Rethink analgo-sedation in digestive endoscopy: the role of scientific societies in tracing training path.

OBJECTIVE: The Italian Society of Anesthesia, Analgesia, Reanimation and Intensive Care Medicine (SIAARTI) and the Italian Society of Digestive Endoscopy (SIED) worked together to produce a joint Good Clinical Practice (GCP) on analgo-sedation in digestive endoscopy and launched a survey to support the document. The aim was to identify and describe the actual clinical practice of sedation in Italian digestive endoscopy units and offer material for a wider and more widespread discussion among anesthetists and endoscopists. SUBJECTS AND METHODS: A national survey was planned, in order to support the statements of the GCP. Twelve thousand and five hundred questionnaires were sent to the members of SIAARTI and SIED in June 2020. RESULTS: A total of 662 forms (5.3%) returned completed. Highly complex procedures are performed according to 70% of respondents; daily anesthesiologist's assistance is guaranteed in 26%, for scheduled sessions in 14.5% and as needed in 8%. 69% of respondents declared not to have a dedicated team of anesthesiologists, while just 5% reported an anesthesiologist in charge. A complete monitoring system was assured by 70% of respondents. Dedicated pathways for COVID-19-positive patients were confirmed in <40% of the answers. With regard to moderate/deep sedation, 90% of respondents stated that an anesthetist decides timing and doses. Propofol was exclusively administered by anesthetists according to 94% of answers, and for 6% of respondents the endoscopist is allowed to administer propofol in presence of a dedicated nurse, but with a readily available anesthetist. Only 32.8% of respondents reported institutional training courses on procedural analgo-sedation. CONCLUSIONS: The need to provide patients scheduled for endoscopy procedures with an adequate analgo-sedation is becoming an increasing concern, well-known in almost all countries, but many factors compromise the quality of patient care. Results of a national survey would give strength to the need for a shared GCP in gastrointestinal endoscopy. Training and certification of non-anesthetist professionals should be one of the main ways to center the objective.

Digitalization as a driver of transformation towards sustainable performance in wine tourism - the Italian case

PurposeThe main aim of this research was to investigate whether and how digitalization affects sustainability and performance in wine tourism.Design/methodology/approachBased on the data emerging from the 2019 National Report on Wine Tourism from the National Association of "Wine Cities" in Italy (the most extreme case in the world of wine), three macro-agglomerates were investigated: digitalization, sustainability and performance, adopting descriptive and inferential statistics.FindingsAlthough rigorous correlation between adopted digitalization and performed sustainability on one side and performed sustainability and market performance on the other cannot be verified for the 92 wineries under investigation, there is visible evidence that the more digitalized wineries are, the more sustainable they become and the better their performance. Evidence was not found to support the idea that the more sustainable wineries are, the more they are digitalized and the better their performance. Research implications and limitations to theoretical and practical application have been discussed.Originality/valueWine tourism, which is naturally associated with rural tourism, is a form of tourism in which sustainability has strong relevance, particularly considering the future needs/desires of post-pandemic tourists. At the same time, digitalization, especially in pandemic and post-pandemic tourism, is credited with developing a huge impact in this business, although wine tourism is most probably conceivable as a meta-market, with a strong cultural essence. In this respect, a digitalization > sustainability > performance approach seems practicable and globally profitable.

Electrospun nanofibers for medical face mask with protection capabilities against viruses: State of the art and perspective for industrial scale-up.

Face masks have proven to be a useful protection from airborne viruses and bacteria, especially in the recent years pandemic outbreak when they effectively lowered the risk of infection from Coronavirus disease (COVID-19) or Omicron variants, being recognized as one of the main protective measures adopted by the World Health Organization (WHO). The need for improving the filtering efficiency performance to prevent penetration of fine particulate matter (PM), which can be potential bacteria or virus carriers, has led the research into developing new methods and techniques for face mask fabrication. In this perspective, Electrospinning has shown to be the most efficient technique to get either synthetic or natural polymers-based fibers with size down to the nanoscale providing remarkable performance in terms of both particle filtration and breathability. The aim of this Review is to give further insight into the implementation of electrospun nanofibers for the realization of the next generation of face masks, with functionalized membranes via addiction of active material to the polymer solutions that can give optimal features about antibacterial, antiviral, self-sterilization, and electrical energy storage capabilities. Furthermore, the recent advances regarding the use of renewable materials and green solvent strategies to improve the sustainability of electrospun membranes and to fabricate eco-friendly filters are here discussed, especially in view of the large-scale nanofiber production where traditional membrane manufacturing may result in a high environmental and health risk.

