Experiencing Forest Therapy in the Italian Landscape: Bathing in the Selva of Castelfidardo

According to several evidence, forest environmental seems able to provide beneficial effects on functional and psychological parameters, related to cardiovascular, metabolic, respiratory functions as well depression and anxiety. The aim of this study is to investigate the effect of a one-day forest walking in the Selva of Castelfidardo (AN, Italy) on 37 participants aged 21-68, most of them living in either urban or suburban areas of large cities. We observed a statistically significant effect on sympathicovagal balance by the means of heart rate, systolic and diastolic blood pressure, body temperature, skin temperature, skin conductance, HRV parameters (AVNN, SDNN, rMSSD, pNN50, LF, HF, LF/HF ratio), oxygen oximetry, PEF, FEV1. A significant difference was also detected on the Perceived Stress Scale responses (19.27 pre vs 13.81 post- immersion, p=<0,05; -28,3% variation). Our data contribute to increase the body of literature about the effect of forest walking, adding data on an Italian area assigned to forest bathing

Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections

Urinary tract infections (UTIs) are among the most frequent community-acquired infections worldwide. Escherichia coli is the most common UTI pathogen although underlying host factors such as patients' age and gender may influence prevalence of causative agents. In this study, 61 273 consecutive urine samples received over a 22-month period from outpatients clinics of an urban area of north Italy underwent microbiological culture with subsequent bacterial identification and antimicrobial susceptibility testing of positive samples. A total of 13 820 uropathogens were isolated and their prevalence analyzed according to patient's gender and age group. Overall Escherichia coli accounted for 67.6% of all isolates, followed by Klebsiella pneumoniae (8.8%), Enterococcus faecalis (6.3%), Proteus mirabilis (5.2%), and Pseudomonas aeruginosa (2.5%). Data stratification according to both age and gender showed E. coli isolation rates to be lower in both males aged ≥60 years (52.2%), E. faecalis and P. aeruginosa being more prevalent in this group (11.6% and 7.8%, resp.), as well as in those aged ≤14 years (51.3%) in whom P. mirabilis prevalence was found to be as high as 21.2%. Streptococcus agalactiae overall prevalence was found to be 2.3% although it was shown to occur most frequently in women aged between 15 and 59 years (4.1%). Susceptibility of E. coli to oral antimicrobial agents was demonstrated to be as follows: fosfomycin (72.9%), trimethoprim/sulfamethoxazole (72.9%), ciprofloxacin (76.8%), ampicillin (48.0%), and amoxicillin/clavulanate (77.5%). In conclusion, both patients' age and gender are significant factors in determining UTIs etiology; they can increase accuracy in defining the causative uropathogen as well as providing useful guidance to empiric treatment

Effect of external PEEP in patients under controlled mechanical ventilation with an auto-PEEP of 5 cmH2O or higher.

In some patients with auto-positive end-expiratory pressure (auto-PEEP), application of PEEP lower than auto-PEEP maintains a constant total PEEP, therefore reducing the inspiratory threshold load without detrimental cardiovascular or respiratory effects. We refer to these patients as complete PEEP-absorbers. Conversely, adverse effects of PEEP application could occur in patients with auto-PEEP when the total PEEP rises as a consequence. From a pathophysiological perspective, all subjects with flow limitation are expected to be complete PEEP-absorbers, whereas PEEP should increase total PEEP in all other patients. This study aimed to empirically assess the extent to which flow limitation alone explains a complete PEEP-absorber behavior (i.e., absence of further hyperinflation with PEEP), and to identify other factors associated with it.One hundred patients with auto-PEEP of at least 5 cmH2O at zero end-expiratory pressure (ZEEP) during controlled mechanical ventilation were enrolled. Total PEEP (i.e., end-expiratory plateau pressure) was measured both at ZEEP and after applied PEEP equal to 80 % of auto-PEEP measured at ZEEP. All measurements were repeated three times, and the average value was used for analysis.Forty-seven percent of the patients suffered from chronic pulmonary disease and 52 % from acute pulmonary disease; 61 % showed flow limitation at ZEEP, assessed by manual compression of the abdomen. The mean total PEEP was 7 ± 2 cmH2O at ZEEP and 9 ± 2 cmH2O after the application of PEEP (p < 0.001). Thirty-three percent of the patients were complete PEEP-absorbers. Multiple logistic regression was used to predict the behavior of complete PEEP-absorber. The best model included a respiratory rate lower than 20 breaths/min and the presence of flow limitation. The predictive ability of the model was excellent, with an overoptimism-corrected area under the receiver operating characteristics curve of 0.89 (95 % CI 0.80-0.97).Expiratory flow limitation was associated with both high and complete PEEP-absorber behavior, but setting a relatively high respiratory rate on the ventilator can prevent from observing complete PEEP-absorption. Therefore, the effect of PEEP application in patients with auto-PEEP can be accurately predicted at the bedside by measuring the respiratory rate and observing the flow-volume loop during manual compression of the abdomen

