Several circulating Bacillus anthracis strains isolated in Italy and belonging to the A1.a cluster, genotype 3 (A1.a-3) are genotypically indistinguishable from Carbosap, a live attenuated vaccine ...strain, containing both pXO1 and pXO2 plasmids. The genotype was assessed by using eight-locus multilocus variable-number tandem repeat analysis. We describe here the use of a ninth locus able to explore variability among strains that have the same genotype. It is important to be able to genotype the wild isolate of B. anthracis strains from outbreaks of anthrax in areas where Carbosap vaccination of cattle and sheep is common practice. A total of 27 representative field strains isolated in Italy and four vaccinal strains, namely, Carbosap, Sterne, Pasteur I, and Pasteur II, were characterized by a ninth marker, called pXO2-A. Twenty-three field strains were genotype 3 and therefore identical to Carbosap. The marker was in the pXO2 plasmid and is based on the polymorphism of the already-known VX2-3 locus. Detection was obtained by PCR with fluorescence-labeled forward primers in order to produce appropriate fragments for capillary electrophoresis with an ABI 310 genetic analyzer. Genetic relationships showed heterogeneity in all of the examined samples. Interestingly, with respect to genotype 3, samples grouped into eight different subtypes, A to H, and the subtype G, had only two samples indistinguishable from Carbosap. The results of the present study confirm the validity of a hierarchical progressive protocol for discrimination among closely related isolates.
An analysis of solar neutrino data from the fourth phase of Super-Kamiokande (SK-IV) from October 2008 to May 2018 is performed and the results are presented. The observation time of the dataset of ...SK-IV corresponds to 2970 days and the total live time for all four phases is 5805 days. For more precise solar neutrino measurements, several improvements are applied in this analysis: lowering the data acquisition threshold in May 2015, further reduction of the spallation background using neutron clustering events, precise energy reconstruction considering the time variation of the PMT gain. The observed number of solar neutrino events in 3.49–19.49 MeV electron kinetic energy region during SK-IV is 65,443 − 388 + 390 ( stat . ) ± 925 ( syst . ) events. Corresponding B 8 solar neutrino flux is ( 2.314 ± 0.014 ( stat . ) ± 0.040 ( syst . ) ) × 10 6 cm − 2 s − 1 , assuming a pure electron-neutrino flavor component without neutrino oscillations. The flux combined with all SK phases up to SK-IV is ( 2.336 ± 0.011 ( stat . ) ± 0.043 ( syst . ) ) × 10 6 cm − 2 s − 1 . Based on the neutrino oscillation analysis from all solar experiments, including the SK 5805 days dataset, the best-fit neutrino oscillation parameters are sin 2 θ 12 , solar = 0.306 ± 0.013 and Δ m 21 , solar 2 = ( 6.1 0 − 0.81 + 0.95 ) × 10 − 5 eV 2 , with a deviation of about 1.5 σ from the Δ m 21 2 parameter obtained by KamLAND. The best-fit neutrino oscillation parameters obtained from all solar experiments and KamLAND are sin 2 θ 12 , global = 0.307 ± 0.012 and Δ m 21 , global 2 = ( 7.5 0 − 0.18 + 0.19 ) × 10 − 5 eV 2 . Published by the American Physical Society 2024
Abstract Among multimessenger observations of the next Galactic core-collapse supernova, Super-Kamiokande (SK) plays a critical role in detecting the emitted supernova neutrinos, determining the ...direction to the supernova (SN), and notifying the astronomical community of these observations in advance of the optical signal. In 2022, SK has increased the gadolinium dissolved in its water target (SK-Gd) and has achieved a Gd concentration of 0.033%, resulting in enhanced neutron detection capability, which in turn enables more accurate determination of the supernova direction. Accordingly, SK-Gd’s real-time supernova monitoring system has been upgraded. SK_SN Notice, a warning system that works together with this monitoring system, was released on 2021 December 13, and is available through GCN Notices. When the monitoring system detects an SN-like burst of events, SK_SN Notice will automatically distribute an alarm with the reconstructed direction to the supernova candidate within a few minutes. In this paper, we present a systematic study of SK-Gd’s response to a simulated Galactic SN. Assuming a supernova situated at 10 kpc, neutrino fluxes from six supernova models are used to characterize SK-Gd’s pointing accuracy using the same tools as the online monitoring system. The pointing accuracy is found to vary from 3° to 7° depending on the models. However, if the supernova is closer than 10 kpc, SK_SN Notice can issue an alarm with three-degree accuracy, which will benefit follow-up observations by optical telescopes with large fields of view.
