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Underwater cultural heritage (UCH) in Italy is under-documented despite its significance. Creating a comprehensive UCH database is essential but faces challenges, such as complex documentation processes, data interoperability, and international standard adherence. This paper examines data models, standards, and the use of webGIS and databases for underwater cultural heritage documentation in Italy and globally. International documents like the 1996 ICOMOS Charter and the 2001 UNESCO Convention emphasize in-situ preservation. However, documentation efforts remain scattered, lacking a unified database. GIS technologies are vital for managing and analyzing UCH data but are underutilized for public access and tourism. Projects like Andar per Mare and Archim3des in the Puglia region aim to promote underwater cultural heritage using webGIS platforms. However, existing sources like CartaPulia face limitations, including a lack of standardization, specialized fields for underwater cultural heritage characteristics, and language barriers. The proposed solution involves creating a new data model based on standards, resulting in a bilingual geodatabase. This geodatabase will support scientific and tourism-focused webGIS applications, enhancing accessibility and promoting Italy's underwater cultural heritage. A unified database will prevent duplication, facilitate discoveries, and promote Italy's cultural heritage.

3D documentation of the Underground Built Heritage (UBH) is always fundamental for knowledge, management, conservation, and enhancement of cultural heritage, but the challenges involved in documenting this kind of site are many and various, With the aim of providing an accurate and reliable representation of the surveyed area without employing time-consuming processes, Mobile Mapping Systems (MMSs) based on SLAM (Simultaneous Localization And Mapping) technology have now the potential to overcome these challenges, proving to be a useful alternative to traditional surveying techniques. The underground site of Grotta Zinzulusa in Castro (LE), Italy, is an anchialine cave system difficult to access and document due to its narrow passages, large rooms, and poor illumination. Within this case study, the effectiveness of using an MMS approach, employing the STONEX® X120GO SLAM Laser Scanner system, to document the cave system and integrates the data with those obtained from other traditional geomatics techniques, such as UAS (Uncrewed Aerial System) and TLS (Terrestrial Laser Scanning) surveys, has been proved. The study aims to define the best practices and operational methodologies for enhancing the speediness, usability, and cost-effectiveness of using MMSs in underground settings for 3D documentation of heritage sites to provide metrically correct and accurate products for researchers, scientists, and the wider public.

The 2020 underwater archaeological research in the inlet of Torre Santa Sabina – Baia dei Camerini (Municipality of Carovigno, Brindisi, Italy) represented the first phase of the pilot intervention of the Interreg Italia-Croatia UnderwaterMuse project. The project aims to enhance and make accessible the vast underwater heritage of the areas involved; this will be done by creating submerged archaeological parks and using virtual reality's narrative and communicative tools and platforms. During the 2020 campaign, different survey activities were carried out using several techniques and methodology to produce the area's multi-scale documentation. First of all, the entire stretch of coast was mapped with UASs (Uncrewed Aerial Systems) flights to reconstruct the coastal landscape in various phases. Furthermore, an underwater photogrammetric survey carried out by expert scuba divers has been achieved in the wreck's aft area (the site analyzed during the 2020 excavation activities). The fruitful synergy between the various actors involved and the support of the territory and the community has allowed the achievement of this campaign's objectives, preliminary to the broader and more articulated intervention foreseen for the following year.

The paper presents a database of information on wrecks, natural and artificial reefs located in the Adriatic Sea, collected within the framework of the Interreg Italy–Croatia project ADRIREEF – Innovative exploitation of Adriatic Reefs in order to strengthen Blue Economy. The data collection lasted more than 1 year and included three surveys and a wide literature review. After being collected, data were harmonized and, where possible, made machine-readable. Moreover, data were widely metadated, published in a WebGIS (https://adrireef.github.io/sandbox3/, last access: 3 May 2021), and shared as open data in EMODnet (European Marine Observation and Data Network) Data Ingestion Portal through the SEANOE repository (Ferrà et al., 2020; https://doi.org/10.17882/74880). The database is composed of 285 three-dimensional records, each one described by 51 attributes. Parameters are clustered in four main groups: identification, reef description, site description, and management/exploitation information. Available literature (scientific and/or grey) was also included in the database and linked to the corresponding site.

