Characterization of the Pathogenic Potential of the Beach Sand Microbiome and Assessment of Quicklime as a Remediation Tool

Beach sand may act as a reservoir for potential human pathogens, posing a public health risk. Despite this, the microbiological monitoring of sand microbiome is rarely performed to determine beach quality. In this study, the sand microbial population of a Northern Adriatic Sea beach sand was profiled by microbiological (CFU counts) and molecular methods (WGS, microarray), showing significant presence of potential human pathogens including drug-resistant strains. Consistent with these results, the potential of quicklime as a restoring method was tested in vitro and on-field. Collected data showed that adding 1-3% quicklime (w/w) to sand provided an up to -99% of bacteria, fungi, and viruses, in a dose- and time-dependent manner, till 45 days post-treatment. In conclusion, data suggest that accurate monitoring of sand microbiome may be essential, besides water, to assess beach quality and safety. Moreover, first evidences of quicklime potential for sand decontamination are provided, suggesting its usage as a possible way to restore the microbiological quality of sand in highly contaminated areas

Maintaining over time Clinical Performance targets on Anaemia correction in unselected population on chronic dialysis at 20 Italian Centres. Data from a retrospective study for a Clinical Audit

<p>Abstract</p> <p>Background</p> <p>The Italian and European Best Practice Guidelines (EBPG) recommend a target haemoglobin value greater than 11 g/dl in most patients with Chronic Kidney Diseases. However, it is still difficult to maintain these values at a steady rate. Thus, the main aim of the study was to evaluate, throughout 2005, how many patients steadily maintained the performance targets related to anaemia treatment.</p> <p>Methods</p> <p>The survey was conducted on 3283 patients on haemodialysis (HD) and peritoneal dialysis (PD) at 20 Italian dialysis centres. 540 patients were randomly selected; each centre provided a statistically significant sample proportional to its total number of patients. Maintenance of the following target levels was assessed over time: Haemoglobin (HB) 11-12 gr/dl; Iron: 60-160 mcg/dl; Ferritin: 30-400 mcg/l; Transferrin: 200-360 mg/dl; Transferrin saturation percentage (TSAT %):> 25 <50; Dialysis doses (KT/V): >1.2 <2.0 for non-diabetic HD patients; >1.5 <2.2 for diabetic HD patients; DP: >1.8 <2.5.</p> <p>Outcome included:</p> <p indent="1">1- Percentage of target maintenance for each parameter.</p> <p indent="1">2- Erythropoietin dose in relation to dialysis techniques, presence of cancer or myeloma, diabetic status, Vitamin B therapy.</p> <p indent="1">3- Erythropoietin dose (International Units/kg/week) (IU/kg/wk) depending on: haemoglobin values, hospitalization of more than 3 days.</p> <p>Results</p> <p>Mean age was 65.1; mean haemoglobin concentration over the whole population was 11.3 gr/dl (Standard Deviation (SD): 0.91). The clinical performance targets were maintained over time as follows: HB: 4.3% (Mean 11.43 gr/dl) (SD: 0.42); Ferritin: 71.1% (Mean: 250.23 mcg/L (SD:104.07); Iron: 95.0% (Mean 59.79 mcg/dl)(SD:16.76); Transferrin: 44.8% (Mean 216.83 mg/dl) (SD: 19,50); TSAT %: in 8.4% (Mean: 34.33% (SD: 6.56); HD KT/V: 61.0% (Mean:1.46) (SD: 0.7); PD KT/V:31.4% (Mean: 2.10) (SD: 0.02). The average weekly dose of Erythropoietin (IU/Kg/Wk) was significantly lower for the peritoneal dialysis technique; the higher haemoglobin values, the lower the Erythropoietin dose (IU/Kg/Wk).</p> <p>Conclusion</p> <p>A very low percentage of patients maintained haemoglobin target values over time. We need to identify precise criteria to evaluate the stability over time of clinical performance targets proposed by the guidelines.</p

