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Background: The severe acute respiratory syndrome coronavirus 2 (SARS-Cov-2) is a highly contagious illness associated with a hyperactivated and dysregulated host immune humoral response. In detail, there is a cytokine storm which may take to the release of interleukin IL-6 as a critical mediator for respiratory failure, shock and multiorgan dysfunction. Such dysregulation may act as a target for therapeutics and, in this view, a blockade of IL-6 function by an anti-IL-6 receptor antibody (tocilizumab) has been described to be effective for the treatment of the inflammatory process COVID-19-related. Timing of administration of therapy was reported in literature to have a critical role in benefit for patients;thus, the aim of the present study is to compare two different methods for the IL-6 assessment: the Human IL-6 ELISA Kit (Invitrogen) and the Elecsys IL-6 (Roche). Method(s): IL-6 levels of 128 COVID-19 patients, who were consequently admitted to the Emergency and Medicine Department of AOU Careggi (Hospital in Florence -Italy ) between April and May 2020, were assessed by using the two above mentioned methods and were analysed through Passing-Bablok regression fit and Bland-Altman plot. Result(s): The analyses showed that the two methods correlate, but do not agree in terms of numeric results. In particular, further investigation were performed on the Bland-Altman results, showing that the maximum number of samples for which the differences between the two methods is close to "0" (p > 0.05) (which means a good overlap between the two methods) is 49 (p=0.07), and among them, 40 samples showed a complete agreement of results (p=0.95). These results can be attributed to the different methods' linearities: 3.1-200 pg/mL for ELISA and 1.5#5000 pg/mL for ECLIA, which could be extended to 50 000 pg/mL. Conclusion(s): Although a small percentage of data overlapping in a certain range, still a high correlation among the two methods can be found;given the overall analytical performance of the ECLIA, it can be considered more adequate for different reasons: i) it is available on a fully automated platform h24, ii) it uses of a small sample volume, iii) it is low cost and no-time consuming and iiii) the different timing for measuring IL-6 is much attractive.
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The presence of numerous scientific contributions in the program is certainly demonstrative of the fact that research in the field of paleopathology and anthropology has not stopped since the beginning of Covid-19. Furthermore, the same emergency that we are still partially feeling, has pushed our community scientific research to question itself more intensely in connection to the epidemic relationship and measures that repeatedly led to profound transformations in the societies of the past from different points of view: demographic, economic, social and the history buried under the bioarchaeological strata is today more capable than ever to show this connection. It can do this by bringing to light the paleodemographic data that is obtained from the study of human remains. Today we will listen to many paleopathological stories and among these I am very happy to also present ours. Twenty years ago, the University of Insubria started a collaboration with the Archaeological Superintendence of Lombardy for the study of osteological remains found mostly during emergency archaeology recoveries. These experiences led us to reach those bioarchaeological sites again with the aim of extracting all those cemetery layers that remained there because they were not subjected at that time by building reclamation interventions. Returning to those sites that in the past brought to light fragmentary anthropological data means allowing oneself the possibility of obtaining new palaeodemographic and palaeopathological data which are decisive for reconstructing the demographic and epidemiological history of the populations of the past. These new interventions led us to create an operational model that immediately intended to underline the importance of an evident continuity between the archaeological recovery and the anthropological study of the finds through the setting up of physical anthropology and paleopathology laboratories directly on the sites of the finds. All this in harmony with the final design of the projects or the museumization of bioarchaeological sites in their complexity aimed at enhancing cultural tourist routes in the area. In this regard, I would like to thank the community foundation of Varese and the Cariplo foundation for supporting our current initiatives. These include the project financed by the emblematic provincial tender and which has as its final objective the enhancement of three bioarchaeological sites in Valcuvia: the medieval sites of San Biagio in Cittiglio, Sant’Agostino in Caravate, and the modern crypt of the church of the Convent of Azzio. Today, our Research Centre works in Piedmont in different sites in the province of Vercelli and Alessandria. Aware of the importance of a physical anthropological approach in the field, our young Centre goes beyond the continental borders to reach Eritrea, the ancient city of Adulis, because it is in dissecting the taphonomic events and the funeral actions that will make it possible to identify the funerary ritual adopted by the ancient populations. The operational model of paleopathological research, which gradually enriches itself thanks to the multidisciplinary nature of the interventions and thanks to the individual experiences in the field, is thus continuously transferred and adapted to other anthropological contexts that retain potential both in terms of investigative and enhancement of the bioarchaeological heritage. Through the musealization of the sites it is also possible to acquire an attractive force towards all those potentially bioarchaeological areas but which today are in conditions of neglect because they are marginal with respect to the conventionally understood cultural tourist good. And we all know how important it is to