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Objectives: The aim of this study was to assess sleep quality in people living with HIV (PLWH), and to examine how the sleep sphere interacts with mental health, quality of life and internalized stigma. Methods: A total of 250 PLWH were consecutively enrolled during routine outpatient visits. Each participant completed a 67-item questionnaire. Sleep disturbances were measured using the Pittsburgh Sleep Quality Index (PSQI). The Depression, Anxiety and Stress Scale (DASS-21) was used to measure the mental health status. The Short Form 12 (SF-12) questionnaire was used to measure participants’ quality of life. Internalized HIV-related stigma was evaluated using the modified six-item internalized AIDS-related stigma scale. Results: Many of the PLWH were male (69.2%) and the time between HIV diagnosis and first antiretroviral therapy (ART) was over 10 years (69.2% and 64%, respectively). The PSQI component most-cited as problematic by PLWH was habitual sleep efficiency (52.4%). In multivariate analysis models, a higher mean in the PSQI total score was significantly associated with internalized stigma (mean change 1.10), depression (mean change 6. 20), anxiety (mean change 12.15), stress (mean change 6.24), physical (mean change 7.54) and mental (mean change 3.56) quality of life, health status (mean change −6.04), ART adherence (mean change −5.08) and physical activity (mean change −6.20). Conclusions: Our results confirm the role of sleep quality in both mental and physical health and suggest that sleep disorders might also be a significant indicator of psychosocial challenges faced by PLWH.

Background Long-acting Cabotegravir and Rilpivirine (LA CAB + RPV) shows potential advantages in heavily comorbid and even in viremic people with HIV (PWH). We assessed LA CAB + RPV durability in a cohort of PWH with a high comorbidity burden and adherence issues. Methods Retrospective observational study in two Italian outpatient settings enrolling PWH who switched to LA CAB + RPV from February 2021 to January 2024 in presence of exclusion criteria enlisted in registrational trials or with other worrisome clinical risks. Kaplan-Meier (KM) was used to assess the probability of CAB/RPV discontinuation. Cox regression analysis was used to evaluate potential predictors of discontinuation. Results We enrolled 74 PWH, with a median of 7 injections (IQR 5–9), a median age of 53 years (IQR 45–61), median time of exposure to antiretrovirals of 11 years (IQR 8–18) and median time from HIV diagnosis of 11.8 years (IQR 6.6–18.2). Eleven (14.9%) discontinued LA CAB + RPV mainly for injection-site pain. Of 53 PWH who were undetectable before switch, 37 maintained viral suppression at week 52. We registered only one virological failure at week 12. Twenty-one started injections with unsuppressed viral loads (median 66 cps/ml, IQR 40–215) and 10 (47.6%) achieved viral suppression. Overall probability of discontinuation was 14.9% at week 52. Younger age was protective against discontinuation (HR 0.93, 95%CI 0.88–0.99, p  = 0.048). Conclusions Our results support the potential advantages in using LA CAB + RPV in PWH with adherence issues and comorbidities.

Thanks to the modern ARV regimens and the fact that the morbidity and mortality of metabolic syndrome increases with age, clinicians are continuously researching effective and safe antiretroviral regimens with low impact on the lipid profile. Doravirine (DOR) is the latest non-nucleoside reverse-transcriptase inhibitor (NNRTI) that shows long-term safety and tolerability and a favorable lipid profile. The aim of this study is to assess the impact of DOR-based three-drug regimens on the lipid profile in clinical practice. We retrospectively analyzed a cohort of 38 treatment-experienced, virologically suppressed people living with HIV (PLWH) switching to this regimen, following the eligibility criteria. We carried out comparison analysis of immunological and metabolic parameters between baseline and 48 weeks of follow up. In our cohort of treatment-experienced, virologically suppressed PLWH, three-drug regimens with DOR showed good efficacy and a positive profile on lipid metabolism at 48 weeks of follow up.

