Clinical and Socio-demographic Variables Associated with the Outcome of Vocational Rehabilitation Programs: A Community-Based Italian Study.

This study aims to identify clinical and socio-demographic variables associated with the outcome of vocational rehabilitation programs (VRPs). All users of an Italian Community Mental Health Centre (CMHC) included in VRPs delivered according to the model of Supported Employment in years 2011-2016 were retrospectively enrolled. Fifty users who ended the program with employment were compared with fifty users who dropped out, with respect to clinical and socio-demographic variables. VRPs lasting less than 6 months and oriented toward the competitive labor market had a higher probability of employment. Among users who successfully ended the VRP, the median of health interventions significantly decreased after employment. In the same group of users, less non-health interventions strictly linked to the VRP were required, when compared with users who dropped out. We conclude that employment is associated with improvement of users' clinical conditions and reduced workload for the CMHC.

Antibiotic prescribing for endodontic infections: a survey of dental students in Italy.

AIM: To determine the knowledge of final year undergraduate students attending Italian universities on the appropriate use of systemic antibiotics for endodontic infections. METHODOLOGY: Final year dental students from twenty Italian universities completed a one-page questionnaire on antibiotic use for the treatment of endodontic infections. Data were analysed using descriptive statistics and chi-square tests. RESULTS: A total of three hundred and three students completed the questionnaire. The average duration of antibiotic prescription proposed by respondents was 5.48 ± 1.06 days. Amoxicillin with clavulanic acid was the first-choice antibiotic (85.2%) followed by amoxicillin alone (13.5%), azithromycin (1.0%) and clarithromycin (0.3%), for patients not allergic to penicillin. Clarithromycin was the first-choice drug for patients with a penicillin allergy (56.1%), followed from azithromycin (31.7%), clindamycin (11.9%) and levofloxacin (0.3%). Alveolar abscess with systemic manifestations was reported as the principal reason to prescribe antibiotics (97.7%) followed by the same condition without systemic manifestations (85.5%). For the scenario of irreversible pulpitis, 5% of students considered antibiotics necessary. Almost 52% of students would prescribe antibiotics for apical acute periodontitis; 29.7% would prescribe antibiotics for chronic apical periodontitis with sinus tract, and 13.5% indicated these drugs for chronic apical periodontitis without sinus tract. CONCLUSIONS: The results demonstrate that it is necessary to improve the knowledge of Italian students on antibiotics and indications for their use in endodontics.

An ultrastable Michelson interferometer for high-resolution spectroscopy in the XUV.

We developed an ultra-stable and accurately-controllable Michelson interferometer to be used in a deeply unbalanced arm configuration for split-pulse XUV Ramsey-type spectroscopy with high-order laser harmonics. The implemented active and passive stabilization systems allow one to reach instabilities in the nanometer range over meters of relative optical path differences. Producing precisely delayed pairs of pump pulses will generate XUV harmonic pulses that may significantly improve the achievable spectral resolution and the precision of absolute frequency measurements in the XUV.

Zika virus infection in a traveller returning to Europe from Brazil, March 2015.

We report a case of laboratory-confirmed Zika virus infection imported into Europe from the Americas. The patient developed fever, rash, and oedema of hands and feet after returning to Italy from Brazil in late March 2015. The case highlights that, together with chikungunya virus and dengue virus, three major arboviruses are now co-circulating in Brazil. These arboviruses represent a burden for the healthcare systems in Brazil and other countries where competent mosquito vectors are present.

Adaptive detection of arbitrarily shaped ultrashort quantum light states.

A quantum state of light is the excitation of a particular spatiotemporal mode of the electromagnetic field. A precise control of the mode structure is therefore essential for processing, detecting, and using photonic states in novel quantum technologies. Here we demonstrate an adaptive scheme, combining techniques from the fields of ultrafast coherent control and quantum optics, for probing the arbitrary complex spectrotemporal profile of an ultrashort quantum light pulse. The ability to access the modal structure of a quantum light state could boost the capacity of current quantum information protocols.

COVID-19 vaccinations: An overview of the Italian national health system's online communication from a citizen perspective.

COVID-19 vaccine hesitancy is still widespread. During the pandemic, the internet has been the preferred channel for health-related information, especially for less-educated citizens who tend to be the most hesitant about vaccination. A well-structured web communication strategy could help both to overcome vaccine hesitancy and to ensure equity in healthcare service access. This study investigated how the various regional and local health authorities in Italy used their institutional websites to inform users about COVID-19 vaccinations between March and April 2021. We browsed 129 institutional websites, checking the availability, quality and quantity, actionability and readability of information using a literature-based common grid. Descriptive statistics and statistical tests were performed. The online public dissemination of COVID-19 vaccination information in Italy was fragmented, both across and within regions. The side effects of vaccinations, were often not reported on the websites, thus missing an opportunity to enhance vaccination uptake. More focus should also be placed on readability, since readability indexes showed that they were difficult to understand. Our research revealed that several actions could be implemented to enhance online communication on COVID-19 vaccination. For instance, simplifying texts can make them more understandable and the information reported actionable.

