Salinity stress on three representative species from Mediterranean semifixed dunes: Assessment of salinity exposure and substrate conductivity data reveal variable response strategies and tolerance between species.

Coastal ecotones can disrupt natural conditions, yielding intricate ecological contexts where salinity plays a variable role. The aim of this study was to assess the salinity effect on three species representatives of semifixed dune (Crucianella maritima, Helianthemum caput-felis and Teucrium dunense). Field data were collected to assess plant cover in semifixed dunes, ecotone with other coastal habitats, and artificial Posidonia oceanica wracks. Soil samples were collected, and conductivity measured. Then, experimental exposure to salinity was conducted with 6 seawater (SW) treatments (Control, 6.25 % SW, 12.5 % SW, 25 % SW, 50 % SW, 100 % SW). Flowering, gas exchange, chlorophyll fluorescence and enzymatic antioxidant measurements were conducted after two months of exposure. In the field trial, species presence varied depending on the habitat and was null on P. oceanica. The relation between conductivity and species abundance showed moderate tolerance for the three species. For C. maritima this relation was variable depending on the habitat. Experimental data suggest moderate tolerance with stress occurring at 25 % SW onwards. Gas exchange response to salinity was similar among species, but more drastic reduction in assimilation rate and larger decrease in water use efficiency was observed for C. maritima. Instead, photoinhibition occurred in H. caput-felis and T. dunense but was absent in C. maritima likely related to the fact that H. caput-felis and T. dunense activated catalase and superoxide dismutase enzymes, while C. maritima showed activation of glutathione-related enzymes. Malondialdehyde (MDA) increased in C. maritma and decreased for the other species indicating a more complex involvement of MDA under stress conditions. Flowering response to salinity was overall more resilient in T. dunense. Our results, based on field conductivity data and measurements of physiological, antioxidant, and reproductive traits, delineate specific tolerance differences and strategies towards salinity for Mediterranean semifixed dune species.

Healthcare-associated infections and antimicrobial use in long-term care facilities (HALT3): an overview of the Italian situation.

BACKGROUND: Awareness of healthcare-associated infections (HAIs) and antimicrobial use in long-term care facilities (LTCFs) is increasing. In 2017, the third national point prevalence survey (PPS) was conducted in Italy as part of the third 'Healthcare-Associated Infections in European Long-Term Care Facilities' (HALT3) study. AIM: To report the results of HALT3 and analyse the resident population of LTCFs, implementation of good practices, prevalence of infections and antimicrobial use. METHODS: The survey was designed as a PPS, carried out from April to June 2017. All residents who lived full-time in the institution were included. All facilities were asked to complete an institutional questionnaire, a ward list for all residents, and a resident questionnaire for those residents presenting with signs/symptoms of active infection and/or receiving an antimicrobial agent. FINDINGS: In total, 418 facilities took part in the study; 24,132 residents were eligible, and most were aged >85 years, disoriented and incontinent. The prevalence of HAIs was 3.9%, and 50% of the institutions reported that they had a professional trained in infection control on their staff. Only 26.4% of infections were confirmed by a microbiological sample, and 26.9% of the isolated micro-organisms were resistant to at least one antimicrobial class. In total, 1022 residents received at least one antimicrobial agent, and cephalosporins were prescribed most commonly. CONCLUSION: The number of infection control and antimicrobial stewardship measures implemented was found to be considerably higher in this study compared with previous studies. This could lead to a reduction in the prevalence of HAIs, antimicrobial use and antimicrobial resistance. Further studies are needed to monitor these aspects.

Knowledge, attitudes and beliefs towards compulsory vaccination: a systematic review.

Currently, many countries are dealing with groups refusing available recommended vaccinations. Despite several studies having demonstrated the efficacy of mandatory vaccinations in ensuring herd immunity, opposition is widespread. The aim of our study was to systematically review published studies evaluating attitudes towards mandatory vaccination programs. PubMed and Scopus scientific databases were searched and 4,198 results were returned, of these 29 met the inclusion criteria. Twenty-two studies assessed attitudes towards mandatory vaccination programs in general, while 9 papers focused specifically on the Human Papilloma Virus (HPV) vaccine. Most of the studies were performed in Europe and North America. According to the assessed studies, the majority of the population seems to be in favour of compulsory vaccinations, although attitudes differed among studies. The results presented in this review could be an important starting point to further understand the issue of vaccine hesitancy and support the implementation of effective vaccination strategies.

Peritoneal lavage with povidone-iodine solution in experimentally induced peritonitis.

Two experimental studies were carried out upon dogs to clarify the efficacy of peritoneal povidone-iodine lavage in peritonitis. With an experimental model of peritonitis which closely resembles the clinical situation, we found that peritoneal lavage with povidone-iodine was not more effective than other lavage regimens in decreasing bacterial colony counts and was associated with an early 100 per cent mortality. Renal function was not affected by the treatment with this antiseptic solution. However, we found a statistically significant superimposed metabolic acidosis in the peritonitis group treated with povidone-iodine when compared with the other groups, by means of a significant decrease in base excess, p less than 0.01, at the two hour postlavage measures. This metabolic acidosis was also observed in normal dogs undergoing peritoneal lavage with povidone-iodine, showing a significant decrease in serum bicarbonate level one hour, p less than 0.05, and three hours, p less than 0.01, three hours postlavage, when compared with a sham laparotomy group in the nonperitonitis study. This has not previously been experimentally investigated. In view of these results, we do not recommend the clinical use of povidone-iodine solution for peritoneal lavage in peritonitis.

The significance of elevation of serum phosphate levels in experimental intestinal ischemia.

It has been suggested that the serum phosphate level is significantly elevated early in massive intestinal infarction. We attempted to determine whether or not this elevation in serum phosphate level is indeed an early and reliable diagnostic finding and to define the relationship between this elevation, the re-establishment of mesenteric blood flow and the viability of the intestinal wall. Significant elevation in serum phosphate value occurred after four hours of ischemia. This was associated with irreversibility of the ischemic process and intestinal necrosis according to an intravenous fluorescein test and pathologic data. The results of other superior mesenteric artery-12 parameters followed were erratic and appeared to have no diagnostic value in acute mesenteric arterial occlusion. Significant serum phosphate level elevation occurs in arterial intestinal ischemia, but this is not an early diagnostic sign, becoming significant only after irreversible necrosis of the intestine.