Companies' views of teleworking difficulties

Since the start of the COVID-19 pandemic, several countries have recommended or imposed teleworking. This study examines the arrangements made by companies in French-speaking Switzerland to prevent or reduce the negative aspects of teleworking in order to improve the experience for their employees. To do so, semistructured interviews were conducted with human resources or team managers in companies from various industries. The literature review enabled these risks to be classified into six categories and was used to guide the interviews. The results offer interesting insights for academic researchers and practitioners. For the first, they can use these findings to investigate this issue in other geographical regions or expand by doing a quantitative study. For the second, they can use the insights to tailor their management practices when crises materialize. © 2022 The Author(s). Published with license by Taylor & Francis Group, LLC.

Liquid biopsy on serum samples: Fourier-Transform Infrared Spectroscopy as fatality predictor for COVID-19

The fatality prediction in hyperinflammation diseases like COVID-19 is a challenge. We show here that FTIR could probe the degree of IgG glycosylation discriminating subpopulations of COVID-19 patients depending on their degree of severity. © Optica Publishing Group 2022 The Authors.

Liquid biopsy on serum samples: Fourier-Transform Infrared Spectroscopy as fatality predictor for COVID-19

The fatality prediction in hyperinflammation diseases like COVID-19 is a challenge. We show here that FTIR could probe the degree of IgG glycosylation discriminating subpopulations of COVID-19 patients depending on their degree of severity. © Optica Publishing Group 2022 The Authors.

Multinational perspectives on Covid-19 challenges: Faculty responses to distance education in Italy and the USA

In this study focusing on distance teaching during the Covid-19 pandemic, 47 higher education faculty in Italy and the USA responded to a survey circulated internationally between July and November 2021. In both contexts, perceptions of the institutional support and professional training for distance education (DE) were found to be similar in many ways, although the experiences with DE's opportunities and challenges proved quite different. Respondents in the USA reported being more at ease with DE, while Italian faculty reported greater recognition of the barriers to DE. HE faculty in both contexts equally recognized the importance of professional development for DE. Possible reasons for these similarities and differences are discussed.

Occupational hazards and gender differences: a narrative review

Personalized medicine, and particularly gender medicine, is becoming essential in daily medical practice. This narrative review aims to assess sex and gender differences in occupational risks among workers. We point out that female workers are more exposed to biological risks (i.e., 70% of healthcare workers during the COVID-19 pandemic were women), but also seem to be more protected against microorganisms (i.e., for HBV vaccination: OR 1.21, p = 0.0023);with regard to physical risks, women are more susceptible to radiations (the estimated incidence of solid tu-mors for 0.1 Gy of exposure is 0.013% in females and 0.008% in males), while men are more susceptible to heat (infertility prevalence was 22.7% in exposed workers vs 3.0% in con-trols);female video terminal workers are more susceptible to both computer vision syndrome (aOR 2.57 and aOR 2.35) and musculoskeletal symptoms (OR 3.6). From a psychological point of view, women are more at risk for work-relat-ed stress and burnout, as well as workplace mobbing (65% of affected workers are women) and verbal violence, while physical violence was more common among men. In conclu-sion, important sex and gender differences are present with regard to occupational risks and hazards, thus showing the necessity to improve medical surveillance and to allow occupational physicians to personalize health surveillance. © 2022, Il Pensiero Scientifico Editore s.r.l.. All rights reserved.