Changing the focus of care: from curative to palliative care

The improvements in the obstetrical and neonatal diagnosis and therapies have resulted into an increase in the survival rate of infants previously considered as non-viable. Debate is focusing on professionals’ behaviour about withdrawal or withholding of life sustaining treatment (LST) and administration of palliative care for newborns whose conditions are incompatible with a prolonged life. Decisions about treatment should be made jointly by the professionals’ team and the family, placing the interest of the baby at the very heart of the decision process. It is very important that the environment in which the family has to make the decision is characterized by openness, dialogue and frankness. A proper and effective communication with parents is always necessary and can resolve any conflict caused by disagreement. Furthermore, parents need time in the decision making process. Other supports, which could help the family in the final decision are the possibility to ask for a specialist’s second opinion and the involvement of religious leaders and of an indipendent clinical ethics committee. Withholding or withdrawal of LST does not mean cessation of care for the baby, it means to change the focus of care from curative to palliative care.   Proceedings of the 10th International Workshop on Neonatology · Cagliari (Italy) · October 22nd-25th, 2014 · The last ten years, the next ten years in Neonatology Guest Editors: Vassilios Fanos, Michele Mussap, Gavino Faa, Apostolos Papageorgio

Enhancing Machine Translation of Academic Course Catalogues with Terminological Resources

This paper describes an approach to translating course unit descriptions from Italian and German into English, using a phrase-based machine translation (MT) system. The genre is very prominent among those requiring translation by universities in European countries in which English is a non-native language. For each language combination, an in-domain bilingual corpus including course unit and degree program descriptions is used to train an MT engine, whose output is then compared to a baseline engine trained on the Europarl corpus. In a subsequent experiment, a bilingual terminology database is added to the training sets in both engines and its impact on the output quality is evaluated based on BLEU and postediting score. Results suggest that the use of domain-specific corpora boosts the engines quality for both language combinations, especially for German-English, whereas adding terminological resources does not seem to bring notable benefit

Introduction of percutaneous-tunneled transfontanellar external ventricular drainage in the management of hydrocephalus in extremely low-birth-weight infants

Objective: Hydrocephalus treatment in extremely low-birth-weight (ELBW) infants still represents a challenge for the pediatric neurosurgeon, particularly when the patient weighs far less than 1000 g. In such cases, the benefits in terms of neurological outcome following early treatment do not always outweigh the surgical risks, especially considering the great difference in the surgical risk before patient weight increases. To assess the efficacy and reliability of a percutaneous-tunneled, transfontanellar external ventricular drain (PTTEVD) in ELBW infants, the authors started a new protocol for the early surgical treatment of hydrocephalus. Methods: Ten cases of posthemorrhagic hydrocephalus (PHH) in ELBW infants (5 cases < 700 g, range for all cases 550-1000 g) were treated with a PTTEVD that was implanted at bedside as the first measure in a stepwise approach. Results: The average duration of the procedure was 7 minutes, and there was no blood loss. The drain remained in place for an average of 24 days (range 8-45 days). In all cases early control of the hydrocephalus was achieved. One patient had a single episode of CSF leakage (due to insufficient CSF removal). In another patient Enterococcus in the CSF sample was detected the day after abdominal surgery with ileostomy (infection resolved with intrathecal vancomycin). One patient died of Streptococcus sepsis, a systemic infection existing prior to drain placement that never resolved. One patient had Pseudomonas aeruginosa sepsis prior to drain insertion; a PTTEVD was implanted, the infection resolved, and the hydrocephalus was treated in the same way as with a traditional EVD, while the advantages of a quick, minimally invasive, bedside procedure were maintained. Once a patient reached 1 kg in weight, when necessary, a ventriculoperitoneal shunt was implanted and the PTTEVD was removed. Conclusions: The introduction of PTTEVD placement in our standard protocol for the management of PHH has proved to be a wise option for small patients

Phisical performance and quality of life in dialysis patients: Effects of an exercise program prescribed at hospital and carried out at home

