Global Measles Surveillance: Trends, Challenges, and Implications for Public Health Interventions.

Measles, a highly contagious disease primarily affecting children, carries serious health risks, including complications and mortality. Vaccination remains the most effective preventive measure against measles transmission. The COVID-19 pandemic has exacerbated challenges in surveillance and immunization efforts, leaving millions of people exposed to preventable diseases such as measles. Globally accelerated immunization campaigns are critical for achieving regional elimination goals and mitigating the risk of outbreaks. Our team has developed an open-access database for global measles monitoring, facilitating standardized data collection and analysis. The analysis of measles cases from 2011 to 2023 reveals fluctuating trends, with notable increases in Africa in 2019 and 2023, indicating potential gaps in control strategies. Using an automated signal detection tool developed by the European Centre for Disease Prevention and Control (ECDC) team, we identified significant variations between World Health Organization (WHO) regions, underscoring the importance of continuous monitoring to detect epidemiological changes early. These results underscore the need for robust surveillance systems and accelerated vaccination efforts to safeguard public health.

Phylodynamic and Evolution of the Hemagglutinin (HA) and Neuraminidase (NA) Genes of Influenza A(H1N1) pdm09 Viruses Circulating in the 2009 and 2023 Seasons in Italy.

The influenza A(H1N1) pdm09 virus, which emerged in 2009, has been circulating seasonally since then. In this study, we conducted a comprehensive genome-based investigation to gain a detailed understanding of the genetic and evolutionary characteristics of the hemagglutinin (HA) and neuraminidase (NA) surface proteins of A/H1N1pdm09 strains circulating in Italy over a fourteen-year period from 2009 to 2023 in relation to global strains. Phylogenetic analysis revealed rapid transmission and diversification of viral variants during the early pandemic that clustered in clade 6B.1. In contrast, limited genetic diversity was observed during the 2023 season, probably due to the genetic drift, which provides the virus with a constant adaptability to the host; furthermore, all isolates were split into two main groups representing two clades, i.e., 6B.1A.5a.2a and its descendant 6B.1A.5a.2a.1. The HA gene showed a faster rate of evolution compared to the NA gene. Using FUBAR, we identified positively selected sites 41 and 177 for HA and 248, 286, and 455 for NA in 2009, as well as sites 22, 123, and 513 for HA and 339 for NA in 2023, all of which may be important sites related to the host immune response. Changes in glycosylation acquisition/loss at prominent sites, i.e., 177 in HA and 248 in NA, should be considered as a predictive tool for early warning signs of emerging pandemics, and for vaccine and drug development.

Shark Microbiome Analysis Demonstrates Unique Microbial Communities in Two Distinct Mediterranean Sea Shark Species.

Our knowledge regarding the role of the microbiome in fish health has been steadily increasing in the last decade, especially for species of commercial interest. Conversely, relatively few studies focus on the microbiomes of wild fish, especially apex predators like sharks, due to lower economic interest and greater difficulty in obtaining samples. Studies investigating microbiome differences between diverse anatomical locations of sharks are limited, and the majority of the available studies are focused on the microbial diversity present on shark teeth, with the aim of preventing infections due to bites of these animals or evaluating the presence of certain pathogens in healthy or diseased specimens. Here, we investigated the skin, mouth, gills, and cloaca microbiomes of five individuals of two phylogenetically distant species of sharks (Prionace glauca and Somniosus rostratus) to obtain a better understanding of the diversity regarding the microbiomes of these animals, how they change throughout different body parts, and how much they are influenced and determined by the ecology and evolutionary relationship between host and microbiome. To confirm the taxonomy of the sharks under study, we barcoded the specimens by sequencing the mtDNA COI from a biopsy of their skin. Microbial diversity based on the 16S rRNA gene reveals that partially overlapping microbiomes inhabit different body parts of each shark species, while the communities are distinct between the two species. Our results suggest that sharks' microbiome species-specific differences are controlled by the ecology of the shark species. This is the first study comparatively analyzing the microbiome diversity of different anatomical locations in two shark species of the Mediterranean Sea.

