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BACKGROUND: Respiratory syncytial virus (RSV) is a leading cause of acute respiratory infections worldwide. While historically RSV research has been focused on children, data on RSV infection in adults are limited. The goal of this study was to establish the prevalence of RSV in community-dwelling Italian adults and analyze its genetic variability during the 2021/22 winter season. METHODS: In this cross-sectional study, a random sample of naso-/oropharyngeal specimens from symptomatic adults seeking for SARS-CoV-2 molecular testing between December 2021 and March 2022 were tested for RSV and other respiratory pathogens by means of reverse-transcription polymerase chain reaction. RSV-positive samples were further molecularly characterized by sequence analysis. RESULTS: Of 1,213 samples tested, 1.6% (95% CI: 0.9-2.4%) were positive for RSV and subgroups A (44.4%) and B (55.6%) were identified in similar proportions. The epidemic peak occurred in December 2021, when the RSV prevalence was as high as 4.6% (95% CI: 2.2-8.3%). The prevalence of RSV detection was similar (p = 0.64) to that of influenza virus (1.9%). All RSV A and B strains belonged to the ON1 and BA genotypes, respectively. Most (72.2%) RSV-positive samples were also positive for other pathogens being SARS-CoV-2, Streptococcus pneumoniae and rhinovirus the most frequent. RSV load was significantly higher among mono-detections than co-detections. CONCLUSION: During the 2021/22 winter season, characterized by the predominant circulation of SARS-CoV-2 and some non-pharmaceutical containment measures still in place, a substantial proportion of Italian adults tested positive for genetically diversified strains of both RSV subtypes. In view of the upcoming registration of vaccines, establishment of the National RSV surveillance system is urgently needed.
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COVID-19 , Vírus Sincicial Respiratório Humano , Criança , Adulto , Humanos , Estudos Transversais , Vida Independente , Estações do Ano , COVID-19/epidemiologia , SARS-CoV-2/genética , Vírus Sincicial Respiratório Humano/genéticaRESUMO
OBJECTIVES: In order to support policymakers in allocating resources, we aimed to assess vaccine effectiveness (VE) of inactivated influenza vaccines (IIVs) available for Italian adults in the 2023/2024 season. METHODS: A hospital-based test-negative case-control study was conducted in Genoa between mid-October 2023 and mid-April 2024. Adult (≥18 years) inpatients with prescription of a polymerase chain reaction test for influenza were eligible. RESULTS: Of 1,664 adults analyzed, most (82%) of which were ≥65 years, 114 (6.9%) tested positive for influenza A. Most (92%) cases were caused by subclades 6B.1A.5a.2a and 6B.1A.5a.2a.1 of the A(H1N1)pdm09 subtype. In older adults aged ≥65 years vaccination was effective at 51% (95% CI: 8%, 74%) against any influenza A and 49% (95% CI: 2%, 73%) against A(H1N1)pdm09. Compared with non-vaccinated older adults, VE point estimates for the adjuvanted and, especially, high-dose IIVs were higher than those for the standard-dose non-adjuvanted IIV. CONCLUSION: The 2023/2024 seasonal influenza vaccination proved moderately effective in preventing hospitalization for laboratory-confirmed influenza. Being more appropriate for older adults, local policymakers and vaccinating physicians should maximize adoption of the enhanced IIVs.
