ABSTRACT
One of the main policies to contain a pandemic spreading is to reduce people mobility. However, it is not easy to predict its actual impact, and this is a limitation for policy-makers who need to act effectively and timely to limit virus spreading. Data are fundamental for monitoring purposes;however, models are needed to predict the impact of different scenarios at a granular scale. Based on this premise, this paper presents the first results of an agent-based model (ABM) able to dynamically simulate a pandemic spreading under mobility restriction scenarios. The model is here used to reproduce the first wave of COVID-19 pandemic in Italy and considers factors that can be attributed to the diffusion and lethality of the virus and population mobility patterns. The model is calibrated with real data (considering the first wave), and it is based on a combination of static and dynamic parameters. First results show the ability of the model to reproduce the pandemic spreading considering the lockdown strategy adopted by the Italian Government and pave the way for scenario analysis of different mobility restrictions. This could be helpful to support policy-making by providing a strategic decision-tool to contrast pandemics. © 2021 Copyright for this paper by its authors.
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Background: Eosinophilic granulomatosis with polyangiitis (EGPA) is a medium and small vessel vasculitis. Discussion: A 58-years man was admitted to the Emergency Department in January 2022 for myalgia and weakness of lower limbs in recent COVID-19 infection. He had a clinical history of allergic asthma and eosinophilic pneumonia (ANCA negative) diagnosed as secondary to sensitization work-related in 2001. Blood test showed a severe hypereosinophilia (absolute eosinophil count: 9875/microL) and elevated creatine kinase (CK: 7555 U/L). He was hospitalized in HUB COVID. During hospitalization reported paraesthesia of upper and lower limbs and fever;blood test showed elevation of inflammation markers. Autoimmune screening showed a antineutrophil cytoplasmic antibodies positivity (ANCA anti-MPO 178UI/mL). A sinus CT showed nasal polyposis. A neurological evaluation and electromyography were performed with the evidence of polyneuropathy. Muscle biopsy showed eosinophil-associated vascular occlusion and eosinophilassociated tissue damage. The investigation excluded renal, cardiac, pulmonary and gastro-intestinal involvement. A steroid therapy (Prednisone 1 mg/kg/die) was started with clinical improvement. Conclusions: EGPA is a multisystemic disorder, typically suspected based on a combination of clinical findings, such as asthma, nasal and sinus symptoms, peripheral neuropathy, and eosinophilia ≥1500/microL. ANCA antibodies are positive in around 40% of patients and diagnosis can often be challenging and delayed.
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Background and Aim: Monoclonal antibodies (mAb) are a promising treatment for patients with COVID-19. The primary objective of this analysis was to evaluate the effectiveness and safety of mAb, using real-world data relating to patients belonging to the HUB COVID of the Varese Hospital. Materials and Methods: A retrospective analysis was carried out on patients treated with mAb from April 2021 to January 31, 2022. Information was collected on: disease status, immediate and late adverse drug reactions (ADRs), and outcome at 10 and 30 days after mAb administration. Results: Three hundred twenty-eight patients (M/F 191/137;median age 59.3 yrs) were treated: 176 with bamlanivimab/etesevimab, 117 with casirivimab/imdevimab, 35 with sotrovimab. One hundred eight (32.9%) patients were not fully vaccinated and 10 (3%) vaccinated with only 2 doses more than 120 days. Eighty (24.4%) were affected by cardiovascular disease, 73 (22.2%) immunodeficiency, 69 (21%) BMI>=30, 52 (15.8%) diabetes, 35 (10.7%) chronic lung disease and 7 (2.1%) end-stage renal failure. Severe ADRs did not occur. The median time between treatment and symptom resolution was 4 days. Among the 190 outpatients, only 9 (4.7%) needed hospitalization for COVID pneumonia, with a favorable outcome. In addition, 89.8% of hospitalized patients (60 with pneumonia and negative serology, 78 hospitalized not for COVID pneumonia) had symptom resolution without disease progression. Conclusions: Our study confirms the effectiveness and safety of the early treatment with mAb for COVID-19 to reduce the risk of disease progression.
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Purpose During the Covid-19 pandemic, people were deprived of their freedom, unable to engage in physical and social activities, and worried about their health. Uncertainty, insecurity, and confinement are all factors that may induce stress, uneasiness, fear, and depression. In this context, this study aims to identify possible relationships of emotions caused by health risks and restrictions to outdoor activities with well-informed decisions about food consumption. Design/methodology/approach The theoretical framework of this research draws on the stimulus-organism-response paradigm yielding six research hypotheses. An online survey was designated to test these hypotheses. A total of 1,298 responses were gathered from Italy, Greece, and the United Kingdom. Data analyses include demographic group comparisons, moderation, and multiple regression tests. Findings The results showed that when people miss their usual activities (including freedom of movement, social contact, travelling, personal care services, leisure activities, and eating at restaurants) and worry about their health and the health of their families, they turn to safer food choices of higher quality, dedicating more of their time and resources to cooking and eating. Research limitations/implications The findings showcase how risk-based thinking is critical for management and marketing strategies. Academics and practitioners may rely on these findings to include extreme conditions within their scope, understanding food literacy as a resilience factor to cope with health risks and stimulated emotions. Originality/value This study identified food behavioural patterns under risk-laden conditions. A health risk acted as an opportunity to look at food consumption as a means of resilience.
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COVID-19 pandemic changed quickly world's clinical picture. Symptoms often are sneaky, hiding dramatic clinical scenarios. A 52-year-old man was sent to the Emergency Department with persistent chest pain, dyspnea and hypoxia. He also complained of cough and fever (38 degrees C) since four days without clinical improvements by paracetamol. Nasopharyngeal swab was positive for SARS-CoV-2. High resolution computer tomography (HRCT) showed typical CT pattern of bilateral COVID-19 pneumonia. During hospital stay clinical worsening occurred and a CT pulmonary angiography revealed a bilateral massive acute pulmonary embolism. The patient was treated with unfractionated heparin.
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The emergency we are experiencing due to the coronavirus infection is changing the role of technologies in our daily life. In particular, movements of persons need to be monitored or driven for avoiding gathering of people, especially in small environments. In this paper, we present an efficient and cost-effective indoor navigation system for driving people inside large smart buildings. Our solution takes advantage of an emerging short-range wireless communication technology - IoT-based Bluetooth Low Energy (BLE), and exploits BLE Beacons across the environment to provide mobile users equipped with a smartphone hints on how to arrive at the destination. The main scientific contribution of our work is a new proximity-based navigation system that identifies the user position according to information sent by Beacons, processes the best path for indoor navigation at the edge computing infrastructure, and provides it to the user through the smartphone. We provide some experimental results to test the communication system considering both the Received Signal Strength Indicator (RSSI) and the Mean Opinion Score (MOS).
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The digital field certainly provides a lot of information in the medical field, it is possible, in a computerized way, also to simulate epidemics, and the spread of these. There have been events in the past, in some simulation games, which are currently being studied, as they could provide important clues for the resolution of epidemics such as the one from COVID-19. One of these events occurred due to a bug in 2005 in the role-playing online game World of Warcraft. Through these simulations it is possible to make prophylactic plans to intervene preventively or plan interventions throughout mathematical models.
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The recent COVID-19 carries potential risk factors for VTE and worse clinical course in some patients has an association with thrombosis. While low molecular weight heparins are under investigation for appropriate dosage, other elements could be useful. We share our experience about two patients with unexpected clinical course. © 2020 Czech Society of Cardiology Z.S. All rights reserved.