Mink-413: A Next Generation Armored Allogenic Bcma Car Inkt Product

Background We are developing MiNK-413;a novel allogeneic CAR-iNKT product targeting BCMA and secreting soluble IL-15 for treatment of relapsed/refractory Multiple Myeloma (rrMM). Chimeric Antigen Receptor (CAR)-T cell therapy has revolutionized treatment of rrMM with two autologous products already approved by the FDA. However, current treatments come with significant toxicity, cost, and logistical challenge and many patients relapse, with 60% of relapsed patients still expressing BCMA. To address these, we propose the use of invariant Natural Killer T (iNKT) cells as a platform for BCMA-targeted allogenic cell therapy for rrMM. iNKT cells have potent immunostimulatory activity and intrinsic CD1d-and NK receptor ligand targeted cytotoxicity, and do not cause Graft versus Host Disease due to their invariant T cell receptor. In our native iNKT cell (agenT-797) clinical trials for COVID, solid tumors and Multiple Myeloma we observe excellent tolerability to up to 1 billion cell dosing with minimal treatment-related adverse events, absence of signs of CRS or peripheral neuropathy, and early signs of biological activity. AgenT-797 is administered without prior lymphodepletion, which is an approach we intend to pursue with MiNK-413. Methods Our proprietary CARDISTM platform consists of highly diverse (>1010) scFv library screening followed by library-based direct functional selection in CAR format using mammalian display. Candidates can be further optimized using affinity tuning to ensure optimal and highly selective on-target/ on-tumor activity. We developed a manufacturing approach to engineer and specifically expand CAR and soluble IL-15-expressing allogeneic iNKT cells. Lead candidates are assessed in vitro and in vivo for cytotoxicity, cytokine secretion, exhaustion, tumor homing and persistence. Results Discovery using our CARDISTM platform generated a fully human, potent, and specific anti-BCMA CAR which forms the basis for MiNK-413. Xenograft in vivo studies demonstrate effective bone marrow homing, and potent cytotoxic activity, with soluble IL-15 prolonging persistence. In vitro data show potent immunomodulatory activity and lack of exhaustion against BCMA+ human hematologic tumor cell lines in vitro and in vivo. Conclusions Combination of our proprietary CARDISTM and iNKT platforms enabled rapid discovery and development of MiNK-413, a next generation armored allogeneic BCMA-targeting CAR therapies. MiNK-413 is eligible to target a broader rrMM patient population due to intrinsic iNKT cell properties such as effective bone-marrow homing, high BCMA specific activity augmented by natural CD1d and NK receptorligand mediated activity. We believe MiNK-413 will provide additional benefits to rrMM patients beyond currently available treatments.

COVID-19 sequelae among competitive athletes: a systematic review : Valerio Flavio Corona

Background During the COVID-19 pandemic, several professional athletes from different sports were infected by SARS-CoV-2. The aim of this systematic review was to evaluate the currently available scientific evidence regarding the cardiological, pulmonary, psychological, and combined sequelae, in professional athletes. Methods The present systematic review was performed following the PRISMA statements, thereby searching on 3 databases: PubMed, ISI Web of Science, Scopus. Primary studies published between January 2020 and March 2022, investigating symptomatic and instrumental sequelae in competitive athletes after COVID-19 infection, were included. Results A total of 1,957 articles were screened, finally 18 were included (6 cohort studies, 2 case-control studies and 10 cross-sectional studies). Studies’ sample size ranged from a minimum of 12 to 1908 athletes playing different sports. In addition, the studies examined the following type of sequelae: 12 cardiological, 2 psychological, 1 pulmonary and 3 combined. Regarding the cardiological field, the prevalence of anomalies in instrumental examinations ranged 0-27.89% for first level tests (echocardiography, electrocardiogram, troponin), and 0-6.21% for second level tests (cardiac magnetic resonance). The prevalence of myocarditis and pericarditis in the athletes ranged from 0 to 3.33%, whereby the prevalence of myocarditis was in the range 0-2.32% and that of pericarditis in the range 0-2.22%. Conclusions The results show that post SARS-CoV-2 infection cardiac sequelae have a quite low prevalence among competitive athletes included in our review, but it would be important to set up a gradual and continuous testing approach to preserve sports performance. Public health framework, such as vaccination campaign, is important both at European and international level in order to address potential consequences of infectious diseases among competitive athletes. Key messages • It is important to monitor all COVID-19 sequelae in European competitive athletes playing different sports. • Considering anti-COVID-19 vaccination in competitive athletes as an important preventive measure, to limit the circulation of the virus and the physical consequences that may occur.