Flexible Textile Sensors-Based Smart T-Shirt for Respiratory Monitoring: Design, Development, and Preliminary Validation.

Respiratory rate (fR) monitoring through wearable devices is crucial in several scenarios, providing insights into well-being and sports performance while minimizing interference with daily activities. Strain sensors embedded into garments stand out but require thorough investigation for optimal deployment. Optimal sensor positioning is often overlooked, and when addressed, the quality of the respiratory signal is neglected. Additionally, sensor metrological characterization after sensor integration is often omitted. In this study, we present the design, development, and feasibility assessment of a smart t-shirt embedded with two flexible sensors for fR monitoring. Guided by a motion capture system, optimal sensor design and position on the chest wall were defined, considering both signal magnitude and quality. The sensors were developed, embedded into the wearable system, and metrologically characterized, demonstrating a remarkable response to both static (sensitivity 9.4 Ω⋅%-1 and 9.1 Ω⋅%-1 for sensor A and sensor B, respectively) and cyclic loads (min. hysteresis span 20.4% at 36 bpm obtained for sensor A). The feasibility of the wearable system was assessed on healthy volunteers both under static and dynamic conditions (such as running, walking, and climbing stairs). A mean absolute error of 0.32 bpm was obtained by averaging all subjects and tests using the combination of the two sensors. This value was lower than that obtained using both sensor A (0.53 bpm) and sensor B (0.78 bpm) individually. Our study highlights the importance of signal amplitude and quality in optimal sensor placement evaluation, as well as the characterization of the embedded sensors for metrological assessment.

Changing and evolution of influenza virus: is it a trivial flu?

BACKGROUND: Influenza viruses are etiological agents which cause contagious respiratory, seasonal epidemics and, for Influenza A subtypes, pandemics. The clinical picture of Influenza has undergone continuous change over the years, due to intrinsic viral evolution as well as "reassortment" of its genomic segments. The history of Influenza highlights its ability to adapt and to rapidly evolve, without specific circumstances. This reflects the complexity of this pathology and poses the fundamental question about its assumption as a "common illness" and its impact on public health. SUMMARY: The global influenza epidemics and pandemics claimed millions of deaths, leaving an indelible mark on public health, and showing the need for a better comprehension of the influenza virus. The clear understanding of genetic variations during the Influenza seasonal epidemics is a crucial point for developing effective strategies for prevention, treatment, and vaccine design. The recent advance in Next Generation Sequencing approaches, model systems to virus culture and bioinformatics pipeline played a key role in the rapid characterization of circulating Influenza strains. In particular, the increase of computational power allowed to perform complex tasks in healthcare setting through Machine Learning (ML) algorithms, which analyze different variables, such as medical and laboratory outputs, to optimize medical research and to improve public health systems. The early detection of emerging and re-emerging pathogens is of matter importance to prevent next pandemics. KEY MESSAGES: The perception of influenza as a "trivial flu" or a more serious public health concern is a subject of ongoing debate, reflecting the multifaceted nature of this infectious disease. The variability in the severity of influenza shed the light on the unpredictability of the viral characteristics, coupled with the challenges in accurately predicting circulating strains. This adds complexity to the public health burden of Influenza and highlights the need of targeted interventions.

Marine polysaccharides, proteins, lipids, and silica for drug delivery systems: A review.

Marine environments represent an incredible source of biopolymers with potential biomedical applications. Recently, drug delivery studies have received great attention for the increasing need to improve site specificity, therapeutic value, and bioavailability, reducing off-target effects. Marine polymers, such as alginate, carrageenan, collagen, chitosan, and silica, have reported unique biochemical features, allowing an efficient binding with drugs, and a controlled release to the target tissue, also obtainable through "green processes". In the present review, we i) analysed the last ten years of scientific peer-reviewed literature; ii) divided the articles based on the achieved experimental phases, tagged as chemistry, drug release, and drug delivery, and iii) compared the best performances among marine polymers extracted from micro- and macro-organisms. Many reviews describe drug carriers from marine organisms, focusing on a single biopolymer or a chemical class. Our study is a groundbreaking literature collection, representing the first thorough investigation of all marine biopolymers described. Most articles report experimental results on the chemical characterisation of marine biopolymers and their in vitro behaviour as drug carriers, although development processes and commercial applications are still in the early stages. Hence, the next efforts should be focused on the sustainable production of marine polymers and final product development.

