Invasive meningococcal disease in the Veneto region of Italy: A capture-recapture analysis for assessing the effectiveness of an integrated surveillance system

open8noBACKGROUND: Epidemiology of Neisseria meningitidis has been changing since the introduction of universal vaccination programmes against meningococcal serogroup C (MenC) and meningococcal serogroup B (MenB) has now become dominant. This study aimed to analyse the cases reported in institutional data recording systems to estimate the burden of invasive meningococcal diseases (IMDs) and assess the effectiveness of surveillance in Veneto region (Italy). METHODS: Analysis was performed from 2007 to 2014 on data recorded in different systems: Mandatory Notification System, National Surveillance of Invasive Bacterial Diseases System and Laboratories Surveillance System (LSS), which were pooled into a combined surveillance system (CSS) and hospital discharge records (HDRs). A capture-recapture method was used and completeness of each source estimated. Number of cases with IMD by source of information and year, incidence of IMD by age group, case fatality rate (CFR) and distribution of meningococcal serogroups by year were also analysed. RESULTS: Combining the four data systems enabled the identification of 179 confirmed cases with IMD, achieving an overall sensitivity of 94.7% (95% CI: 90.8% to 98.8%), while it was 76.7% (95% CI: 73.6% to 80.1%) for CSS and 77.2% (95% CI: 74.1% to 80.6%) for HDRs. Typing of isolates was done in 80% of cases, and 95.2% of the typed cases were provided by LSS. Serogroup B was confirmed in 50.3% of cases. The estimated IMD notification rate (cases with IMD diagnosed and reported to the surveillance systems) was 0.48/100 000 population, and incidence peaked at 6.2/100 000 in children aged <1 year old (60.9% due to MenB), and increased slightly in the age group between 15 and 19 years (1.1/100 000). A CFR of 14% was recorded (8.7% in paediatric age). CONCLUSIONS: Quality of surveillance systems relies on case ascertainment based on serological characterisation of the circulating strains by microbiology laboratories. All available sources should be routinely combined to improve the epidemiology of IMD and the information used by public health departments to conduct timely preventive measures.openBaldovin, Tatjana; Lazzari, Roberta; Cocchio, Silvia; Furlan, Patrizia; Bertoncello, Chiara; Saia, Mario; Russo, Francesca; Baldo, VincenzoBaldovin, Tatjana; Lazzari, Roberta; Cocchio, Silvia; Furlan, Patrizia; Bertoncello, Chiara; Saia, Mario; Russo, Francesca; Baldo, Vincenz

On the exponential decay of the Euler-Bernoulli beam with boundary energy dissipation

We study the asymptotic behavior of the Euler-Bernoulli beam which is clamped at one end and free at the other end. We apply a boundary control with memory at the free end of the beam and prove that the "exponential decay" of the memory kernel is a necessary and sufficient condition for the exponential decay of the energy.Comment: 13 page

On the asymptotic behavior of the quasi-static problem for a linear viscoelastic fluid

In this paper we study the quasi-static problem for a viscoelastic fluid by means of the concept of minimal state. This implies the use of a different free energy defined in a wider space of data. The existence and uniqueness is proved in this new space and the asymptotic decay for the problem with non vanishing supplies is obtained for a large class of memory kernels, including those presenting an exponential or polynomial decay.Comment: 6 page

Pregnane X receptor and constitutive androstane receptor modulate differently CYP3A-mediated metabolism in earlyand late-stage cholestasis

AIM: To ascertain whether cholestasis affects the expression of two CYP3A isoforms (CYP3A1 and CYP3A2) and of pregnane X receptor (PXR) and constitutive androstane receptor (CAR). METHODS: Cholestasis was induced by bile duct ligation in 16 male Wistar rats; whereas 8 sham-operated rats were used as controls. Severity of cholestasis was assessed on histological examination of liver sections, and serum concentrations of albumin, AST, ALT, GGT, ALPK and bilirubin. Gene and protein expressions of PXR, CAR, CYP3A1 and CYP3A2 were assessed by means of qRT-PCR and Western blot, respectively. Alterations in CYP3A activity were measured by calculating the kinetic parameters of 4-OH and 1'-OH-midazolam hydroxylation, marker reactions for CYP3A enzymes. RESULTS: The mRNA and protein expression of CYP3A1 increased significantly in mild cholestasis (P < 0.01). At variance, mRNA and protein expression of CYP3A2 didn't change in mild cholestasis, whereas the expression and activity of both CYP3A1 and CYP3A2 decreased dramatically when cholestasis became severe. Consistently with these observations, the nuclear expression of both PXR and CAR, which was measured because they both translocate into the cell nucleus after their activation, virtually disappeared in the late stage of cholestatic injury, after an initial increase. These results indicate that early- and late-stage cholestasis affects CYP3A-mediated drug metabolism differently, probably as consequence of the different activation of PXR and CAR. CONCLUSION: Early- and late-stage cholestasis affects CYP3A-mediated drug metabolism differently. PXR and CAR might be targeted therapeutically to promote CYP3A-mediated liver detoxification