ON THE PLACEMENT OF APRON DOSEMETERS AND DOSE ASSESSMENT IN INTERVENTIONAL CARDIOLOGY PROCEDURES: PRELIMINARY RESULTS.

Personnel involved in interventional practices are likely to be exposed to higher radiation doses than other workers in the medical field. Personnel monitoring and radiation protection measures play a crucial role in keeping these doses below the limits. EURADOS (European Radiation Dosimetry Group) Working Group 12 performed a series of investigations showing how the complexity of the scattered field reaching the operators can influence the doses to the operators. The present work was aimed at determining the possible effects on the registered doses of the scattered field and the actual position of a dosemeter on apron. This study has been performed through Monte Carlo simulations and it was validated through measurements. It does not claim to identify the 'best' position for the dosemeter, but to assess the variability of its response, showing how a variability of the order of +/- 30% to 40 should be taken into account.

Backreaction during inflation: a physical gauge invariant formulation.

Within a genuinely gauge invariant approach recently developed for the computation of the cosmological backreaction, we study, in a cosmological inflationary context and with respect to various observers, the impact of scalar fluctuations on the space-time dynamics in the long wavelength limit. We stress that such a quantum backreaction effect is evaluated in a truly gauge independent way using a set of effective equations which describe the dynamics of the averaged geometry. In particular we show under what conditions the free falling (geodetic) observers do not experience any scalar-induced backreaction in the effective Hubble rate and fluid equation of state.

Structure of liquid n-hexane.

The structure of deuterated liquid n-hexane has been investigated at room temperature by neutron diffraction and molecular dynamics simulations. By carrying out a careful analysis of the measurements, experimental data were obtained in very good agreement with the simulated data. This allowed a thorough analysis of the simulation results aiming at the evaluation of the partial, intra-, and intermolecular components of the n-hexane structure. We finally compare the intramolecular differential cross sections calculated from the most probable n-hexane molecular configurations with the measured and simulated data.

Where is West Nile fever? Lessons learnt from recent human cases in northern Italy.

West Nile disease in humans has been detected for the first time in Italy in two regions, Emilia-Romagna and Veneto. We conclude that also West Nile fever cases should be specifically targeted by surveillance.

Presence of humans and domestic cats affects bat behaviour in an urban nursery of greater horseshoe bats (Rhinolophus ferrumequinum).

Proximity to humans is a primary stressor for wildlife, especially in urban habitats where frequent disturbance may occur. Several bat species often roost in buildings but while the effects of disturbance inside the roost are well documented, little is known about those occurring in the proximity of roosts. We tested the effects of anthropogenic stressors on bats by monitoring reactions to disturbance in a colony of greater horseshoe bats (Rhinolophus ferrumequinum). We assessed disturbance by recording and quantifying the presence of people, domestic cats and noise sources near the roost. Disturbance outside the roost caused the disruption of roosting clusters; when cats entered the roost, bats decreased indoor flight activity. Emergence timing was delayed when people were close to the roost exit, and the delay increased along with the number of people. The occurrence of a cat increased the degree of group clustering during emergence. Cats entered the roost especially when young bats were present, and bat remains occurred in 30% of the cat scats we examined. We show that the occurence of human activities near roosts and free-ranging domestic cats are important albeit overlooked sources of disturbance.

Long-term productivity of lowland and upland switchgrass cytotypes as affected by cutting frequency.

A considerable number of studies has been conducted on switchgrass (Panicum virgatum L.) as a bioresource for energy over the last few years. Nonetheless, some important issues concerning the agro-technique are still open. This research examines the long-term total dry matter yield (TDM) and ash content of two lowland (L) and two upland (U) switchgrass cytotypes, as affected by one or two-cut system, under southern EU climatic conditions (44 degrees 33' N). Overall, L produced higher TDM than U (on average 14.9 and 11.7 Mg ha(-1), respectively); two-cut system allowed to produce higher biomass yields (especially in U) than single harvest during the two first years, but it also drastically reduced plant vigour and productivity of all cytotypes in the following two years. Moreover, under two-cut system almost total seasonal biomass derived from the early harvest, while the second cut slightly contributed to the total seasonal biomass, nor it appeared to offset the additional harvest costs. Biomass quality was also significantly affected by cutting frequency, with two-cut system leading to a considerably higher ash content of biomass. Therefore, it is perceived that two-cut system is not worthwhile with U and L cytotypes as bioresource for energy production under southern EU conditions.

Genetic interactions between GLC7, PPZ1 and PPZ2 in saccharomyces cerevisiae.