The fragility of organic artefacts in presence of water and their volumetric variation caused by the marine life on or surrounding them dictate that their physical dimensions be measured soon after their extraction from the seabed. In an ideal context, it would be appropriate to preserve and restore all the archaeological elements, rapidly and with the latest methods. Unfortunately however, the large number of artefacts makes the cost of such an operation prohibitive for a public institution. For this reason, digital technologies for documentation, restoration, display and conservation are being considered by many institutions working with limited budgets. In this paper, we illustrate the experience of the University of Salento in 3D imaging technology for waterlogged wooden artefacts from shipwrecks. The interest originates from the need to develop a protocol for documentation and digital restoration of archaeological finds discovered along the coast of Torre S. Sabina (BR) Italy. This work has allowed us to explore recent technologies for 3D acquisitions, both underwater and in the laboratory, as well as methods for data processing. These technologies have permitted us to start defining a protocol to follow for all waterlogged wooden artefacts requiring documentation and restoration.

We aimed to analyze bone mineralization and the effect of different risk factors for osteoporosis in postmenopausal women. We studied 2,756 postmenopausal subjects out of ≥10,000 records from the ROIS registry in the frame of the PROF Project, a population study carried out in Salento (Taranto, Brindisi, Lecce) from 2009 to 2012. All subjects were assessed by phalangeal Quantitative Ultrasound (QUS) to evaluate their bone mineralization (assessed by Amplitude Dependent Speed of Sound, AD-SoS) and the association between demineralization and the presence of other conditions or risk factors. Mean age was 64±9.5 years and mean BMI was 28.7±3.5 Kg/m 2 . Pearson correlation analyses revealed a negative association between bone mineralization (AD-SoS) and BMI (P

Electrophoretical and histological analysis were performed on Mytilus galloprovincialis digestivegland samples, in order to detect the presence of a previously identified protein ca 30 kDa MW,synthesized during Dinophysis spp. blooms, and assess a possible correlation between the occurrenceof this protein and okadaic acid (OA) exposure by ingestion. Mussels were sampled monthly from July2000 to November 2001 in the Gulf of Trieste (upper Adriatic Sea) and immediately processed. Parallelsamples were maintained in sea water plastic tanks and fed with marine invertebrate feed mixed withOA and derivatives at different concentration of toxins for each experimental group (25 mg, 50 mg, 100mg). In tank reared mussels fed with OA, degeneration of digestive cells and appearance of 24.6 kDaprotein were observed, while in wild mussels, neither histological alterations nor presence of a 24.6kDa protein, were detected. A correlation between the toxins concentration and time of appearancewas highlighted, to demonstrate this protein is synthesized in response to OA and derivativesexposure. About the identity of 24.6 kDa protein, it could be an enzyme involved in detoxificationreactions, probably Glyoxalase I.

We investigated the structural and functional changes of the soft-bottom macrofaunal community following the improvement of a wastewater treatment-WWT plant. The macrofauna was collected at increasing distance from the main outfall in 2018, 2019, and 2021. Organic matter and nutrients were analysed in the water column near the outfalls to detect possible changes due to the improved treatment. We examined Functional Entities-FEs (i.e. a unique combination of species functional traits), species richness, Shannon-Wiener diversity-H', and taxonomic and functional β-diversity. From 2018 (before the year of the treatment change), to 2021, we noted a gradual decrease of organic carbon in the water column. In contrast, sediment characteristics (i.e. grain-size) did not change before and after treatment enhancement, with the exception of redox potential. Species richness and FEs gradually increased moving far from the source of organic contamination and after wastewater treatment enhancement, especially near the outfall. We observed different phases of macrofaunal succession stage after the WWT amelioration. A 'normal stage', i.e. slightly lower species richness, was reflected in decreasing functional richness. Higher taxonomic β-diversity values with significant turnover components indicated that the community was subjected to broad changes in species composition. However, functional β-diversity did not follow the same pattern. After treatment improvement, modified environmental conditions led to the establishment of new species, but with the same functions. Towards 2021, the community improved its resilience by increasing functional redundancy and reduction of vulnerability, which enhanced community stability. The latter was also reflected in the well-balanced proportion of macrofaunal feeding habits after the WWT upgrade. Integrating the classical taxonomic approach with the analysis of FEs, and environmental characteristics can provide an accurate insight into macrofauna sensitivity to stressors that are likely to lead to changes in the ecological state of an area., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