A compactação do solo desencadeia problemas ambientais e agronômicos como erosão, lixiviação e baixa produtividade. O penetrômetro é o instrumento que mede a resistência da introdução de uma haste de ...ponta cônica no solo; teoricamente, solos mais compactados oferecem maior resistência. Há uma variedade de modelos de penetrômetro no mercado e literatura: bancada ou campo, manual ou automático, estático (penetrógrafo) ou dinâmico (de impacto), com ou sem registro eletrônico de dados etc. Naturalmente, surge a dúvida se é possível comparar dados de penetrômetros diferentes. Nesse trabalho, comparou-se três modelos de penetrômetros (de impacto, manual e automático). O experimento foi realizado em um latossolo vermelho eutroférrico de textura argilosa no município de Pirassununga-SP. A resistência mecânica a penetração foi avaliada simultaneamente pelos três penetrômetros em um perfil de oito camadas com variações de 0,05 m entre 0 e 0,40 m. A resistência variou inversamente com a umidade do solo nos três, podendo concluir assim, que é seguro comparar valores de resistência de penetrômetros diferentes, desde que os dados tenham sido coletados sob as mesmas condições de umidade do solo.
Abstract
Background
Pepper mild mottle virus (PMMoV), a plant virus belonging to Virgoviridae, has recently been suggested as a potential viral indicator for faecal pollution in aquatic environments, ...since it has been found to be abundantly excreted from healthy human subjects.
Methods
The occurrence, amount and diversity of PMMoV was investigated in water environments by nested RT-PCR and TaqMan based quantitative PCR. During 2017-2019, 251 water samples (92 urban wastewaters, 32 treated effluents, 16 surface water samples, 9 estuarine samples, 20 seawater samples, 67 groundwater samples, and 15 drinking waters) were analysed.
Results
PMMoV was detected in 73/92 (79%) wastewater samples, 22/32 (69%) treated sewages, 11/16 (69%) river samples, 6/9 (67%) estuarine samples, 5/20 (25%) bathing waters, and 9/67 (13%) groundwaters, whilst drinking water samples tested always negative. Mean viral concentrations (genome copies/L) were: raw sewage 4.2 × 106, treated sewage 7.4 × 105, river 3.2 × 103, estuarine waters 9.6 × 102, seawaters 3.0 × 102, groundwaters 7.7 × 101.
Conclusions
This study highlights the significant occurrence of PMMoV in aquatic environment in Italy, and a clear gradient of viral prevalence and concentrations from polluted to clean waters (wastewaters to drinking waters).
Key messages
PMMoV is ubiquitous throughout the water cycle in Italy with different concentrations. Studies are needed to evaluate the suitability of PMMoV as a viral indicator for human fecal pollution in waters.
