Publications by authors named "Mariachiara Carestia"

8 Publications

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Biological Risk in Italian Prisons: From the COVID-19 Management to the Development of a Standardized Model for Emergency Response.

Int J Environ Res Public Health 2021 Oct 1;18(19). Epub 2021 Oct 1.

Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy.

Within the confinements of critical infrastructures, the COVID-19 pandemic is posing a series of challenges to Health Management. In the spotlight of highly contagious and quick spreading diseases within such enclosed facilities, whether it be a detention facility or otherwise, the health and safety of those living within its internment is paramount. This paper aims to highlight the specific challenges and the possible solutions to counteract this problem, starting from the lessons learnt from the Italian prison system case study. Following the general description of the available resources within the Italian prisons, the study aimed at specifically describing the first counteracting measures deployed by the Italian prison authorities during the first phase of the COVID-19 outbreak (February-July 2020). The aim was to propose an integrated plan capable of responding to a biological threat within the prisons. In particular, the study describes the actions and technical features that, in accordance with national and international legal frameworks and the relevant organisational bodies that run the Italian Prison Service, had been adopted in managing, right from the start, the COVID-19 pandemic until Summer 2020. Available information and data showed the ability of the prison administration to comply almost completely with WHO's technical and human rights recommendations and also, in successfully handling prison emergencies both in terms of the sick and the deceased in line with the epidemiological framework of the general population. In addition, the paper proposes a draft of guidelines that should involve the National Health Service and the Prison Service that are aimed at supporting the local prison facilities with drawing up their own biological incident contingency plans. An approved, legal, standardised plan could increase the awareness of prison managers. It could even increase their self-confidence, in particular, with regard to cases of dispute and their ability to respond to them. In fact, it is valuable and forward-thinking to be able to demonstrate that every endeavour has been taken and that 'certified' best practices have been put in place in accordance with the national standards.
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http://dx.doi.org/10.3390/ijerph181910353DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8508282PMC
October 2021

Infectious Diseases Seeker (IDS): An Innovative Tool for Prompt Identification of Infectious Diseases during Outbreaks.

Int J Environ Res Public Health 2021 03 20;18(6). Epub 2021 Mar 20.

Department of Industrial Engineering, University of Rome "Tor Vergata", 00133 Rome, Italy.

Background: Several technologies for rapid molecular identification of pathogens are currently available; jointly with monitoring tools (i.e., web-based surveillance tools, infectious diseases modelers, and epidemic intelligence methods), they represent important components for timely outbreak detection and identification of the involved pathogen. The application of these approaches is usually feasible and effective when performed by healthcare professionals with specific expertise and skills and when data and resources are easily accessible. Contrariwise, in the field situation where healthcare workers or first responders from heterogeneous competences can be asked to investigate an outbreak of unknown origin, a simple and suitable tool for rapid agent identification and appropriate outbreak management is highly needed. Most especially when time is limited, available data are incomplete, and accessible infrastructure and resources are inadequate. The use of a prompt, user-friendly, and accessible tool able to rapidly recognize an infectious disease outbreak and with high sensitivity and precision may be a game-changer to support emergency response and public health investigations.

Methods: This paper presents the work performed to implement and test an innovative tool for prompt identification of infectious diseases during outbreaks, called Infectious Diseases Seeker (IDS). IDS is a standalone software that runs on the most common operative systems. It has been built by integrating a database containing an interim set of 60 different disease causative agents and COVID-19 data and is able to work in an off-line mode without requiring a network connection.

Results: IDS has been applied in a real and complex scenario in terms of concomitant infectious diseases (yellow fever, COVID-19, and Lassa fever), as can be in the second part of 2020 in Nigeria. The outcomes have allowed inferring that yellow fever (YF), and not Lassa fever, was affecting the area under investigation.

Conclusions: Our result suggests that a tool like IDS could be valuable for the quick and easy identification and discrimination of infectious disease outbreaks even when concurrent outbreaks occur, like for the case study of YF and COVID-19 pandemic in Nigeria.
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http://dx.doi.org/10.3390/ijerph18063216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8003641PMC
March 2021

Predicting SARS-CoV-2 Weather-Induced Seasonal Virulence from Atmospheric Air Enthalpy.

Int J Environ Res Public Health 2020 Dec 4;17(23). Epub 2020 Dec 4.

Department of Astronautical, Electrical and Energy Engineering, Sapienza University of Rome, 00184 Rome, Italy.