We studied the macrobenthic invertebrate biomass (B), production (P), productivity (P/B̅-ratio), and transfer efficiency (TE) influenced by sewage effluents discharge in a diffusion zone. Our results indicated a clear distribution pattern of macrofauna communities along the sewage discharge gradient where biological factors (B, P, P/B̅, and TE) were driven by changes observed in community structure, composition, and the influence of environmental variables. The lowest B, P, and P/B̅ were observed at the stations sampled close to the pipelines. Abundance, biomass, production, and productivity increased with increasing distance from the pipelines toward stations placed at 100 m distance and then decreased toward the stations placed at >200 m, where there was a negative relationship between TE and B of macrofauna at sampling stations. Overall, there was a clear influence of the sewage discharge on macrofauna communities, but surrounding environment was influenced moderately by organic impact and discharges had no negative impacts., (Copyright © 2022 Elsevier Ltd. All rights reserved.)

We assessed the effect of sewage-derived materials on the structural and functional attributes of the soft-bottom macrofauna at an increasing distance from the entire diffusion area. Our results showed clear spatial changes of macrofaunal density and biomass along the distance gradient from the main outfall. High values of biodiversity, species composition, and species linked to organic enrichment near the duct suggested that moderate organic stress affected this community. The traits analysis abundance-based, compared to biomass-based one, distinguished most clearly sewage contamination conditions. Functional diversity displayed spatial patterns with higher values in the less impacted sites and was significantly related to species numbers and the biotic indices (like M-AMBI). This approach is ideal for detecting macrofaunal functional changes due to sewage contamination. Thus, we infer that traits analyses could offer great potential for environmental assessment and monitoring of coastal areas influenced by human activities., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Reactive microgliosis is a pathological hallmark that accompanies neuronal demise in many neurodegenerative diseases, ranging from acute brain/spinal cord injuries to chronic diseases, such as amyotrophic lateral sclerosis (ALS), Alzheimer's disease (AD) and age-related dementia. One strategy to assess and monitor microgliosis is to use positron emission tomography (PET) by exploiting radioligands selective for the 18 kDa translocator protein (TSPO) which is highly upregulated in the brain in pathological conditions. Several TSPO ligands have been developed and validated, so far. Among these, PBR28 has been widely adopted for PET imaging at both preclinical and clinical levels, thanks to its high brain penetration and high selectivity. For this reason, PBR28 represents a good candidate for functionalization strategies, where this ligand could be exploited to drive selective targeting of TSPO-expressing cells. Since the PBR28 structure lacks functional moieties that could be exploited for derivatization, in this work we explored a synthetic pathway for the synthesis of a PBR28 derivative carrying an alkyne group (PBR-alkyne), enabling the fast conjugation of the ligand through azide-alkyne cycloaddition, also known as click-chemistry. As a proof of concept, we demonstrated in silico that the derivatized PBR28 ligand maintains the capability to fit into the TSPO binding pocked, and we successfully exploited PBR-alkyne to decorate zwitterionic biodegradable polymer nanoparticles (NPs) resulting in efficient internalization in cultured microglia-like cell lines.

Biodegradable polymeric nanoparticles (NPs) are attracting increasing attention as carriers for drug delivery. However, one of the main factors limiting their transition to the market is their premature degradation and release of the payload during the storage. Therefore, for increasing the formulation shelf-life, the removal of water is of paramount importance. In this work, we synthesized both polyethylene glycol (PEG)-stabilized and zwitterionic NPs via Reversible Addition Fragmentation Chain Transfer (RAFT) Polymerization. We demonstrated that lyophilization leads the PEGylated NPs to irreversible aggregation, while the stability of the zwitterionic NPs was preserved only using a cryoprotectant. Therefore, we developed an alternative method for the NP concentration, based on the dialysis against a concentrated PEG solution. This method was optimized in terms of concentration factor (Fc), the ratio between the final and initial NP concentration, by acting on the PEG concentration in the dialysis medium, on its volume and on the initial NP concentration. With this approach, Fc up to 40 can be achieved in less than 10 h, preserving the possibility of redispersing the NPs to their original particle size distribution. Therefore, the dialysis proposed herein is a valuable alternative to lyophilization for the concentration of polymer NPs preserving their stability., (Copyright © 2020 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.)