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Nowadays, adolescents have extensive access to Information and Communication Technologies, which allow them to engage in social networking activities that may expose them to Online Hate Speech (OHS). While there are few cross-sectional studies about the effects of OHS Exposure on attitudes and aggressive behavior, no study aims to analyze the tendency to Speak Up when exposed to certain content (e.g., reporting, etc.). In addition, no instruments have yet been validated to assess these constructs. The aim of the present study, focused on Online ethnic Hate Speech (OeHS), is double: (a) develop a scale to measure OeHS Exposure and the tendency to Speak Up and analyze its psychometric properties; (b) analyze the longitudinal association between Xenophobia (XEN), OeHS Exposure, and Speaking Up against OeHS, while taking into account gender differences and the nested nature of the data. Six hundred sixty-six Italian high school students (52.7 percent male; MAge = 15[0.64]), nested in 36 ninth grade classes (10 schools), took part in the longitudinal study. The first wave of data collection occurred in early 2020, before the COVID-19 pandemic. The second and third waves took place 12 and 15 months later, respectively. Findings suggest that the OeHS Scale has good psychometric properties. Moreover, according to the findings, while the three variables of interest are always cross-sectionally correlated, a longitudinal negative association have been found between XEN and both Exposure and Speaking Up. Regarding the impact of OeHS Exposure, the good news is related to the absence of a longitudinal association with both XEN and Speaking Up.
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BACKGROUND: Validated measures of cyber dating violence are scarce and have barely explored the sexual dimension. The present study advanced this line of research by developing a new instrument that differentiates between sexual, verbal and control dimensions. METHOD: The instrument was created in four phases: literature review, focus groups with young people, expert review, and creation of the final scale. This instrument was administered to 600 students from high schools in Seville and Córdoba, aged between 14 and 18 ( M = 15.54; SD = 1.22). RESULTS: A three-factor latent structure was confirmed for the aggression and victimization scales: verbal/emotional, control, and sexual. Using Item Response Theory, a refined version of the scales resulted in 19 items for both aggression and victimisation. Prevalence analysis showed that verbal/emotional forms were the most frequent, followed by control and sexual. CONCLUSIONS: The CyDAV-T instrument can be considered a valid instrument for assessing cyber dating violence in the adolescent population.
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Comportamento do Adolescente , Bullying , Vítimas de Crime , Violência por Parceiro Íntimo , Humanos , Adolescente , Violência por Parceiro Íntimo/psicologia , Vítimas de Crime/psicologia , Agressão/psicologia , Comportamento Sexual , Comportamento do Adolescente/psicologiaRESUMO
Callous-Unemotional (CU) traits are strongly related to early-onset and severe levels of conduct problems. However, much less research has focused on their association with potential problems in adolescents' social relationships. Further, it is important to determine if CU traits explain variance in important social variables, independent of conduct problems or general personality dimensions related to sociability, like agreeableness. In the current study, we examined the association of CU traits with a range of social variables in a community sample of Italian adolescents (Nâ¯=â¯563; 460 girls; mean ageâ¯=â¯15.80, SDâ¯=â¯1.50). Measures for the social variables included assessment of peer rejection, adolescents' prosocial behaviors, satisfaction in peer relationships, and feelings of connection with school and classmates. We also obtained self-report ratings of CU traits, conduct problems (CP) and agreeableness. Analyses showed that CU traits were significantly associated with all the social variables. After controlling for CP and agreeableness, CU traits were still positively associated with ratings of peer rejection and negatively associated with prosocial behavior and satisfaction in relationships with peers. However, the negative associations with feelings of connection to school and peers were no longer significant. These findings provide further support for the clinical usefulness of CU traits and further evidence for potential targets of intervention, particularly focused on the adolescent's relational skills.
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Transtorno da Conduta , Comportamento Problema , Adolescente , Feminino , Humanos , Transtorno da Conduta/psicologia , Emoções , Empatia , Comportamento Problema/psicologia , EstudantesRESUMO
The effectiveness of seasonal influenza vaccination (SIV) varies from year to year. Interim estimates of vaccine effectiveness (VE) in outpatient settings have suggested that the 2022/23 northern hemisphere SIV was 54â¯% effective. The main goal of this study was to measure the 2022/23 SIV VE among Italian adults in a hospital setting. The study adopted a retrospective test-negative case-control design and was conducted in a large tertiary hospital (Genoa, Italy) between October 2022 and April 2023. Adult (≥18 years) patients accessing the hospital's Emergency Department for symptoms ascribable to an acute respiratory infection, for which a reverse-transcription real-time polymerase chain reaction test for the detection of influenza virus was prescribed, were potentially eligible. Of 33,692 referrals assessed, 487 patients were included in the study. A total of 13â¯% of patients were positive for influenza, most of which (63â¯%) belonged to the A(H3N2) subtype. SIV VE was 57â¯% (95â¯% CI: 11-81â¯%), 53â¯% (95â¯% CI: 2-80â¯%) and 38â¯% (95â¯% CI: -34-74â¯%) against any influenza, influenza A and A(H3N2), respectively. Although no cases caused by A(H1N1)pdm09 and B strains were observed among vaccinated individuals, VE estimates against the latter were imprecise, owing to their low detection rates. In conclusion, the 2022/23 SIV was moderately effective against hospital encounters for laboratory-confirmed influenza.