GLC7 encodes an essential serine/threonine protein type I phosphatase in Saccharomyces cerevisiae. Three other phosphatases (Ppz1p, Ppz2p, and Sal6p) share >59% identity in their catalytic region with Glc7p. ppz1 ppz2 null mutants have no apparent growth defect on rich media. However, null alleles of PPZ1 and PPZ2, in combination with mutant alleles of GLC7, confer a range of growth defects varying from slow growth to lethality. These results indicate that Glc7p, Ppz1p, and Ppz2p may have overlapping functions. To determine if this overlap extends to interaction with targeting subunits, Glc7p-binding proteins were tested for interaction in the two-hybrid system with the functional catalytic domain of Ppz1p. Ppz1p interacts strongly with a number of Glc7p regulatory subunits, including Glc8p, a protein that shares homology with mammalian PP1 inhibitor I2. Genetic data suggest that Glc8p positively affects both Glc7p and Ppz1p functions. Together our data suggest that Ppz1p and Ppz2p may have overlapping functions with Glc7p and that all three phosphatases may act through common regulatory proteins.

TM9SF4 is a novel V-ATPase-interacting protein that modulates tumor pH alterations associated with drug resistance and invasiveness of colon cancer cells.

An inverted pH gradient across the cell membranes is a typical feature of malignant cancer cells that are characterized by extracellular acidosis and cytosol alkalization. These dysregulations are able to create a unique milieu that favors tumor progression, metastasis and chemo/immune-resistance traits of solid tumors. A key event mediating tumor cell pH alterations is an aberrant activation of ion channels and proton pumps such as (H+)-vacuolar-ATPase (V-ATPase). TM9SF4 is a poorly characterized transmembrane protein that we have recently shown to be related to cannibal behavior of metastatic melanoma cells. Here, we demonstrate that TM9SF4 represents a novel V-ATPase-associated protein involved in V-ATPase activation. We have observed in HCT116 and SW480 colon cancer cell lines that TM9SF4 interacts with the ATP6V1H subunit of the V-ATPase V1 sector. Suppression of TM9SF4 with small interfering RNAs strongly reduces assembly of V-ATPase V0/V1 sectors, thus reversing tumor pH gradient with a decrease of cytosolic pH, alkalization of intracellular vesicles and a reduction of extracellular acidity. Such effects are associated with a significant inhibition of the invasive behavior of colon cancer cells and with an increased sensitivity to the cytotoxic effects of 5-fluorouracil. Our study shows for the first time the important role of TM9SF4 in the aberrant constitutive activation of the V-ATPase, and the development of a malignant phenotype, supporting the potential use of TM9SF4 as a target for future anticancer therapies.

Performance of an in-house genotypic antiretroviral resistance assay in patients pretreated with multiple human immunodeficiency virus type 1 protease and reverse transcriptase inhibitors.

An in-house genotypic antiretroviral resistance assay was evaluated by testing 32 plasma samples obtained from heavily pretreated human immunodeficiency virus type 1 (HIV-1)-infected patients failing multiple antiretroviral regimens. The same samples were also sent to Virco Laboratories for genotypic (VircoGEN) and phenotypic (Antivirogram) resistance analysis. Sequencing results obtained by in-house (HG) and VircoGEN (VG) genotyping were concordant for 387 of 400 (96.75%) drug resistance mutations. Genotype-based prediction of drug susceptibility for 13 currently licensed antiretroviral compounds were in agreement in 336 (80.78%) cases, partially concordant in 73 (17.54%) cases and discordant in only seven (1.68%) cases. VG indicated 'possible resistance' twice as much as HG. When genotype interpretation was compared with the Antivirogram phenotypic data, there were 27 (6.49%) and 23 (5.52%) wrong calls by HG and by VG, respectively. Both assays were more sensitive in detecting drug resistance than drug susceptibility (94.61 vs. 65.19% for HG, 80.84 vs. 56.91% for VG) and more specific in detecting drug susceptibility than drug resistance (93.62 vs. 73.49% for HG, 93.62 vs. 80.32% for VG). Rule-based algorithms can reliably interpret genotypic data obtained from most heavily pretreated patients. However, occasional genotypic patterns may be erroneously interpreted without resistance phenotyping.

Ultrasensitive in-house reverse transcription-competitive PCR for quantitation of HIV-1 RNA in plasma.