Evaluating the effects of anthropogenic pressure on the marine environment is one of the focal objectives in identifying strategies for its use, conservation and restoration. In this paper, we assessed the effects of chemical pollutants, grain size and plastic litter on functional traits, biodiversity and biotic indices. The study was conducted on the benthic communities of three harbours in the central Mediterranean Sea: Malta, Augusta and Syracuse, subjected to different levels of anthropogenic stress (high, medium and low, respectively). Six traits were considered, subdivided into 22 categories: reproductive frequency, environmental position, mobility, life habit, feeding habit and bioturbation. Functional diversity indices analysed were: Functional Divergence, Quadratic Entropy, Functional Evenness and Functional Richness. To assess the trait responses to environmental gradients, we applied RLQ analysis, which considers simultaneously the relationship between three components: environmental data (R), species abundances (L) and species traits (Q). From our analyses, significant relationships (P-value = 0.0018 for permutation of samples, and P-value = 0.00027 for permutation of species) between functional traits and environmental data were highlighted. The trait categories significantly influenced by environmental variables were those representing feeding habits and mobility. In particular, the first category was influenced by chemical pollutants (organotin compounds and polycyclic aromatic hydrocarbons) and grain size (silt and sand), while the latter category was influenced only by chemical pollutants. Pearson correlations performed for functional vs biotic and diversity indices confirmed the validity of the chosen conceptual framework for harbour environments. Finally, linear models assessing the influence of stressors on functional parameters underlined the link between environmental data vs benthic and functional indices. Our results highlight the fact that functional trait analysis provides a useful and fast method for detecting in greater depth the effects of multiple stressors on functional diversity in marine ecosystems., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

The intense shipping traffic characterising the Adriatic Sea favours the spread of marine organisms. Yet, a study of 12 Adriatic ports (4 on the western side and 8 on the eastern side of the basin) found that non-indigenous species (NIS) accounted for only 4% of the benthic communities settled on hard substrates. The cirripeds Amphibalanus amphitrite and Balanus trigonus, found in 8 harbours, were the most common invaders followed by Amphibalanus eburneus, the ascidian Styela plicata, and the bivalve Magallana gigas. The highest percentage of NIS was recorded in Venice and Ploče, the harbours with the least rich native communities; the lowest percentage was retrieved in Trieste, Koper, Pula, and Rijeka, the harbours hosting the highest species diversity. In contrast, the ports of Bari and Ancona showed both high NIS percentages and highly diversified communities., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

Port baseline surveys (PBS) provide species inventories in and around ports, with a focus on non-indigenous species that may have been introduced by vessels, primarily via ballast water. PBS are an essential tool to support effective management strategies for non-indigenous as well as native harmful aquatic organisms and pathogens (HAOP). This paper describes the methodology of PBS that were conducted in 12 Adriatic ports. The PBS employed existing protocols that were adapted to meet the characteristics of the Adriatic sites. Their results are reported in several papers included in this special issue, each of which is devoted to a specific community. An overview of existing surveys protocols - which provide valuable support to decision-making and to design effective monitoring of non-indigenous species - is also supplied., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Estuaries are known to export huge quantities of terrigenous/riverine organic matter and nutrients to coastal areas, subsidizing food sources to their communities; however, this process is seldom investigated in complex multichannel delta-prodelta systems. Stable isotope analysis was used to investigate the contribution of organic sources originated from the Po River Delta, one of the widest deltaic wetlands in the northern Mediterranean Sea, to the diet of the nearby coastal macrobenthic consumers, and their influence on invertebrates' trophic structure and biomass. Following intense river flood events, macrofauna samples were collected in the prodelta area at increasing distance from the main river distributary mouth. Potential primary resources were collected within the delta and the prodelta areas. A terrestrial signal in the primary consumers' diet was evident as a shift in their δ 13 C, being this more 13 C depleted near the main river distributary. The Bayesian mixing models indicated an important contribution of deltaic sources, in particular C4-grass detritus (25-57%), to primary consumers' diet, confirming a strong energetic link between delta and prodelta areas. Overall, most of the consumers' biomass were concentrated at sites close to the main distributary mouth, mainly as suspension and surface deposit feeders. A simplification of the macrobenthic community structure, accompanied by narrower transfer pathways was also evident at sites more distant from the main river distributary, in relation to changes in the quality of resources. Our data, although limited to winter season, suggest that during periods of low in situ productivity but high river flow energy, invertebrates are able to efficiently exploit terrigenous food sources, restraining the detrimental effect of increased turbidity and sedimentation. We conclude that riparian/wetland vegetation associated with river deltas can provide important food sources to marine primary consumers. These results furthermore highlight the need for integrated management and protection strategies of connected land-sea ecosystems., (Copyright © 2018 Elsevier B.V. All rights reserved.)

