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Tiwari A, Radu E, Kreuzinger N, Ahmed W, Pitkänen T. Key considerations for pathogen surveillance in wastewater. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 945:173862. [PMID: 38876348 DOI: 10.1016/j.scitotenv.2024.173862] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 06/03/2024] [Accepted: 06/06/2024] [Indexed: 06/16/2024]
Abstract
Wastewater surveillance (WWS) has received significant attention as a rapid, sensitive, and cost-effective tool for monitoring various pathogens in a community. WWS is employed to assess the spatial and temporal trends of diseases and identify their early appearances and reappearances, as well as to detect novel and mutated variants. However, the shedding rates of pathogens vary significantly depending on factors such as disease severity, the physiology of affected individuals, and the characteristics of pathogen. Furthermore, pathogens may exhibit differential fate and decay kinetics in the sewerage system. Variable shedding rates and decay kinetics may affect the detection of pathogens in wastewater. This may influence the interpretation of results and the conclusions of WWS studies. When selecting a pathogen for WWS, it is essential to consider it's specific characteristics. If data are not readily available, factors such as fate, decay, and shedding rates should be assessed before conducting surveillance. Alternatively, these factors can be compared to those of similar pathogens for which such data are available.
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Affiliation(s)
- Ananda Tiwari
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio, Finland; University of Helsinki, Faculty of Veterinary Medicine, Helsinki, Finland.
| | - Elena Radu
- Institute for Water Quality and Resource Management, Vienna University of Technology, Karlsplatz 13/226, 1040 Vienna, Austria; Stefan S. Nicolau Institute of Virology, Department of Cellular and Molecular Pathology, 285 Mihai Bravu Avenue, 030304 Bucharest, Romania; University of Medicine and Pharmacy Carol Davila, Department of Virology, 37 Dionisie Lupu Street, 020021 Bucharest, Romania.
| | - Norbert Kreuzinger
- Institute for Water Quality and Resource Management, Vienna University of Technology, Karlsplatz 13/226, 1040 Vienna, Austria.
| | - Warish Ahmed
- CSIRO Environment, Ecosciences Precinct, 41 Boggo Road, Dutton Park, QLD 4102, Australia.
| | - Tarja Pitkänen
- Finnish Institute for Health and Welfare, Department of Health Security, Kuopio, Finland; University of Helsinki, Faculty of Veterinary Medicine, Helsinki, Finland.
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Brunori D, Frajese GV, Sarno E. Retrospective Analyses of COVID-19 and Population Ageing Effects on Italian Mortality during the Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:6481. [PMID: 37569021 PMCID: PMC10418737 DOI: 10.3390/ijerph20156481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 07/23/2023] [Accepted: 07/26/2023] [Indexed: 08/13/2023]
Abstract
The spread of COVID-19 led to an extremely high number of deaths in Italy in 2020 with respect to previous years. Because the total number of deaths may depend on both the population structure and the mortality rate by age groups, a detailed overview of the Italian pandemic situation is here provided by following two main lines of inquiry: (i) checking for similarities and differences among mortality rates per age groups before and during the COVID-19 spread; (ii) analyzing the responsiveness of the Italian population structure to different mortality rates. Real-based evidence led us to conduct analyses for two groups associated with different population stages of life, referred to as younghood and adulthood periods. We focus on the Italian pandemic from February 2020 to March 2021. Our study helps to understand why elders dramatically impacted the total number of deaths. In addition, it reveals how badly the 2020 Italian population structure would have reacted to mortality rates already faced in the past. Finally, politicians, scientists, and journalists' statements and other ways of communicating information about COVID-19 are questioned in the light of scientific data available at that time.
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Affiliation(s)
- Damiano Brunori
- Department of Computer, Control and Management Engineering, Sapienza University of Rome, Via Ariosto 25, 00185 Rome, Italy
| | - Giovanni Vanni Frajese
- Department of Sports Science, Human and Health, University of Rome ‘Foro Italico’, Piazza Lauro de Bosis, 15, 00135 Rome, Italy;
| | - Emma Sarno
- Department of Human and Social Sciences, University of Naples L’Orientale, Largo San Giovanni Maggiore 30, 80134 Naples, Italy;
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Losurdo A, Lisa AVE, Tomatis M, Ponti A, Montemezzi S, Bonzano E, Fortunato L. Highly specialized Breast Centers did not experience delay of care during COVID-19 pandemic in Italy: the Senonetwork experience. Breast Cancer Res Treat 2022; 196:87-95. [PMID: 36018455 PMCID: PMC9412793 DOI: 10.1007/s10549-022-06694-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 07/24/2022] [Indexed: 11/30/2022]
Abstract
Aim of the study The study aims to evaluate the performance of selected, high-volume, highly specialized, Italian Breast Centers at the time of COVID-19 pandemic (year 2020), compared to pre-pandemic time (year 2019), highlighting differences in terms of clinical presentation of breast cancer (BC) and therapeutic strategies. Methods Patients’ data were provided by the Senonetwork data warehouse Senonet. In order to examine changes in the surgical and oncological management of BC patients during different phases of COVID-19 pandemic, we took advantage of a selection quality indicators (QIs). We performed the analyses in two time-frames, from July to September (Jul-Sep) (2019 versus 2020) and from October to December (Oct-Dec) (2019 versus 2020). Results Our analysis did not show any statistically significant difference in terms of diagnosis, surgical, oncological and radiation therapy procedures between the two trimesters 2019 and 2020. Nevertheless, we observed statistically significant differences, favoring 2020, when analyzing time-to surgery and time-to radiotherapy. On the other hand, we observed a significant reduction of neoadjuvant chemotherapy and we did not recollect any data on a major use of neoadjuvant endocrine therapy. Conclusions In Italian Breast Centers, partners of Senonetwork, we could not observe any treatment delay or change in standard clinical practice for BC care during the 2020 pandemic year, compared to 2019 pre-pandemic year. This finding is in contrast with the globally reported decrease in the performance of the Italian Breast Centers due to the COVID-19 pandemic, and has to be linked to the sharp selection of Senonetwork Breast Centers.