An ultrasensitive version of an 'in-house' reverse transcription-competitive polymerase chain reaction assay described previously for quantitation of human immunodeficiency virus type 1 (HIV-1) RNA in plasma was developed. The increase in sensitivity from 400 to 50 HIV-1 RNA copies/ml was achieved by pelleting virus particles from 1.8 ml plasma by centrifugation prior to RNA extraction, modifying competitor DNA structure and amounts, and redesigning primers. Quantitation of HIV-1 RNA in 130 samples tested previously by the standard assay showed that the two procedures yield comparable results (mean absolute difference, 0.26+/-0.20 log) and that the ultrasensitive version detects HIV-1 RNA below the threshold of sensitivity of the standard method. The ultrasensitive 'in-house assay' and the reference QUANTIPLEX HIV-1 RNA 3.0 had the same sensitivity and gave equivalent results (mean absolute difference, 0.19+/-0.11 log), as shown by parallel blinded testing of 47 plasma samples. Titration experiments with reconstructed plasma samples allowed the determination of a dynamic range of 50-500000 HIV-1 RNA copies/ml for the 'in-house' system. The interassay coefficient of variation for samples nominally containing 200, 4000 and 80000 HIV-1 RNA copies/ml were 33.4, 22.9 and 38.2%, respectively. The performance, turnaround time, and cost-effectiveness of this system make it suitable for medium-scale clinical application.

Long-read direct infrared sequencing of crude PCR products for prediction of resistance to HIV-1 reverse transcriptase and protease inhibitors.

Patients infected with human immunodeficiency virus type 1 (HIV-1) are being treated with a number of different combinations of antiretroviral compounds that target the essential viral enzymes reverse transcriptase and protease. Different sets of HIV-1 mutations that confer drug resistance have been well defined; they allow reasonable prediction of the drug sensitivity pattern from analysis of the HIV-1 genotype in vivo. Since periodical monitoring of genotypic resistance is expected to improve clinical management in a large number of infected patients, practical and cost-effective methods are highly desirable to set at least medium-scale sequencing in clinical diagnostic settings. We present a complete protocol for direct sequencing of HIV-1 reverse transcriptase and protease-coding regions. Features making the system amenable to routine clinical use include: 1. Highly robust presequencing steps (plasma RNA extraction, reverse transcription, and nested PCR); 2. Direct use of the crude unpurified PCR product as the sequencing template; and 3. Use of infrared-labeled sequencing primers consistently allowing long reads, thus obviating the need for sequencing of both DNA strands.

Biological monitoring of acrylonitrile exposure.

This study reports the results obtained with the environmental and biological monitoring of 34 workers exposed to acrylonitrile (ACN). Occupational exposure was monitored during 8-h work shifts with both active and diffusive personal samplers which yielded comparable results. The median exposure was 78 micrograms/m3. The ACN concentration in urine collected at the end of the work shifts correlated significantly with the environmental exposure. The ACN concentration in the pre-shift urine samples (median 3.6 micrograms/l) was lower than that found in the post-shift samples (median 10.9 micrograms/l), but higher than in the urine of non-exposed people (median 0.45 microgram/l). Smoking is an important confounding factor in monitoring exposure to ACN. The ACN concentration in urine provides reliable information about occupational and non-occupational exposure to ACN. Aspects of the mechanism of ACN excretion in urine are also discussed.

[Repetitive movements of the upper extremities: the results of assessing exposure to biomechanical overload and of a clinical study in a group of workers employed in the production of plywood and veneer panels]. / Movimenti ripetitivi degli arti superiori: risultati della valutazione dell'esposizione a sovraccarico biomeccanico e dell'indagine clinica in un gruppo di lavoratrici addette alla produzione di pannelli di compensato e multistrato in legno (plywood).

In a group of 27 female workers employed on the manual "moulding" of plywood panels exposure to factors of biomechanical overload for the upper limbs was assessed and an anamnestic and clinical examination was made in order to clarify the occurrence of a series of WMSDs type diseases and disorders. Data are reported on the risk factors, frequency of action (range: right limb-->14.5 divided by 22.0 actions/min,-->5.5 divided by 11.0 actions/min), use of strength (right limb-->Borg 3.7-4.9; left limb-->Borg 3.0-3.8), incongruous postures and movements, complementary factors, and on the lack of recovery pauses (4 hours in an 8-hour shift). The OCRA indices were: single press: right limb-->146-208; left limb-->61-85; multi press: right limb-->4.8-7.1; left limb-->1.1-2.3. The EPM method showed that the factors producing greatest overloading were excessive use of strength, incongruous postures and movements (specially of wrist, hand and elbow) and of complementary factors like constant compression of the palm of the right hand, tearing movements and the use of gloves. Clinical examination according to EPM showed that tendon disorders (69% of which 34% were carpal tunnel syndrome) were the most frequent disorders followed by epicondylosis (23%); disorders of the shoulder were less frequent (8%). In view of the clear significance of the statistical data of these disorders which were proved to be caused by current work organization (Fisher test was highly significant for 65% and significant for 75% of the disorders), further diagnostic and therapeutic investigations for each single female worker are necessary along with specific interventions to improve working conditions. Among the possible prevention measures the need is stressed for improvements on tools, on job organization, and for an adequate information and training program for all workers.