Biological Traits Analysis (BTA) was used to identify functional features of infaunal polychaete assemblages associated with contamination in two Italian coastal areas: the harbour of Trieste (Adriatic Sea) and the Mar Piccolo of Taranto (Ionian Sea). The analysis was performed on 103 taxa, collected at four stations in each area. The two areas differed in species composition. The low diversity and the presence of stress-tolerant species in more polluted sites were not reflected in functional diversity, due to species contributing little to community functions or being functionally redundant. Sand and clay fractions were significant drivers of trait category expressions, however other environmental parameters (depth, total organic carbon and nitrogen, and Hg in sediments) influenced traits composition. Motile was the prevalent trait in environments with coarse sediments, and tube-builder were related to fine-grained ones. Motile, endobenthic and burrower were essential traits for living in contaminated sediments. Epibenthic and sessile polychaetes dominated at stations subjected to high organic loads. BTA offers an integrative approach to detect functional adaptations to contaminated sediments and multiple anthropogenic stressors., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Objective: Cognitive deficits are common in Parkinson's disease (PD) since the early stages and many patients eventually develop dementia. Yet, occurrence of dementia in PD is unpredictable. Evidence supports the hypothesis that insulin-like growth factor-1 (IGF-1) is involved in cognitive deficits. Our aim was to evaluate the relationship between serum IGF-1 levels and neuropsychological scores in a large cohort of drug-naïve PD patients during the earliest stages of the disease., Methods: Serum IGF-1 levels were determined in 405 early, drug-naïve PD patients and 191 healthy controls (HC) enrolled in the Parkinson's Progression Markers Initiative (PPMI). The association between serum IGF-1 levels and neuropsychological scores was evaluated with linear regression analysis., Results: IGF-1 levels were similar in PD and HC. In PD patients the lowest IGF-1 quartile was a predictor of lower performances at the Semantic Fluency task (β = -3.46, 95%CI: -5.87 to -1.01, p = 0.005), the Symbol Digit Modalities Score (β = -2.09, 95%CI: -4.02 to -0.15, p = 0.034), and Hopkins Verbal Learning Test Retention (β = -0.05, 95%CI: -0.09 to -0.009, p = 0.019)., Conclusions: Lower serum IGF-1 levels are associated to poor performances in cognitive tasks assessing executive function, attention and verbal memory in a large cohort of early PD patients. Follow-up studies are warranted to assess if IGF-1 is related to the development of dementia in PD.

Acromegaly is a rare disorder caused by chronic growth hormone (GH) hypersecretion. While diagnostic and therapeutic methods have advanced, little information exists on trends in acromegaly characteristics over time. The Liège Acromegaly Survey (LAS) Database , a relational database, is designed to assess the profile of acromegaly patients at diagnosis and during long-term follow-up at multiple treatment centers. The following results were obtained at diagnosis. The study population consisted of 3173 acromegaly patients from ten countries; 54.5% were female. Males were significantly younger at diagnosis than females (43.5 vs 46.4 years; P  < 0.001). The median delay from first symptoms to diagnosis was 2 years longer in females ( P  = 0.015). Ages at diagnosis and first symptoms increased significantly over time ( P  < 0.001). Tumors were larger in males than females ( P  < 0.001); tumor size and invasion were inversely related to patient age ( P  < 0.001). Random GH at diagnosis correlated with nadir GH levels during OGTT ( P  < 0.001). GH was inversely related to age in both sexes ( P  < 0.001). Diabetes mellitus was present in 27.5%, hypertension in 28.8%, sleep apnea syndrome in 25.5% and cardiac hypertrophy in 15.5%. Serious cardiovascular outcomes like stroke, heart failure and myocardial infarction were present in <5% at diagnosis. Erythrocyte levels were increased and correlated with IGF-1 values. Thyroid nodules were frequent (34.0%); 820 patients had colonoscopy at diagnosis and 13% had polyps. Osteoporosis was present at diagnosis in 12.3% and 0.6-4.4% had experienced a fracture. In conclusion, this study of >3100 patients is the largest international acromegaly database and shows clinically relevant trends in the characteristics of acromegaly at diagnosis., (© 2017 The authors.)

