African swine fever (ASF) continues to spread worldwide, and has reached multiple countries across Asia, the Caribbean, Europe, and the Pacific, representing a serious economic burden threatening pig health and welfare, as well as food security. The disease affects domestic pigs and wild boar, and in several European countries the disease is endemic in wild boars. The lack of vaccines or effective treatments highlights the importance of effective control measures used to keep domestic and feral pigs separated to prevent the spread of the virus. However, the study of the livestock-wildlife interface is quite complex and has many aspects to consider, including the uncertainty of wild-boar population data. In this study, we determined the risk of spread of the ASF virus at the interface between domestic pigs and wild boars using indicators that can indirectly indicate the presence of wild boars in order to target specific control measures in the highest risk areas. The results of the study were compared with those obtained by Pittiglio, in which the population data for wild boars was estimated using a geostatistical method and similar results were obtained. However, the present study used specific information relating to the wild-boar population and this allowed us to use fewer variables.

Abstract. Drought events are growingly affecting European and Italian territories, hampering local environments and biodiversity, such as the ones relying on rivers for their subsistence. Monitoring of rivers is becoming an important issue to face drought crisis and may be exploited with different tools. Among the most commons, satellite imagery is exploited to map water coverage, basing on optical or radar sources. This work proposes a combination of the two sensors to overcome possible limitations of the single dataset exploitation, reaching a reliable result. The methodology is applied to a stretch of Po River in Lombardy region (Italy). Through Google Earth Engine platform, optical satellite Sentinel-2 and radar satellite Sentinel-1 data are processed. The combination of the radar data and of the optical spectral indices is carried out through a pixel-based supervised classification, with a Random Forest classifier. Maps of water coverage are obtained, numerical outcomes of water surface evaluation are recorded and validated by the mean of reference hydrometric data. A multitemporal analysis is then reported, aiming to prove the efficiency of the procedure. All iterations show reliable accuracies and correlation among water surface estimation and water table measurements in two sections of interest. In perspective, the proposed methodology will be implemented in tools for supporting drought monitoring to be integrated in environmental public administration policies.

This exploratory research investigated the work of healthcare professionals during the COVID-19 pandemic, highlighting the major critical aspects, including healthcare providers’ needs as well as personal, professional, and social changes brought about by the pandemic upon both living and dying. In general, for many healthcare providers, the changes imposed by COVID-19 together with their inadequate training led to an excessive emotional load that caused high levels of stress and, consequently, the risk of burnout. In the present study, we wanted to investigate the impact of the COVID-19 pandemic on healthcare professionals and to explore if and how spirituality influenced their experience. We adopted a qualitative methodological design based on interpretative phenomenological analysis. The respondents were 15 healthcare professionals (12 general practitioners, 1 physician, and 2 nurses). This research was carried out in Italy during the first lockdown, that is, between March and September 2020. Following the analysis of participants’ experiences, four main themes were created: (1) critical issues in healthcare, critical incidents, and changes in the attitudes and habits of general practitioners during the pandemic; (2) emotional experiences and primary needs during the emergency; (3) dying during the pandemic and new psychological symptoms in noninfected patients; and (4) resilience and the role of spirituality. Since healthcare professionals, and general practitioners more specifically, were extensively exposed to the dying process and to changes in the end-of-life scenario, the support offered by palliative care is desirable, in terms of both the special skills that palliative physicians can provide and the presence of psychologists as well as through death education.