transfer the study data even outside the academic context because making this aspect of archaeology, the truly human one, usable too, cannot fail to arouse a strong awareness of our past. We also know how much more we will have to work, following in the footsteps of the professors who started this path, to ensure that the d sciplines of paleopathology and physical anthropology arrive within all those degree courses still discovered today by these teachings to heal an important lack: knowing the human past from a physical and pathological point of view allows us to understand the evolutionary path of some pathologies, especially those of infectious nature. If my title of the speech “Paleopathology and osteoarchaeology in the province of Varese” does not respond to what is being said today, it is because my feeling about paleopathology and osteoarchaeology in the province of Varese is understood as that of carrying out research, what I could feel everywhere, through the operational model, the enthusiasm for paleopathological research and of course the people I am lucky enough to work with. The Morgagni Museum of Pathological Anatomy of the University of Padua preserves a wide series of pathological specimens, mostly from the second half of the 19th century and the early 20th century. The Museum was recently renewed, as the result of an intervention of enhancement of the museum and cultural heritage of the University of Padua and its Medical School, being also testimony to the history and evolution of human pathology and past population lifestyle. In the collection of the Morgagni Museum there are several specimens affected by atherosclerotic lesions. Atherosclerosis is characterized by a chronic inflammatory disease in which different factors are involved, such as lipoproteins, immune cells and endothelial damage. The main clinical syndromes related to atherosclerosis are angina pectoris, acute myocardial infarction, transient ischemic attack, cerebral stroke, intermittent claudication, aortic aneurysm and nephro-vascular hypertension. Atherosclerosis was believed to be a modern disease, related almost exclusively to age and current lifestyle. The cases from the Morgagni Museum are therefore useful for studying the presence of the atherosclerosis in a recent past population. In the collection there were identified six atherosclerotic cases: an atherosclerotic aneurysm of the ascending aorta: the specimen highlights the left ventricular outflow tract and the aortic root. There is a severe atherosclerosis of the ascending aorta with saccular aneurysm including a large thrombus;a syphilitic aortitis complicated by atherosclerosis: the finding highlights the left ventricular outflow tract and aortic root. It is possible to note the intima of the ascending aorta with ulcer-calcific atherosclerotic plaques and “tree-bark” whitish areas;an atherosclerotic aneurysm of the abdominal aorta: abdominal aorta with saccular atherosclerotic aneurysm, proximal to the iliac bifurcation;a case of aortic atherosclerosis: aorta with severe atherosclerosis complicated by calcification and thrombosis;a case of aortic atherosclerosis: massive dissemination of atheromatous-calcific plaques;a case of aortic atherosclerosis with parietal thrombi: widespread presence of plaques along the aortic wall. Thanks to this collection, it is possible to notice the spread of pathology on an atheromatous basis in the recent past populations. Moreover, current paleopathological investigations on ancient populations mummified remains also showed traces of atherosclerotic lesions in both sexes and different ages. It is therefore possible to support a ubiquitous diffusion in space and time of this complex multifactorial pathology which has so far considered to be almost an exclusive prerogative of old age and current lifestyle. The Morgagni Museum of Pathological Anatomy of the University of Padua, founded by Lodovico Brunetti (1813-1899) in the 1860s, gathers important pathological specimens mainly from the 19th century. Among them, there is a very peculiar preparation: it consists of a dried head representing a case of argyria dating back to 1873. The specimen is preserved in a sealed jar, all the skin has a blue-gray coloration with white-blonde hair and beard. The eyes are not preserved, but since the ocular cavities remain open, it is possible to presume that origin lly there were glass eyes. Two glass sticks are inserted inside the mouth to show that also tongue and gums have the same blue-gray pigmentation as the face. The upper teeth are strongly eroded. Argyria is a rare disease caused by chronic absorption of products with a high silver content, which surpass body’s renal and hepatic excretory capacities, leading to silver granules being deposited in the skin and its appendages, mucosae and internal organs. It is characterized by blue-gray or black staining of the skin and mucous membranes. Our case was first mentioned in 1862 as a syphilitic man who was treating himself with some caustic silver nitrate, the so called “infernal stone”, since 1840s. According to him, this medicament cured the syphilis, but turned him into a “graphite man”. The patient died in 1873 of an intestinal infection, most likely related to the prolonged ingestion of the silver nitrate. This case was described as “spectacular” by Austrian dermatologist Isidor Neumann (1832-1906), who studied a sample of the tongue of the specimen sent by Brunetti. In fact, Brunetti performed the autopsy on the body of the individual and prepared also a plaster cast of the head along with the sample for Neumann. Thus, we can assume Brunetti was also the one who preserved the original head, taxidermizing it (so-called stuffed head preparation) in order to preserve the skin color, because his famous tannisation method would not maintained the original characteristics. Human taxidermy is quite rare, and it is limited to a few cases in the 19th century. Moreover, there are just a few known human stuffed heads in the world, making the Paduan specimen particularly unique both for the pathology and the technique used for the preparation.