High incidence mpox rates suggest asymptomatic individuals may contribute to virus transmission. We undertook this study to assess the seroprevalence of IgG anti-MPXV in a cohort of asymptomatic PLWH, to analyze the size of the phenomenon of asymptomatic infections. From October 2022 to March 2023 we serially collected serum samples from PLWH attending our Clinic. IgG against MPXV have been assessed on stored cryopreserved samples with an ELISA. Only people with no previous reported vaccine against smallpox or mpox nor previous clinical manifestations consistent with a mpox diagnosis were included. 285 PLWH were included. Twenty-one participants tested positive for IgG anti MPXV (7.37 %, 95 % CI 4.62–11.0). Seropositivity was predominant in male (15/285, 71.4) with a small fraction of female (6/285,28.6 %) and PWID (1/285,4.8 %). Our findings suggest the possibility of an asymptomatic course of the mpox infection even in populations beyond traditional high-risk groups.

Echinococcal disease (hydatid disease (HD) is an endemic parasitosis caused by Echinococcus granulosus in the larval stage, and it is typically due to the production of unilocular cystic lesions, usually involving the liver for the majority of patients and the lungs in 25%, but also any other organs can be potentially involved in developing echinococcal disease. We report a case of extrahepatic, retroperitoneal echinococcal disease, caused by Echinococcus granulosus . The patient underwent a surgical removal of the abdominal mass, revealed by abdominal ultrasound and computerized tomography scanning, and in the founded clinical and radiological suspicion of echinococcal disease, multiple bioptical samples were sent for microbiological analysis and albendazole therapy was started ; Echinococcus granulosus protoscolices were found on the bioptical sample, and the diagnosis was successfully confirmed. According to the current parasitology literature on echinococcal disease, extrahepatic localization, although rare, can be found, and it should be considered in the differential diagnosis of an abdominal mass when epidemiological risk factors and anamnestic data are present, regardless of the usual site of the disease.

Background Oxidative stress (OS) is the imbalance between oxidant and antioxidant molecules, in favour of oxidants, that has been associated with an increased risk of morbidity and mortality in ART-treated people living with HIV (PLWH). We aimed to assess factors associated with OS in virologically suppressed PLWH on long-term modern ART. Method In this cross-sectional study we evaluated OS by measuring both the levels of derivatives-reactive oxygen metabolites (d-ROMs) and the biological antioxidant potential (BAP). We also calculated the BAP/d-ROMs ratio, (OS index, OSi); a cut-off value < 7.3 indicated OS. Factors associated with OS markers were explored by linear regression model. Results We enrolled 299 experienced PLWH with virological suppression (HIV-RNA < 50cps/mL). The mean of the d-ROMs levels was 409 UCARR (95%CI 394–422), whereas the mean of the BAP levels was 1.809 µmol/L (95%CI 1706–1851). The OSi mean value was 4.84, and 91.6% of the participants were below the cut-off value. By regression analysis, higher production of oxidants was associated with female sex ( p  < 0.001), current exposition to PIs ( p  = 0.030) and HCV co-infection ( p  = 0.006). Higher antioxidant capacity was correlated with higher HDL levels ( p  = 0.001). A lower OSi was associated with female sex ( p  = 0.003) and the current use of triple vs. dual regimen ( p  = 0.036). The OSi correlated negatively with cholesterol levels ( p  = 0.002) and positively with HDL ( p  < 0.001). Conclusions Virologically suppressed PLWH on long-term ART showed a marked OS. Female sex, the exposure to PIs, and HCV co-infection were associated with higher oxidants, while higher HDL levels were linked to better antioxidant capacity. Interestingly, dual therapy, especially INSTI-based regimens, was associated with lower oxidative stress compared to triple therapy.