European studies to evaluate COVID-19 vaccine effectiveness in HCWs: results from Italian hospitals : Antonella Agodi

Background Evaluating COVID-19 vaccine coverage and risk factors is useful to develop public health strategies against COVID-19 pandemic. In the framework of two studies commissioned by the European Centre for Disease Prevention and Control (ECDC) and coordinated by Epiconcept, France, we reported findings about incidence and seroprevalence among healthcare workers (HCWs) enrolled from three Italian hospitals. Methods From July 2021 to date, the AOUP “G. Rodolico-San Marco” (Catania), the San Gerardo Hospital (Monza) and the Policlinico Gemelli (Rome) participated in the ECDC study to measure COVID-19 vaccine effectiveness. Catania and Rome also participated to the ECDC study of nosocomial transmission. HCWs were asked to complete a weekly questionnaire to report changes in health status and professional/personal exposures. At recruitment, a nasopharyngeal swab for RT-PCR and a blood sample for serology test were collected. Moreover, HCWs were followed-up with a weekly or bimonthly nasopharyngeal or saliva swabs. Blood samples were collected every one or two months. Results A total of 226 HCWs was enrolled from Catania, 330 from Rome and 132 from Monza in the COVID-19 vaccine effectiveness study. As of February 2022, PCR tests performed were 2270 in Catania, 5475 in Rome and 891 in Monza sites. Moreover, the serological tests performed were 845 in Catania, 760 in Rome and 395 in Monza sites. A total of 6 SARS-CoV-2 infections were identified in Catania, 34 in Rome and 4 in Monza sites. Interestingly, the study of nosocomial transmission reported the highest incidence rate in Catania (4 per 10,000 person-day), while 0.7 per 10,000 person-day in Rome. During the study period seroprevalence declined by 17% among HWCs enrolled in Catania. Conclusions Our findings revealed low number of COVID-19 infections, with high COVID-19 vaccine coverage among HCWs. However, further analyses are needed to provide more robust estimates of vaccine effectiveness. Key messages Monitoring risk factors is useful to understand the pandemic scenario among high-risk groups. A larger sample size and follow-up will improve public health vaccination strategies against COVID-19.

THE POPULARISATION OF SCIENTIFIC CONCEPTS IN THE PRESS: DEFINITIONS BY METAPHOR

The COVID-19 pandemic has represented a fundamental ‘discursive moment’ (Moirand) in recent decades;in particular, this event has put to the test the shared concepts of ‘scientific truth’ (Charaudeau) and ‘expertise’ (Vicari). This period has also been marked by unprecedented activity in the popularisation of specialised concepts, linked to the fields of medicine and biology, and also to the fields of economics and social life, notably through media channels (press, radio, television, the Internet and social networks). The explanation of highly technical notions, as well as of new terms resulting from the pandemic, has often taken various forms, among which defining strategies play a major role. Our contribution aims to highlight the framing function that metaphor can play when it is used as an instrument to define a scientific concept (Rossi). To this end, we analyse a corpus of the French and Italian press from 2020 and 2021, detecting the metaphors used to define the reformulations of concepts related to the pandemic. © 2022 Towarzystwo Naukowe KUL. All Rights Reserved.

Surveillance of SARS-CoV-2 in Urban Wastewater in Italy

The presence of SARS-CoV-2 RNA in wastewaters was demonstrated early into the COVID-19 pandemic. Data on the presence of SARS-CoV-2 in urban wastewater can be exploited for different aims, including: i) description of outbreaks trends, ii) early warning system for new COVID-19 outbreaks or for the spread of the virus in new territories, iii) study of SARS-Co V-2 genetic diversity and detection of its variants, and iv) estimating the prevalence of COVID-19 infections. Therefore, wastewater surveillance (known as Wastewater Based Epidemiology, WBE) can be a powerful tool to support the decision-making process on public health measures. Italy was among the first EU countries investigating the occurrence and concentration of SARS-Co V-2 RNA in urban wastewaters, virus detection being accomplished at an early phase of the epidemic, between February and May 2020 in north and central Italy. The present study reports on the methodological issues, related to sample data collection and management, encountered in establishing the systematic, wastewater-based SARS-CoV-2 surveillance, and describes the results of the first six months of surveillance. © 2022 IEEE.

