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ABSTRACT: Vulvar examination during procedures for cervical carcinoma screening (CCS) can be a valid chance for early diagnosis of vulvar diseases and precancerous lesions. With this aim an online questionnaire was sent to the members of the Italian Cervical Carcinoma Screening Group (GISCi) from either first level group (FLG, Pap/human papillomavirus test sampling) or second level group (SLG, colposcopy and treatments) to assess if and how vulvar examination was performed. 86% of FLG and 90.2% of SLG report performing vulvar examination prior to CCS procedures. 15% of SLG cannot manage basic vulvar diseases and they refer patients to specialized center. 54.3% underline lack of standardized protocol in case of vulvar disease detection. Despite most health care professionals report examining the vulva during CCS procedures, vulvar cancer early diagnosis is still challenging.
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We consider a dynamical system involving seven populations to model the presence of voles in a cultivated orchard. The plant population is stratified by age (three groups) and by health status (being damaged or not). The last equation models the voles with a modified logistic equation with Allee effect, where the modification takes into account the disturbance provided by the human activity on the orchard. Both an analytical investigation and numerical simulations on a case study are presented. The latter support the observed differences in the literature, in terms of number of voles, between cultivated and uncultivated fields.
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Arvicolinae , Animales , Humanos , Dinámica PoblacionalRESUMEN
OBJECTIVE: To evaluate the association between human papillomavirus vaccination status and participation in cervical cancer screening (at age 25) by the first cohorts of girls who were offered vaccination at the age of 15 to 16 years in Italy. METHODS: Women born in 1993, 1994 and 1995 were invited to participate in cervical cancer screening between 2018 and 2020. We report participation in screening by vaccination status in three large areas, Florence province, Piedmont region and Savona province, where the Consensus Project was carried out. The relative risk of participation among vaccinated (≥2 doses) and unvaccinated women was estimated. Odds ratios (OR) of participation by vaccination status were estimated by logistic regression, adjusted by birthplace and birth cohort. RESULTS: Overall, 34,993 women were invited for screening: 13,006 (37.2%) participated and 10,062 of these agreed to participate in the Consensus intervention study. Among the invited women and screening participants, vaccinated women were 51.0% and 60.6%, respectively. Comparing vaccinated and unvaccinated women, the adjusted OR of screening participation was 1.80 (95% confidence interval (CI): 1.72-1.89), 2.17 (95% CI: 1.94-2.42), 1.59 (95% CI: 1.50-1.68) and 1.15 (95% CI: 0.86-1.54) for overall, Florence, Piedmont and Savona, respectively. About 33% of the invited women were unvaccinated and did not participate in screening: 25.8%, 59.5% and 64.2% of women born in Italy, in high migration pressure countries and in advanced development countries, respectively. CONCLUSIONS: Screening participation was higher among vaccinated than unvaccinated women. Active policies are needed to reduce inequalities, targeting the unscreened and unvaccinated population, particularly non-native women, to accelerate cervical cancer elimination in Italy.
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Infecciones por Papillomavirus , Vacunas contra Papillomavirus , Neoplasias del Cuello Uterino , Femenino , Humanos , Adulto , Adolescente , Neoplasias del Cuello Uterino/diagnóstico , Neoplasias del Cuello Uterino/prevención & control , Infecciones por Papillomavirus/diagnóstico , Infecciones por Papillomavirus/prevención & control , Infecciones por Papillomavirus/epidemiología , Detección Precoz del Cáncer , Consenso , Tamizaje Masivo , Modelos Logísticos , Vacunación , Italia/epidemiologíaRESUMEN
INTRODUCTION: Unusual metastatic sites of renal cell carcinoma (RCC) are not infrequent. We report a rare case of solitary pharyngeal metastasis as first presentation of RCC. CASE DESCRIPTION: A 74 years-old man was referred to our hospital due to rapidly progressive dyspnoea and dysphagia. Physical examination showed a large right para-pharyngeal mass. Imaging findings showed a 5.5 cm mass, suspicious for malignancy, which extended to right para and retro-pharyngeal spaces with compression of the major right cervical vessels, C2-C3 vertebral bodies osteolysis, dural sac compression and dislocation. Futhermore, a small (2.6 × 2 cm) mass located at the upper pole of the right kidney was shown. Patient underwent partial trans-oral removal of the mass. Pathological examination and immunochemistry resulting strongly suggestive for metastatic RCC. Considering the metastatic stage of the tumour and the rapidly progressive clinical worsening with poor performance status, we offered the patient a palliative treatment with tyrosine kinase and cytoreductive radiotherapy on vertebral bodies. The patient developed a rapidly progressive multifocal metastatic disease and died 4 months after the presentation. CONCLUSION: We think that our case is noteworthy for some aspects. Firstly, pharyngeal localizations of RCC are very rare and this is the first case of solitary pharyngeal metastasis. Secondly, this metastatic lesion was really particular because it was synchronous and twice as big than the primary tumour. Thirdly, this case is consistent with previous evidence that synchronous compared with metachronous metastasis RCC is associated with adverse effect on outcome and response to targeted treatment.