High BCR::ABL1 Expression Defines CD34+ Cells with Significant Alterations in Signal Transduction, Short-Proliferative Potential and Self-Renewal Ability.

Purpose: Chronic Myeloid Leukemia (CML) is a clonal disorder of the hematopoietic stem cell caused by expression of the BCR::ABL1 oncoprotein. High BCR::ABL1 levels have been associated to proliferative advantage of leukemic cells, blast crisis progression and tyrosine kinase inhibitors (TKIs) inefficacy. We have previously shown that high BCR::ABL1/GUSIS transcripts measured at diagnosis are associated with inferior responses to standard dose Imatinib (IM). However, the mechanisms underlying the higher rates of disease progression and development of TKIs resistance dependent on elevated BCR::ABL1 levels remain unclear. Methods: Leukemic cells were collected from CML patients showing, at diagnosis, high or low BCR::ABL1/GUSIS. BCR::ABL1 expression levels were measured using real-time PCR. Short-term culture and long-term culture-initiating cells assays were employed to investigate the role of BCR::ABL1 gene-expression levels on proliferation, clonogenicity, signal transduction, TKIs responsiveness and self-renewal ability. Cell division was performed by carboxyfluorescein-succinimidyl ester (CFSE) assay. Results: We found that BCR::ABL1 oncogene expression levels correlate in both PMNs and CD34+ cells. Furthermore, high oncogene levels increased both proliferation and anti-apoptotic signaling via ERK and AKT phosphorylation. Moreover, high BCR::ABL1 expression reduced the clonogenicity of leukemic CD34+ cells and increased their sensitivity to high doses IM but not to those of dasatinib. Furthermore, we observed that high BCR::ABL1 levels are associated with a reduced self-renewal of primitive leukemic cells and, also, that these cells showed comparable TKIs responsiveness with cells expressing lower BCR::ABL1 levels. Interestingly, we found a direct correlation between high BCR::ABL1 levels and reduced number of quiescent leukemic cells caused by increasing their cycling. Conclusion: Higher BCR::ABL1 levels improving the proliferation, anti-apoptotic signaling and reducing self-renewal properties cause an increased expansion of leukemic clone.

Bioaccumulation of Trace Elements in the Muscle of the Blackmouth Catshark Galeus melastomus from Mediterranean Waters.

Environmental pollution, particularly in the marine environment, has become a significant concern due to the increasing presence of pollutants and their adverse effects on ecosystems and human health. This study focuses on the bioaccumulation of trace elements in the muscle tissue of the blackmouth catshark (Galeus melastomus) from different areas in the Mediterranean Sea. Trace elements are of interest due to their persistence, toxicity, and potential for bioaccumulation. This research aims to assess the distribution and accumulation of trace elements in the muscle tissue of G. melastomus and investigate their potential impact on the deep-sea environment of the Mediterranean. The focused areas include the Ligurian Sea, the northern and central Tyrrhenian Sea, the southern Tyrrhenian Sea, the Ionian Sea, the Pantelleria Waters, and the Gela Waters. Samples were collected following established protocols, and trace element analysis was conducted using inductively coupled plasma mass spectrometry. The study provides data on the concentrations of 17 trace elements, namely aluminum, arsenic, cadmium, cobalt, copper, manganese, molybdenum, nickel, zinc, selenium, strontium, lead, chromium, iron, barium, bismuth, and uranium. The findings contribute to a better understanding of trace element bioaccumulation patterns in elasmobranch species, specifically G. melastomus, and highlight the potential risks associated with chemical contamination in the Mediterranean Sea. This research emphasizes the importance of studying the impacts of pollutants on marine organisms, particularly those occupying key ecological roles, like sharks, to support effective conservation and management strategies.

