Fitting Early Phases of the COVID-19 Outbreak: A Comparison of the Performances of Used Models

The COVID-19 outbreak involved a spread of prediction efforts, especially in the early pandemic phase. A better understanding of the epidemiological implications of the different models seems crucial for tailoring prevention policies. This study aims to explore the concordance and discrepancies in outbreak prediction produced by models implemented and used in the first wave of the epidemic. To evaluate the performance of the model, an analysis was carried out on Italian pandemic data from February 24, 2020. The epidemic models were fitted to data collected at 20, 30, 40, 50, 60, 70, 80, 90, and 98 days (the entire time series). At each time step, we made predictions until May 31, 2020. The Mean Absolute Error (MAE) and the Mean Absolute Percentage Error (MAPE) were calculated. The GAM model is the most suitable parameterization for predicting the number of new cases; exponential or Poisson models help predict the cumulative number of cases. When the goal is to predict the epidemic peak, GAM, ARIMA, or Bayesian models are preferable. However, the prediction of the pandemic peak could be made carefully during the early stages of the epidemic because the forecast is affected by high uncertainty and may very likely produce the wrong results

An advanced seismic network in the Southern Apennines (Italy) for seismicity investigations and experimentation with earthquake early warning.

The last strong earthquake that occurred in the southern Apennines, the Irpinia earthquake on 23 November 1980 (M 6.9), was characterized by a complex rupture mechanism that ruptured three different faults (Bernard and Zollo 1989). This earthquake was well studied, and the quantity of data available has allowed a very detailed definition of the geometry and mechanisms of faults activated during this seismic event (Westaway and Jackson 1987; Pantosti and Valensise 1990). Even more than 20 years after the main event, the seismotectonic environment that contains the fault system on which the 1980 earthquake occurred shows continued background seismic activity including moderate-sized events such as the 1996 (M 5.1), 1991 (M 5.1) and 1990 (M 5.4) events. Moreover, the locations of the microearthquakes (taken from the database of the Istituto Nazionale di Geofisica e Vulcanologia, INGV) define an epicentral area with a geometry and extent surprisingly similar to that of the 1980 earthquake and its aftershocks (figure 1A). These simple observations suggest that it may be possible to study the preparation cycles of strong earthquakes on active faults by studying the microseismicity between seismic events. With this in mind, a seismic network of large dynamic range was planned and is now in an advanced phase of completion in the southern Apennines. Called ISNet (Irpinia Seismic Network), it is equipped with sensors that can record high-quality seismic signals from both small-magnitude and strong earthquakes, from which it will be possible to retrieve information about the rupture process and try to understand the scaling relationships between small and large events. Due to its high density, wide dynamic range, and advanced data-acquisition and data-transmission technologies, the network is being upgraded to become the core infrastructure of a prototype system for seismic early warning and rapid post-event ground-shaking evaluation in the Campania region, which has seismic hazard that ranks among the highest in Italy (Cinti et al. 2004). ISNet will be devoted to real-time estimation of earthquake location and magnitude and to measuring peak ground-motion parameters so as to provide rapid ground-shaking maps for the whole of the Campania region. The information provided by ISNet during the first seconds of a potentially damaging seismic event can be used to activate several types of security measures, such as the shutdown of critical systems and lifelines (Iervolino et al. 2006). The implementation of a modern seismic network involves many different research and technological aspects related to the development of sophisticated data management and processing. The communication systems need to rapidly generate useful, robust, and secure alert notifications. Here we provide a general technical and seismological overview of ISNet's complex architecture and implementation.Published622-6344.1. Metodologie sismologiche per l'ingegneria sismicaJCR Journalreserve

Body composition parameters, immunonutritional indexes, and surgical outcome of pancreatic cancer patients resected after neoadjuvant therapy: A retrospective, multicenter analysis