Spectrometer for X-ray emission experiments at FERMI free-electron-laser

A portable and compact photon spectrometer to be used for photon in-photon out experiments, in particular x-ray emission spectroscopy, is presented. The instrument operates in the 25\u2013800 eV energy range to cover the full emissions of the FEL1 and FEL2 stages of FERMI. The optical design consists of two interchangeable spherical varied-lined-spaced gratings and a CCD detector. Different input sections can be accommodated, with/without an entrance slit and with/without an additional relay mirror, that allow to mount the spectrometer in different end-stations and at variable distances from the target area both at synchrotron and at free-electron-laser beamlines. The characterization on the Gas Phase beamline at ELETTRA Synchrotron (Italy) is presented

Three-Dimensional Shapes of Spinning Helium Nanodroplets

A significant fraction of superfluid helium nanodroplets produced in a free-jet expansion have been observed to gain high angular momentum resulting in large centrifugal deformation. We measured single-shot diffraction patterns of individual rotating helium nanodroplets up to large scattering angles using intense extreme ultraviolet light pulses from the FERMI free-electron laser. Distinct asymmetric features in the wide-angle diffraction patterns enable the unique and systematic identification of the three-dimensional droplet shapes. The analysis of a large dataset allows us to follow the evolution from axisymmetric oblate to triaxial prolate and two-lobed droplets. We find that the shapes of spinning superfluid helium droplets exhibit the same stages as classical rotating droplets while the previously reported metastable, oblate shapes of quantum droplets are not observed. Our three-dimensional analysis represents a valuable landmark for clarifying the interrelation between morphology and superfluidity on the nanometer scale

The Cornelia de Lange Syndrome-associated factor NIPBL interacts with BRD4 ET domain for transcription control of a common set of genes

Mutations in NIPBL are the major cause of Cornelia de Lange Syndrome (CdLS). NIPBL is the cohesin-loading factor and has recently been associated with the BET (bromodomains and extra-terminal (ET) domain) proteins BRD2 and BRD4. Related to this, a CdLS-like phenotype has been described associated to BRD4 mutations. Here, we show direct interaction of NIPBL with different BET members in yeast, and selective interaction with BRD4 in cells, being the ET domain involved in the interaction. To understand the relationship between NIPBL and BET proteins, we have performed RNA-Seq expression analysis following depletion of the different proteins. Results indicate that genes regulated by NIPBL largely overlap with those regulated by BRD4 but not with those regulated by BRD2. ChIP-Seq analysis indicates preferential NIPBL occupancy at promoters, and knockdown experiments show mutual stabilization of NIPBL and BRD4 on co-regulated promoters. Moreover, human fibroblasts from CdLS probands with mutations in NIPBL show reduced BRD4 at co-occupied promoters. Functional analysis in vivo, using mutants of Drosophila melanogaster, confirmed the genetic interaction between Nipped-B and fs(1)h, the orthologs of human NIPBL and BRD4, respectively. Thus, we provide evidence for NIPBL and BRD4 cooperation in transcriptional regulation, which should contribute to explain the recently observed CdLS-like phenotype associated with BRD4 mutations.Ministry of Economy and Competitiveness (MINECO), Spain BFU2015-64721-

The cientificWorldJOURNAL Research Article Gender and Age-Dependent Etiology of Community-Acquired Urinary Tract Infections