Since the 1990's cabergoline has been the treatment of choice in prolactinoma, as it permits rapid and effective hormonal and tumor control in most cases. Evidence of cardiac valvulopathy was demonstrated in Parkinson's disease patients treated with dopamine agonists. Retrospective studies in prolactinoma patients treated with cabergoline at lower doses did not show such an effect. However, few prospective data with long-term follow-up are available. The aim of this study was to assess the safety of cabergoline regarding cardiac valvular status during prospective follow-up in patients treated for prolactinoma or idiopathic hyperprolactinemia. We report here a series of 100 patients (71F; median age at diagnosis: 41.5 years) treated with cabergoline for endocrine diseases (prolactinoma n = 89, idiopathic hyperprolactinemia n = 11). All patients underwent complete transthoracic echocardiographic studies at baseline and during long-term prospective surveillance using the same equipment and performed by the same technicians. The median interval between baseline and last follow-up echocardiographic studies while on cabergoline was 62.5 months (interquartile range: 34.75-77.0). The median total duration of cabergoline treatment was 124.5 months (interquartile range: 80.75-188.75) and the median cumulative total dose of cabergoline was 277.8 mg (interquartile range : 121.4-437.8 mg) at last follow-up. We found no clinically relevant alterations in cardiac valve function or valvular calcifications with cabergoline treatment. Our data suggest that findings from retrospective analyses are correct and that cabergoline is a safe chronic treatment at the doses used typically in endocrinology.

Carbon and nitrogen stable isotope analysis was used to examine the food web of the Mar Piccolo of Taranto, a coastal basin experiencing several anthropogenic impacts. Main food sources (algal detritus, seaweeds, particulate organic matter (POM) and sediment organic matter (SOM)) and benthic and pelagic consumers were collected during two contrasting seasons (June and April), at four sites distributed over two inlets, and characterized by different level of confinements, anthropogenic inputs and the presence of mussels farming. δ(13)C values of organic sources revealed an important contribution of POM to both planktonic and benthic pathways, as well as the influence of terrigenous inputs within both inlets, probably due to high seasonal land runoff. Although δ(13)C of both sources and consumers varied little between sampling sites and dates, δ(15)N spatial variability was higher and clearly reflected the organic enrichment in the second inlet as well as the uptake of anthropogenically derived material by benthic consumers. On the other hand, within the first inlet, the isotopic composition of consumers did not change in response to chemical contamination. However, the impact of polluted sediments near the Navy Arsenal in the first inlet was detectable at the level of the macrobenthic trophic structure, showing high dominance of motile, upper level consumers capable to face transient conditions and the reduction of the more resident deposit feeders. We therefore underline the great potential of matching stable isotope analysis with quantitative studies of community structure to assess the effects of multiple anthropogenic stressors.

The Mar Piccolo of Taranto, classified as a 'Site of National Interest' (SIN), is a semi-enclosed basin divided into two inlets with lagoon features and sea influences, seriously affected by anthropic activities. In the framework of the RITMARE project, a study has been carried out to evaluate the functionality of this ecosystem. As part of this work, measurements of the water abiotic parameters were performed in order to assess the physical-chemical features of this area after the activation, in the last decade, of treatment plants for various urban and industrial dumping. Seawater intrusions and continental inputs, as well as several submarine freshwater springs, clearly affect physical-chemical characteristics of the water column in the two inlets. This finding suggests that small-scale patterns in water circulation have the potential to influence the chemical properties of the seawater. The comparison with a 20-year dataset reveals a drastic decrease in nutrient concentrations after the year 2000, validating the functionality of the treatment plants. The reduction of nutrient inputs into the basin (up to -90 % in the first inlet characterized by lower hydraulic residence time) has changed the biogeochemical characteristics of the Mar Piccolo from being relatively eutrophic to moderately oligotrophic.

