 100%, 86%, and 17% respectively; specificities were 84%, 92%, and 100%; estimates obtained using a composite reference standard were similar. If all specimens contained norovirus, RT²-PCR or EIA would be associated with > 99.9% likelihood of at least one test being positive after three specimens tested. Testing of more than 5 true negative specimens with RT²-PCR would be associated with a greater than 50% likelihood of a false positive test.</p> <p>Conclusion</p> <p>Our findings support the characterization of EM as lacking sensitivity for NVG outbreaks. The high sensitivity of RT²-PCR and EIA permit identification of NVG outbreaks with testing of limited numbers of clinical specimens. Given risks of false positive test results, it is reasonable to limit the number of specimens tested when RT²-PCR or EIA are available.</p

Genetic influences on the insulin response of the beta cell to different secretagogues

Aims/hypothesis: The aim of the present study was to estimate the heritability of the beta cell insulin response to glucose and to glucose combined with glucagon-like peptide-1 (GLP-1) or with GLP-1 plus arginine. Methods: This was a twin-family study that included 54 families from the Netherlands Twin Register. The participants were healthy twin pairs and their siblings of the same sex, aged 20 to 50 years. Insulin response of the beta cell was assessed by a modified hyperglycaemic clamp with additional GLP-1 and arginine. Insulin sensitivity index (ISI) was assessed by the euglycaemic-hyperinsulinaemic clamp. Multivariate structural equation modelling was used to obtain heritabilities and the genetic factors underlying individual differences in BMI, ISI and secretory responses of the beta cell. Results: The heritability of insulin levels in response to glucose was 52% and 77% for the first and second phase, respectively, 53% in response to glucose+GLP-1 and 80% in response to an additional arginine bolus. Insulin responses to the administration of glucose, glucose+GLP-1 and glucose+GLP-1+arginine were highly correlated (0.62<r<0.79). Heritability of BMI and ISI was 74% and 60% respectively. The genetic factors that influenced BMI and ISI explained about half of the heritability of insulin levels in response to the three secretagogues. The other half was due to genetic factors specific to the beta cell. Conclusions/interpretation: In healthy adults, genetic factors explain most of the individual differences in the secretory capacity of the beta cell. These genetic influences are partly independent from the genes that influence BMI and ISI. © 2009 Springer-Verlag

Early stage transplantation of bone marrow cells markedly ameliorates copper metabolism and restores liver function in a mouse model of Wilson disease

<p>Abstract</p> <p>Background</p> <p>Recent studies have demonstrated that normal bone marrow (BM) cells transplantation can correct liver injury in a mouse model of Wilson disease (WD). However, it still remains unknown when BM cells transplantation should be administered. The aim of this study was to investigate the potential impact of normal BM cells transplantation at different stages of WD to correct liver injury in toxic milk (tx) mice.</p> <p>Methods</p> <p>Recipient tx mice were sublethally irradiated (5 Gy) prior to transplantation. The congenic wild-type (DL) BM cells labeled with CM-DiI were transplanted via caudal vein injection into tx mice at the early (2 months of age) or late stage (5 months of age) of WD. The same volume of saline or tx BM cells were injected as controls. The DL donor cell population, copper concentration, serum ceruloplasmin oxidase activity and aspartate aminotransferase (AST) levels in the various groups were evaluated at 1, 4, 8 and 12 weeks post-transplant, respectively.</p> <p>Results</p> <p>The DL BM cells population was observed from 1 to 12 weeks and peaked by the 4^thweek in the recipient liver after transplantation. DL BM cells transplantation during the early stage significantly corrected copper accumulation, AST across the observed time points and serum ceruloplasmin oxidase activity through 8 to 12 weeks in tx mice compared with those treated with saline or tx BM cells (all <it>P </it>< 0.05). In contrast, BM cells transplantation during the late stage only corrected AST levels from 4 to 12 weeks post-transplant and copper accumulation at 12 weeks post-transplant (all <it>P </it>< 0.05). No significant difference was found between the saline and tx BM cells transplantation groups across the observed time points (<it>P </it>> 0.05).</p> <p>Conclusions</p> <p>Early stage transplantation of normal BM cells is better than late stage transplantation in correcting liver function and copper metabolism in a mouse model of WD.</p

Characterization of a fluvial aquifer at a range of depths and scales: the Triassic St Bees Sandstone Formation, Cumbria, UK

Fluvial sedimentary successions represent porous media that host groundwater and geothermal resources. Additionally, they overlie crystalline rocks hosting nuclear waste repositories in rift settings. The permeability characteristics of an arenaceous fluvial succession, the Triassic St Bees Sandstone Formation in England (UK), are described, from core-plug to well-test scale up to ~1 km depth. Within such lithified successions, dissolution associated with the circulation of meteoric water results in increased permeability (K~10−1–100 m/day) to depths of at least 150 m below ground level (BGL) in aquifer systems that are subject to rapid groundwater circulation. Thus, contaminant transport is likely to occur at relatively high rates. In a deeper investigation (> 150 m depth), where the aquifer has not been subjected to rapid groundwater circulation, well-test-scale hydraulic conductivity is lower, decreasing from K~10−2 m/day at 150–400 m BGL to 10−3 m/day down-dip at ~1 km BGL, where the pore fluid is hypersaline. Here, pore-scale permeability becomes progressively dominant with increasing lithostatic load. Notably, this work investigates a sandstone aquifer of fluvial origin at investigation depths consistent with highly enthalpy geothermal reservoirs (~0.7–1.1 km). At such depths, intergranular flow dominates in unfaulted areas with only minor contribution by bedding plane fractures. However, extensional faults represent preferential flow pathways, due to presence of high connective open fractures. Therefore, such faults may (1) drive nuclear waste contaminants towards the highly permeable shallow (< 150 m BGL) zone of the aquifer, and (2) influence fluid recovery in geothermal fields

Nematic pairing from orbital-selective spin fluctuations in FeSe

FeSe is an intriguing iron-based superconductor. It presents an unusual nematic state without magnetism and can be tuned to increase the critical superconducting temperature. Recently it has been observed a noteworthy anisotropy of the superconducting gaps. Its explanation is intimately related to the understanding of the nematic transition itself. Here, we show that the spin-nematic scenario driven by orbital-selective spin fluctuations provides a simple scheme to understand both phenomena. The pairing mediated by anisotropic spin modes is not only orbital selective but also nematic, leading to stronger pair scattering across the hole and X electron pocket. The delicate balance between orbital ordering and nematic pairing points also to a marked k z dependence of the hole\u2013gap anisotropy