Explore the vast range of titles available.

The aim of the study was to validate the impact of the single-nucleotide polymorphism rs2413739 (T > C) in the PACSIN2 gene on thiopurines pharmacological parameters and clinical response in an Italian cohort of pediatric patients with acute lymphoblastic leukemia (ALL) and inflammatory bowel disease (IBD). In ALL, PACSIN2 rs2413739 T allele was associated with a significant reduction of TPMT activity in erythrocytes (p = 0.0094, linear mixed-effect model, multivariate analysis considering TPMT genotype) and increased severe gastrointestinal toxicity during consolidation therapy (p = 0.049). A similar trend was present also for severe hematological toxicity during maintenance. In IBD, no significant effect of rs2413739 could be found on TPMT activity, however azathioprine effectiveness was reduced in patients carrying the T allele (linear mixed effect, p = 0.0058). In PBMC from healthy donors, a positive correlation between PACSIN2 and TPMT protein concentration could be detected (linear mixed effect, p = 0.045). These results support the role of PACSIN2 polymorphism on TPMT activity and mercaptopurine adverse effects in patients with ALL. Further evidence on PBMC and pediatric patients with IBD supports an association between PACSIN2 variants, TPMT activity, and thiopurines effects, even if more studies are needed since some of these effects may be tissue specific.

Background Home chemotherapy programs for children with cancer are safe and feasible, and their impact on the quality of life has been reported in different countries. A home chemotherapy program was implemented between 2011 and 2019 in an Italian region. This pilot study investigates its safety and feasibility, along with parental satisfaction. Methods Patients between 0 and 18 years diagnosed with malignancy were included. Deceased patients and patients whose families moved abroad or interrupted contact with the service were excluded. Adverse events comprised immediate deterioration of the patient’s condition, equipment failure, errors in drug storage, dose or patient identification and personnel safety issues. Parental satisfaction was explored through an email survey of 32 Likert-type and short open questions. Results Thirty-five patients received 419 doses of intravenous chemotherapy at home (cytarabine, vincristine, vinblastine). No adverse events were reported. Twenty-three families out of 25 eligible completed the survey. Most reported being “very satisfied” with the possibility of maintaining a work/domestic routine and reducing time and financial burden of hospital access. Most were “very satisfied” with the opportunity for their child of being less troubled by the treatment. Besides, most reported being “very satisfied” with the chance for healthy siblings of maintaining their routine and coping with their brother/sister’s disease. Most perceived the program as safe. All families recommended extending the program to all children in the region. Conclusions This first Italian study supports home chemotherapy as safe and effective, positively influencing the quality of life for children and their families.

Objectives Cytomegalovirus (CMV)‐related encephalitis is a rare but potentially life‐threatening complication of CMV infection in immunocompromised patients. The high mortality rate is associated with deficient immune system reconstitution after hematopoietic stem cell transplant (HSCT) and poor bioavailability of antiviral drugs in cerebrospinal fluid (CSF). CMV‐related central nervous system (CNS) infection may occur with aspecific symptoms, without evidence of either blood viral load or magnetic resonance imaging (MRI) signs of encephalitis. Methods Here, we describe a 10‐year‐old girl who underwent an allogeneic HSCT and subsequently developed CMV encephalitis. Because of the absence of CMV antigen in the blood, the diagnosis of encephalitis was proposed only after a delay, following the onset of immune reconstitution inflammatory syndrome (IRIS). Two months of combined dual antiviral therapy with ganciclovir and foscarnet proved ineffective against CMV and caused significant bone marrow and renal toxicity. To avoid further toxicity, the girl was given daily treatment with CMV‐hyperimmune globulins alone. Results After three weeks, the CSF viral load dropped significantly and was undetectable within three more weeks. In the meantime, the renal impairment resolved, and there was a complete bone marrow recovery. Conclusion We suggest that this patient succeeded in achieving CMV CSF clearance with high dose of CMV‐hyperimmune globulin, given alone, because of the ability of immunoglobulins to penetrate the blood–brain barrier (BBB). This case describes the high‐dose anti‐cytomegalovirus (CMV) hyperimmune globulin treatment of CMV‐induced encephalitis after allogeneic hematopoietic stem cell transplant. After two months of combined dual antiviral therapy with ganciclovir and foscarnet, the CSF viral load remained very high; meanwhile, the patient, a 10‐year‐old girl, developed severe bone marrow and renal toxicity. Complete CSF clearance was obtained with high doses of anti‐CMV hyperimmune globulins given alone. We suggest this treatment succeeded because of the ability of immunoglobulins to penetrate the blood–brain barrier.