Background and aims: Body composition parameters and immunonutritional indexes provide useful information on the nutritional and inflammatory status of patients. We sought to investigate whether they predict the postoperative outcome in patients with pancreatic cancer (PC) who received neoadjuvant therapy (NAT) and then pancreaticoduodenectomy. Methods: Data from locally advanced PC patients who underwent NAT followed by pancreaticoduodenectomy between January 2012 and December 2019 in four high-volume institutions were collected retrospectively. Only patients with two available CT scans (before and after NAT) and immunonutritional indexes (before surgery) available were included. Body composition was assessed and immunonutritional indexes collected were: VAT, SAT, SMI, SMA, PLR, NLR, LMR, and PNI. The postoperative outcomes evaluated were overall morbidity (any complication occurring), major complications (Clavien-Dindo ≥ 3), and length of stay. Results: One hundred twenty-one patients met the inclusion criteria and constituted the study population. The median age at the diagnosis was 64 years (IQR16), and the median BMI was 24 kg/m2 (IQR 4.1). The median time between the two CT-scan examined was 188 days (IQR 48). Skeletal muscle index (SMI) decreased after NAT, with a median delta of −7.8 cm2/m2 (p < 0.05). Major complications occurred more frequently in patients with a lower pre-NAT SMI (p = 0.035) and in those who gained in subcutaneous adipose tissue (SAT) compartment during NAT (p = 0.043). Patients with a gain in SMI experienced fewer major postoperative complications (p = 0.002). The presence of Low muscle mass after NAT was associated with a longer hospital stay [Beta 5.1, 95%CI (1.5, 8.7), p = 0.006]. An increase in SMI from 35 to 40 cm2/m2 was a protective factor with respect to overall postoperative complications [OR 0.43, 95% (CI 0.21, 0.86), p < 0.001]. None of the immunonutritional indexes investigated predicted the postoperative outcome. Conclusion: Body composition changes during NAT are associated with surgical outcome in PC patients who receive pancreaticoduodenectomy after NAT. An increase in SMI during NAT should be favored to ameliorate the postoperative outcome. Immunonutritional indexes did not show to be capable of predicting the surgical outcome

Physiological levels of estradiol limit murine osteoarthritis progression

Among patients with knee osteoarthritis (OA), postmenopausal women are overrepresented. The purpose of this study was to determine whether deficiency of female sex steroids affects OA progression and to evaluate the protective effect of treatment with a physiological dose of 17β-estradiol (E2) on OA progression using a murine model. Ovariectomy (OVX) of female mice was used to mimic a postmenopausal state. OVX or sham-operated mice underwent surgery for destabilization of the medial meniscus (DMM) to induce OA. E2 was administered in a pulsed manner for 2 and 8 weeks. OVX of OA mice did not influence the cartilage phenotype or synovial thickness, while both cortical and trabecular subchondral bone mineral density (BMD) decreased after OVX compared with sham-operated mice at 8 weeks post-DMM surgery. Additionally, OVX mice displayed decreased motor activity, reduced threshold of pain sensitivity, and increased number of T cells in the inguinal lymph nodes compared to sham-operated mice 2 weeks after OA induction. Eight weeks of treatment with E2 prevented cartilage damage and thickening of the synovium in OVX OA mice. The motor activity was improved after E2 replacement at the 2 weeks time point, which was also associated with lower pain sensitivity in the OA paw. E2 treatment protected against OVX-induced loss of subchondral trabecular bone. The number of T cells in the inguinal lymph nodes was reduced by E2 treatment after 8 weeks. This study demonstrates that treatment with a physiological dose of E2 exerts a protective role by reducing OA symptoms. © 2022 The authors Published by Bioscientifica Ltd.</p

New understandings of the genetic basis of isolated idiopathic central hypogonadism

