Diagnostic Accuracy of Five Serologic Tests for Strongyloides stercoralis Infection

Background:The diagnosis of Strongyloides stercoralis (S. stercoralis) infection is hampered by the suboptimal sensitivity of fecal-based tests. Serological methods are believed to be more sensitive, although assessing their accuracy is difficult because of the lack of sensitivity of a fecal-based reference ("gold") standard.Methods:The sensitivity and specificity of 5 serologic tests for S. stercoralis (in-house IFAT, NIE-ELISA and NIE-LIPS and the commercially available Bordier-ELISA and IVD-ELISA) were assessed on 399 cryopreserved serum samples. Accuracy was measured using fecal results as the primary reference standard, but also using a composite reference standard (based on a combination of tests).Results:According to the latter standard, the most sensitive test was IFAT, with 94.6% sensitivity (91.2-96.9), followed by IVD-ELISA (92.3%, 87.7-96.9). The most specific test was NIE-LIPS, with specificity 99.6% (98.9-100), followed by IVD-ELISA (97.4%, 95.5-99.3). NIE-LIPS did not cross-react with any of the specimens from subjects with other parasitic infections. NIE-LIPS and the two commercial ELISAs approach 100% specificity at a cut off level that maintains ≥70% sensitivity.Conclusions:NIE-LIPS is the most accurate serologic test for the diagnosis of S. stercoralis infection. IFAT and each of the ELISA tests are sufficiently accurate, above a given cut off, for diagnosis, prevalence studies and inclusion in clinical trials.Fil: Bisoffi, Zeno. Sacro Cuore Hospital; ItaliaFil: Buonfrate, Dora. Sacro Cuore Hospital; ItaliaFil: Sequi, Marco. Istituto Di Ricerche Farmacologiche Mario Negri; ItaliaFil: Mejia, Rojelio. National Institute Of Allergy And Infectious Diseases; Estados UnidosFil: Cimino, Rubén Oscar. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Krolewiecki, Alejandro Javier. Universidad Nacional de Salta. Sede Regional Orán. Instituto de Investigación de Enfermedades Tropicales; Argentina. Consejo Nacional de Investigaciones Científicas y Técnicas; ArgentinaFil: Albonico, Marco. Sacro Cuore Hospital; ItaliaFil: Gobbo, Maria. Sacro Cuore Hospital; ItaliaFil: Bonafini, Stefania. Sacro Cuore Hospital; ItaliaFil: Angheben, Andrea. Sacro Cuore Hospital; ItaliaFil: Requena-Mendez, Ana. Universidad de Barcelona; EspañaFil: Muñoz, José. Universidad de Barcelona; EspañaFil: Nutman, Thomas B.. National Institute Of Allergy And Infectious Diseases; Estados Unido

Wide intra- and inter-country variability in drug use and dosage in very-low-birth-weight newborns with severe infections

Purpose: To describe the use of ciprofloxacin and fluconazole for the treatment of sepsis in European neonatal intensive care units (NICUs) in order to better orient research aimed at acquiring essential knowledge in this critical area. Methods: The survey consisted of an online questionnaire for all participating NICUs on treatment schemes employed, rationales behind drug choices and interest in participation in research involving the two drugs. Results: A total of 189 level II and III NICUs participated in the survey, representing 25 countries, with Italy, UK and France providing the greatest number of centres (54% of total). Ciprofloxacin is used in 25% of NICUs that responded, although the indications for administering it vary between centres and the dosage ranges vary considerably, with 25% of NICUs giving ≤10 mg/kg/day and another 25 % giving ≥21 mg/kg/day. Factors given as affecting the decision to use ciprofloxacin are uncertainty about its safety and pharmacokinetics and level of penetration in the cerebrospinal fluid. Among the 70% of responding units that use fluconazole to treat fungal infection, 45% administer 6 mg/kg unit doses while 33% administer 12 mg/kg; 41% of NICUs use a 24-h interval between administrations while 20% wait 72h. Among the responding NICUs, 57% were willing to participate in a project on ciprofloxacin and 59% would consider participating in a randomized controlled trial evaluating fluconazole versus micafungin. Conclusions: Great variability in therapies exists within and between countries. Numerous centres are interested in participating in research on these drugs, highlighting the need for further knowledge on sepsis treatment and European centres’ interest in off-patent medicine research

Computer programs for the solution of systems of linear algebraic equations

FORTRAN subprograms for the solution of systems of linear algebraic equations are described, listed, and evaluated in this report. Procedures considered are direct solution, iteration, and matrix inversion. Both incore methods and those which utilize auxiliary data storage devices are considered. Some of the subroutines evaluated require the entire coefficient matrix to be in core, whereas others account for banding or sparceness of the system. General recommendations relative to equation solving are made, and on the basis of tests, specific subprograms are recommended