Following the coronavirus disease 2019 (COVID-19) pandemic, several studies have examined the possibility of correlating the virulence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that causes COVID-19, to the climatic conditions of the involved sites; however, inconclusive results have been generally obtained. Although neither air temperature nor humidity can be independently correlated with virus viability, a strong relationship between SARS-CoV-2 virulence and the specific enthalpy of moist air appears to exist, as confirmed by extensive data analysis. Given this framework, the present study involves a detailed investigation based on the first 20-30 days of the epidemic before public health interventions in 30 selected Italian provinces with rather different climates, here assumed as being representative of what happened in the country from North to South, of the relationship between COVID-19 distributions and the climatic conditions recorded at each site before the pandemic outbreak. Accordingly, a correlating equation between the incidence rate at the early stage of the epidemic and the foregoing average specific enthalpy of atmospheric air was developed, and an enthalpy-based seasonal virulence risk scale was proposed to predict the potential danger of COVID-19 outbreak due to the persistence of weather conditions favorable to SARS-CoV-2 viability. As an early detection tool, an unambiguous risk chart expressed in terms of coupled temperatures and relative humidity (RH) values was provided, showing that safer conditions occur in the case of higher RHs at the highest temperatures, and of lower RHs at the lowest temperatures. Despite the complex determinism and dynamics of the pandemic and the related caveats, the restriction of the study to its early stage allowed the proposed risk scale to result in agreement with the available infectivity data highlighted in the literature for a number of cities around the world.
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http://dx.doi.org/10.3390/ijerph17239059DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729562PMC
December 2020

Epidemiology of Hypoalbuminemia in Hospitalized Patients: A Clinical Matter or an Emerging Public Health Problem?

Nutrients 2020 Nov 27;12(12). Epub 2020 Nov 27.

Section of Hygiene and Public Health, Department of Biomedicine and Prevention, University of Rome Tor Vergata, Via Montpellier, 1-00133 Rome, Italy.

Serum albumin levels are strongly associated with the morbidity, prognosis, and mortality rates of patients with hypoalbuminemia, which is a frequent problem during hospitalization. An observational retrospective study was carried out to analyze changes in albumin levels in hospitalized patients at the "Fondazione Policlinico Tor Vergata-PTV" in 2018. The prevalence of preexisting hypoalbuminemia at the time of discharge from hospital was investigated using a sample of 9428 patients. Information was collected from the discharge files recorded in the central informatics system of the hospital. Analysis of albumin levels at admission and at discharge was conducted by classes of albuminemia and then stratified by age. At the time of admission, hypoalbuminemia was found to be present in more than half of the sample, with no sex differences. The serum albumin level tended to decrease with age, with pathologic levels appearing from 50 years and progressive worsening thereafter. The condition of marked and mild hypoalbuminemia was more prevalent in patients over 65 years of age. Our findings suggest that hypoalbuminemia should be considered a dangerous condition in itself and a serious public health problem. We aimed to emphasize the role of albumin as useful marker of the in-hospital malnutrition and frailty, to be integrated in the routinely assessment of patients for reconsidering ad hoc healthcare pathways after discharge from hospital, especially when dealing with fragile populations.
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http://dx.doi.org/10.3390/nu12123656DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7760225PMC
November 2020

On the Optimal Indoor Air Conditions for SARS-CoV-2 Inactivation. An Enthalpy-Based Approach.

Int J Environ Res Public Health 2020 08 21;17(17). Epub 2020 Aug 21.

Department of Astronautical, Electrical and Energy Engineering, Sapienza University of Rome, 00184 Rome, Italy.

In the CoViD-19 pandemic, the precautionary approach suggests that all possible measures should be established and implemented to avoid contagion, including through aerosols. For indoor spaces, the virulence of SARS-CoV-2 could be mitigated not only via air changes, but also by heating, ventilation, and air conditioning (HVAC) systems maintaining thermodynamic conditions possibly adverse to the virus. However, data available in literature on virus survival were never treated aiming to this. In fact, based on comparisons in terms of specific enthalpy, a domain of indoor comfort conditions between 50 and 60 kJ/kg is found to comply with this objective, and an easy-to-use relationship for setting viable pairs of humidity and temperature using a proper HVAC plant is proposed. If confirmed via further investigations on this research path, these findings could open interesting scenarios on the use of indoor spaces during the pandemic.
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http://dx.doi.org/10.3390/ijerph17176083DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7504028PMC
August 2020

Laser-induced fluorescence (LIF) as a smart method for fast environmental virological analyses: validation on Picornaviruses.