SOCIAL SUPPORT MITIGATES THE EFFECT OF STRESS ON SEXUAL AND GENDER MINORITY PEOPLE'S MENTAL HEALTH DURING COVID-19

Sexual and gender minority (SGM) people face pre-existing inequalities that may have been exacerbated by the Coronavirus-19 (COVID-19) pandemic. Canadian sexual minorities are twice as likely to live alone compared to heterosexual people and are more vulnerable to anxiety, depression, self-harm, and substance abuse. Despite these vulnerabilities, several studies suggest that social support and community solidarity can mitigate the effect of stress on SGM mental health. Using a cross-sectional online survey, our team examined SGM and cisgender heterosexual mental health and social support during the first four months of the COVID-19 crisis in Quebec, Canada. A total of 2900 adults (n = 304 SGM people, n = 2596 cisgender heterosexual people) completed questionnaires measuring perceived social support, perceived stress, depressive symptoms, anxiety symptoms, and loneliness. A series of one-way ANOVAs revealed that SGM people presented worse health outcomes than cisgender heterosexual people on all questionnaires (p < .001). Post hoc analyses also showed that some particularly marginalised SGM sub-groups, including bisexual and asexual people, showed the worst health outcomes. Moderation analyses later revealed that social support moderated the relationship between perceived stress and depressive symptoms among both SGM and cisgender heterosexual people - but this effect was four times stronger among SGM people (ΔR2 = .041;p < .001) than among cisgender heterosexual people (ΔR2 = .010;p < .001). These results suggest fostering social connectedness among SGM people may be especially beneficial in buffering against distress in the face of a crisis. To better understand how SGM mental health is evolving during this pandemic, our team is currently conducting a follow-up longitudinal study examining mental health, trauma, coping strategies and resilience among SGM and cisgender heterosexual adults before and after vaccination efforts started in Canada (to date, N = 6083). Preliminary results from time 1 (July 2020) and 2 (Fall 2021) are being treated and will also be presented.

THE GREAT IMITATOR: A CASE OF RENAL SQUAMOUS CELL CARCINOMA DISGUISED AS CHRONIC PYELONEPHRITIS

CASE: A 78-year-old female with a history of recurrent nephrolithiasis and left ureteral reconstruction presented to our institution with hematuria, flank pain, anorexia and weight loss. 3-4 months prior, she had similar symptoms in her home country and was treated with multiple courses of antibiotics. She attempted to present to the US for evaluation earlier, but was unable to due to COVID. She first presented to a nearby US hospital and was diagnosed with an atrophic kidney with a superimposed infection based on imaging and labs. An EGD/ Colonoscopy done for her weight loss was unrevealing. She was discharged on antibiotics and told to follow up for possible nephrectomy. 1 days later, she presented to our institution with continued symptoms. Repeat CT was concerning for emphysematous pyelonephritis. Vital signs were unremarkable. Labs showed no leukocytosis, normal creatinine, hypercalcemia to 13.0 and urinalysis showed hematuria, pyuria and proteinuria. She was initially treated with IV antibiotics and a percutaneous nephrostomy for source control. To continue work up for her weight loss, a CT chest was done that showed multiple lung nodules and a re-review of the CT abdomen noted a T12 lytic lesion. 2 weeks into her admission, she had a left nephrectomy. Pathology revealed an invasive, grade 3, poorly differentiated squamous cell carcinoma arising from the renal pelvis, with lymphovascular invasion. A biopsy of the T12 lesion was consistent with metastasis. Due to her functional status and aggressive nature of her malignancy, palliative therapies were recommended. Patient's course was further complicated by ileus, massive aspiration and spinal cord compression from the T12 lesion. She passed away on hospital day 45. IMPACT/DISCUSSION: Squamous cell carcinoma of the renal pelvis is a rare malignancy. Most present at an advanced stage with a long history of nonspecific symptoms, such as hematuria and/or flank pain, which are typically attributed to recurrent nephrolithiasis;one of the most well-documented risk factors. Additionally, there are no characteristic findings on imaging, making radiological differentiation between renal SCC and other chronic infectious processes difficult. Often there is no suspicion for malignancy until the pathology results. For these reasons, renal SCC should be considered in patients who have underlying risk factors. One may also benefit from a renal biopsy, which can be done before a nephrectomy and has been shown to have a high degree of diagnostic accuracy. Adding to this diagnostic challenge, our patient's care was delayed due to COVID, demonstrating the importance of considering alternative diagnoses when patients have deferred presentations and fractured workups. CONCLUSION: Consider the diagnosis of renal SCC in patients with recurrent nephrolithiasis, UTIs, unexplained hematuria and/or flank pain and refer for a renal biopsy if appropriate. Be mindful of the impact of fragmented and delayed medical care on vulnerable patients.