The Mar Piccolo is a semi-enclosed basin subject to different natural and anthropogenic stressors. In order to better understand plankton dynamics and preferential carbon pathways within the planktonic trophic web, an integrated approach was adopted for the first time by examining all trophic levels (virioplankton, the heterotrophic and phototrophic fractions of pico-, nano- and microplankton, as well as mesozooplankton). Plankton abundance and biomass were investigated during four surveys in the period 2013-2014. Beside unveiling the dynamics of different plankton groups in the Mar Piccolo, the study revealed that high portion of the plankton carbon (C) pool was constituted by small-sized (<2 μm) planktonic fractions. The prevalence of small-sized species within micro- and mesozooplankton communities was observed as well. The succession of planktonic communities was clearly driven by the seasonality, i.e. by the nutrient availability and physical features of the water column. Our hypothesis is that beside the 'bottom-up' control and the grazing pressure, inferred from the C pools of different plankton groups, the presence of mussel farms in the Mar Piccolo exerts a profound impact on plankton communities, not only due to the important sequestration of the plankton biomass but also by strongly influencing its structure.

The response of phytoplankton assemblages to the closure of urban sewage outfalls (USOs) was examined for the Mar Piccolo of Taranto (Mediterranean Sea), a productive semi-enclosed coastal marine ecosystem devoted to shellfish farming. Phytoplankton dynamics were investigated in relation to environmental variables, with a particular emphasis on harmful algal blooms (HABs). Recent analyses evidenced a general reduction of the inorganic nutrient loads, except for nitrates and silicates. Also phytoplankton biomass (chlorophyll a) and abundances were characterized by a decrease of the values, except for the inner area of the basin (second inlet). The phytoplankton composition changed, with nano-sized species, indicators of oligotrophic conditions, becoming dominant over micro-sized species. If the closure of the USOs affected phytoplankton dynamics, however, it did not preserve the Mar Piccolo from HABs and anoxia crises. About 25 harmful species have been detected throughout the years, such as the potentially domoic acid producers Pseudo-nitzschia cf. galaxiae and P seudo-nitzschia cf. multistriata, identified for the first time in these waters. The presence of HABs represents a threat for human health and aquaculture. Urgent initiatives are needed to improve the communication with authorities responsible for environmental protection, economic development, and public health for a sustainable mussel culture in the Mar Piccolo.

The benthic ecosystem functioning is a rarely applied holistic approach that integrates the main chemical and biological features of the benthic domain with the key processes responsible for the flux of energy and C through the system. For the first time, such conceptual model, with an emphasis on the heterotrophic pathways, has been applied to the sediments at four stations within one of the most polluted coastal areas in Italy: the Mar Piccolo of Taranto. The functioning of the benthic ecosystem was different according to the investigated site. Nearby the military arsenal, i.e., the main source of organic contaminants and heavy metals, the system seemed inhibited at all the investigated structural and functional levels. Slow microbial processes of C reworking together with very limited densities of benthic fauna suggested a modest transfer of C both into a solid microbial loop and to the higher trophic levels. On the other hand, the ingression of marine water through the "Navigabile" channel seemed to stimulate the organic matter degradation and, consequently, the proliferation of meiofauna and macrofauna. In the innermost part of the basin, the system functioning, to some extent, is less impacted by contaminants and more influenced by mussel farms. The organic matter produced by these bivalves fueled faster C reworking by benthic prokaryotes and enhanced the proliferation of filter feeders.

Objective: Alendronate is a second generation bisphosphonate which has been widely used in medical practice for two decades to treat osteoporosis and prevent fragility fractures both in elderly people and in younger patients., Methods: Since many papers have been recently published and new formulations or dosages have been developed, our aim was to review the most significant medical literature addressing the issues of efficacy, safety, posology and formulations of the treatment with alendronate in osteoporotic patients., Results: The efficacy of alendronate in reducing the risk of vertebral and non-vertebral fractures has been demonstrated in several studies. Despite favourable data coming from clinical trials, tolerability of alendronate represented a critical issue since its introduction into real clinical practice, possibly leading to early discontinuation of the therapy, especially when combined with lack of motivation of the patient. For this reason, new dosages and formulations of alendronate have been developed, alone or in combination with vitamin D, which have shown to reduce the impact of gastro-oesophageal adverse events, and minimize discomfort due to the need of adopting unfavourable postural positions every day, fasting for at least one hour., Conclusions: Alendronate is the most frequently used antifracture therapy among those currently available. The increasing use of the 70 mg weekly dosages and newest formulations of this drug are expected to reduce adverse events and increase adherence to the antifracture therapy, thus resulting in better clinical outcomes when treating osteoporotic patients.