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Carcinoma de Células Renales , Neoplasias Renales , Masculino , Humanos , Anciano , Carcinoma de Células Renales/secundario , Neoplasias Renales/patologíaRESUMEN
In this paper, we propose a mathematical model to assess the impact of social media advertisements in combating the coronavirus pandemic in India. We assume that dissemination of awareness among susceptible individuals modifies public attitudes and behaviours towards this contagious disease which results in reducing the chance of contact with the coronavirus and hence decreasing the disease transmission. Moreover, the individual's behavioral response in the presence of global information campaigns accelerate the rate of hospitalization of symptomatic individuals and also encourage the asymptomatic individuals for conducting health protocols, such as self-isolation, social distancing, etc. We calibrate the proposed model with the cumulative confirmed COVID-19 cases for the Republic of India. We estimate eight epidemiologically important parameters, and also the size of basic reproduction number for India. We find that the basic reproduction number for India is greater than unity, which represents the substantial outbreak of COVID-19 in the country. Sophisticated techniques of sensitivity analysis are employed to determine the impacts of model parameters on basic reproduction number and symptomatic infected population. Our results reveal that to reduce disease burden in India, non-pharmaceutical interventions strategies should be implemented effectively to decrease basic reproduction number below unity. Continuous propagation of awareness through the internet and social media platforms should be regularly circulated by the health authorities/government officials for hospitalization of symptomatic individuals and quarantine of asymptomatic individuals to control the prevalence of disease in India.
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In this work a mathematical model is built in order to validate on theoretical grounds field study results on a three-species system made of two prey, of which one is native and another one invasive, together with a native predator. Specifically, our results mathematically describe the negative effect on the native European hare after the introduction of the invasive Eastern cottontail, mediated by an increased predation rate by foxes. Two nonexclusive assumptions can be made: an increase in cottontail abundance would lead to a larger fox population, magnifying their predatory impact ("hyperpredation") on hares; alternatively, cottontails attract foxes in patches where they live, which are also important resting sites for hares and consequently the increased presence of foxes results in a higher predation rates on hares. The model results support hyperpredation of increasing fox populations on native hares.
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Liebres , Modelos Biológicos , Animales , Europa (Continente) , Cadena Alimentaria , Zorros/fisiología , Liebres/fisiología , Especies Introducidas , ConejosAsunto(s)
COVID-19 , Neoplasias , Control de Enfermedades Transmisibles , Diagnóstico Tardío , Humanos , Italia , Neoplasias/diagnóstico , Neoplasias/terapia , Pandemias , SARS-CoV-2RESUMEN
OBJECTIVES: We performed data collection concerning the coronavirus disease 2019 (COVID-19) pandemic-related delay in the diagnosis of cancers to individuate proper corrective procedures. METHODS: A comparison was made among the number of first pathologic diagnoses of malignancy made from weeks 11 to 20 of 2018, 2019, and 2020 at seven anatomic pathology units serving secondary care hospitals in northern-central Italy. RESULTS: Cancer diagnoses fell in 2020 by 44.9% compared with the average number recorded in 2018 and 2019. Melanoma and nonmelanoma skin cancer represented 56.7% of all missing diagnoses. The diagnostic decrease in colorectal (-46.6%), prostate (-45%), and bladder (-43.6%) cancer was the most relevant among internal malignancies; for prostate, however, high-grade tumors were only moderately affected (-21.7%). CONCLUSIONS: Diagnosis of cutaneous malignancies was mostly affected by the lockdown; among internal malignancies, corrective actions were mostly needed for colorectal cancer and invasive bladder cancer.
