Hypolimnetic withdrawal coupled with oxygenation as lake restoration measures : the successful case of Lake Varese (Italy)

Lake Varese is a relatively small lake, belonging to the drainage basin of lake Maggiore (northern Italy). It has had a long history (since 1960s) of water quality deterioration as the result of cultural eutrophication. In 1967 a restoration project was designed, including a sewerage network, an O-ring sewage diversion system, and a centralised wastewater treatment plant with phosphorus and nitrogen control. Since the 1990's, the lake has been the object of a cooperative research program supported by the European Commission, the Italian Ministry of the Environment, the Lombardy Region, and the Varese Province. The subsequent studies revealed that the lake responded to the decreased external nutrient loads. Besides, mathematical models predicted a rather long period (30 years) to attain the restoration goal, recognising the importance of internal P loading from sediments. Also, it was predicted that the application of in-lake measures would be beneficial in accelerating lake recovery. Recently, two measures have been suggested, i.e. hypolimnetic withdrawal in the deepest section (maximum depth: 26 m) and oxygenation in the shallower section, during summer stratification. Lake Varese constitutes the first case in Italy where in-lake methods are used to counteract the problems caused by excessive nutrient enrichment in a relative large system (lake surface: 14.52 km2). In this paper, preliminary results of the first two years of operation (2000/2001) are summarised. The results are greatly encouraging. Lake water quality characteristics are as follows: Secchi transparency increased from 3.2 m to 4.9 m; annual mean total P concentrations decreased from 180 mg/m3 to 70 mg/m3; average chlorophyll values decreased from 40 mg/m3 to 17 mg/m3; the frequency of nuisance algal blooms declined to half in comparison to the 1990's and the algal density declined by a factor of 4, and anoxia periods decreased in time and space. Moreover, it has been evaluated that nutrient loads from lake Varese, due to the selected water discharges, did not affect the total nutrient budget of lake Maggiore and the downstream water quality.El lago Varese es un lago relativamente pequeño, situado en la cuenca de drenaje del lago Maggiore (norte de Italia). Presenta una larga historia (desde los años 60) de degradación de la calidad del agua como resultado de una eutrofización cultural. En 1967 se diseñó un proyecto de restauración, incluyendo una red de alcantarillado, un sistema en anillo de desvío de aguas residuales, y una planta centralizada de tratamiento de aguas residuales con control de fósforo y nitrógeno. Desde los años 90, el lago ha sido objeto de un programa de cooperación científica financiado por la Comisión Europea, el Ministerio de Medio Ambiente de Italia, la Región de Lombardy y la provincia de Varese. Los estudios resultantes mostraron la respuesta del lago a la disminución de la carga de nutrientes externa. Además, los modelos matemáticos predijeron un período bastante largo (30 años) para lograr el objetivo de restauración, reconociendo la importancia de la carga interna de P de los sedimentos. También, se predijo que la aplicación de medidas en el propio lago sería beneficiosa en la aceleración de la recuperación del lago. Recientemente, se han propuesto dos medidas, i.e. drenaje hipolimnético en la cubeta más profunda (profundidad máxima: 26 m) y oxigenación en la zona más somera, durante la estratificación estival. El lago Varese constituye el primer caso en Italia donde se han adoptado medidas en el propio lago para contrarrestar los problemas causados por un enriquecimiento excesivo de nutrientes en un sistema relativamente grande (superficie del lago: 14.52 km2). En este artículo se resumen los resultados preliminares de los dos primeros años de actuación (2000/2001). Los resultados son enormemente alentadores. Las características de la calidad del agua del lago son las siguientes: la transparencia del Secchi aumentó de 3.2 a 4.9 m; las concentraciones medias anuales de P total disminuyeron de 180 mg/m3 a 70 mg/m3; los valores medios de clorofila disminuyeron de 40 mg/m3 a 17 mg/m3; la frecuencia de florecimiento de algas se redujo a la mitad en comparación con los años 90 y la densidad de algas se dividió por un factor de 4, y los períodos de anoxia disminuyeron en el tiempo y en el espacio. Además, se ha comprobado que la carga de nutrientes procedente del lago Varese, a causa de las descargas de agua selectivas, no afectó al balance total de nutrientes del lago Maggiore ni a la calidad del agua del río aguas abajo

Influence of biochemical diagnosis of growth hormone deficiency on replacement therapy response and retesting results at adult height