Urinary tract infections (UTIs) are among the most frequent community-acquired infections worldwide. Escherichia coli is the most common UTI pathogen although underlying host factors such as patients&apos; age and gender may influence prevalence of causative agents. In this study, 61 273 consecutive urine samples received over a 22-month period from outpatients clinics of an urban area of north Italy underwent microbiological culture with subsequent bacterial identification and antimicrobial susceptibility testing of positive samples. A total of 13 820 uropathogens were isolated and their prevalence analyzed according to patient&apos;s gender and age group. Overall Escherichia coli accounted for 67.6% of all isolates, followed by Klebsiella pneumoniae (8.8%), Enterococcus faecalis (6.3%), Proteus mirabilis (5.2%), and Pseudomonas aeruginosa (2.5%). Data stratification according to both age and gender showed E. coli isolation rates to be lower in both males aged ≥60 years (52.2%), E. faecalis and P. aeruginosa being more prevalent in this group (11.6% and 7.8%, resp.), as well as in those aged ≤14 years (51.3%) in whom P. mirabilis prevalence was found to be as high as 21.2%. Streptococcus agalactiae overall prevalence was found to be 2.3% although it was shown to occur most frequently in women aged between 15 and 59 years (4.1%). Susceptibility of E. coli to oral antimicrobial agents was demonstrated to be as follows: fosfomycin (72.9%), trimethoprim/sulfamethoxazole (72.9%), ciprofloxacin (76.8%), ampicillin (48.0%), and amoxicillin/clavulanate (77.5%). In conclusion, both patients&apos; age and gender are significant factors in determining UTIs etiology; they can increase accuracy in defining the causative uropathogen as well as providing useful guidance to empiric treatment. Background Urinary tract infections (UTIs) are among the most frequent bacterial infections worldwide Although women, particularly those aged 16-64 years, are significantly more likely to experience UTIs than men Microbial etiology of UTIs has been regarded as well established, with E. coli being the causative pathogen in 50-80% of cases Methods A retrospective study was performed at the Bacteriological Laboratory of the &quot;Centro Diagnostico Italiano&quot; (CDI), based in Milan (Italy), on all bacterial strains isolated from consecutive urine samples received from outpatients clinics of a high-populated urban area of North Italy, between March 2008 and December 2009. Urine samples, accompanied by microbiology request forms, were delivered either directly to the CDI laboratory or through 7 collaborating laboratories. All sample processing and patients&apos; data collection were carried out centrally by the CDI laboratory. CDI Laboratory follows Internal Quality Control procedures and participates to an External Program for Quality Assessment with positive evaluations. As part of the routine procedure, patients received indications to avoid antimicrobials assumption during the previous 7 days and instructions on urine sampling (including cleaning of the genital area prior to midstream specimen collection) and its transport to the laboratories (within 2 hours of collection). Specimens from collaborating laboratories were transported in Vacutainer tubes containing boric acid at 1-2% as preservative. All samples were plated as soon as possible and no later than 24 hours on Chromagar Orientation-BD plates and incubated for 18-24 hours at 37 • C. Criterion for defining significant bacteriuria (positive samples) was the presence of ≥10 5 colony-forming units (CFU)/mL of urine The statistical analysis was performed by the SAS System version 9.2. The difference between females and males in the frequency of positive samples of each agent was analyzed by the chi-square test. The frequency of the positive samples of each agent as a function of gender and age groups (≤14; 15-29; 30-59; ≥60 years) was analyzed by the logistic regression, including in the model the terms gender, age, and the gender by age interaction. Results A total of 61 273 urine cultures were performed over a 22-month period; of these 13 820 (22.6%) were found to be positive for bacterial infection. Nearly 80% of all isolates were from women (female to male ratio (F/M) = 3.8) and 58% from subjects aged 60 years or more. Cumulatively, the two younger age groups accounted for 11.2% of total isolates. Female to male ratio was highest in age group 15-29 years (F/M = 13.5) and lowest in the youngest age group (F/M = 1.4). Overall the most frequently encountered pathogen was Escherichia coli (67.6%), followed by