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Affiliation(s)
- Agnese Losurdo
- UO of Medical Oncology, Department of Oncology and Hematology, IRCCS Humanitas Research Hospital, via Manzoni 56, 20089, Rozzano, Milan, Italy.,Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20090, Pieve Emanuele, Milan, Italy
| | - Andrea Vittorio Emanuele Lisa
- Department of Medical Biotechnology and Translational Medicine BIOMETRA - Plastic Surgery Unit, Reconstructive and Aesthetic Plastic Surgery School, University of Milan, Humanitas Research Hospital, IRCCS, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
| | - Mariano Tomatis
- AOU Città della Salute e Della Scienza'University Hospital, CPO Piemonte, Turin, Italy
| | - Antonio Ponti
- AOU Città della Salute e Della Scienza'University Hospital, CPO Piemonte, Turin, Italy
| | - Stefania Montemezzi
- Department of Radiology, Azienda Ospedaliera Universitaria Integrata Verona, Verona, Italy
| | - Elisabetta Bonzano
- Radiation Oncology Department, Fondazione IRCCS Policlinico San Matteo and University of Pavia, Pavia, Italy
| | - Lucio Fortunato
- Breast Surgery Unit, Azienda Ospedaliera San Giovanni Addolorata, Rome, Italy
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Armaou A, Katch B, Russo L, Siettos C. Designing social distancing policies for the COVID-19 pandemic: A probabilistic model predictive control approach. MATHEMATICAL BIOSCIENCES AND ENGINEERING : MBE 2022; 19:8804-8832. [PMID: 35942737 DOI: 10.3934/mbe.2022409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The effective control of the COVID-19 pandemic is one the most challenging issues of recent years. The design of optimal control policies is challenging due to a variety of social, political, economical and epidemiological factors. Here, based on epidemiological data reported in recent studies for the Italian region of Lombardy, which experienced one of the largest and most devastating outbreaks in Europe during the first wave of the pandemic, we present a probabilistic model predictive control (PMPC) approach for the systematic study of what if scenarios of social distancing in a retrospective analysis for the first wave of the pandemic in Lombardy. The performance of the proposed PMPC was assessed based on simulations of a compartmental model that was developed to quantify the uncertainty in the level of the asymptomatic cases in the population, and the synergistic effect of social distancing during various activities, and public awareness campaign prompting people to adopt cautious behaviors to reduce the risk of disease transmission. The PMPC takes into account the social mixing effect, i.e. the effect of the various activities in the potential transmission of the disease. The proposed approach demonstrates the utility of a PMPC approach in addressing COVID-19 transmission and implementing public relaxation policies.