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BACKGROUND AND AIMS: Acute kidney injury (AKI) is a common complication in patients affected by coronavirus disease-19 (COVID-19) and its development is associated with high mortality [1]. However, it is also clear that the COVID-19 pandemic has effects on the management of diseases not directly related to COVID-19 [2]. In this study, we investigated the impact of the COVID-19 pandemic on general intrahospital AKI incidence and outcomes. METHOD: We performed a retrospective cohort study comparing data on AKI epidemiology and outcomes of patients hospitalized from January 2016 to December 2019 (pre-COVID-19 period) and from January to December 2020 (COVID-19 period, including both SARS-CoV-2 negative and positive patients). AKI was defined and classified by evaluating the kinetics of intra-hospital creatinine (comparing the peak to the minimum serum creatinine level, considered as the basal value) [3]. The prevalence of chronic kidney disease (CKD) (i.e. eGFR < 60 mL/min) was calculated in patients with previous creatinine values available. Patients with CKD stage 4-5 (i.e. eGFR < 30 mL/min/1.73 m2) and with a length of hospital stay > 30 days were excluded. RESULTS: A total of 51 681 patients during the pre-COVID-19 period and 10 ,062 during the COVID-19 period (9026 SARS-CoV-2 negative and 1036 SARS-CoV-2 positive patients) were analysed. Patients admitted in the COVID-19 period were significantly older, with a higher prevalence of males and a reduced prevalence of chronic conditions. In-hospital AKI incidence was 31.7% during the COVID-19 period (30.5% in SARS-CoV-2 negative patients and 42.2% in SARS-CoV-2 positive ones) as compared with 25.9% during the pre-COVID-19 period (P < .0001) (Fig. 1). Similarly, the COVID-19 period showed an increase in AKI stage 2-3 incidence both for AKI on CKD and for 'de novo AKI'. In multivariate analysis, demographic characteristics, length of hospital stay, ICU admission, main comorbidities, basal sCr, admission period (pre-COVID-19 or COVID-19) and SARS-CoV-2 infection were significantly associated with the risk of AKI. In particular, the admission in the COVID-19 period increased the risk of AKI [OR 1.18, 95% confidence interval (95% CI) 1.12-2.25] regardless of SARS-CoV-2 infection. Moreover, we found that in the COVID-19 period, there was an increased number of patients admitted to ICU, accompanied by a significant increase in the length of hospital stay and intrahospital mortality. In the multivariate analysis, development of AKI, admission in the COVID- 19 period and active SARS-CoV-2 infection remained significantly and independently associated with mortality risk (Fig. 2). CONCLUSION: Overall, we found that AKI was more common and severe in the COVID-19 period, regardless of SARS-CoV-2 infection, when compared with patients admitted to the same hospital during the four years before the pandemic. So, we provide evidence that the COVID-19 pandemic has changed general in-hospital AKI epidemiology. These findings call attention to the need to adapt the resources dedicated to the prevention and management of the intra-hospital AKI in response to health emergencies. (Table Presented).
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Purpose This paper aims to understand how the sustainability theme has been incorporated into the new Olympic planning guidelines based on analysing the case of Tokyo (2020), which was severely impacted by the COVID-19 pandemic. Design/methodology/approach For this, field research using the case study method was carried out that involved 21 in-depth interviews with experts from different entities affected by the event. Findings As a result, it was possible to identify that some characteristics already presented in the Tokyo project came to break away from the gigantism observed in the past Olympic editions in an attempt to demonstrate alignment with the new principles brought by the IOC (2020) and 2020 + 5 Agenda that had as one of its main objectives to simplify the Olympics, making the event more sustainable and accessible for future host societies. Originality/value At the end, some trends for the future of the Olympic Games are also presented in order to guide future studies in the area, as well as help the future host cities and their companies in planning their investments.
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Background In educational settings, health promotion refers to a whole-school approach to help individuals realize their potential, cope with the everyday stresses of life, work productively and fruitfully, and contribute to their community. In these regards, it is essential to enhance a vast repertoire of knowledge, skills, attitudes, and values, a narrower set of psychosocial skills (Life Skills - LS). The Local Health Unit of Palermo, the Centre of Training and the National Institute of Health (ISS) developed the project “Life Skills and resilience: effective strategies to promote health at school”. Objectives The project's general aim was to provide headteachers and teachers with methodologies and tools to develop and promote LS in educational settings. Through the participatory approach, training was structured in 5 modules of 16 hours each. The training activities began in October 2019 and ended online due to the Covid-19 emergency in July 2020. The evaluation plan provides the assessment of learning, satisfaction, monitoring and assessment of attitudes and behaviours using a validated questionnaire. The aim was to identify improvements in relationships inside and outside the school context and increase self-efficacy and job satisfaction among teachers. Data analysis is currently being processed. Results 169 Teachers, 12 Healthcare workers attended the training. The preliminary results show that: i. there is an improvement in relationships between colleagues, students and parents;ii. there is a slight improvement in the perceived self-efficacy in managing negative emotions;iii. there is an improvement in the personal and collective effectiveness perceived in the school environment and job satisfaction. Conclusions The project was designed for implementing sustainable interventions. The advent of COVID-19 has allowed further reflection on the usefulness of this approach for promoting resilience and protective factors and managing the consequences of the pandemic. Key messages The training improved personal and professional skills on design and methods to apply LS. The use of qualitative/quantitative assessment made it possible to illustrate the entire training process.