Background: Home chemotherapy programs for children with cancer are safe and feasible, and their impact on the quality of life has been reported in different countries. A home chemotherapy program was implemented between 2011 and 2019 in an Italian region. This pilot study investigates its safety and, feasibility, along with parental satisfaction. Methods: Patients between 0 and 18 years diagnosed with malignancy were included. Deceased patients and patients whose families moved abroad or interrupted contact with the service were excluded. Adverse events comprised immediate deterioration of the patient’s condition, equipment failure, errors in drug storage, dose or patient identification and personnel safety issues. Parental satisfaction was explored through an email survey of 32 Likert-type and short open questions. Results: Thirty-five patients received 419 doses of intravenous chemotherapy at home (cytarabine, vincristine, vinblastine). No adverse events were reported. Twenty-three families out of 25 eligible completed the survey. Most reported being “very satisfied” with the possibility of maintaining a work/domestic routine and reducing time and financial burden of hospital access. Most were “very satisfied” with the opportunity for their child of being less troubled by the treatment. Besides, most reported being “very satisfied” with the chance for healthy siblings of maintaining their routine and coping with their brother/sister’s disease. Most perceived the program as safe. All families recommended extending the program to all children in the region. Conclusions: This first Italian study supports home chemotherapy as safe and effective, positively influencing the quality of life for children and families.

Binaural beats (BB) are a non‐acoustic perception generated when two pure tones with a slight mismatch in frequency are presented separately to each ear. The aims of our study were to analyze the ability of 6‐Hz BB in entraining cortical activity, altering cortical connectivity, and influencing Autonomic Nervous System (ANS) functioning to evaluate, in future studies, their application in improving compliance with Non‐Invasive Ventilation (NIV) in critically ill patients. Twenty healthy volunteers underwent four 10‐min experimental auditory conditions while their electroencephalographic and polygraphic activities were recorded: Resting‐state, 6‐Hz BB, 6‐Hz monaural beats (MB), and random noise (RN). Frequency analysis and analysis of lagged‐phase connectivity were computed through eLORETA. Heart rate variability, respiratory rate, and pulse transit time were analyzed as indicators of ANS activity. 6‐Hpz BB entrained cortical activity at the beat frequency in the left cuneus and precuneus, in contrast with other experimental conditions. All auditory stimuli increased the interhemispheric lagged‐phase connectivity between auditory cortices. Contrary to MB and RN, BB induced only minimal changes in ANS parameters. 6‐Hz BB is effective in entraining cortical activity and induces only minimal changes in ANS parameters. These findings support the future use of BB as tools for increasing NIV compliance.

Background The 30‐day hospital re‐admission rate is a quality measure of hospital care to monitor the efficiency of the healthcare system. The hospital re‐admission of acute stroke (AS) patients is often associated with higher mortality rates, greater levels of disability and increased healthcare costs. The aim of our study was to identify predictors of unplanned 30‐day hospital re‐admissions after discharge of AS patients and define an early re‐admission risk score (RRS). Methods This observational, retrospective study was performed on AS patients who were discharged between 2014 and 2019. Early re‐admission predictors were identified by machine learning models. The performances of these models were assessed by receiver operating characteristic curve analysis. Results Of 7599 patients with AS, 3699 patients met the inclusion criteria, and 304 patients (8.22%) were re‐admitted within 30 days from discharge. After identifying the predictors of early re‐admission by logistic regression analysis, RRS was obtained and consisted of seven variables: hemoglobin level, atrial fibrillation, brain hemorrhage, discharge home, chronic obstructive pulmonary disease, one and more than one hospitalization in the previous year. The cohort of patients was then stratified into three risk categories: low (RRS = 0–1), medium (RRS = 2–3) and high (RRS >3) with re‐admission rates of 5%, 8% and 14%, respectively. Conclusions The identification of risk factors for early re‐admission after AS and the elaboration of a score to stratify at discharge time the risk of re‐admission can provide a tool for clinicians to plan a personalized follow‐up and contain healthcare costs.