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Vírus da Influenza A Subtipo H1N1 , Vacinas contra Influenza , Influenza Humana , Adulto , Humanos , Influenza Humana/epidemiologia , Influenza Humana/prevenção & controle , Vacinas contra Influenza/uso terapêutico , Estações do Ano , Estudos Retrospectivos , Vírus da Influenza A Subtipo H3N2 , Eficácia de Vacinas , Estudos de Casos e Controles , Itália/epidemiologia , Vacinação , Hospitais , Vírus da Influenza B/genéticaRESUMO
Monkeypox (MPXV) usually causes a mild and self-limited infection. To date there are no data about cidofovir for the treatment for MPXV in humans. We report a case of a 25 years-old Brazilian man with a concurrent diagnosis of acute HIV (human immunodeficiency virus) infection, primary syphilis and MPXV infection with a nasal lesion successfully treated with intravenous cidofovir.
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Monkeypox virus , Mpox , Masculino , Humanos , Adulto , Mpox/diagnóstico , Mpox/patologia , Cidofovir/uso terapêutico , BrasilRESUMO
Slow continuous ultrafiltration (SCUF) is an extracorporeal therapy able to reduce fluid overload in chronic or acute heart failure resistant to diuretics. An in-vitro study demonstrated the SCUF feasibility using a standard fluid infusion central venous catheter (CVC). We describe the clinical application of this SCUF in regional citrate anticoagulation (SCUF-RCA) in a patient admitted to the Intensive Care Unit for acute decompensate heart failure with severe systemic fluid overload resistant to diuretics. To avoid risks deriving from a new catheterization, we used a pre-existing multi-lumen CVC for drug administration to provide 10 h of SCUF-RCA with a blood flow of 35 mL/min and 100 mL/h of ultrafiltration with a final weight loss of 1 Kilogram without technical and clinical complications. The patient had a hemodynamics improvement with the diuresis recovery from the previous oliguria after the SCUF-RCA. This clinical case can open the use of the SCUF-RCA in the clinical practice to treat the fluid overload unresponsive to maximal diuretic therapy not exposing the patient to the risks and complications related to the use of SCUF with CVC for dialysis and systemic anticoagulation with heparin. Accordingly, this technique may be useful in the treatment of fluid overload in outpatients.