Isolated growth hormone deficiency (IGHD) is the most frequent endocrinological disorder in children with short stature, however the diagnosis is still controversial due to the scarcity of reliable diagnostic criteria and pre-treatment predictive factors of long term-response. To evaluate recombinant growth hormone (rGH) long-term response and retesting results in three different groups of children divided in accordance with the biochemical criteria of initial diagnosis. Height gain (∆HT) at adult height (AH) and retesting results were evaluated in 57 rGH treated children (M = 34, 59.6%) divided into 3 groups according to initial diagnosis: Group A (n = 25) with max GH peak at stimulation test < 8 μg/L, Group B (n = 19) between 8 and 10 μg/L and Group C (n = 13) with mean overnight GH < 3 μg/L (neurosecretory dysfunction, NSD). Retesting was carried out in all patients after at least one month off therapy upon reaching the AH. 40/57 (70.2%) patients were pre-pubertal at diagnosis and showed ∆HT of 1.37 ± 1.00 SDS, with no significant differences between groups (P = 0.08). Nonetheless, 46% patients in Group B showed ∆HT < 1SDS (vs 13% and 12% in Group A and C, respectively) and 25% children failed to reach mid-parental height (vs 6% and 0% in Group A and C, respectively). At AH attainment, IGHD was reconfirmed in 28% (7/25) and 10% (2/19) in Group A and B, respectively. A reduction of diagnostic cut-off at GH stimulation tests could better discriminate between “good” and “poor responders” and predict the persistence of IGHD through transition. Group C response and the predictive value of baseline IGF-I SDS bring back to light NSD: should we consider an underlying hypothalamic derangement when the clinical presentation is strongly consistent with IGHD but pharmacological stimulation test is normal

Epidemiology of Strongyloides stercoralis in northern Italy: Results of a multicentre case-control study, February 2013 to July 2014

Strongyloides stercoralis is a soil-transmitted helminth widely diffused in tropical and subtropical regions of the world. Autochthonous cases have been also diagnosed sporadically in areas of temperate climate. We aimed at defining the epidemiology of strongyloidiasis in immigrants and Italians living in three northern Italian Regions. Screening for S. stercoralis infection was done with serology, confirmation tests were a second serological method or stool agar culture. A case-control approach was adopted and patients with a peripheral eosinophil count 65 500/mcL were classified as cases. Of 2,701 individuals enrolled here 1,351 were cases and 1,350 controls; 86% were Italians, 48% women. Italians testing positive were in 8% (97/1,137) cases and 1% (13/1,178) controls (adjusted odds ratio (aOR) 8.2; 95% confidence interval (CI): 4.5-14.8), while positive immigrants were in 17% (36/214) cases and in 2% (3/172) controls (aOR 9.6; 95% CI: 2.9-32.4). Factors associated with a higher risk of infection for all study participants were eosinophilia (p < 0.001) and immigration (p = 0.001). Overall, strongyloidiasis was nine-times more frequent in individuals with eosinophilia than in those with normal eosinophil count

Case Report: Late-Onset Congenital Adrenal Hyperplasia and Acute Covid-19 Infection in a Pregnant Woman: Multidisciplinary Management

Background The impact of the Covid-19 infection on patients with chronic endocrine disease is not fully known. We describe here the first case of a pregnant woman with Covid-19 acute infection and non-classical congenital adrenal hyperplasia (NCAH). Case description A woman at 36 weeks of gestation was referred to our Maternity Hospital for premature rupture of membranes (PROM). Her medical history was positive for NCAH on chronic steroid replacement till the age of 17 years (cortisone acetate and dexamethasone, both in the morning). At admission, her naso-oro-pharyngeal swab resulted positive for SARS-CoV-2. Due to hyperpyrexia and late preterm PROM, cesarean section was planned, and she was started on a 100 mg-bolus of hydrocortisone, followed by continuous infusion of 200 mg/24 h. A female neonate in good clinical condition and with a negative nasopharyngeal Covid-19 swab was delivered. On second postpartum day, the mother was in good condition and was switched to oral steroid therapy. On third postpartum day she worsened, with radiological signs of acute pulmonary embolism. Oro-tracheal intubation and mechanical ventilation were started, and she was switched back to intravenous steroid therapy. On April 30, pulmonary embolism was resolved, and on May 13th she was discharged in good condition. Conclusions We report the first case of Covid-19 acute infection that occurred in late-pregnancy in a woman with NCAH on chronic steroid replacement. The management of the patient in a reference center with early involvement of a multidisciplinary team granted prompt care and adequate protection for all the involved sanitary operators

Oropouche fever cases diagnosed in Italy in two epidemiologically non-related travellers from Cuba, late May to early June 2024

Oropouche fever is caused by Oropouche virus (OROV), transmitted primarily through the bite of infected midges, particularly of the genus Culicoides. The virus is mainly circulating in Central and South America where several countries reported an ongoing outbreak. We report here two imported cases of OROV infection identified in Italy, late May-early June 2024. These cases indicate that in the shadow of a massive dengue outbreak in the Americas, the Oropouche outbreak might be more widespread than previously estimated

Daylight entanglement-based quantum key distribution with a quantum dot source

Entanglement-based quantum key distribution can enable secure communication in trusted node-free networks and over long distances. Although implementations exist both in fiber and in free space, the latter approach is often considered challenging due to environmental factors. Here, we implement a quantum communication protocol during daytime for the first time using a quantum dot source. This technology presents advantages in terms of narrower spectral bandwidth-beneficial for filtering out sunlight-and negligible multiphoton emission at peak brightness. We demonstrate continuous operation over the course of three days, across an urban 270 m-long free-space optical link, under different light and weather conditions