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COVID-19/prevención & control , Diagnóstico Tardío/tendencias , Detección Precoz del Cáncer/tendencias , Neoplasias/diagnóstico , Distanciamiento Físico , COVID-19/epidemiología , Humanos , Italia/epidemiología , PandemiasRESUMEN
Metaecoepidemic models generalize metapopulation systems, combining local population dynamics with inter-patch migration coupled with an epidemic proliferation. A resource-consumer model is introduced with an ecosystem composed by two patches, in which consumers can freely move. A disease affects resources of the second patch. This situation corresponds to a grassland-herbivore environment, where one patch, managed in an extensive way, has a wider plant diversity, while the other one is highly fertilized leading to an important forage production. The latter is also subject to a fungal disease. Herbivores both feed on healthy or infected crop and can freely migrate between the two patches. A preliminary investigation focuses on behaviors emerging from some parts of the model, respectively, formed by uncoupled patches and by the purely demographic coupled model. Equilibria of the whole system are assessed and characterized. Results are then compared with the purely demographic model to highlight the role of the disease in this dynamics. A thorough numerical investigation of the model completes this analysis to assess the system behavior near each equilibrium. System bifurcations have also been explored as well as the response of the system equilibria to parameter perturbations. The disease eradication is possible under suitable circumstances. Coexistence of the five populations through persistent oscillations is also possible, but it is not at a stable level.
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Pradera , Modelos Biológicos , Migración Animal , Animales , Ecosistema , Herbivoria , Conceptos Matemáticos , Enfermedades de las Plantas/microbiología , Plantas , Dinámica PoblacionalRESUMEN
Most of the plant viral diseases spread through vectors. In case of the persistently transmitted disease, there is a latent time of infection inside the vector after acquisition of the virus from the infected plant. Again, the plant after getting infectious agent shows an incubation time after the interaction with an infected vector before it becomes diseased. The goal of this work is to study the effect of both incubation delay and latent time on the dynamics of plant disease, and accordingly a delayed model has been proposed. The existence of the equilibria, basic reproductive number ([Formula: see text]) and stability of equilibria have been studied. This study shows the relevance of the presence of two time delays, which may lead to system stabilization.
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Modelos Biológicos , Enfermedades de las Plantas/virología , Animales , Simulación por Computador , Vectores de Enfermedades , Conceptos Matemáticos , Enfermedades de las Plantas/prevención & control , Enfermedades de las Plantas/estadística & datos numéricos , Factores de TiempoRESUMEN
Herpes-Simplex Virus type 2 (HSV-2) is a lifelong infection, which has infected over 400 million individuals aged 15-49 years, worldwide. While the disease can be treated with episodic and suppressive antiviral drugs to reduce the rate of recurrence (i.e., symptomatic disease) and viral shedding, none of the currently available therapies can clear the virus from the body of an infected person. A number of therapeutic vaccine platforms are currently in development in order to achieve similar effects to treatment. Due to the inadequate data from clinical trials of therapeutic vaccines, modeling efforts to quantify the impact of vaccination have been limited. In this study, we propose a compartmental deterministic model for the dynamics of HSV-2 to evaluate the effect of a potential vaccine candidate with the inclusion of a booster dose. Despite its simplicity that may not address the complexity of HSV-2 disease, the model shows that targeting symptomatic infection for vaccination is the most effective strategy in the long-term. This conclusion is based on the assumption of an optimal vaccine efficacy, conferring immunity levels that prevent viral shedding and recurrence transiently. Our model provides a framework for developing a computational system to include more heterogeneous characteristics of the disease and individuals, and investigate effectiveness and cost-effectiveness of vaccination scenarios when clinical data become available.
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In any ecosystem, chaotic situations may arise from equilibrium state for different reasons. To overcome these chaotic situations, sometimes the system itself exhibits some mechanisms of self-adaptability. In this paper, we explore an eco-epidemiological model consisting of three aquatic groups: phytoplankton, zooplankton, and marine free viruses. We assume that the phytoplankton population is infected by external free viruses and zooplankton get affected on consumption of infected phytoplankton; also, the infected phytoplankton do not compete for resources with the susceptible one. In addition, we model a mechanism by which zooplankton recognize and avoid infected phytoplankton, at least when susceptible phytoplankton are present. The zooplankton extinction chance increases on increasing the force of infection or decreasing the intensity of avoidance. Further, when the viral infection triggers chaotic dynamics, high zooplankton avoidance intensity can stabilize again the system. Interestingly, for high avoidance intensity, nutrient enrichment has a destabilizing effect on the system dynamics, which is in line with the paradox of enrichment. Global sensitivity analysis helps to identify the most significant parameters that reduce the infected phytoplankton in the system. Finally, we compare the dynamics of the system by allowing the infected phytoplankton also to share resources with the susceptible phytoplankton. A gradual increase of the virus replication factor turns the system dynamics from chaos to doubling state to limit cycle to stable state and the system finally settles down to the zooplankton-free equilibrium point. Moreover, on increasing the intensity of avoidance, the system shows a transcritical bifurcation from the zooplankton-free equilibrium to the coexistence steady state and remains stable thereafter.