Resumo Fundamento Apesar da necessidade de opções terapêuticas específicas para a doença do coronavírus 2019 (covid-19), ainda não há evidências da eficácia de tratamentos específicos no contexto ...ambulatorial. Há poucos estudos randomizados que avaliam a hidroxicloroquina (HCQ) em pacientes não hospitalizados. Esses estudos não indicaram benefício com o uso da HCQ; no entanto, avaliaram desfechos primários diferentes e apresentaram vieses importantes na avaliação dos desfechos. Objetivo Investigar se a HCQ possui o potencial de prevenir hospitalizações por covid-19 quando comparada ao placebo correspondente. Métodos O estudo COVID-19 Outpatient Prevention Evaluation (COPE) é um ensaio clínico randomizado, pragmático, duplo-cego, multicêntrico e controlado por placebo que avalia o uso da HCQ (800 mg no dia 1 e 400 mg do dia 2 ao dia 7) ou placebo correspondente na prevenção de hospitalizações por covid-19 em casos precoces confirmados ou suspeitos de pacientes não hospitalizados. Os critérios de inclusão são adultos (≥ 18 anos) que procuraram atendimento médico com sintomas leves de covid-19, com randomização ≤ 7 dias após o início dos sintomas, sem indicação de hospitalização na triagem do estudo e com pelo menos um fator de risco para complicações (> 65 anos, hipertensão, diabetes melito, asma, doença pulmonar obstrutiva crônica ou outras doenças pulmonares crônicas, tabagismo, imunossupressão ou obesidade). Todos os testes de hipótese serão bilaterais. Um valor de p < 0,05 será considerado estatisticamente significativo em todas as análises. Clinicaltrials.gov: NCT04466540. Resultados Os desfechos clínicos serão avaliados centralmente por um comitê de eventos clínicos independente cegado para a alocação dos grupos de tratamento. O desfecho primário de eficácia será avaliado de acordo com o princípio da intenção de tratar. Conclusão Este estudo apresenta o potencial de responder de forma confiável a questão científica do uso da HCQ em pacientes ambulatoriais com covid-19. Do nosso conhecimento, este é o maior estudo avaliando o uso de HCQ em indivíduos com covid-19 não hospitalizados.
Abstract
Aims
To investigate the prevalence of high bleeding risk (HBR) criteria and compare clinical outcomes between HBR and non–HBR patients receiving cangrelor in the peri–percutaneous coronary ...intervention (PCI) phase.
Methods
Consecutive patients treated with cangrelor in 7 Italian institutions were retrospectively enrolled in the ICARUS (“Intravenous CAngrelor in high–bleeding Risk patients Undergoing percutaneouS coronary intervention”, NCT05505591) registry. HBR status was assessed according to the Academic Research Consortium (ARC–HBR) definition. The primary endpoint was net adverse clinical events (NACE), defined as a composite of cardiovascular death, myocardial infarction, stroke, definite or probable stent thrombosis and Bleeding Academic Research Consortium (BARC) 2, 3 or 5 bleeding, at 48 hours. Secondary endpoints were assessed at 48 hours and throughout the hospital stay.
Results
We enrolled 551 patients undergoing PCI with cangrelor between January 2019 and August 2022. HBR definition was met in 33% of cases. HBR patients were older (76±10 vs. 63±10 years, p<0.001), more frequently affected by peripheral arterial disease (16% vs. 8%, p=0.010), atrial fibrillation (24% vs. 2%, p<0.001), chronic kidney disease (35% vs. 3%, p<0.001), active cancer (7% vs. 0%, p<0.001) and heart failure (17% vs. 7%, p<0.001). At 48 hours, HBR patients had a significantly higher rate of NACE (13% vs. 6%, p=0.004), and BARC 2, 3 or 5 bleeding (12% vs. 4%, p=0.001). In the HBR group, the frequency of the primary endpoint increased proportionally to the HBR score. There was no significant difference with respect to other 48–hour and in–hospital endpoints.
Conclusions
Among consecutive patients treated with cangrelor in the peri–PCI phase, about 30% fulfilled the ARC–HBR definition. In the HBR subpopulation, the incidence of 48–hour adverse events was higher than in the non–HBR subgroup, primarily driven by a higher rate of clinically relevant and major bleeding.
Abstract
Aims
To assess the clinical characteristics and compare in–hospital outcomes of elderly and non–elderly patients receiving cangrelor in the peri–percutaneous coronary intervention (PCI) ...phase.
Methods
Consecutive patients treated with cangrelor in 7 Italian institutions were retrospectively enrolled in the ICARUS (“Intravenous CAngrelor in high–bleeding Risk patients Undergoing percutaneouS coronary intervention”, NCT05505591) registry. Elderly patients were defined if age was ≥75 years at the time of PCI. The primary endpoint was net adverse clinical events (NACE), defined as a composite of cardiovascular death, myocardial infarction, stroke, definite or probable stent thrombosis and Bleeding Academic Research Consortium (BARC) 2, 3 or 5 bleeding, at 48 hours. Secondary endpoints were assessed at 48 hours and throughout the hospital stay. Independent predictors of the primary endpoint were also assessed.