Respiratory Rate Estimation during Walking and Running Using Breathing Sounds Recorded with a Microphone.

Emerging evidence suggests that respiratory frequency (fR) is a valid marker of physical effort. This has stimulated interest in developing devices that allow athletes and exercise practitioners to monitor this vital sign. The numerous technical challenges posed by breathing monitoring in sporting scenarios (e.g., motion artifacts) require careful consideration of the variety of sensors potentially suitable for this purpose. Despite being less prone to motion artifacts than other sensors (e.g., strain sensors), microphone sensors have received limited attention so far. This paper proposes the use of a microphone embedded in a facemask for estimating fR from breath sounds during walking and running. fR was estimated in the time domain as the time elapsed between consecutive exhalation events retrieved from breathing sounds every 30 s. Data were collected from ten healthy subjects (both males and females) at rest and during walking (at 3 km/h and 6 km/h) and running (at 9 km/h and 12 km/h) activities. The reference respiratory signal was recorded with an orifice flowmeter. The mean absolute error (MAE), the mean of differences (MOD), and the limits of agreements (LOAs) were computed separately for each condition. Relatively good agreement was found between the proposed system and the reference system, with MAE and MOD values increasing with the increase in exercise intensity and ambient noise up to a maximum of 3.8 bpm (breaths per minute) and -2.0 bpm, respectively, during running at 12 km/h. When considering all the conditions together, we found an MAE of 1.7 bpm and an MOD ± LOAs of -0.24 ± 5.07 bpm. These findings suggest that microphone sensors can be considered among the suitable options for estimating fR during exercise.

Additional Genetic Alterations and Clonal Evolution of MPNs with Double Mutations on the MPL Gene: Two Case Reports.

Essential thrombocythemia (ET) and primary myelofibrosis (PMF) are two of the main BCR-ABL1-negative chronic myeloproliferative neoplasms (MPNs) characterized by abnormal megakaryocytic proliferation. Janus kinase 2 (JAK2) mutations are detected in 50-60% of ET and PMF, while myeloproliferative leukemia (MPL) virus oncogene mutations are present in 3-5% of cases. While Sanger sequencing is a valuable diagnostic tool to discriminate the most common MPN mutations, next-generation sequencing (NGS) is a more sensitive technology that also identifies concurrent genetic alterations. In this report, we describe two MPN patients with simultaneous double MPL mutations: a woman with ET presenting both MPLV501A-W515R and JAK2V617F mutations and a man with PMF displaying an uncommon double MPLV501A-W515L. Using colony-forming assays and NGS analyses, we define the origin and mutational landscape of these two unusual malignancies and uncover further gene alterations that may contribute to the pathogenesis of ET and PMF.

Sudan Black B Pretreatment to Suppress Autofluorescence in Silk Fibroin Scaffolds.

Natural polymers are extensively utilized as scaffold materials in tissue engineering and 3D disease modeling due to their general features of cytocompatibility, biodegradability, and ability to mimic the architecture and mechanical properties of the native tissue. A major limitation of many polymeric scaffolds is their autofluorescence under common imaging methods. This autofluorescence, a particular challenge with silk fibroin materials, can interfere with the visualization of fluorescently labeled cells and proteins grown on or in these scaffolds, limiting the assessment of outcomes. Here, Sudan Black B (SBB) was successfully used prefixation prior to cell seeding, in various silk matrices and 3D model systems to quench silk autofluorescence for live cell imaging. SBB was also trialed postfixation in silk hydrogels. We validated that multiple silk scaffolds pretreated with SBB (hexafluoro-2-propanol-silk scaffolds, salt-leached sponges, gel-spun catheters, and sponge-gel composite scaffolds) cultured with fibroblasts, adipose tissue, neural cells, and myoblasts demonstrated improved image resolution when compared to the nonpretreated scaffolds, while also maintaining normal cell behavior (attachment, growth, proliferation, differentiation). SBB pretreatment of silk scaffolds is an option for scaffold systems that require autofluorescence suppression.