An Edge-based Architecture for Phasor Measurements in Smart Grids

This paper investigates the application of Kubernetes and Edge computing technologies to operate IT services in the context of power systems and smart grids. Traditional services for grid monitoring such as Phasor Measurement Units (PMUs) and Phasor Data Concentrators (PDCs) require a centralized architecture and a rigid networking infrastructure in order to properly function, which today is only achieved at the High Voltage (HV) transmission level. Furthermore, manual intervention is often the only option for PMUs/PDCs maintenance. In this work, the traditional PMU/PDC services were deployed as docker-containers in a decentralized Kubernetes cluster, which can represent any kind of geographically dispersed TCP/IP network. By leveraging remote orchestration, several key benefits are achieved: (1) no manual reconfiguration of the PMU-PDC communications upon network reconfiguration, (2) automatic PMU traffic redirection in case of PDC service redeployment in a different location, and (3) reduced data-loss upon PDC failure and enhanced overall system resiliency due to minimized ICT services down-time

Thermal degradation kinetics and lifetime prediction of cellulose biomass cryogels reinforced by its pyrolysis waste

Degradation kinetics is an important tool in order to understand and improve energy conversion and the final application of a material. Cellulose cryogels (CC) are a new class of materials that can be reinforced by several types of particle, including biochar. Apart from it, degradation kinetics and lifetime prediction of biomass cellulose cryogels reinforced by cellulose pyrolysis waste (BC) has been investigated using TG techniques and iso-conversional model free methods. Additionally, the same study was applied to cellulose cryogels reinforced by graphene nanoplatelets (NPG) to compare the behavior of a filler from waste (BC) and a noble filler (NPG). Furthermore, the influence of the addition of the fillers into the cellulose biomass were evaluated in terms of thermal stability and crystallinity. BC and GNP led to higher values of activation energies (Ea) calculated from model-free isoconversional methods and all samples degraded in two-steps. Finally, lifetime prediction was successfully applied and the CC cryogel became more stable over time, maintaining almost 80% of the mass for 1 year exposed at 180 °C. The results of this study shown that only cellulose biomass cryogels are more suitable to produce thermal insulators due to it higher thermal stability

A surveillance system of Invasive Pneumococcal Disease in North-Eastern Italy

Background From 2007, in the Veneto Region (Italy), a surveillance system for invasive pneumococcal diseases (IPD) was implemented to estimate the regional epidemiology of IPD and to evaluate the impact of 13-valent pneumococcal conjugate vaccine (PCV13) vaccination. Methods Data were collected from 2007 to 2014 and the total, annual and age-specific IPD notification rates were calculated. A Poisson regression model was used to identify the possible risk factors for developing IPD. Results A total of 713 IPD cases were notified and the overall IPD notification rate was equal to 2.0 cases per 100,000 population (95% CI: 1.7-2.1), with an increasing trend between 2007 and 2014. The pneumococcal serotypes were identified in 608 (85.3%) isolates from biological specimens, and the most distributed serotypes were those contained in PCV13. Children < 5 year-old and the adults over 65 year-old showed the highest PCV13 vaccine-type IPD notification rate, equal to 2.7/100,000 and 2.8/100,000, respectively. The risk to develop IPD was greater in children aged 65 years (RR = 4.3, 95% CI: 2.7-6.9; p 65 years of age (RR = 1.7, 95% CI: 1.0-2.8; p = 0.042). The invasive pneumococcal disease was mainly caused by the PCV13 serotypes (RR = 2.9, 95%CI: 2.3-3.9; p<0.0001), principally after the PCV13 introduction (RR = 2.3, 95% CI: 1.4-3.8; p<0.001). In spite of that, a significant reduction of the overall IPD incidence is evident in the period following the PCV13 vaccine introduction (RR = 0.4, 95% CI: 0.3-0.5; p<0.0001), particularly in children aged <5 years (RR = 0.3, 95% CI: 0.2-0.7; p = 0.002), demonstrating the real efficacy of PCV13 immunization for children. Conclusions In the Veneto Region, the surveillance system has allowed to describe the detailed epidemiological profile of invasive pneumococcal disease, pointing out that the most circulating pneumococcal serotypes were those contained in the PCV13 vaccine

Avoidable blindness and value based healthcare: more value with a population approach

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