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BACKGROUND AND AIMS: Uncontrolled inflammation plays a relevant role in the pathogenesis of Coronavirus Disease-19 (COVID-19) and has been related to disease severity and unfavorable outcomes. Here, we studied the time trend of pro-and antiinflammatory markers in a population of patients undergoing hemodialysis (HD) affected by COVID-19, evaluating the potential modulating effects of two different dialysis approaches. METHOD: For this prospective randomized study, we recruited maintenance hemodialysis patients with confirmed COVID-19 infection. After diagnosis, the patients were randomized to two different dialysis modalities, expanded HD (HDx), performed by use of a medium cut-off membrane, and standard treatment based on the use of a protein-leaking dialyzer (PLD). Clinical and laboratory data were collected, including circulating pre and post-dialysis levels of interleukin-6 (IL-6), interleukin-8 (IL-8), interleukin-10 (IL-10), soluble TLR4 (sTLR4), and interferon-gamma (IFN-g). Samples were collected at diagnosis (T0), one and two weeks after the diagnosis (T7 and T14, respectively). RESULTS: Twenty-seven HD patients with COVID-19 (69.7 616.6 years, 14 males) were compared with 14 non-infected HD patients, as the control group. COVID-19 patients presented a significantly reduced number of lymphocytes, including CD4 andCD8 subpopulations, and higher levels of ferritin and lactate dehydrogenase. Moreover, COVID-19 patients had higher levels of IL-6 [35.5 (59.4) vs 12 (43) pg/ml, p=0.048] and IL-10 [9.3 (20.8) vs 1.2 (1.4) pg/ml, p=0.02], while the levels of IL-8 and sTLR4 were comparable. Then, twenty-five patients were randomized to undergo HDx (n.15) or PLD (n.10). Basal characteristics and cytokine levels were not significantly different between the two groups. All over the study, no significant modifications of circulating cytokine levels were observed. Similarly, no significant differences were found between patients on HDx or PLD evaluated at different time points. After a single HD treatment, IL-8 showed a significant reduction compared to pre-dialysis levels in both groups. IL-8 reduction rate resulted significantly correlated with IL-8 pre-dialysis levels. Finally, there were no correlations between cytokine levels and clinical characteristics and outcomes. CONCLUSION: In maintenance HD patients, COVID-19 is not related to a sustained inflammatory response. Modulation of the inflammation is not a suitable therapeutic target in this specific population. Other mechanisms could be involved in the pathogenesis of COVID-19 in HD patients. MO905 Figure 1: Time trends of pro-and anti-inflammatory cytokines in HD patients with COVID-19. A) IL-6 showed a trend to decrease in the first week after the diagnosis of COVID-19, reaching statistical significance in PLD group. B) IL-10 presented a significant increase in the first week after the diagnosis of COVID-19 in HDx group. C) IL-8 circulating levels, as well as D) sTLR4 levels, did not present significant modifications during the study. Expanded hemodialysis (HDx): black lines;Protein-leaking dialysis (PLD): red lines.
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This paper provides an econometric analysis aiming at evidencing the dynamics showed by the S&P 500 market index during the period of 4 January 2001–28 April 2020, in which the subprime crisis has taken place and the COVID-19 crisis has begun. In particular, we fit a three-regime switching model that allows market parameters to behave differently during economic downturns, with the regimes representative of the tranquil, volatile, and turbulent states. We document that the tranquil regime is the most frequent for the whole period, while the dominant regime is the volatile one for the crisis of 2008 and the turbulent one for the first four months of 2020. We fit the same model to the returns of the Dow Jones Industrial Average index and find that during the same period of investigation, the most frequent regime has been the tranquil one, while the volatile and turbulent regimes share the same frequencies. Additionally, we use a multinomial logit model to describe the probabilities of volatile or turbulent regimes. We show that, in the case of the S&P 500 index, the returns from the Volatility Index (VIX) index are significant for both the volatile and the turbulent regimes, while the gold, WTI oil, and the dollar indices have some explanatory power only for the turbulent regime. © 2020 by the authors. Licensee MDPI, Basel, Switzerland.