Diet and Plastic Ingestion in the Blackmouth Catshark Galeus melastomus, Rafinesque 1810, in Italian Waters.

Galeus melastomus is the most common Pentanchidae in the Mediterranean Sea. A scavenger and opportunistic feeder, and despite the wide distribution, little is known about its feeding habits in Italian waters. The main purpose of this study was to investigate the diet of the blackmouth catshark by analysing the stomach contents. The specimens analysed were obtained from five populations of the Tyrrhenian and of the Ionian Seas, collected from a depth between 40 and 700 m. A total of 259 stomachs were analysed. The stomach contents were grouped into macro-categories and identified to the lowest taxonomic level possible. Crustaceans such as Parapenaeus longirostris, the Cephalopods Heteroteuthis dispar and Onychoteuthis banksii, and Osteichthyes, mostly Myctophidae, were identified. Plastic debris was also found among the stomach contents and classified according to its colour and shape. Osteichthyes represent the most abundant item (44%), above all the Myctophidae family, except for the catshark population from Tuscany, in which the most frequent species were Cephalopods, such as Abralia veranyi and Heteroteuthis dispar. Differences in the plastic debris contents were also observed between the Tuscany population and other populations. These could be explained as a probable consequence of the different depths at which the blackmouth catshark populations were sampled.

Design and Testing of a Smart Facemask for Respiratory Monitoring during Cycling Exercise.

Given the importance of respiratory frequency (fR) as a valid marker of physical effort, there is a growing interest in developing wearable devices measuring fR in applied exercise settings. Biosensors measuring chest wall movements are attracting attention as they can be integrated into textiles, but their susceptibility to motion artefacts may limit their use in some sporting activities. Hence, there is a need to exploit sensors with signals minimally affected by motion artefacts. We present the design and testing of a smart facemask embedding a temperature biosensor for fR monitoring during cycling exercise. After laboratory bench tests, the proposed solution was tested on cyclists during a ramp incremental frequency test (RIFT) and high-intensity interval training (HIIT), both indoors and outdoors. A reference flowmeter was used to validate the fR extracted from the temperature respiratory signal. The smart facemask showed good performance, both at a breath-by-breath level (MAPE = 2.56% and 1.64% during RIFT and HIIT, respectively) and on 30 s average fR values (MAPE = 0.37% and 0.23% during RIFT and HIIT, respectively). Both accuracy and precision (MOD ± LOAs) were generally superior to those of other devices validated during exercise. These findings have important implications for exercise testing and management in different populations.

Linear and Non-Linear Heart Rate Variability Indexes from Heart-Induced Mechanical Signals Recorded with a Skin-Interfaced IMU.

Heart rate variability (HRV) indexes are becoming useful in various applications, from better diagnosis and prevention of diseases to predicting stress levels. Typically, HRV indexes are retrieved from the heart's electrical activity collected with an electrocardiographic signal (ECG). Heart-induced mechanical signals recorded from the body's surface can be utilized to record the mechanical activity of the heart and, in turn, extract HRV indexes from interbeat intervals (IBIs). Among others, accelerometers and gyroscopes can be used to register IBIs from precordial accelerations and chest wall angular velocities. However, unlike electrical signals, the morphology of mechanical ones is strongly affected by body posture. In this paper, we investigated the feasibility of estimating the most common linear and non-linear HRV indexes from accelerometer and gyroscope data collected with a wearable skin-interfaced Inertial Measurement Unit (IMU) positioned at the xiphoid level. Data were collected from 21 healthy volunteers assuming two common postures (i.e., seated and lying). Results show that using the gyroscope signal in the lying posture allows accurate results in estimating IBIs, thus allowing extracting of linear and non-linear HRV parameters that are not statistically significantly different from those extracted from reference ECG.

