Relationship between Pre-Implant Interleukin-6 Levels, Inflammatory Response, and Early Outcome in Patients Supported by Left Ventricular Assist Device: A Prospective Study

Purpose: The immune response is crucial in the development of multi-organ failure (MOF) and complications in end-stage heart failure patients supported by left ventricular assist device (LVAD). However, at pre-implant, the association between inflammatory state and post-LVAD outcome is not yet clarified. Aim of the study was to assess the relationship among preimplant levels of immune-related cytokines, postoperative inflammatory response and 3-month outcome in LVAD-patients. Methods: In 41 patients undergoing LVAD implantation, plasma levels of interleukin (IL)-6, IL-8, crucial for monocyte modulation, and urine neopterin/creatinine ratio (Neo/Cr), marker of monocyte activation, were assessed preoperatively, at 3 days, 1 and 4 weeks post-LVAD. MOF was evaluated by total sequential organ failure assessment (tSOFA) score. Intensive care unit (ICU)-death and/or post-LVAD tSOFA $11 was considered as main adverse outcome. Length of ICU-stay, 1 weektSOFA score, hospitalisation and 3-month survival were considered additional end-points. Results: During ICU-stay, 8 patients died of MOF, while 8 of the survivors experienced severe MOF with postoperative tSOFA score$11. Pre-implant level of IL-6 $ 8.3 pg/mL was identified as significant marker of discrimination between patients with or without adverse outcome (OR 6.642, 95% CI 1.201-36.509, p = 0.030). Patients were divided according to pre-implant IL-6 cutoff of 8.3 pg/ml in A [3.5 (1.2-6.1) pg/mL] and B [24.6 (16.4-38.0) pg/mL] groups. Among pre-implant variables, only white blood cells count was independently associated with pre-implant IL-6 levels higher than 8.3 pg/ml (OR 1.491, 95% CI 1.004-2.217, p = 0.048). The ICU-stay and hospitalisation resulted longer in B-group (p = 0.001 and p = 0.030, respectively). Postoperatively, 1 week-tSOFA score, IL-8 and Neo/Cr levels were higher in B-group. Conclusions: LVAD-candidates with elevated pre-implant levels of IL-6 are associated, after intervention, to higher release of monocyte activation related-markers, a clue for the development of MOF, longer clinical course and poor outcome

West Nile virus transmission. results from the integrated surveillance system in Italy, 2008 to 2015

IIn Italy a national Plan for the surveillance of imported and autochthonous human vector-borne diseases (chikungunya, dengue, Zika virus disease and West Nile virus (WNV) disease) that integrates human and veterinary (animals and vectors) surveillance, is issued and revised annually according with the observed epidemiological changes. Here we describe results of the WNV integrated veterinary and human surveillance systems in Italy from 2008 to 2015. A real time data exchange protocol is in place between the surveillance systems to rapidly identify occurrence of human and animal cases and to define and update the map of affected areas i.e. provinces during the vector activity period from June to October. WNV continues to cause severe illnesses in Italy during every transmission season, albeit cases are sporadic and the epidemiology varies by virus lineage and geographic area. The integration of surveillance activities and a multidisciplinary approach made it possible and have been fundamental in supporting implementation of and/or strengthening preventive measures aimed at reducing the risk of transmission of WNV trough blood, tissues and organ donation and to implementing further measures for vector control

Road traffic pollution and childhood leukemia: a nationwide case-control study in Italy

Background The association of childhood leukemia with traffic pollution was considered in a number of studies from 1989 onwards, with results not entirely consistent and little information regarding subtypes. Aim of the study We used the data of the Italian SETIL case-control on childhood leukemia to explore the risk by leukemia subtypes associated to exposure to vehicular traffic. Methods We included in the analyses 648 cases of childhood leukemia (565 Acute lymphoblastic–ALL and 80 Acute non lymphoblastic-AnLL) and 980 controls. Information on traffic exposure was collected from questionnaire interviews and from the geocoding of house addresses, for all periods of life of the children. Results We observed an increase in risk for AnLL, and at a lower extent for ALL, with indicators of exposure to traffic pollutants. In particular, the risk was associated to the report of closeness of the house to traffic lights and to the passage of trucks (OR: 1.76; 95% CI 1.03–3.01 for ALL and 6.35; 95% CI 2.59–15.6 for AnLL). The association was shown also in the analyses limited to AML and in the stratified analyses and in respect to the house in different period of life. Conclusions Results from the SETIL study provide some support to the association of traffic related exposure and risk for AnLL, but at a lesser extent for ALL. Our conclusion highlights the need for leukemia type specific analyses in future studies. Results support the need of controlling exposure from traffic pollution, even if knowledge is not complete

Standalone vertex finding in the ATLAS muon spectrometer

A dedicated reconstruction algorithm to find decay vertices in the ATLAS muon spectrometer is presented. The algorithm searches the region just upstream of or inside the muon spectrometer volume for multi-particle vertices that originate from the decay of particles with long decay paths. The performance of the algorithm is evaluated using both a sample of simulated Higgs boson events, in which the Higgs boson decays to long-lived neutral particles that in turn decay to bbar b final states, and pp collision data at √s = 7 TeV collected with the ATLAS detector at the LHC during 2011

The integration of the detection units of KM3NET in Genova

The KM3NeT experiment (1) for the detection of high energy cosmic neutrinos is being built in two sites of the Mediterranean Sea: Capo Passero in Sicily and Toulon in the French coast. The full detection system includes 3 building blocks of Detection Units (DU) (2), each block of 115 DUs. The DU accommodates up to 18 digital optical modules (DOMs) (3). In this note we describe the facility to integrate the DOMs to the vertical cable of the line (VEOC) as realized in our ground floor laboratory of the INFN Institute in Genova

Ibrido di Gallinella d’acqua (Gallinula chloropus, Linnaeus 1758) × Folaga (Fulica atra, Linnaeus 1758) in una zona umida urbana del Friuli Venezia Giulia

Nel 2012 e nel 2015 un ibrido di Gallinella d’acqua Gallinula chloropus e Folaga Fulica atra è stato osservato nel Rio Bujon nel capoluogo del comune di Porcia (Pordenone, Italia nord-orientale). L’ibrido presentava dimensioni e alcune caratteristiche del piumaggio tipiche di G. chloropus (mantello e parti superiori delle ali bruno-oliva; linea bianca dal profilo spezzato sui fianchi; sottocoda bianco con linea centrale scura), mentre il becco e lo scudo frontale apparivano di colore bianco candido, con sfumature rosate in corrispondenza delle narici, come tipicamente viene osservato in F. atra

Impact-based flash-flood forecasting system: Sensitivity to high resolution numerical weather prediction systems and soil moisture

In recent years, continuous improvements have been made in weather forecasting and flood prediction with great benefit from Early Warning Systems (EWSs). Despite the continuous quest for innovation from the scientific and user communities, EWSs remain based mostly on hazard forecast, and the information on possible consequences and potential impacts is generally missing. In this work, a methodology for quantitative real-time impact assessment for flash floods is presented. The methodology uses a multi-model ensemble approach and considers soil moisture uncertainty. Moreover, the flood forecasting chain, which normally provides only the discharge probability of exceeding a given threshold, is extended to include a fully 2D hydraulic model and a damage estimation model to quantitatively assess impacts in terms of economic losses and the people involved. The procedure was tested on recent flood events occurring in Genoa in northwestern Italy. This paper discusses the potential challenges and opportunities offered by this approach in the decision-making workflow in an operational context