Idiopathic hypogonadotropic hypogonadism is a rare disease that is characterized by delayed/absent puberty and/or infertility due to an insufficient stimulation of an otherwise normal pituitary-gonadal axis by gonadotrophin-releasing hormone (GnRH) action. Because reduced or normal luteinizing hormone (LH)/follicle-stimulating hormone (FSH) levels may be observed in the affected patients, the term idiopathic central hypogonadism (ICH) appears to be more appropriate. This disease should be distinguished from central hypogonadism that is combined with other pituitary deficiencies. Isolated ICH has a complex pathogenesis and is fivefold more prevalent in males. ICH frequently appears in a sporadic form, but several familial cases have also been reported. This finding, in conjunction with the description of numerous pathogenetic gene variants and the generation of several knockout models, supports the existence of a strong genetic component. ICH may be associated with several morphogenetic abnormalities, which include osmic defects that, with ICH, constitute the cardinal manifestations of Kallmann syndrome (KS). KS accounts for approximately 40% of the total ICH cases and has been generally considered to be a distinct subgroup. However, the description of several pedigrees, which include relatives who are affected either with isolated osmic defects, KS, or normo-osmic ICH (nICH), justifies the emerging idea that ICH is a complex genetic disease that is characterized by variable expressivity and penetrance. In this context, either multiple gene variants or environmental factors and epigenetic modifications may contribute to the variable disease manifestations. We review the genetic mechanisms that are presently known to be involved in ICH pathogenesis and provide a clinical overview of the 227 cases that have been collected by the collaborating centres of the Italian ICH Network

Probabilistic examination of the change in eigenfrequencies of an offshore wind turbine under progressive scour incorporating soil spatial variability

The trend for development in the offshore wind sector is towards larger turbines in deeper water. This results in higher wind and wave loads on these dynamically sensitive structures. Monopiles are the preferred foundation solution for offshore wind structures and have a typical expected design life of 20 years. These foundations have strict serviceability tolerances (e.g. mudline rotation of less than 0.25° during operation). Accurate determination of the system frequency is critical in order to ensure satisfactory performance over the design life, yet determination of the system stiffness and in particular the operational soil stiffness remains a significant challenge. Offshore site investigations typically focus on the determination of the soil conditions using Cone Penetration Test (CPT) data. This test gives large volumes of high quality data on the soil conditions at the test location, which can be correlated to soil strength and stiffness parameters and used directly in pile capacity models. However, a combination of factors including; parameter transformation, natural variability, the relatively small volume of the overall sea bed tested and operational effects such as the potential for scour development during turbine operation lead to large uncertainties in the soil stiffness values used in design. In this paper, the effects of scour erosion around unprotected foundations on the design system frequencies of an offshore wind turbine is investigated numerically. To account for the uncertainty in soil-structure interaction stiffness for a given offshore site, a stochastic ground model is developed using the data resulting from CPTs as inputs. Results indicate that the greater the depth of scour, the less certain a frequency-based SHM technique would be in accurately assessing scour magnitude based solely on first natural frequency measurements. However, using Receiver Operating Characteristic (ROC) curve analysis, the chance of detecting the presence of scour from the output frequencies is improved significantly and even modest scour depths of 0.25 pile diameters can be detected

Diagnosis, treatment and prevention of pediatric obesity: consensus position statement of the Italian Society for Pediatric Endocrinology and Diabetology and the Italian Society of Pediatrics

The Italian Consensus Position Statement on Diagnosis, Treatment and Prevention of Obesity in Children and Adolescents integrates and updates the previous guidelines to deliver an evidence based approach to the disease. The following areas were reviewed: (1) obesity definition and causes of secondary obesity; (2) physical and psychosocial comorbidities; (3) treatment and care settings; (4) prevention. The main novelties deriving from the Italian experience lie in the definition, screening of the cardiometabolic and hepatic risk factors and the endorsement of a staged approach to treatment. The evidence based efficacy of behavioral intervention versus pharmacological or surgical treatments is reported. Lastly, the prevention by promoting healthful diet, physical activity, sleep pattern, and environment is strongly recommended since the intrauterine phase