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Reacción de Prevención , Modelos Biológicos , Fitoplancton/fisiología , Fitoplancton/virología , Zooplancton/fisiología , Zooplancton/virología , AnimalesRESUMEN
We introduce a mathematical model to describe the tritrophic interaction between crop,pest and the pest natural enemy where the release of Volatile Organic Compounds (VOCs) by crop istaken into account. The VOCs may be considered as an indirect defence mechanism of the plant asthey attract the pest natural enemies toward the attacked plants. The model dynamics is studied throughqualitative analysis and numerical simulations. The factors that may enhance pest disappearance areidentified. In particular, we show that VOCs may have a beneficial effect on the environment sincetheir release may be able to stabilize the model dynamics. Specifically, for the parameter values thatwe have explored, this effect can arise only when both the phenomena of VOCs basic plant release andVOCs plant release due to pest attack are present.
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Brassica/química , Compuestos Orgánicos Volátiles/química , Animales , Áfidos , Simulación por Computador , Ecología , Herbivoria , Hordeum/química , Modelos Teóricos , Dinámicas no Lineales , Oscilometría , Fitoquímicos/químicaRESUMEN
The ability to form groups to overcome problems has been crucial for the evolution of human beings. To favour the formation of cooperating groups, one of the mechanisms developed is the inter-group bias, namely the tendency of individuals to favour members of their group and hinder the external ones. It is the cognitive equivalent of the "green beard effect" in evolutionary biology, introduced by Hamilton and popularized by Dawkins, for which a group can profit of the altruistic be-haviour of its members. Here, we use a behavioural model based on the Ultimatum Game, to shed ligh on how this behaviour cloud has been stabilized in the human population, estimating the magnitude of favouritism needed to overcome selfish individuals. Through both numerical simulations and analytic approaches, we study how a community of collectivist and individualist agents evolves. The key factor is the mechanism for the evolution of the population, i.e., the replacement of the poor-performing in-dividuals. In the case of replacement by the reproduction of existing individuals, we observe a smooth phase transition and no coexistence. If the replacement is random, the transition smooths, and coex-istence is possible. We developed analytical approaches for these two cases and performed numerical simulations. Although analytical calculations support the behaviour emerging from simulations, some differences ask for more refined treatments.
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Altruismo , Teoría del Juego , Conducta Social , Algoritmos , Evolución Biológica , Humanos , Relaciones Interpersonales , Modelos Teóricos , Probabilidad , ReproducciónRESUMEN
The motivation for the research reported in this paper comes from modeling the spread of vector-borne virus diseases. To study the role of the host versus vector dynamics and their interaction we use the susceptible-infected-removed (SIR) host model and the susceptible-infected (SI) vector model. When the vector dynamical processes occur at a faster scale than those in the host-epidemics dynamics, we can use a time-scale argument to reduce the dimension of the model. This is often implemented as a quasi steady-state assumption (qssa) where the slow varying variable is set at equilibrium and an ode equation is replaced by an algebraic equation. Singular perturbation theory will appear to be a useful tool to perform this derivation. An asymptotic expansion in the small parameter that represents the ratio of the two time scales for the dynamics of the host and vector is obtained using an invariant manifold equation. In the case of a susceptible-infected-susceptible (SIS) host model this algebraic equation is a hyperbolic relationship modeling a saturated incidence rate. This is similar to the Holling type II functional response (Ecology) and the Michaelis-Menten kinetics (Biochemistry). We calculate the value for the force of infection leading to an endemic situation by performing a bifurcation analysis. The effect of seasonality is studied where the force of infection changes sinusoidally to model the annual fluctuations of the vector population. The resulting non-autonomous system is studied in the same way as the autonomous system using bifurcation analysis.
