Measles in Italy: Viral strains and crossing borders.

In 2017, Italy experienced one of the largest outbreaks of measles in recent years, with 5404 notified cases and 4347 confirmed cases. A further 2029 cases were notified during the first 6 months of 2018, and 1516 of them were laboratory-confirmed. The B3 and D8 genotypes were identified as those responsible for the outbreak. Possible transmission routes can be established by monitoring the circulating measles virus strains in support of the national health authorities to warn people and travellers

Neurobiological underpinnings of reward anticipation and outcome evaluation in gambling disorder

Gambling disorder is characterized by persistent and recurrent maladaptive gambling behavior, which leads to clinically significant impairment or distress. The disorder is associated with dysfunctions in the dopamine system. The dopamine system codes reward anticipation and outcome evaluation. Reward anticipation refers to dopaminergic activation prior to reward, while outcome evaluation refers to dopaminergic activation after reward. This article reviews evidence of dopaminergic dysfunctions in reward anticipation and outcome evaluation in gambling disorder from two vantage points: a model of reward prediction and reward prediction error by Wolfram Schultz et al. and a model of “wanting” and “liking” by Terry E. Robinson and Kent C. Berridge. Both models offer important insights on the study of dopaminergic dysfunctions in addiction, and implications for the study of dopaminergic dysfunctions in gambling disorder are suggested

Identification of subgroups of early breast cancer patients at high risk of nonadherence to adjuvant hormone therapy: results of an italian survey.

The aim of this study was the identification of subgroups of patients at higher risk of nonadherence to adjuvant hormone therapy for breast cancer. Using recursive partitioning and amalgamation (RECPAM) analysis, the highest risk was observed in the group of unmarried, employed women, or housewives. This result might be functional in designing tailored intervention studies aimed at improvement of adherence. Background: Adherence to adjuvant endocrine therapy (HT) is suboptimal among breast cancer patients. A high rate of nonadherence might explain differences in survival between clinical trial and clinical practice. Tailored interventions aimed at improving adherence can only be implemented if subgroups of patients at higher risk of poor adherence are identified. Because no data are available for Italy, we undertook a large survey on adherence among women taking adjuvant HT for breast cancer. Patients and Methods: Patients were recruited from 10 cancer clinics in central Italy. All patients taking HT for at least 1 year were invited, during one of their follow-up visit, to fill a confidential questionnaire. The association of sociodemographic and clinical characteristics of participants with adherence was assessed using logistic regression. The RECPAM method was used to evaluate interactions among variables and to identify subgroups of patients at different risk of nonadherence. Results: A total of 939 patients joined the study and 18.6% of them were classified as nonadherers. Among possible predictors, only age, working status, and switching from tamoxifen to an aromatase inhibitor were predictive of nonadherence in multivariate analysis. RECPAM analysis led to the identification of 4 classes of patients with a different likelihood of nonadherence to therapy, the lowest being observed in retired women with a low level of education, the highest in the group of unmarried, employed women, or housewives. Conclusion: The identification of these subgroups of “real life” patients with a high prevalence of nonadherers might be functional in designing intervention studies aimed at improving adherenc