Safety, immunogenicity, efficacy, and acceptability of COVID-19 vaccination in people with multiple sclerosis: a narrative review

In the last two years, a new severe acute respiratory syndrome coronavirus (SARS-CoV) infection has spread worldwide leading to the death of millions. Vaccination represents the key factor in the global strategy against this pandemic, but it also poses several problems, especially for vulnerable people such as patients with multiple sclerosis. In this review, we have briefly summarized the main findings of the safety, efficacy, and acceptability of Coronavirus Disease 2019 (COVID-19) vaccination for multiple sclerosis patients. Although the acceptability of COVID-19 vaccines has progressively increased in the last year, a small but significant part of patients with multiple sclerosis still has relevant concerns about vaccination that make them hesitant about receiving the COVID-19 vaccine. Overall, available data suggest that the COVID-19 vaccination is safe and effective in multiple sclerosis patients, even though some pharmacological treatments such as anti-CD20 therapies or sphingosine l-phosphate receptor modulators can reduce the immune response to vaccination. Accordingly, COVID-19 vaccination should be strongly recommended for people with multiple sclerosis and, in patients treated with anti-CD20 therapies and sphingosine l-phosphate receptor modulators, and clinicians should evaluate the appropriate timing for vaccine administration. Further studies are necessary to understand the role of cellular immunity in COVID-19 vaccination and the possible usefulness of booster jabs. On the other hand, it is mandatory to learn more about the reasons why people refuse vaccination. This would help to design a more effective communication campaign aimed at increasing vaccination coverage among vulnerable people.

milliTRACE-IR: Contact Tracing and Temperature Screening via mmWave and Infrared Sensing

Social distancing and temperature screening have been widely employed to counteract the COVID-19 pandemic, sparking great interest from academia, industry and public administrations worldwide. While most solutions have dealt with these aspects separately, their combination would greatly benefit the continuous monitoring of public spaces and help trigger effective countermeasures. This work presents milliTRACE-IR, a joint mmWave radar and infrared imaging sensing system performing unobtrusive and privacy preserving human body temperature screening and contact tracing in indoor spaces. milliTRACE-IR combines, via a robust sensor fusion approach, mmWave radars and infrared thermal cameras. It achieves fully automated measurement of distancing and body temperature, by jointly tracking the subjects's faces in the thermal camera image plane and the human motion in the radar reference system. Moreover, milliTRACE-IR performs contact tracing: a person with high body temperature is reliably detected by the thermal camera sensor and subsequently traced across a large indoor area in a non-invasive way by the radars. When entering a new room, a subject is re-identified among several other individuals by computing gait-related features from the radar reflections through a deep neural network and using a weighted extreme learning machine as the final re-identification tool. Experimental results, obtained from a real implementation of milliTRACE-IR, demonstrate decimeter-level accuracy in distance/trajectory estimation, inter-personal distance estimation (effective for subjects getting as close as 0.2 m), and accurate temperature monitoring (max. errors of 0.5 degrees C). Furthermore, milliTRACE-IR provides contact tracing through highly accurate (95%) person re-identification, in less than 20 seconds.

Ontology Based Risk Self-assessment and Mitigation for Teleworkers

The COVID-19 health crisis has forced many people to work from home, exposing companies and workers to the various risks brought about by teleworking. In order to raise awareness and enable better management of these risks, we have built an ontology for the control and mitigation of teleworking risks as well as a tool for self-assessment of individual worker risk profiles. We have conducted a literature review and interviews about corporate practices to manage telework’s negative impacts. The resulting ontology allows us to link the risks with adaptations provided by the employers and employees. In order to circulate this self-assessment tool, we have integrated the ontology into a user-friendly website, where people can fill out an anonymous survey to establish their personal risk profile and get recommendations about further adaptations that could be beneficial in their situation. © 2022, The Author(s), under exclusive license to Springer Nature Switzerland AG.