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Nowadays, an increasing number of children and adolescents living in Europe have an immigrant background. Because ethnicity is a recognizable characteristic that may become the driver of bullying, these youths are at high risk of victimization. School interventions based on peer-led approaches, assuming all the conditions postulated in contact theory, could be suitable to counteract bias-based bullying and victimization.This study aims to analyze whether the NoTrap! antibullying program, an evidence-based peer-led intervention, may also be effective in counteracting ethnic bullying and victimization when students with an immigrant background are involved as peer educators. There were 1,570 students who participated in the study: 24 control classes (N = 476) and 50 experimental classes (N = 1094). Within the last group we identified two conditions: 30 classes in which all peer educators were Italian (Experimental A, N = 661); 20 classes in which at least one of them had an immigrant background (Experimental B, N = 433). Results of two linear mixed models showed a significant interaction Time × Experimental condition for ethnic victimization, F(1, 1170) = 4.185; p = .015. Specifically, the NoTrap! is effective in reducing ethnic victimization when at least one student with an immigrant background is involved as a peer educator. Only in this condition, indeed, peer educators are directly involved in the phenomenon they counteract, and all four circumstances postulated in the contact theory are satisfied. No effects on ethnic bullying have been found, F(1, 1162) = .215; p = .806. This is in line with the activities proposed in the program, which is more focused on empowering victims than on acting directly on bullies. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Bullying , Vítimas de Crime , Emigrantes e Imigrantes , Adolescente , Criança , Etnicidade , Humanos , Grupo Associado , Instituições AcadêmicasRESUMO
Critical clinical forms of COVID-19 infection often include Acute Kidney Injury (AKI), requiring kidney replacement therapy (KRT) in up to 20% of patients, further worsening the outcome of the disease. No specific medical therapies are available for the treatment of COVID-19, while supportive care remains the standard treatment with the control of systemic inflammation playing a pivotal role, avoiding the disease progression and improving organ function. Extracorporeal blood purification (EBP) has been proposed for cytokines removal in sepsis and could be beneficial in COVID-19, preventing the cytokines release syndrome (CRS) and providing Extra-corporeal organ support (ECOS) in critical patients. Different EBP procedures for COVID-19 patients have been proposed including hemoperfusion (HP) on sorbent, continuous kidney replacement therapy (CRRT) with adsorbing capacity, or the use of high cut-off (HCO) membranes. Depending on the local experience, the multidisciplinary capabilities, the hardware, and the available devices, EBP can be combined sequentially or in parallel. The purpose of this paper is to illustrate how to perform EBPs, providing practical support to extracorporeal therapies in COVID-19 patients with AKI.
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The rapid and presumptive detection of SARS-CoV-2 variants may be performed using multiplex RT-PCR assays. The aim of this study was to evaluate the diagnostic performance of five qualitative RT-PCR tests as compared with next-generation sequencing (NGS). We retrospectively examined a multi-variant panel (n = 72) of SARS-CoV-2-positive nasopharyngeal swabs categorized as variants of concern (Alpha, Beta, Gamma and Delta), variants under monitoring (Iota and Kappa) and wild-type strains circulating in Liguria (Italy) from January to August 2021. First, NGS libraries of study samples were prepared and mapped to the reference genome. Then, specimens were screened for the detection of L452R, W152C, K417T, K417N, E484Q, E484K and N501Y mutations using the SARS-CoV-2 Variants II Assay Allplex, UltraGene Assay SARS-CoV-2 452R & 484K & 484Q Mutations V1, COVID-19 Ultra Variant Catcher, SARS-CoV-2 Extended ELITe MGB and Simplexa SARS-CoV-2 Variants Direct. The overall accuracy of these assays ranged from 96.9% to 100%. Specificity and sensitivity were 100% and 96-100%, respectively. We highly recommend the use of these assays as second-level tests in the routine workflow of SARS-CoV-2 laboratory diagnostics, as they are accurate, user friendly, low cost, may identify specific mutations in about 2-3 h and, therefore, optimize the surveillance of SARS-CoV-2 variants.
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Research has underlined that moral disengagement processes, by which people switch off their moral values and act aggressively without experiencing guilt, are highly connected with contextual factors. However, research on situational variations in moral disengagement is limited, especially considering the associations with characteristics such as the ethnic origin of potential victims. The general aim of the present study was to develop a brief, specific measure of ethnic moral disengagement able to catch individual justification used in the case of ethnic bullying and cyberbullying, and test its validity and reliability. An eight items scale was developed and administered in study 1, in a sample of 961students attending several Italian high schools (53.5% female; Mage 15 years). Considering the results of the CFA, we modified one of the items and the scale was administered again, in a second sample of 1,229 students (49.9% female; Mage 15.62 years) in study 2. A one-factor model of ethnic moral disengagement fit the data well and internal consistency showed to be good. As an additional step, we found that the model was invariant across Italian adolescents and youths with a different ethnic or culture of origin (having at least one parent born abroad) strengthened our confidence regarding the factorial integrity of the scale. Last, the scale showed to be positively associated with ethnic bullying and cyberbullying. Generally, findings suggested that the Ethnic Moral Disengagement scale can be a useful tool for those interested in measuring moral disengagement and evaluating how it impacts bullying and cyberbullying of minority groups.