Neuroendocrine Tumors: A Comprehensive Review on Nutritional Approaches

Simple Summary Neuroendocrine neoplasms and their main subtype neuroendocrine tumors have an increasing incidence worldwide, associated with a high survival and prevalence rate. Both the tumor itself and systemic therapy can have an impact on patients' nutrition. Conversely, preliminary data suggest that malnutrition has a negative impact on the development and prognosis of neuroendocrine tumors, as does obesity. The aim of this review is to condense the latest evidence on the role of the most widely used dietary patterns, the Mediterranean diet, the ketogenic diet and intermittent fasting, in the context of neuroendocrine tumors. Nutritional plans are an integral part of the multidisciplinary treatment team of patients with neuroendocrine tumors because they improve the patient's quality of life. The nutritional approach must be tailored, based on nutritional needs and nutritionally manageable signs and/or symptoms related to drug treatment. Neuroendocrine neoplasms are a heterogeneous group of neoplasms with increasing incidence, high prevalence, and survival worldwide. About 90% of cases are well differentiated forms, the so-called neuroendocrine tumors (NETs), with slow proliferation rates and prolonged survival but frequent development of liver metastases and endocrine syndromes. Both the tumor itself and systemic therapy may have an impact on patient nutrition. Malnutrition has a negative impact on outcome in patients with NETs, as well as obesity. In addition, obesity and metabolic syndrome have been shown to be risk factors for both the development and prognosis of NET. Therefore, dietary assessment based on body composition and lifestyle modifications should be an integral part of the treatment of NET patients. Nutrition plans, properly formulated by a dietician, are an integral part of the multidisciplinary treatment team for patients with NETs because they allow an improvement in quality of life, providing a tailored approach based on nutritional needs and nutritional manageable signs and/or symptoms related to pharmacological treatment. The aim of this review is to condense the latest evidence on the role of the most used dietary models, the Mediterranean diet, the ketogenic diet, and intermittent fasting, in the context of NETs, while considering the clinical and molecular mechanisms by which these dietary models act

Electronic nose and isotope ratio mass spectrometry in combination with chemometrics for the characterization of the geographical origin of Italian sweet cherries

Sweet cherries from two Italian regions, Apulia and Emilia Romagna, were analysed using electronic nose (EN) and isotope ratio mass spectrometry (IRMS), with the aim of distinguishing them according to their geographic origin. The data were elaborated by statistical techniques, examining the EN and IRMS datasets both separately and in combination. Preliminary exploratory overviews were performed and then linear discriminant analyses (LDA) were used for classification. Regarding EN, different approaches for variable selection were tested, and the most suitable strategies were highlighted. The LDA classification results were expressed in terms of recognition and prediction abilities and it was found that both EN and IRMS performed well, with IRMS showing better cross-validated prediction ability (91.0%); the EN–IRMS combination gave slightly better results (92.3%). In order to validate the final results, the models were tested using an external set of samples with excellent results

NLOAD: An interactive, web-based modelling tool for nitrogen management in estuaries

Abstract. Eutrophication of estuaries is an increasing global concern that requires development of new tools to identify causes, quantify conditions, and propose management options that address this environmental problem. Since eutrophication is often associated with increased inputs of land-derived nitrogen to estuaries, we developed NLOAD, a user-friendly, web-based tool that brings together six different published models that predict nitrogen loading to estuaries and two models that estimate nitrogen concentrations in coastal waters. Here we describe each of the models, demonstrate how NLOAD is designed to function, and then use the models in NLOAD to predict nitrogen loads to Barnegat Bay, New Jersey (USA). The four models that we used to estimate nitrogen loads to Barnegat Bay, when adjusted, all had similar results that matched well with measured values and indicated that Barnegat Bay receives roughly 26 kg NÁha . Atmospheric deposition was the dominant source of nitrogen to Barnegat Bay, followed by fertilizer nitrogen. Wastewater in Barnegat Bay is diverted to an offshore outfall and contributes no nitrogen to the system. The NLOAD tool has an additional feature that allows managers to assess the effectiveness of a variety of management options to reduce nitrogen loads. We demonstrate this feature of NLOAD through simulations in which fertilizer inputs to the Barnegat Bay watershed are reduced. Even modest cutbacks in the use of fertilizers on agricultural fields and lawns can be shown to reduce the amount of N entering Barnegat Bay

Evaluation of flu vaccination coverage among healthcare workers during a 3 years’ study period and attitude towards influenza and potential covid-19 vaccination in the context of the pandemic