Introduction and Aims: Physical training has positive psychophysical effect in dialysis patients. Exercise programs should be effective, sustainable for patients in terms of intensity-duration-mode of execution, bearable for health services in terms of costs. This preliminary study evaluates the effects on performance and Quality of Life (QOL) of a 6 month-walking program prescribed at hospital and carried out at precise intensity at home. Methods: Thirty-one dialysis patients (19 males,age 65±11) after written informed consent were included into 2 groups: prescribed exercise (E),n=17 and control (C),n=14. Physical performance was assessed by the 6 minute walking distance (6MWD) and the Maximal Speed in an incremental treadmill test (MWTS). The MOS SF-36 questionnaire was used to evaluate the perceived health-related QOL. Postdialysis fatigue was determined by a scale measuring the intensity (1=least,5=worst) and by the number of hours of rest necessary to overcome the fatigue symptoms. Medical therapy, dialysis prescription and haemoglobin levels were maintained constant during the study period. All parameters were reassessed after 180 days. Two daily indoor/outdoor walking sessions (10 minutes each, at a speed 50% below MWTS) on the non-dialysis day were prescribed to the E group. The training speed, slower than the usual pace, was facilitated at home by a digital metronome. The program included a daily record of exercise data and symptoms and a monthly MWTS re-evaluation to adjust the training speed. Results: Eleven patients (E=4,C=7) interrupted the study (death-acute illness n=7, transplantation n=1, others n=3). Twenty patients (E=13,C=7) completed the 6-month program. Despite a different training load performed in relation to different comorbidities, E group patients reported absence of limiting symptoms and/or tiredness during all sessions. MTWS and 6MWD significantly increased in the E group: from 3.4±1.1 to 4.0 ±1.0 Km/h (p=0.0004) and from 308±105 to 351±118m (p=0.0007), respectively. The percentage variation of measured 6MWD from the predicted distance for healthy adults rose from 56 to 64%. No relationship was found between performance variations and total amount of exercise. No variation of performance was detected in the C group (6MWD: from 277±72 to 271±76m; 6MWD-predicted distance from 60 to 59%). Improvements in QOL were observed only in the E group, for the scale scores Bodily Pain, Physical Role, Mental Health (p<0.05), Physical Activity, Emotional Role, Social Activity, Vitality (ns). 6MWD and Mental Health variations were directly correlated (r=0.567,p<0.05). The postdialysis fatigue score and the time of recovery, unmodified in C group, were reduced in the E group (p=0.025). Conclusions: Low-cost exercise programs carefully prescribed at hospital and performed at home on the non-dialysis day, improve performance capacity and QOL of dialysis patients with comorbidities

Epigenetic Variability Among Saffron Crocus (Crocus sativus L.) Accessions Characterized by Different Phenotypes

This work represents the first epigenomic study carried out on saffron crocus. Five accessions of saffron, showing differences in tepal pigmentation, yield of saffron and flowering time, were analyzed at the epigenetic level by applying a methylationsensitive restriction enzyme-sequencing (MRE-seq) approach. Five accession-specific hypomethylomes plus a reference hypomethylome, generated by combining the sequence data from the single accessions, were obtained. Assembled sequences were annotated against existing online databases. In the absence of the Crocus genome, the rice genome was mainly used as the reference as it is the best annotated genome among monocot plants. Comparison of the hypomethylomes revealed many differentially methylated regions, confirming the high epigenetic variability present among saffron accessions, including sequences encoding for proteins that could be good candidates to explain the accessions’ alternative phenotypes. In particular, transcription factors involved in flowering process (MADS-box and TFL) and for the production of pigments (MYB) were detected. Finally, by comparing the generated sequences of the different accessions, a high number of SNPs, likely having arisen as a consequence of the prolonged vegetative propagation, were detected, demonstrating surprisingly high genetic variability. Gene ontology (GO) was performed to map and visualize sequence polymorphisms located within the GOs and to compare their distributions among different accessions. As well as suggesting the possible existence of alternative phenotypes with a genetic basis, a clear difference in polymorphic GO is present among accessions based on their geographic origin, supporting a possible signature of selection in the Indian accession with respect to the Spanish ones