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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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Altruísmo , Teoria dos Jogos , Comportamento Social , Algoritmos , Evolução Biológica , Humanos , Relações Interpessoais , Modelos Teóricos , Probabilidade , ReproduçãoRESUMO
We report the results of a game-theoretic experiment with human players who solve problems of increasing complexity by cooperating in groups of increasing size. Our experimental environment is set up to make it complicated for players to use rational calculation for making the cooperative decisions. This environment is directly translated into a computer simulation, from which we extract the collaboration strategy that leads to the maximal attainable score. Based on this, we measure the error that players make when estimating the benefits of collaboration, and find that humans massively underestimate these benefits when facing easy problems or working alone or in small groups. In contrast, when confronting hard problems or collaborating in large groups, humans accurately judge the best level of collaboration and easily achieve the maximal score. Our findings are independent on groups' composition and players' personal traits. We interpret them as varying degrees of usefulness of social heuristics, which seems to depend on the size of the involved group and the complexity of the situation.
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Comportamento Cooperativo , Tomada de Decisões/fisiologia , Adulto , Feminino , Teoria dos Jogos , Humanos , Masculino , Pessoa de Meia-Idade , Resolução de Problemas , Adulto JovemRESUMO
Physics is fundamental to secure future needs for scientific and technological competence (Angell et al., 2004), but many countries experience a drop in students' performances in international assessments (Organisation for Economic Co-operation Development [OECD], 2018), as well as in rates of enrolment in undergraduate programs in scientific disciplines (STEM). Socio-constructivist theories have produced a reforming movement in several educational systems, in particular in the area of sciences, but teacher often consider them an idealistic view of education and do not consider themselves metacognitively competent enough to foster thinking in the classroom. In this study, we investigated the efficacy of different teaching methods on high-school students' conceptual knowledge of physics, after the effect of science-related beliefs and critical thinking skills was controlled. We adopted a mixed-method with sequential design, in which quantitative and qualitative data flow are inter-mixed. In specific, we interviewed four high school physics teachers to identify teaching approaches (qualitative approach) and compared them in terms of efficacy on students' performances (quantitative approach). Four teachers and 77 10th grade students participated. Teachers were interviewed during the school years and asked questions about their teaching experience, their teaching approach (Kang and Wallace, 2005) and their epistemic beliefs (Tsai, 2002). Students performances in Science-related beliefs (Conley et al., 2004), critical thinking (Cornell Critical Thinking Test Level X, Millman et al., 2005), and conceptual knowledge in physics (The Force and Motion Conceptual Evaluation, Ramlo, 2002) were evaluated twice, at the beginning and at the end of the school year. The independent-sample t-tests on pre-test variables did not reveal any statistically significant difference between groups. Results from the complex samples GLM revealed statistically significant differences on post-test scores in conceptual knowledge in physics, after the effect of covariates was controlled. Overall, the study contributes to our understanding on current teaching practices in school, and their effect on students' conceptual understanding of physics concepts.
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Fever of unknown origin (FUO) can be an unusual first clinical manifestation of pheochromocytoma. Pheochromocytomas are tumors that may produce a variety of substances in addition to catecholamines. To date, several cases of IL-6-producing pheochromocytomas have been reported. This report describes a 45-year-old woman with pheochromocytoma who was admitted with FUO, normal blood pressure levels, microcytic and hypochromic anemia, thrombocytosis, hyperfibrinogenemia, hypoalbuminemia, and normal levels of urine and plasma metanephrines. After adrenalectomy, fever and all inflammatory findings disappeared.