Klebsiella pneumoniae (8.8%), Enterococcus faecalis (6.3%), Proteus mirabilis (5.2%), Pseudomonas aeruginosa (2.5%), and Streptococcus agalactiae (2.3%) Frequency of isolation of all six main species was found to be statistically different between females and males ( in females, whereas E. faecalis, P. mirabilis, and P. aeruginosa were more common in men. All the six most prevalent bacterial species, with the exception of K. pneumoniae, revealed statistically significant differences in isolation rates within the four chosen age groups Data stratification according to both gender and age showed that differences in frequency of isolation between females and males of E. faecalis and S. agalactiae were not consistent across all age groups Susceptibility to antimicrobials of main isolated uropathogens is shown in K. pneumoniae susceptibility to quinolones (93.0%-95.3%) and to TMP-SMX (89.8%) was higher in comparison to E. coli while fosfomycin activity resulted to be lower (81.0%). E. faecalis susceptibility to ampicillin and fosfomycin was high (96.1% and 100%, resp.), superior with respect to susceptibility to quinolones (71.9%-82.3%). S. agalactiae susceptibility to levofloxacin was found to be 91.1% (data not shown). Discussion As urinary tract infection is a very common disease, its diagnosis and treatment have important implications for patients&apos; health, development of antibiotic resistance, and health care costs The present retrospective study describes the distribution and antimicrobial susceptibility of bacterial species isolated from a large number of urinary samples collected over a 22-month period, as part of routine analyses, from unselected community patients (male and female of any age and clinical condition) living in a urban area in the north of Italy. The high number of available isolates allowed to stratify data according to patients&apos; gender and age and so to evaluate the association of such variables to UTI etiology. As expected E. coli was the most frequently encountered species in our study. Percentage of E. coli isolation (67.6%) well compares with those reported from other outpatients surveys conducted in north (64.6%) Other frequent isolates found in this study included K. pneumoniae, P. mirabilis, and E. faecalis, all having been reported to be highly prevalent species in UTIs Our study, however, showed that prevalence of urinary pathogens following data stratification was not consistent across all age groups further divided by gender. Escherichia coli, for example, was found to be less prevalent in the youngest and oldest male subjects (51.3% and 52.2%, resp.) and more frequent in female patients aged 15 years or older 4 The Scientific World Journal (approximately 71%), Proteus mirabilis prevalence was found to be highest (21.2%) in young males aged ≤14 years, whilst S. agalactiae was mostly found in women aged between 15 and 59 years (approximately 4.0%). Kiffer et al. [21] conducted a study comparable to ours, in terms of patient&apos;s population (both males and females of any age), number of isolates The Scientific World Journal 5 (0-13 years), accounting for 22.1% of isolates (15.6% in our study) with a females to males ratio of 0.45 (0.55 in our study). Already in 1972, Bergström [22] and, more recently, Modarres and Oskoii P. mirabilis has been described to be present in the preputial sac of boys, having been isolated in 22.6% of uncircumcised males of up to 14 years of age Susceptibility of uropathogenic bacteria to antimicrobials agents is also known to vary among countries and over time In our survey, 72.9% of E. coli isolates were susceptible to TMP/SMX. Susceptibility to oral antimicrobials of P. mirabilis strains isolated in our study, was generally lower than that reported both in Italy and other countries. Susceptibility to ciprofloxacin and TMP/SMX of P. mirabilis isolates in our study was of 62.9% and 51.5%, respectively, as compared to rates demonstrated by other authors ranging from 75.5% to 97.9% for ciprofloxacin and from 52.0% to 84.9% for TMP-SMX In conclusion, besides providing further data on the etiology of community-acquired UTIs and antimicrobial susceptibility of uropathogens in Italy, our results confirm that stratification of isolates from unselected patients on the basis of age and gender can improve the assessment of causative pathogens, providing guidance for empiric treatment and interesting clues to the understanding of UTIs etiopathology. In particular, P. mirabilis prevalence was found to be high both in boys (21.2%) and girls (11.8%) suggesting, as previously reporte