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Affiliation(s)
- Antonios Armaou
- Dept. of Chemical Engineering, The Pennsylvania State University, USA
| | - Bryce Katch
- Dept. of Chemical Engineering, The Pennsylvania State University, USA
| | - Lucia Russo
- Institute of Science and Technology for Energy and Sustainable Mobility, Consiglio Nazionale delle Ricerche, Italy
| | - Constantinos Siettos
- Dipartimento di Matematica e Applicazioni "Renato Caccioppoli", Scuola Superiore Meridionale, Università degli Studi di Napoli Federico Ⅱ, Naples, Italy
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Rotondo JC, Martini F, Maritati M, Caselli E, Gallenga CE, Guarino M, De Giorgio R, Mazziotta C, Tramarin ML, Badiale G, Tognon M, Contini C. Advanced Molecular and Immunological Diagnostic Methods to Detect SARS-CoV-2 Infection. Microorganisms 2022; 10:1193. [PMID: 35744711 PMCID: PMC9231257 DOI: 10.3390/microorganisms10061193] [Citation(s) in RCA: 36] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/06/2022] [Accepted: 06/06/2022] [Indexed: 02/06/2023] Open
Abstract
COVID-19 emerged in late 2019 in China and quickly spread across the globe, causing over 521 million cases of infection and 6.26 million deaths to date. After 2 years, numerous advances have been made. First of all, the preventive vaccine, which has been implemented in record time, is effective in more than 95% of cases. Additionally, in the diagnostic field, there are numerous molecular and antigenic diagnostic kits that are equipped with high sensitivity and specificity. Real Time-PCR-based assays for the detection of viral RNA are currently considered the gold-standard method for SARS-CoV-2 diagnosis and can be used efficiently on pooled nasopharyngeal, or oropharyngeal samples for widespread screening. Moreover, additional, and more advanced molecular methods such as droplet-digital PCR (ddPCR), clustered regularly interspaced short palindromic repeats (CRISPR) and next-generation sequencing (NGS), are currently under development to detect the SARS-CoV-2 RNA. However, as the number of subjects infected with SARS-CoV-2 continuously increases globally, health care systems are being placed under increased stress. Thus, the clinical laboratory plays an important role, helping to select especially asymptomatic individuals who are actively carrying the live replicating virus, with fast and non-invasive molecular technologies. Recent diagnostic strategies, other than molecular methods, have been adopted to either detect viral antigens, i.e., antigen-based immunoassays, or human anti-SARS-CoV-2 antibodies, i.e., antibody-based immunoassays, in nasal or oropharyngeal swabs, as well as in blood or saliva samples. However, the role of mucosal sIgAs, which are essential in the control of viruses entering the body through mucosal surfaces, remains to be elucidated, and in particular the role of the immune response in counteracting SARS-CoV-2 infection, primarily at the site(s) of virus entry that appears to be promising.
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Affiliation(s)
- John Charles Rotondo
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
- Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Fernanda Martini
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
- Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
- Laboratory for Technologies of Advanced Therapies (LTTA), University of Ferrara, 44121 Ferrara, Italy
| | - Martina Maritati
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
- Orthopaedic Ward, Casa di Cura Santa Maria Maddalena, 45030 Occhiobello, Italy
| | - Elisabetta Caselli
- Section of Microbiology, CIAS Research Center and LTTA, Department of Chemical, Pharmaceutical and Agricultural Sciences, University of Ferrara, 44121 Ferrara, Italy;
| | - Carla Enrica Gallenga
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
| | - Matteo Guarino
- Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy; (M.G.); (R.D.G.)
| | - Roberto De Giorgio
- Department of Translational Medicine, St. Anna University Hospital of Ferrara, University of Ferrara, 44124 Ferrara, Italy; (M.G.); (R.D.G.)
| | - Chiara Mazziotta
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
- Center for Studies on Gender Medicine, Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy
| | - Maria Letizia Tramarin
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
| | - Giada Badiale
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
| | - Mauro Tognon
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
| | - Carlo Contini
- Department of Medical Sciences, University of Ferrara, 44121 Ferrara, Italy; (F.M.); (M.M.); (C.E.G.); (C.M.); (M.L.T.); (G.B.); (M.T.)
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Standl F, Kowall B, Frost AK, Brune B, Brinkmann M, Dudda M, Oesterling F, Jansen P, Jöckel KH, Stang A. Calculating the number of undetected active SARS-CoV-2 infections from results of population-wide antigen tests. J Med Life 2021; 14:797-801. [PMID: 35126750 PMCID: PMC8811667 DOI: 10.25122/jml-2021-0243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Accepted: 11/26/2021] [Indexed: 11/17/2022] Open
Abstract
Current European research estimates the number of undetected active SARS-CoV-2 infections (dark figure) to be two- to 130-fold the number of detected cases. We revisited the population-wide antigen tests in Slovakia and South Tyrol and calculated the dark figure of active cases in the vulnerable populations and the number of undetected active cases per detected active case at the time of the population-wide tests. Our analysis follows three steps: using the sensitivities and specificities of the used antigen tests, we first calculated the number of test-positive individuals and the proportion of actual positives in those who participated in the antigen tests. We then calculated the dark figure in the total population of Slovakia and South Tyrol, respectively. Finally, we calculated the ratio of the dark figure in the vulnerable population to the number of newly detected infections through PCR tests. Per one positive PCR result, another 0.15 to 0.71 cases must be added in South Tyrol and 0.01 to 1.25 cases in Slovakia. The dark figure was in both countries lower than assumed by earlier studies.
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Affiliation(s)
- Fabian Standl
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany,Corresponding Author: Fabian Standl, Institute for Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen Hufelandstr, 55D-45147 Essen, Germany. Phone: +49 201/723-77263; E-mail:
| | - Bernd Kowall
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Anna Katharina Frost
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Bastian Brune
- Medical Direction Communal Emergency Service of the City Essen, Essen, Germany,Clinic for Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Essen, Germany
| | - Marcus Brinkmann
- Center for Clinical Trials Essen, University Hospital Essen, Essen, Germany
| | - Marcel Dudda
- Medical Direction Communal Emergency Service of the City Essen, Essen, Germany,Clinic for Trauma, Hand and Reconstructive Surgery, University Hospital Essen, Essen, Germany
| | | | - Philipp Jansen
- Clinic for Dermatology, University Hospital Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, Essen, Germany,Department of Epidemiology, Boston University, Boston, United States of America
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