Measurement of the Growth of the Main Commercial Rays (Raja clavata, Raja brachyura, Torpedo marmorata, Dipturus oxyrinchus) in European Waters Using Intercalibration Methods.

The intercalibration of age readings represents a crucial step in the ageing procedure; the use of different sampling methods, structures, preparation techniques, and ageing criteria can significantly affect age and growth data. This study evaluated the precision and accuracy of ageing for the most important North Atlantic (NA) and Mediterranean (M) ray species, Raja clavata, Raja brachyura, Torpedo marmorata, and Dipturus oxyrinchus, through exchange exercises carried out by readers from different laboratories. In addition, growth parameters were estimated from the obtained data. A total of 663 individual batoids were analysed. R. clavata and R. brachyura samples were obtained from both the NA and the M, while vertebral centra of T. marmorata and D. oxyrinchus were only available for the M. High reading variability was observed for all four evaluated species in terms of CV, APE, and PA. D. oxyrinchus and T. marmorata showed relatively slow growth and the von Bertalanffy model with fixed t0 and Gompertz's model were, respectively, the most precise models for each of these species. In R. brachyura, females had a faster growth rate compared to combined sexes. The vbt0p proved the most precise model for describing growth in this species, and no statistical differences were found between the NO and the M. For R. clavata, the best-fitting model was the vbt0p for females and males in the NO and for females from the M, while the best-fitting model for males from the M and sexes combined for both areas was log.p. Distinct growth patterns were observed between the two study areas.

Comparison between Chest-Worn Accelerometer and Gyroscope Performance for Heart Rate and Respiratory Rate Monitoring.

The demand for wearable devices to simultaneously monitor heart rate (HR) and respiratory rate (RR) values has grown due to the incidence increase in cardiovascular and respiratory diseases. The use of inertial measurement unit (IMU) sensors, embedding both accelerometers and gyroscopes, may ensure a non-intrusive and low-cost monitoring. While both accelerometers and gyroscopes have been assessed independently for both HR and RR monitoring, there lacks a comprehensive comparison between them when used simultaneously. In this study, we used both accelerometers and gyroscopes embedded in a single IMU sensor for the simultaneous monitoring of HR and RR. The following main findings emerged: (i) the accelerometer outperformed the gyroscope in terms of accuracy in both HR and RR estimation; (ii) the window length used to estimate HR and RR values influences the accuracy; and (iii) increasing the length over 25 s does not provide a relevant improvement, but accuracy improves when the subject is seated or lying down, and deteriorates in the standing posture. Our study provides a comprehensive comparison between two promising systems, highlighting their potentiality for real-time cardiorespiratory monitoring. Furthermore, we give new insights into the influence of window length and posture on the systems' performance, which can be useful to spread this approach in clinical settings.

Giant Paratesticular Liposarcoma: Molecular Characterization and Management Principles with a Review of the Literature.

Paratesticular liposarcomas are extremely rare malignant tumors originating from fat tissues, with an often-challenging diagnosis. We present here the case of a 76-year-old man with a giant paratesticular liposarcoma, initially misdiagnosed as a scrotal hernia. After two years, the progressively enlarging mass underwent surgical resection, and a diagnosis of well-differentiated liposarcoma (lipoma-like subtype) was made. Post-operative treatments were not indicated, and the patient remains relapse free. Next generation sequencing performed on the neoplastic tissue showed co-amplification of MDM2 and CDK4. These alterations are molecular hallmarks of well-differentiated liposarcomas and corroborate the histological diagnosis. Clinical and molecular features of the presented case are in line with the majority of previously published experiences. In conclusion, the presence of a liposarcoma should be taken into account during the diagnostic workup of scrotal masses, in order to minimize the rate of misdiagnosis and improper management. Molecular analysis may support histological characterization of these rare entities and potentially disclose novel therapeutic targets.