Using soil organic matter fractions as indicators of soil physical quality

The objective of this study was to evaluate the use of chemical and physical fractions of soil organic matter (SOM), rather than SOM per se, as indicators of soil physical quality (SPQ) based on their effect on aggregate stability (AS). Chemically extracted humic and fulvic acids (HA and FA) were used as chemical fractions, and heavy and light fractions (HF and LF) obtained by density separation as physical fractions. The analyses were conducted on medium-textured soils from tropical and temperate regions under cropland and pasture. Results show that soil organic carbon (SOC), SOM fractions and AS appear to be affected by land use regardless of the origin of the soils. A general separation of structurally stable and unstable soils between samples of large and small SOC content, respectively, was observed. SOM fractions did not show a better relationship with AS than SOC per se. In both geographical regions, soils under cropland showed the smallest content of SOC, HA and carbon concentration in LF and HF, and the largest HF/LF ratio (proportion of the HF and LF in percent by mass of bulk soil). With significant associations between AS and SOC content (0.79**), FA/SOC (r = -0.83**), HA/FA (r = 0.58**), carbon concentration of LF (r = 0.69**) and HF (r = 0.70**) and HF/LF ratio (r = 0.80**), cropland showed lowest AS. These associations indicate that SOM fractions provide information about differences in SOM quality in relation to AS and SPQ of soils from tropical and temperate regions under cropland and pasture

Accuracy of Five Serologic Tests for the Follow up of Strongyloides stercoralis Infection

BACKGROUND: Traditional faecal-based methods have poor sensitivity for the detection of S. stercoralis, therefore are inadequate for post-treatment evaluation of infected patients who should be carefully monitored to exclude the persistence of the infection. In a previous study, we demonstrated high accuracy of five serology tests for the screening and diagnosis of strongyloidiasis. Aim of this study is to evaluate the performance of the same five tests for the follow up of patients infected with S. stercoralis. METHODS: Retrospective study on anonymized, cryo-preserved samples available at the Centre for Tropical Diseases (Negrar, Verona, Italy). Samples were collected before and from 3 to 12 months after treatment. The samples were tested with two commercially-available ELISA tests (IVD, Bordier), two techniques based on a recombinant antigen (NIE-ELISA and NIE-LIPS) and one in-house IFAT. The results of each test were evaluated both in relation to the results of fecal examination and to those of a composite reference standard (classifying as positive a sample with positive stools and/or at least three positive serology tests). The associations between the independent variables age and time and the dependent variable value of serological test (for all five tests), were analyzed by linear mixed-effects regression model. RESULTS: A high proportion of samples demonstrated for each test a seroreversion or a relevant decline (optical density/relative light units halved or decrease of at least two titers for IFAT) at follow up, results confirmed by the linear mixed effects model that showed a trend to seroreversion over time for all tests. In particular, IVD-ELISA (almost 90% samples demonstrated relevant decline) and IFAT (almost 87%) had the best performance. Considering only samples with a complete negativization, NIE-ELISA showed the best performance (72.5% seroreversion). CONCLUSIONS: Serology is useful for the follow up of patients infected with S. stercoralis and determining test of cure

¿Qué otra cosa puede ser la infancia? : Deserciones desde un encuentro con la idea filosófica de infancia de Walter Kohan

¿Qué otra cosa puede ser la infancia? Si la infancia se construye desde el lenguaje, correspondiéndole muchas acepciones, sin poder ser atrapada ni señalada con precisión ¿qué otras figuras de la infancia podemos encontrar en un ámbito educativo? ¿Qué otras representaciones podemos contraponer a lo que comúnmente se entiende por infancia: “primera etapa de la vida humana”? Más allá de esta imagen dominante ¿qué otras figuraciones se abren camino y nos habilitan a pensar de manera distinta y novedosa lo que creemos conocer sobre la infancia? La propuesta del presente trabajo consistirá en recorrer infantilmente un territorio de infancia, tomando como trampolín la idea filosófica de infancia de Walter Kohan. Una idea en movimiento, que se desplaza entre diálogos y encuentros. Una idea que nos afecta, invitándonos a re-pensar la infancia, más allá de una mirada cronológica, como interrupción, potencia y posibilidad (Kohan, 2007)Facultad de Humanidades y Ciencias de la Educació

¿Qué otra cosa puede ser la infancia? : Deserciones desde un encuentro con la idea filosófica de infancia de Walter Kohan

¿Qué otra cosa puede ser la infancia? Si la infancia se construye desde el lenguaje, correspondiéndole muchas acepciones, sin poder ser atrapada ni señalada con precisión ¿qué otras figuras de la infancia podemos encontrar en un ámbito educativo? ¿Qué otras representaciones podemos contraponer a lo que comúnmente se entiende por infancia: “primera etapa de la vida humana”? Más allá de esta imagen dominante ¿qué otras figuraciones se abren camino y nos habilitan a pensar de manera distinta y novedosa lo que creemos conocer sobre la infancia? La propuesta del presente trabajo consistirá en recorrer infantilmente un territorio de infancia, tomando como trampolín la idea filosófica de infancia de Walter Kohan. Una idea en movimiento, que se desplaza entre diálogos y encuentros. Una idea que nos afecta, invitándonos a re-pensar la infancia, más allá de una mirada cronológica, como interrupción, potencia y posibilidad (Kohan, 2007)Especialista en Nuevas Infancias y JuventudesUniversidad Nacional de La PlataFacultad de Humanidades y Ciencias de la Educació