Effective response to a mass-casualty incident (MCI) entails the activation of hospital MCI plans. Unfortunately, there are no tools available in the literature to support hospital responders in predicting the proper level of MCI plan activation. This manuscript describes the scientific-based approach used to develop, test, and validate the PEMAAF score (Proximity, Event, Multitude, Overcrowding, Temporary Ward Reduction Capacity, Time Shift Slot [Prossimità, Evento, Moltitudine, Affollamento, Accorpamento, Fascia Oraria], a tool able to predict the required level of hospital MCI plan activation and to facilitate a coordinated activation of a multi-hospital network. Three study phases were performed within the Metropolitan City of Milan, Italy: (1) retrospective analysis of past MCI after action reports (AARs); (2) PEMAAF score development; and (3) PEMAAF score validation. The validation phase entailed a multi-step process including two retrospective analyses of past MCIs using the score, a focus group discussion (FGD), and a prospective simulation-based study. Sensitivity and specificity of the score were analyzed using a regression model, Spearman's Rho test, and receiver operating characteristic/ROC analysis curves. Results of the retrospective analysis and FGD were used to refine the PEMAAF score, which included six items-Proximity, Event, Multitude, Emergency Department (ED) Overcrowding, Temporary Ward Reduction Capacity, and Time Shift Slot-allowing for the identification of three priority levels (score of 5-6: green alert; score of 7-9: yellow alert; and score of 10-12: red alert). When prospectively analyzed, the PEMAAF score determined most frequent hospital MCI plan activation (>10) during night and holiday shifts, with a score of 11 being associated with a higher sensitivity system and a score of 12 with higher specificity. The PEMAAF score allowed for a balanced and adequately distributed response in case of MCI, prompting hospital MCI plan activation according to real needs, taking into consideration the whole hospital response network.

Non-structural risk mitigation tools such as civil protection alerts for citizens proves highly beneficial in minimizing the impacts linked to floods. Flood forecasting represents a challenge due to complex and non-linear hydrological processes involved, especially in highly urbanized areas. In this study, a Flood Warning System (FWS) based on the development of catchment-specific empirical Rainfall Thresholds (RTs) is proposed.Seven river catchments in the “Hydraulic node of Milan,” northern Italy, were analyzed using a dataset of 25 years (1998–2022) of hourly rainfall and discharge data.An empirical methodology, based only on historical rainfall-runoff data and applicable to any river catchment, is proposed with the aim to validate and improve the existing Rainfall Threshold (RT) defined on the same area by the Lombardy Region civil protection.The RTs obtained using the proposed method showed improvements with respect to the existing civil protection RTs, because it allows to derive time-continuous and catchment-specific RTs. Additionally, accounting for the Antecedent Moisture Conditions (AMC) with the proposed “equivalent rainfall” approach results in more accurate RTs, suggesting its consideration for issuing civil protection alerts. The accuracy and uncertainty of the RTs were analyzed by means of binary classification measures coupled with bootstrap resampling.The proposed procedure for constructing RTs, which is applicable to any river catchment having sufficiently long time series of rainfall and runoff data, and not necessarily on urban areas only, indicates potential for being an additional and simple FWS to mitigate flood risks for civil protection purposes.

Abstract Temferon is an ex vivo gene therapy consisting of autologous Hematopoietic Stem Progenitor Cells (HSPCs) genetically modified with a lentiviral vector to deliver IFN-α2 within the tumor microenvironment by Tie-2 expressing macrophages. TEM-GBM is an open-label, Phase I / IIa dose-escalation study evaluating safety and efficacy of Temferon in up to 27 newly diagnosed GBM patients with unmethylated MGMT (uMGMT). As of 30th April 2023, 19 GBM patients in 4 cohorts received incremental doses of Temferon and four are still alive after a median follow-up of 15 months. Six of the treated patients underwent a second surgical intervention at a median of 11 months after 1st surgery. For all patients, median overall survival (OS) and median progression free survival following first surgery reach 15 months and 9.8 months from diagnosis, respectively. The interim survival rate at 2 years in Temferon-treated patients is 28% (5 of 18 patients; 1 patient excluded as follow-up is below 1 year). OS and survival rate at 2 years of uMGMT patients treated as per the current standard of care (SOC) is 12.7 months and 14,8% respectively. One out of the surviving patients is alive 3 years after first surgery without second line therapy added up to 2 years. The other four patients with 2 year follow-up were treated with Gamma-Knife followed by bevacizumab (n = 1), regorafenib followed by bevacizumab (n = 1) and bevacizumab only (n = 2). Bevacizumab administration started 12 months after 1st surgery for one patient and 19 months for the other 2 patients at 5 mg/kg. These data corroborate the initial evidence on safety and tolerability of Temferon. They also suggest that Temferon has potential to counteract disease progression in patients affected by uMGMT GBM.

