Model-averaging of ab initio spectra for the absolute configuration assignment via vibrational circular dichroism.

Vibrational absorption and vibrational circular dichroism spectra (VA and VCD) have been recorded for two hybrid isoindolinone-phtalide stereoisomers dissolved in CDCl3. Density-functional calculations have been performed to determine their absolute configuration. A comparison of calculated and measured values has been made using several goodness-of-fit indicators, and also introducing a model-averaging technique, taking into account the variation of calculated spectra with the details of the computational method. The model-averaging technique, preliminarily tested on two VCD spectra already assigned to two diastereomers of tadalafil, gives higher credibility to the ab initio calculations, and should be useful for other molecules with high flexibility and/or more than one stereogenic center.

A nosocomial measles outbreak in Italy, February-April 2017.

We describe a nosocomial outbreak of measles that occurred in an Italian hospital during the first months of 2017, involving 35 persons and including healthcare workers, support personnel working in the hospital, visitors and community contacts. Late diagnosis of the first case, support personnel not being promptly recognised as hospital workers and diffusion of the infection in the emergency department had a major role in sustaining this outbreak.

Assessing vaccine hesitancy and health literacy using a new Italian vaccine confidence index and a modified Italian medical term recognition test: A cross-sectional survey on Italian parents.

The decline in children's vaccination coverage and the resurgence of preventable infectious diseases draw attention to parents' vaccine hesitancy. Our study introduces two validated tools to independently assess vaccine hesitancy and health literacy among parents with school-age children. We developed a Vaccine Confidence Index (VCI) from 10 Likert items, exploring their relationships through exploratory and confirmatory factor analyses. We modified the IMETER (Italian medical term recognition test) to measure health literacy. We assessed the internal consistency of the modified IMETER and the 10 Likert items using Cronbach's alpha test (α) and McDonald's omega total coefficient (ω) with good results (ω = 0.92, α = 0.90; ω = 0.87, α = 0.82 respectively). We used these tools within a questionnaire conducted on 743 parents recruited from pediatric clinic waiting rooms in Italy, collecting demographic data, information sources on vaccines and vaccine-preventable diseases knowledge. The VCI resulting from factor analyses consisted of six items on a ten-point Likert scale, reflecting the ratio of positive to negative items. The survey revealed significant variations in the VCI according to individual features such as education, use of social networks, or Health institutions as sources of information. Multivariate logistic regression identified an association between vaccine intention and the VCI. Health literacy was functional for 91.2% of participants, but knowledge about vaccine-preventable diseases was generally low. The VCI showed no significant association with health literacy and vaccine-preventable diseases knowledge. The VCI and the modified IMETER effectively assess vaccination attitude and health literacy, offering valuable public health tools for tailoring vaccination campaigns to hesitant population subgroups.

Evaluation of the Cleaning Procedure Efficacy in Prevention of Nosocomial Infections in Healthcare Facilities Using Cultural Method Associated with High Sensitivity Luminometer for ATP Detection.

In healthcare facilities, environmental surfaces may be a reservoir of infectious agents even though cleaning and disinfection practices play a role in the control of healthcare-associated infections. In this study, the effectiveness of cleaning/disinfection procedures has been evaluated in two hospital areas, which have different risk category classifications. According to the contract with the cleaning service, after the daily ambulatory activities, the housekeeping staff apply an alcohol-based detergent followed by a chlorine-based disinfectant (2% Antisapril, Angelini; 540 mg/L active chlorine), properly diluted and sprayed. The contract provides for the use of disposable microfiber wipes which must be replaced with new ones in each health out-patient department. Surface contamination was analyzed using cultural methods and ATP detection, performed with a high-sensitivity luminometer. The values 100 CFU/cm² and 40 RLU/cm² were considered as the threshold values for medium-risk category areas, while 250 CFU/cm² and 50 RLU/cm² were defined for the low-risk category ones. Air quality was evaluated using active and passive sampling microbiological methods and particle count (0.3 µm⁻10 µm) detection. The cleaning/disinfection procedure reduced the medium bacterial counts from 32 ± 56 CFU/cm² to 2 ± 3 CFU/cm² in the low-risk area and from 25 ± 40 CFU/cm² to 7 ± 11 CFU/cm² in the medium-risk one. Sample numbers exceeding the threshold values decreased from 3% and 13% to 1% and 5%, respectively. RLU values also showed a reduction in the samples above the thresholds from 76% to 13% in the low-risk area. From the air samples collected using the active method, we observed a reduction of 60% in wound care and 53% in an ambulatory care visit. From the air samples collected using the passive method, we highlighted a 71.4% and 50% reduction in microbial contamination in the medium-risk area and in the low-risk one, respectively. The 10 µm size particle counts decreased by 52.7% in wound care and by 63% in the ambulatory care visit. Correct surface sanitation proved crucial for the reduction of microbial contamination in healthcare settings, and plays an important role in ensuring air quality in hospital settings.