Sci Rep 2019 08 29;9(1):12598. Epub 2019 Aug 29.

Department of Industrial Engineering, University of Rome "Tor Vergata", Via del Politecnico 1, Rome, 00133, Italy.

Virological analysis is time-consuming and expensive. The aim of this work is to demonstrate the applicability of laser-induced fluorescence (LIF) to the classification of viruses, reducing the time for this analysis and its costs. Experimental tests were performed in which different viruses were irradiated with a UV laser emitting at 266 nm and the emitted spectra were recorded by a spectrometer. The classification techniques show the possibility of discriminating viruses. Although the application of the LIF technique to biological agents has been thoroughly studied by many researchers over the years, this work aims at validating for the first time its applicability to virological analyses. The development of a fast virological analysis may revolutionize this field, allowing fast responses to epidemiologic events, reducing their risks and improving the efficiency of monitoring environments. Moreover, a cost reduction may lead to an increase in the monitoring frequency, with an obvious enhancement of safety and prevention.
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http://dx.doi.org/10.1038/s41598-019-49005-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6715700PMC
August 2019

Viral bioterrorism: Learning the lesson of Ebola virus in West Africa 2013-2015.

Virus Res 2015 Dec 8;210:318-26. Epub 2015 Sep 8.

Department of Industrial Engineering, University of Rome Tor Vergata, Rome, Italy; Didactical Board of the International Master Courses in Protection Against CBRNe events, Department of Industrial Engineering and School of Medicine and Surgery, University of Rome Tor Vergata, Rome, Italy.

Among the potential biological agents suitable as a weapon, Ebola virus represents a major concern. Classified by the CDC as a category A biological agent, Ebola virus causes severe hemorrhagic fever, characterized by high case-fatality rate; to date, no vaccine or approved therapy is available. The EVD epidemic, which broke out in West Africa since the late 2013, has got the issue of the possible use of Ebola virus as biological warfare agent (BWA) to come to the fore once again. In fact, due to its high case-fatality rate, population currently associates this pathogen to a real and tangible threat. Therefore, its use as biological agent by terrorist groups with offensive purpose could have serious repercussions from a psychosocial point of view as well as on closely sanitary level. In this paper, after an initial study of the main characteristics of Ebola virus, its potential as a BWA was evaluated. Furthermore, given the spread of the epidemic in West Africa in 2014 and 2015, the potential dissemination of the virus from an urban setting was evaluated. Finally, it was considered the actual possibility to use this agent as BWA in different scenarios, and the potential effects on one or more nation's stability.
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http://dx.doi.org/10.1016/j.virusres.2015.09.002DOI Listing
December 2015

Ebola virus disease 2013-2014 outbreak in west Africa: an analysis of the epidemic spread and response.

Int J Microbiol 2015 17;2015:769121. Epub 2015 Mar 17.

Department of Industrial Engineering, University of Rome Tor Vergata, Via del Politecnico 1, 00173 Rome, Italy ; International Master Courses in Protection against CBRNe Events, Department of Industrial Engineering and School of Medicine and Surgery, University of Rome Tor Vergata, Via del Politecnico 1, 00173 Rome, Italy.

The Ebola virus epidemic burst in West Africa in late 2013, started in Guinea, reached in a few months an alarming diffusion, actually involving several countries (Liberia, Sierra Leone, Nigeria, Senegal, and Mali). Guinea and Liberia, the first nations affected by the outbreak, have put in place measures to contain the spread, supported by international organizations; then they were followed by the other nations affected. In the present EVD outbreak, the geographical spread of the virus has followed a new route: the achievement of large urban areas at an early stage of the epidemic has led to an unprecedented diffusion, featuring the largest outbreak of EVD of all time. This has caused significant concerns all over the world: the potential reaching of far countries from endemic areas, mainly through fast transports, induced several countries to issue information documents and health supervision for individuals going to or coming from the areas at risk. In this paper the geographical spread of the epidemic was analyzed, assessing the sequential appearance of cases by geographic area, considering the increase in cases and mortality according to affected nations. The measures implemented by each government and international organizations to contain the outbreak, and their effectiveness, were also evaluated.
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http://dx.doi.org/10.1155/2015/769121DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4380098PMC
April 2015
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