Global warming has facilitated the spread of mosquito-borne diseases, including dengue, to non-endemic areas like Italy. People living with HIV (PLWH) are at increased risk of severe dengue, especially during secondary infections, but current vaccination options are constrained by safety considerations. This study assesses the seroprevalence of IgG anti-DENV among PLWH in Italy, after the 2023 Italian autochthonous outbreak. This cross-sectional study enrolled PLWH from July to November 2023 in Rome during the abovementioned outbreak. Blood samples were collected and analyzed for IgG anti-DENV using ELISA. Participants were stratified by country of birth and those with immune profiles suitable for live attenuated virus vaccination were identified. Cryopreserved serum samples from 2021 to 2022 were tested to trace the timing of infections. We included 475 PLWH of whom 37 tested positive for IgG anti-DENV, resulting in an overall seroprevalence of 7.79 % (95 % CI 5.54–10.6). The seroprevalence was significantly higher among PLWH born in DENV-endemic countries (37.14 %) compared to Italian (2.86 %). Notably, among the Italian participants, three individuals who had not traveled outside Italy in the past 12 months showed seroconversion during the 2023 outbreak, providing further evidence of autochthonous dengue transmission in the country. This finding underscores the growing relevance of dengue as an emerging public health concern in Italy. Of the 37 seropositive individuals, 34 (91.9 %) had a CD4 count ≥200 cells/μl, indicating that a significant portion of the at-risk population could safely be vaccinated. Many PLWH have been exposed to DENV, with some experiencing seroconversion during the 2023 outbreak. Most of these individuals could feasibly receive live attenuated virus vaccination without significant risks, but further studies are needed to confirm vaccine safety for PLWH.

Predicting workload for tasks in manufacturing is a complex challenge due to the numerous variables involved. In small- and medium-sized enterprises (SMEs), this process is often experience-based, leading to inaccurate predictions that significantly impact production planning, order management, and consequently the ability to meet customer deadlines. This paper presents an approach that leverages machine learning to enhance workload prediction with minimal data collection, making it particularly suitable for SMEs. A case study application using supervised machine learning models for regression, trained in an open-source data analytics, reporting, and integration platform (KNIME Analytics Platform), has been carried out. An Automated Machine Learning (AutoML) regression approach was employed to identify the most suitable model for task workload prediction based on minimising the Mean Absolute Error (MAE) scores. Specifically, the Regression Tree (RT) model demonstrated superior accuracy compared to more traditional simple averaging and manual predictions when modelling data for a single product type. When incorporating all available product data, despite a slight performance decrease, the XGBoost Tree Ensemble still outperformed the traditional approaches. These findings highlight the potential of machine learning to improve workload forecasting in manufacturing, offering a practical and easily implementable solution for SMEs.

PurposePoor maintenance management leads to non-negligible economic, environmental and social impacts and obstacles to the sustainable manufacturing paradigm. Studies evaluating maintenance impacts on sustainability underline growing interest in the topic, but reports on the industrial field are lacking. Therefore, this paper investigates the industrial environment and the indicators that manufacturing companies use for measuring their maintenance impacts.Design/methodology/approachIn this pilot survey study, several stakeholders of production enterprises in the south of Italy were interviewed to unveil the spread of the measurement of maintenance impacts on sustainability and the indicators used by those companies.FindingsThe interview results showed a low level of awareness among stakeholders about maintenance impacts on sustainability. Maintenance stakeholders are mainly focused on technical and economic factors, whereas environmental, quality and safety stakeholders are becoming more aware of maintenance impacts on environmental and social factors. However, both groups need guidelines to define sustainability indicators to assess such impacts.Originality/valueThis exploratory study allowed us to investigate the current situation in industrial organisations and achieve the first variegated and diversified vision of the awareness of company stakeholders on maintenance impacts on the sustainability of several business functions. This paper provides a valuable contribution to “maintenance and sustainability” research area in production contexts and sheds light on non-negligible maintenance impacts on sustainability, providing preliminary insights on the topic and an effective basis for defining future research opportunities. Moreover, this study enables increased awareness among internal and external manufacturing company stakeholders on the role of maintenance in sustainable production.