AbstractAs part of the Grand Paris Express project, the work package of Metro Line 15 South Lot T2C is situated near Villiers Sur Marne in the south‐eastern outskirts of Paris. It consists in two mechanized tunnels, principal as well as maintenance and storage site lines, respectively 4.7 and 2.2 km long, connected by a shaft approximately 180 m long (O807), 92 m of which is characterized by a traditional tunnel. This article presents the study carried out for the detailed design of the conventional tunnel which is excavated in the Calcaire de Champigny formation, a succession of layers with typical characteristics of a heavily fractured rock mass alternates with marly others, sometimes showing dissolution phenomena due to the presence of gypsum. Due to the urbanized context and the workface planning, a particular construction stage was also foreseen: the lower part of the section has been excavated by tunnel boring machine when the upper was finalized. The discussion is completed with the results of the monitoring activity, designed to check the correct behavior during and after the excavation process.

Abstract Background The third Sustainable Development Goal, specifically in target 3.3, identifies fighting HCV as a priority. It is estimated that in Italy more than 200.000 patients eligible for HCV treatment are not being treated and 20% are not aware of the infection. Lombardy region to promptly identify and treat patients affected, developed a screening program to be offered to all patients born between 1969 and 1989. Healthcare facilities were divided into first and second-level centers and the campaign was designed in 2 phases: at the first level centres patients were screened with blood tests, if positive they were contacted by second level structures to get a diagnostic test and if confirmed positive to start the therapeutic approach. Methods The screening program started in June 2022 and consisted of an opportunistic offer of free testing for serum anti-HCV antibodies in the context of any healthcare performance offered to eligible patients. Data were uploaded and collected on a web database from which second-level centers could obtain data of positive patients to contact them and set appointment for confirmation tests. Results As of 31st December 2022 120,193 individuals underwent HCV screening in 75 screening centers in Lombardy. The mean age was 44 years, 65.2% were females, and 83.7% were tested at outpatient blood collection centers. 604 (0.50%) patients tested positive with mean age 47 (±5). HCV-RNA was detectable in 125 out of 441 (28.3%) anti-HCV positive subjects with available HCV-RNA. Patients with active HCV infection were aged 46 (±6) and were mostly males (56.8%). Overall, the prevalence of active infection in the general population was 0.10% and was higher in elderly. Conclusions The prevalence of active HCV infection in the general population born between 1969 and 1989 in Lombardy was low. Considering the higher prevalence of active infection in the elderly population, an extension of the screening offer to patients born between 1949-70 could be evaluated. Key messages • Prevalence of active HCV infection in screened population is low. • Extending the screening offer may result in higher number of positive results and more people directed towards treatment.

The interplay between space and cognition is a crucial issue in Neuroscience leading to the development of multiple research fields. However, the relationship between architectural space and the movement of the inhabitants and their interactions has been too often neglected, failing to provide a unifying view of architecture's capacity to modulate social cognition broadly. We bridge this gap by requesting participants to judge avatars' emotional expression (high vs. low arousal) at the end of their promenade inside high- or low-arousing architectures. Stimuli were presented in virtual reality to ensure a dynamic, naturalistic experience. High-density electroencephalography (EEG) was recorded to assess the neural responses to the avatar's presentation. Observing highly aroused avatars increased Late Positive Potentials (LPP), in line with previous evidence. Strikingly, 250 ms before the occurrence of the LPP, P200 amplitude increased due to the experience of low-arousing architectures, reflecting an early greater attention during the processing of body expressions. In addition, participants stared longer at the avatar's head and judged the observed posture as more arousing. Source localization highlighted a contribution of the dorsal premotor cortex to both P200 and LPP. In conclusion, the immersive and dynamic architectural experience modulates human social cognition. In addition, the motor system plays a role in processing architecture and body expressions suggesting that the space and social cognition interplay is rooted in overlapping neural substrates. This study demonstrates that the manipulation of mere architectural space is sufficient to influence human social cognition.