Misinformation on vaccination: A quantitative analysis of YouTube videos.

In Italy, the phenomenon of vaccine hesitancy has increased with time and represents a complex problem that requires a continuous monitoring. Misinformation on media and social media seems to be one of the determinants of the vaccine hesitancy since, for instance, 42.8 percent of Italian citizens used the internet to obtain vaccine information in 2016. This article reports a quantitative analysis of 560 YouTube videos related to the link between vaccines and autism or other serious side effects on children. The analysis revealed that most of the videos were negative in tone and that the annual number of uploaded videos has increased during the considered period, that goes from 27 December 2007 to 31 July 2017, with a peak of 224 videos in the first seven months of 2017. These findings suggest that the public institutions should be more engaged in establishing a web presence in order to provide reliable information, answers, stories, and videos so to respond to questions of the public about vaccination. These actions could be useful to allow citizens to make informed decisions about vaccines so to comply with vaccination regulations.

The web and public confidence in MMR vaccination in Italy.

Measles, mumps and rubella (MMR) vaccination coverage in Italy has been decreasing starting from 2012 and, at the present, none of the Italian regions has achieved the goal of 95% coverage target. A decision of the Court of Justice of Rimini in March 2012 that awarded vaccine-injury compensation for a case of autism has been indicated as a probable trigger event leading to a reduction of vaccine confidence in Italy. The aim of the study was to explore the relationship between MMR vaccination coverage to online search trends and social network activity on the topic "autism and MMR vaccine", during the period 2010-2015. A significant inverse correlation was found between MMR vaccination coverage and Internet search activity, tweets and Facebook posts. New media might have played a role in spreading misinformation. Media monitoring could be useful to assess the level of vaccine hesitancy and to plan and target effective information campaigns.

Application of Hydrogen Peroxide as an Innovative Method of Treatment for Legionella Control in a Hospital Water Network.

OBJECTIVES: To evaluate the effectiveness of hydrogen peroxide (HP) use as a disinfectant in the hospital water network for the control of Legionella spp. colonization. METHODS: Following the detection of high levels of Legionella contamination in a 136-bed general hospital water network, an HP treatment of the hot water supply (25 mg/L) was adopted. During a period of 34 months, the effectiveness of HP on Legionella colonization was assessed. Legionella was isolated in accordance with ISO-11731 and identification was carried out by sequencing of the mip gene. RESULTS: Before HP treatment, L. pneumophila sg 2-15 was isolated in all sites with a mean count of 9950 ± 8279 cfu/L. After one-month of HP treatment, we observed the disappearance of L. pneumophila 2-15, however other Legionella species previously not seen were found; Legionellapneumophila 1 was isolated in one out of four sampling sites (2000 cfu/L) and other non-pneumophila species were present in all sites (mean load 3000 ± 2887 cfu/L). Starting from September 2013, HP treatment was modified by adding food-grade polyphosphates, and in the following months, we observed a progressive reduction of the mean load of all species (p < 0.05), resulting in substantial disappearance of Legionella colonization. CONCLUSION: Hydrogen peroxide demonstrated good efficacy in controlling Legionella. Although in the initial phases of treatment it appeared unable to eliminate all Legionella species, by maintaining HP levels at 25 mg/L and adding food-grade polyphosphates, a progressive and complete control of colonization was obtained.