Results
Out of 551 patients undergoing PCI with cangrelor between January 2019 and August 2022, 174 (32%) were elderly. Mean age was 81±5 vs. 61±8 years in elderly vs. non–elderly patients (p<0.001). Female sex (32% vs. 21%, p=0.006), atrial fibrillation (20% vs. 5%, p<0.001), chronic kidney disease (30% vs. 6%, p<0.001) and heart failure (14% vs. 8%, p=0.041) were more frequent in the elderly group, whereas presentation with acute coronary syndrome (ACS) was less frequent (69% vs. 83%, p=0.001). Elderly patients received shorter cangrelor infusion (122±25 vs. 134±43 minutes, p=0.001) and were more frequently administered with clopidogrel after PCI (50% vs. 19%, p<0.001). At 48 hours, elderly patients had higher rates of NACE (13% vs. 6%, p=0.006) and BARC 2, 3 or 5 bleeding (11% vs. 5%, p=0.013), whereas the rates of other 48–hour and in–hospital clinical endpoints did not differ. At multivariable analysis, age ≥75 years (odds ratio OR 1.07, 95% CI 1.02–1.12, p=0.004), major anemia (OR 1.10, 95% CI 1.005–1.22, p=0.038), ACS at presentation (OR 1.08, 95% CI 1.03–1.14), femoral access (OR 1.13, 95% CI 1.06–1.22) and cardiogenic shock (OR 1.35, 95% CI 1.21–1.50) independently predicted the occurrence of 48–hour NACE.
Conclusions
Advanced age is a distinctive risk feature among patients receiving intravenous cangrelor in the peri–PCI phase. Elderly patients had higher rates of adverse events at 48 hours, with advanced age (≥75 years) being an independent predictor of NACE.
Abstract
Aims
To compare the clinical characteristics and in–hospital outcomes of patients undergoing complex vs. non–complex percutaneous coronary intervention (PCI) with peri–procedural use of ...cangrelor.
Methods
Consecutive patients treated with cangrelor in 6 Italian institutions were retrospectively enrolled in the ICARUS (“Intravenous CAngrelor in high–bleeding Risk patients Undergoing percutaneouS coronary intervention”, NCT05505591) registry. Complex PCI was defined as any of the following: 3 vessels treated, ≥3 stents implanted, ≥3 lesions treated, bifurcation with 2 stents implanted, total stent length >60 mm, or chronic total occlusion. The primary endpoint was net adverse clinical events (NACE), defined as a composite of cardiovascular death, myocardial infarction, stroke, definite or probable stent thrombosis and Bleeding Academic Research Consortium (BARC) 2, 3 or 5 bleeding, at 48 hours. Secondary endpoints were assessed at 48 hours and throughout the hospital stay.
Results
Among 551 patients enrolled in the ICARUS registry and undergoing PCI between January 2019 and August 2022, a total of 534 (97%) patients had complete information on PCI complexity, of whom 173 (32%) underwent complex PCI and 361 (68%) underwent non–complex PCI. In general, patients with complex PCI had similar clinical features compared with non–complex PCI patients, including comparable prevalence of high bleeding risk (HBR) status according to the ARC–HBR definition (35% vs. 30%, p=0.253), but complex PCI patients presented more often with cardiogenic shock (9% vs. 2%, p<0.001). PCI with ≥3 stents implanted was the most frequent criterion of procedural complexity (62%). The incidence of the primary endpoint of 48–hour NACE (10% vs. 7%, p=0.264) and other clinical endpoints occurring at 48 hours or during hospitalization did not differ between complex and non–complex PCI patients.
Conclusions
Among patients receiving peri–procedural cangrelor, about 30% of cases underwent complex interventions. Notwithstanding higher procedural complexity, short–term clinical outcomes were similar between complex and non–complex PCI patients.
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