Studies on coffee roasting process by means of nuclear magnetic resonance spectroscopy

The chemical composition of coffee has been widely investigated, focusing the attention both on main components and trace compounds. Most of these studies have been performed by using liquid and gas chromatography, eventually combined with mass spectroscometry. These techniques, although straight and effective, are time demanding due to the sample pretreatments. Here, we propose high-resolution-magic-angle spinning nuclear magnetic resonance spectroscopy (HR-MAS NMR), a system capable of acquiring highly resolved NMR spectra of gel-like and suspension samples. This approach allowed us to determine the chemical composition of coarsely ground coffee beans of two varieties: Arabica and Robusta. Variation of the concentration of relevant species was monitored as a function of roasting temperature, from green beans to completely roasted. The HR-MAS NMR tool demonstrated to be very powerful for quick chemical composition determination, opening up possibilities for novel applications of this approach in food quality control

Mobile Emergency, an Emergency Support System for Hospitals in Mobile Devices: Pilot Study

BACKGROUND: Hospitals are vulnerable to natural disasters, man-made disasters, and mass causalities events. Within a short time, hospitals must provide care to large numbers of casualties in any damaged infrastructure, despite great personnel risk, inadequate communications, and limited resources. Communications are one of the most common challenges and drawbacks during in-hospital emergencies. Emergency difficulties in communicating with personnel and other agencies are mentioned in literature. At the moment of emergency inception and in the earliest emergency phases, the data regarding the true nature of the incidents are often inaccurate. The real needs and conditions are not yet clear, hospital personnel are neither efficiently coordinated nor informed on the real available resources. Information and communication technology solutions in health care turned out to have a great positive impact both on daily working practice and situations. OBJECTIVE: The objective of this paper was to find a solution that addresses the aspects of communicating among medical personnel, formalizing the modalities and protocols and the information to guide the medical personnel during emergency conditions with a support of a Central Station (command center) to cope with emergency management and best practice network to produce and distribute intelligent content made available in the mobile devices of the medical personnel. The aim was to reduce the time needed to react and to cope with emergency organization, while facilitating communications. METHODS: The solution has been realized by formalizing the scenarios, extracting, and identifying the requirements by using formal methods based on unified modeling language (UML). The system and was developed using mobile programming under iOS Apple and PHP: Hypertext Preprocessor My Structured Query Language (PHP MySQL). Formal questionnaires and time sheets were used for testing and validation, and a control group was used in order to estimate the reduction of time needed to cope with emergency cases. First, we have tested the usability and the functionalities of the solution proposed, then a real trial was performed to assess the reduction in communication time and the efficiency of the solution with respect to a case without Mobile Emergency tools. RESULTS: The solution was based on the development of a mobile emergency application and corresponding server device to cope with emergencies and facilitate all the related activities and communications, such as marking the position, contacting people, and recovering the exits information. The solution has been successfully tested within the Careggi Hospital, the largest medical infrastructure in Florence and Tuscany area in Italy, thus demonstrating the validity of the identified modalities, procedures, and the reduction in the time needed to cope with the emergency conditions. The trial was not registered as the test was conducted in realistic but simulated emergency conditions. CONCLUSIONS: By analyzing the requirements for developing a mobile app, and specifically the functionalities, codes, and design of the Mobile Emergency app, we have revealed the real advantages of using mobile emergency solutions compared to other more traditional solutions to effectively handle emergency situations in hospital settings

Sexual-sparing radical cystectomy in the robot-assisted era. A review on functional and oncological outcomes

Background/Objectives: Radical cystectomy (RC) is the standard treatment for muscle-invasive and high-risk non-muscle-invasive bladder cancer, but it often results in significant functional impairments, including sexual and urinary dysfunction, adversely affecting quality of life (QoL). Sexual-sparing robotic-assisted radical cystectomy (RARC) has been introduced to mitigate these effects. This review evaluates the oncological and functional outcomes of sexual-sparing RARC in male and female patients. Methods: A systematic literature search identified 15 studies including 793 patients who underwent sexual-sparing RARC using techniques such as nerve-sparing, capsule-sparing, and pelvic organ-preserving approaches. Data on oncological and functional outcomes were analyzed. Results: Sexual-sparing RARC achieves oncological outcomes comparable to open RC, with negative surgical margin (NSM) rates exceeding 95% in most studies. RFS and CSS rates were robust, often surpassing 85% at intermediate follow-ups. Functional outcomes were also favorable, with continence rates exceeding 90% and erectile function recovery surpassing 70% in well-selected male patients. Female patients undergoing pelvic organ-preserving techniques demonstrated improved continence, preserved sexual function, and enhanced QoL. Patient selection emerged as critical, favoring those with organ-confined disease and good baseline function. Conclusions: Sexual-sparing RARC offers a promising balance between oncological control and functional preservation, making it an effective option for selected patients. Further research is needed to refine techniques and establish standardized protocols for broader adoption