Evaluation of pituitary function after infectious meningitis in childhood

Background: A number of studies of adults have shown that pituitary deficiencies can develop in a considerable proportion of subjects during the acute phase of meningitis or years after the infection has disappeared. The results of the very few studies of the impact of pediatric meningitis on hypothalamic-pituitary function are conflicting.Methods: In order to determine the incidence of pituitary dysfunction in children with central nervous system infection, we evaluated pituitary function and anthropometric parameters in 19 children with meningitis of different etiologies (15 males; mean age \ub1 standard deviation [SD] at pituitary evaluation, 5.9 \ub1 4.0\ua0years; mean time from the acute event \ub1 SD, 18 \ub1 10\ua0months).Results: All of the subjects had a normal stature and growth velocity for their age and gender, and none of them was obese. On the basis of Tanner's reference charts, 17 subjects (13 boys and all four girls) were pre-pubertal; two boys were in Tanner stage 2. None of the subjects had central hypothyroidism. All of the patients had normal serum of insulin growth factor (IGF)-I and prolactin. Their sex steroid and gonadotropin levels were concordant with their age and pubertal status. Early morning urine osmolality and serum electrolyte levels showed no signs of diabetes insipidus. All of the patients had normal plasma adrenocorticotropic hormone (ACTH) levels. Peak cortisol responses to the standard dose Synacthen test (SDST) were normal in all cases.Conclusions: The results showed that hypopituitarism following infectious meningitis appears to be infrequent in childhood and children's pituitary glands seem to be less vulnerable to damage than those of adults

Human <i>ITGAV </i>variants are associated with immune dysregulation, brain abnormalities, and colitis

Integrin heterodimers containing an Integrin alpha V subunit are essential for development and play critical roles in cell adhesion and signaling. We identified biallelic variants in the gene coding for Integrin alpha V (ITGAV) in three independent families (two patients and four fetuses) that either caused abnormal mRNA and the loss of functional protein or caused mistargeting of the integrin. This led to eye and brain abnormalities, inflammatory bowel disease, immune dysregulation, and other developmental issues. Mechanistically, the reduction of functional Integrin αV resulted in the dysregulation of several pathways including TGF-β-dependent signaling and αVβ3-regulated immune signaling. These effects were confirmed using immunostaining, RNA sequencing, and functional studies in patient-derived cells. The genetic deletion of itgav in zebrafish recapitulated patient phenotypes including retinal and brain defects and the loss of microglia in early development as well as colitis in juvenile zebrafish with reduced SMAD3 expression and transcriptional regulation. Taken together, the ITGAV variants identified in this report caused a previously unknown human disease characterized by brain and developmental defects in the case of complete loss-of-function and atopy, neurodevelopmental defects, and colitis in cases of incomplete loss-of-function.</p

Neurological manifestations of COVID-19 in adults and children

Different neurological manifestations of coronavirus disease 2019 (COVID-19) in adults and children and their impact have not been well characterized. We aimed to determine the prevalence of neurological manifestations and in-hospital complications among hospitalized COVID-19 patients and ascertain differences between adults and children. We conducted a prospective multicentre observational study using the International Severe Acute Respiratory and emerging Infection Consortium (ISARIC) cohort across 1507 sites worldwide from 30 January 2020 to 25 May 2021. Analyses of neurological manifestations and neurological complications considered unadjusted prevalence estimates for predefined patient subgroups, and adjusted estimates as a function of patient age and time of hospitalization using generalized linear models. Overall, 161 239 patients (158 267 adults; 2972 children) hospitalized with COVID-19 and assessed for neurological manifestations and complications were included. In adults and children, the most frequent neurological manifestations at admission were fatigue (adults: 37.4%; children: 20.4%), altered consciousness (20.9%; 6.8%), myalgia (16.9%; 7.6%), dysgeusia (7.4%; 1.9%), anosmia (6.0%; 2.2%) and seizure (1.1%; 5.2%). In adults, the most frequent in-hospital neurological complications were stroke (1.5%), seizure (1%) and CNS infection (0.2%). Each occurred more frequently in intensive care unit (ICU) than in non-ICU patients. In children, seizure was the only neurological complication to occur more frequently in ICU versus non-ICU (7.1% versus 2.3%, P &lt; 0.001). Stroke prevalence increased with increasing age, while CNS infection and seizure steadily decreased with age. There was a dramatic decrease in stroke over time during the pandemic. Hypertension, chronic neurological disease and the use of extracorporeal membrane oxygenation were associated with increased risk of stroke. Altered consciousness was associated with CNS infection, seizure and stroke. All in-hospital neurological complications were associated with increased odds of death. The likelihood of death rose with increasing age, especially after 25 years of age. In conclusion, adults and children have different neurological manifestations and in-hospital complications associated with COVID-19. Stroke risk increased with increasing age, while CNS infection and seizure risk decreased with age