(1) Background: vaccination of healthcare workers (HCWs) against seasonal influenza is considered the most effective way to protect HCWs, ensure patient’s safety and to maintain essential health care services during influenza epidemics. With the present study we aimed to evaluate the efficacy of incremental bundles of measures implemented during the last three flu campaigns and to assess the attitudes towards influenza vaccination and a potential vaccine against COVID-19 among HCWs, in a large university hospital in Pisa, Italy. (2) Methods: We described measures implemented during 2018/2019, 2019/2020 and 2020/2021 and assessed their impact on flu vaccine coverage (VC) among employees and residents in Pisa university hospital. We considered sex, profession and ward to investigate differences in uptake. In addition, in 2020 a survey was developed and distributed to all employees to evaluate flu and COVID-19 vaccines attitudes. (3) Results: during the 2018/19 and 2019/20 flu campaigns the overall VC rate among HCWs was, respectively, 10.2% and 11.9%. In 2020/21 the overall VC rate jumped to 39.3% (+230.6%). Results from the survey indicated a more positive attitude towards flu vaccine as compared to COVID-19 vaccines among the 10.6% of the staff members who responded to the survey. In addition, 70.97% of HCWs totally agreed that being vaccinated against influenza would be more important than the previous years because of COVID-19 emergency. (4) Conclusions: a significant increase in VC was observed in 2020/21, especially among those sub-groups with consistently lower uptake in previous years. The COVID-19 pandemic positively influenced flu vaccination uptake during the 2020/21 season

Flash flood mitigation as a positive consequence of anthropogenic forcing on the groundwater resource in a karst catchment

The Mediterranean coastal region is prone to high-intensity rainfall events that are frequently associated with devastating flash floods. This paper discusses the role of a karst aquifer system in the flash floods of a Mediterranean river, the Lez river. Most of the Lez river watershed is located on karst terrains where interactions between surface water and groundwater take place. During extreme rainfall events, the presence of fractures and well-developed karst features in carbonate terrains enhances the infiltration processes and involves the concentration of the recharge into highly organized and permeable flow paths. The groundwater, therefore, quickly moves towards the natural outlets of the karst system. The influence of the Lez karst aquifer system on the associated river floods dynamics is analysed while considering the spatially distributed rainfall, as well as the time series of the groundwater level within the aquifer and of the Lez river discharge measured at various gauging stations. Special attention is given to the relative importance of the surface and underground processes involved in flash flood genesis. It is shown that the karst groundwater contributes to flash floods under certain conditions, while high-rate pumping within the karst aquifer, which generates significant drawdown, may mitigate flash floods under other conditions

Human RSPO1/R-spondin1 Is Expressed during Early Ovary Development and Augments beta-Catenin Signaling

Human testis development starts from around 42 days post conception with a transient wave of SRY expression followed by up-regulation of testis specific genes and a distinct set of morphological, paracrine and endocrine events. Although anatomical changes in the ovary are less marked, a distinct sub-set of ovary specific genes are also expressed during this time. The furin-domain containing peptide R-spondin1 (RSPO1) has recently emerged as an important regulator of ovary development through up-regulation of the WNT/beta-catenin pathway to oppose testis formation. Here, we show that RSPO1 is upregulated in the ovary but not in the testis during critical early stages of gonad development in humans (between 6-9 weeks post conception), whereas the expression of the related genes WNT4 and CTNNB1 (encoding beta catenin) is not significantly different between these tissues. Furthermore, reduced R-spondin1 function in the ovotestis of an individual (46,XX) with a RSPO1 mutation leads to reduced beta-catenin protein and WNT4 mRNA levels, consistent with down regulation of ovarian pathways. Transfection of wildtype RSPO1 cDNA resulted in weak dose-dependent activation of a beta-catenin responsive TOPFLASH reporter (1.8 fold maximum), whereas co-transfection of CTNNB1 (encoding beta-catenin) with RSPO1 resulted in dose-dependent synergistic augmentation of this reporter (approximately 10 fold). Furthermore, R-spondin1 showed strong nuclear localization in several different cell lines. Taken together, these data show that R-spondin1 is upregulated during critical stages of early human ovary development and may function as a tissue-specific amplifier of beta-catenin signaling to oppose testis determination