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Vectores de Enfermedades , Epidemias , Modelos Biológicos , Enfermedades Transmitidas por Vectores/epidemiología , Enfermedades Transmitidas por Vectores/transmisión , Aedes/virología , Animales , Simulación por Computador , Dengue/epidemiología , Dengue/transmisión , Epidemias/estadística & datos numéricos , Heurística , Humanos , Conceptos Matemáticos , Modelos Estadísticos , Mosquitos Vectores/virología , Estaciones del AñoRESUMEN
Caprine Arthritis Encephalitis is an endemic disease in goat breedings, caused by viral strains belonging to the Small Ruminant Lentivirus group and characterized by a progressive chronic course. Its clinical signs are not immediately recognizable and can only be detected via costly serological tests. No vaccine is available. Two main strategies for fighting it are in common use. The "test-and-slaughter" approach, that selects infected goats and directly slaughters them, is expensive, time consuming and often leads to endemic low level persistence of the infection. Alternatively, newborns are removed from their mothers to be raised by healthy goats. After weaning they would rejoin their breeds, but then they could still be subject to horizontal contagion. In this study a mathematical model that considers the cocirculation of two different SRLV viral genotypes (B and E) is devised and analyzed, based on the key assumption of perfect cross-protection between the two genotypes' infections. Two strategic measures arise from its analysis, that are strongly recommended and whose implementation is encouraged: in the presence of both genotypes, the farmer should not isolate the newborns from their mothers but rather raise them with all the other animals. In the case of genotype-B-only affected farm, serological testing and mother-offspring separation should still be considered the best strategy for CAEV control. These strategies completely reverse the current removal policy and, in due conditions, would lead to disease eradication. These represent very reasonable and cheap measures for the eventual control of the epidemics.
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Cruzamiento , Cabras/virología , Lentivirus/fisiología , Animales , Modelos BiológicosRESUMEN
In this paper we formulate a model for assessing the interaction between the phytopathogen Spilocaea oleaginea and the phyllosphere microorganisms that are present in the olive tree leaves. The model describes the evolution in time of the foliage of the olive tree and the two different microorganisms, the phytopathogen fungi, that negatively affect the plant causing spots in the leaves, and the beneficial phyllosphere microorganisms, that help in keeping in check the invasion of the former. The system possesses five equilibria that are suitably analysed for feasibility and stability. The model shows interesting features: a bistable behavior, exhibited by three different pairs of equilibria. The separatrix surface of the basins of attraction of one such pair is computed. This allows the possible assessment of human intervention for control of the disease. Persistent oscillations via Hopf bifurcation are also discovered.
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Ascomicetos , Modelos Biológicos , Micosis/microbiología , Olea/microbiología , Enfermedades de las Plantas/microbiologíaRESUMEN
The speciation phenomenon is the process used by the evolution to allow populations to become distinct species. The speciation is the primary cause of the complexity of the ecological network. Sympatric speciation concerns the rise of a new species from a surviving ancestral species while both continue to inhabit the same ecological niche or geographical region. In sympatric speciation, reproductive isolation evolves within a population in an ecological niche without the aid of geographic barriers. Different models have been proposed for alternative modes of sympatric speciation. The most popular was first put forward by John Maynard Smith in 1966 who suggested that in a given population homozygous individuals may, under particular environmental conditions, have a greater fitness than those with alleles heterozygous for a certain trait, eventually leading to speciation in the population. In this framework we assume an effective description of the speciation process based on a dynamical model for the populations in an ecological system. Our basic assumption is the existence of an ancestral population in an ecological niche that can express two phenotypes. In presence of certain environmental conditions one of the phenotypes has the propensity to separate from the original population in the reproduction process. Then new individuals may give rise to a new species in the ecosystem realizing a sympatric speciation. Due to the finite resources in the niche the populations are continuously competing each other's, and their numerousness fluctuates according to the changes of the environmental conditions. The effect of natural selection is introduced in the model by stochastic perturbations, that decrease the reproduction rate of the populations in the niche. We show some the dynamical properties of the system and we prove the existence of a threshold values in the environmental stress in order to observe the speciation process. We also discuss some biological implications of the model and the validation problem using empirical data.
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Ecosistema , Especiación Genética , Selección Genética , SimpatríaRESUMEN
A model of interspecific host competition in a system with one parasite (butterfly-Maculinea) and multiple potential hosts (ants-Myrmica) is presented. Results indicate that host interspecific competition increases the occurrence of multiple host behaviour in Maculinea natural populations but decreases the ability of the parasite populations to adapt to the most abundant host species. These qualitative predictions were compared with data on host specificity, with good agreement. Analysis of the data also indicates that Maculinea teleius and Maculinea arion respond differently to changes in relative host abundances. Maculinea teleius shows a larger fraction of sites where it displays multiple host behaviour and a larger fraction of sites where the niches of the hosts overlap. In some instances, Maculinea teleius is adapted to Myrmica hosts that are present in lower frequencies. Maculinea arion is locally more host-specific and occurs at sites where host interspecific competition is unlikely and is more frequently adapted to the most abundant host species.