Rapid SARS-CoV-2 intra-host and within-household emergence of novel haplotypes

In February 2020, the municipality of Vo’, a small town near Padua (Italy) was quarantined due to the first coronavirus disease 19 (COVID-19)-related death detected in Italy. To investigate the viral prevalence and clinical features, the entire population was swab tested in two sequential surveys. Here we report the analysis of 87 viral genomes, which revealed that the unique ancestor haplotype introduced in Vo’ belongs to lineage B, carrying the mutations G11083T and G26144T. The viral sequences allowed us to investigate the viral evolution while being transmitted within and across households and the effectiveness of the non-pharmaceutical interventions implemented in Vo’. We report, for the first time, evidence that novel viral haplotypes can naturally arise intra-host within an interval as short as two weeks, in approximately 30% of the infected individuals, regardless of symptom severity or immune system deficiencies. Moreover, both phylogenetic and minimum spanning network analyses converge on the hypothesis that the viral sequences evolved from a unique common ancestor haplotype that was carried by an index case. The lockdown extinguished both the viral spread and the emergence of new variant

Association of COVID-19 Vaccinations With Intensive Care Unit Admissions and Outcome of Critically Ill Patients With COVID-19 Pneumonia in Lombardy, Italy

IMPORTANCE Data on the association of COVID-19 vaccination with intensive care unit (ICU) admission and outcomes of patients with SARS-CoV-2-related pneumonia are scarce. OBJECTIVE To evaluate whether COVID-19 vaccination is associated with preventing ICU admission for COVID-19 pneumonia and to compare baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU. DESIGN, SETTING, AND PARTICIPANTS This retrospective cohort study on regional data sets reports: (1) daily number of administered vaccines and (2) data of all consecutive patients admitted to an ICU in Lombardy, Italy, from August 1 to December 15, 2021 (Delta variant predominant). Vaccinated patients received either mRNA vaccines (BNT162b2 or mRNA-1273) or adenoviral vector vaccines (ChAdOx1-S or Ad26.COV2). Incident rate ratios (IRRs) were computed from August 1, 2021, to January 31, 2022; ICU and baseline characteristics and outcomes of vaccinated and unvaccinated patients admitted to an ICU were analyzed from August 1 to December 15, 2021. EXPOSURES COVID-19 vaccination status (no vaccination, mRNA vaccine, adenoviral vector vaccine). MAIN OUTCOMES AND MEASURES The incidence IRR of ICU admission was evaluated, comparing vaccinated people with unvaccinated, adjusted for age and sex. The baseline characteristics at ICU admission of vaccinated and unvaccinated patients were investigated. The association between vaccination status at ICU admission and mortality at ICU and hospital discharge were also studied, adjusting for possible confounders. RESULTS Among the 10 107 674 inhabitants of Lombardy, Italy, at the time of this study, the median [IQR] agewas 48 [28-64] years and 5 154 914 (51.0%) were female. Of the 7 863 417 individuals who were vaccinated (median [IQR] age: 53 [33-68] years; 4 010 343 [51.4%] female), 6 251 417 (79.5%) received an mRNA vaccine, 550 439 (7.0%) received an adenoviral vector vaccine, and 1 061 561 (13.5%) received a mix of vaccines and 4 497 875 (57.2%) were boosted. Compared with unvaccinated people, IRR of individuals who received an mRNA vaccine within 120 days from the last dosewas 0.03 (95% CI, 0.03-0.04; P &lt;.001), whereas IRR of individuals who received an adenoviral vector vaccine after 120 days was 0.21 (95% CI, 0.19-0.24; P &lt;.001). There were 553 patients admitted to an ICU for COVID-19 pneumonia during the study period: 139 patients (25.1%) were vaccinated and 414 (74.9%) were unvaccinated. Compared with unvaccinated patients, vaccinated patients were older (median [IQR]: 72 [66-76] vs 60 [51-69] years; P &lt;.001), primarily male individuals (110 patients [ 79.1%] vs 252 patients [60.9%]; P &lt;.001), with more comorbidities (median [IQR]: 2 [1-3] vs 0 [0-1] comorbidities; P &lt;.001) and had higher ratio of arterial partial pressure of oxygen (PaO2) and fraction of inspiratory oxygen (FiO(2)) at ICU admission (median [IQR]: 138 [100-180] vs 120 [90-158] mm Hg; P =.007). Factors associated with ICU and hospital mortality were higher age, premorbid heart disease, lower PaO2/FiO(2) at ICU admission, and female sex (this factor only for ICU mortality). ICU and hospital mortality were similar between vaccinated and unvaccinated patients. CONCLUSIONS AND RELEVANCE In this cohort study, mRNA and adenoviral vector vaccines were associated with significantly lower risk of ICU admission for COVID-19 pneumonia. ICU and hospital mortality were not associated with vaccinated status.These findings suggest a substantial reduction of the risk of developing COVID-19-related severe acute respiratory failure requiring ICU admission among vaccinated people

The Low Density Matter (LDM) beamline at FERMI: Optical layout and first commissioning

The Low Density Matter (LDM) beamline has been built as part of the FERMI free-electron laser (FEL) facility to serve the atomic, molecular and cluster physics community. After the commissioning phase, it received the first external users at the end of 2012. The design and characterization of the LDM photon transport system is described, detailing the optical components of the beamline