Various modelling techniques are available to understand the temporal and spatial variations of the phenology of species. Scientists often rely on correlative models, which establish a statistical relationship between a response variable (such as species abundance or presence-absence) and a set of predominantly abiotic covariates. The choice of the modeling approach, i.e., the algorithm, is itself a significant source of variability, as different algorithms applied to the same dataset can yield disparate outcomes. This inter-model variability has led to the adoption of ensemble modelling techniques, among which stacked generalisation, which has recently demonstrated its capacity to produce robust results. Stacked ensemble modelling incorporates predictions from multiple base learners or models as inputs for a meta-learner. The meta-learner, in turn, assimilates these predictions and generates a final prediction by combining the information from all the base learners. In our study, we utilized a recently published dataset documenting egg abundance observations of Aedes albopictus collected using ovitraps. and a set of environmental predictors to forecast the weekly median number of mosquito eggs using a stacked machine learning model. This approach enabled us to (i) unearth the seasonal egg-laying dynamics of Ae. albopictus for 12 years; (ii) generate spatio-temporal explicit forecasts of mosquito egg abundance in regions not covered by conventional monitoring initiatives. Our work establishes a robust methodological foundation for forecasting the spatio-temporal abundance of Ae. albopictus, offering a flexible framework that can be tailored to meet specific public health needs related to this species.

Abstract Background and aims Studies from the USA have reported lower access to reperfusion treatments (RTs) for Ischemic Stroke (IS) among racial/ethnic minorities; however, evidence from Italy is lacking. We aimed to assess the impact of race/ethnicity on RTS administration and onset-to-door time (ODT). Methods Consecutive adult patients with IS presenting to 14 Italian stroke centers between October 2024 and November 2025 were prospectively enrolled. Based on self-reported race/ethnicity, patients were classified as White or non-White. Outcomes were Intravenous Thrombolysis (IVT), Endovascular Treatment (EVT), and ODT. Associations between ODT and race/ethnicity were assessed using linear regression adjusted for demographics, comorbidities, baseline NIHSS, premorbid mRS, education level, mode of arrival, occupational status, language barriers, and cohabitation status. Logistic regressions adjusted for the same variables, plus large vessel occlusion, anticoagulant use, and ASPECTs were used to identify predictors of IVT and EVT. Results Overall, 2402 patients were enrolled in the study, of whom 2257 were Whites (94.0%). Overall, 830 patients (35.7%) received IVT and 648 (27.9%) EVT. Compared with White patients, non-White patients were younger (62.9±16.7 vs 74.1±13.9 years; p<0.001) and less frequently women (33.8% vs 47.2%, p=0.002). White category was not associated with IVT and EVT administration (aOR 0.70 95%CI (0.34-1.67), p=0.497 and aOR 2.50 95%CI (0.84-7.40), p=0.098, respectively) but was independently associated with shorter ODT (aβ -631.69 95%CI (-1100.34 - -163.03); p=0.008). Conclusions Our study suggests that racial/ethnic disparities in timely access to stroke care exist even in countries with universal healthcare systems, highlighting the need for public health interventions. Conflict of interest Nothing to disclose

Abstract Background and aims Risk factors for Ischemic Stroke (IS) and adherence to primary prevention strategies may differ substantially across racial/ethnic groups. However, available evidence derives from the USA, where the racial/ethnic composition differs from that of Europe. The primary aim of our study was to investigate racial/ethnic differences in the prevalence of stroke risk factors and primary prevention therapies in Italy. Methods Consecutive adult patients with IS presenting to 14 Italian stroke centers between October 2024 and November 2025 were prospectively enrolled. Based on self-reported race/ethnicity, patients were classified as White or non-White. Outcomes were the prevalence of stroke risk factors and preventive therapies in use at stroke onset. The Mann-Whitney U-test and χ2-test were used for statistical comparisons. To identify independent associations between race/ethnicity and stroke risk factors, multivariable logistic regression models adjusted for sex and age were performed. Results Overall, 2402 patients were enrolled in the study, of whom 2257 were Whites (94.0%). Compared with White patients, non-White patients were younger (62.9±16.7 vs 74.1±13.9 years; p<0.001) and less frequently women (33.8% vs 47.2%, p=0.002). Cardiopathy (p=0.037), dyslipidaemia (p=0.016), and atrial fibrillation (p=0.001) were more prevalent among White patients, whereas non-White patients more frequently reported no ongoing therapy at admission (p<0.001). However, after adjustment for age and sex, White race was not independently associated with any of these factors. Conclusions Non-White patients experience ischemic stroke at a younger age than White patients, potentially reflecting earlier exposure to cardiovascular risk factors and lower awareness of them and their management. Conflict of interest Nothing to disclose