Objective: Non-invasive testing often does not identify coronary artery disease (CAD) in diabetic subjects. This study was designed in order to examine the prevalence of CAD in a cohort of asymptomatic type 2 diabetic patients at high cardiovascular risk and negative nuclear imaging, using multi-slice computed tomography (MSCT) angiography., Methods: In total, 770 type 2 diabetic patients were screened from January 2008 through July 2010. Of these, 132 Caucasians with diabetic nephropathy and asymptomatic for angina were eligible for a cross-sectional study. Patients underwent MSCT after ischaemia was excluded by myocardial Single Photon Emission Computed Tomography (SPECT) at rest and after dynamic exercise. When obstructive plaques were found (≥ 50% lumen narrowing), patients were sent to conventional coronary angiography (CCA)., Results: Six subjects were not included in the analysis because of motion artefacts. MSCT was positive for CAD in 114 patients (90%). Within patients with positive MSCT, 60 (48% of all) showed one or more obstructive plaques. CCA confirmed significant stenosis (≥ 50%) in 48 of these 60 patients (80%). Some 21 (35%) showed stenosis ≥ 75% and were submitted to the revascularisation procedure., Conclusion: MSCT seems to better identify CAD than myocardial SPECT in asymptomatic patients with type 2 diabetes and diabetic nephropathy.

Context: Impaired glucose tolerance and diabetes mellitus are frequently present in acromegalic patients in whom the degree of impaired glucose metabolism seems directly correlated with GH levels. Microalbuminuria is reported to be directly correlated with insulin resistance, and both conditions predict cardiovascular disease mortality., Objective: Our objective was to investigate the microalbuminuria levels as a marker of endothelial dysfunction in acromegalic patients., Design: We conducted an observational, multicenter, open prospective study., Subjects: Subjects included 74 patients with active acromegaly (52 with normal glucose tolerance, 16 with impaired glucose tolerance, and six with diabetes), and 50 healthy subjects matched for age, gender, and body mass index were studied as controls., Results: In the whole group, mean GH and IGF-I levels were 24.2+/-3.9 ng/ml and 700.1+/-23.0 microg/liter, respectively. The insulin sensitivity index (ISI) in the patients was lower than in the controls (P<0.0005). In impaired glucose tolerance and diabetic patients, microalbuminuria was higher than in normal glucose tolerance patients (P<0.05 and P<0.0005 respectively). Hypertensive patients had higher levels of microalbuminuria than normotensive ones (P<0.005). The levels of microalbuminuria related to creatinine were directly correlated with fasting glucose levels (r=0.27; P=0.0019), fasting insulin levels (r=0.28; P=0.017), and insulin after 90 (r=0.26; P=0.027) and 120 min after glucose load (r=0.26; P=0.023) and indirectly correlated with ISI composite (P<0.0001; r=-0.48). By a multivariate analysis, the log-ISI composite was the strongest predictor of microalbuminuria (t=-3.19; P=0.0021)., Conclusions: Impairment of glucose tolerance in acromegaly is associated with high levels of microalbuminuria. For this reason, microalbuminuria should be part of cardiovascular risk assessment in these patients.

Objective: To verify the safety of desmopressin treatment and its associated side-effects in a large number of patients., Material and Methods: The study was conducted in accordance with the guidelines of the Italian Club for Nocturnal Enuresis, whose criteria are: age >5 years; absence of malformations and infections of the urinary tract; absence of psychological disorders or neurological alterations; number of "wet nights" >5-7; control of liquid intake during the afternoon and evening; monitoring of serum electrolytes before beginning treatment; control of body weight before the beginning of treatment and during the first 4-5 days of therapy; and the informed consent of the parents. The therapeutic regimen provided for a maximum dose of desmopressin of 40 microg/day (four puffs/nostril or two tablets), starting from an initial dosage of 20 microg/day (two puffs/nostril or one tablet) 1 h before going to bed. The study involved two groups of patients with monosymptomatic enuresis: some of them had been administered desmopressin in the form of a spray and others in the form of tablets., Results: A small percentage of patients presented mild, transient side-effects; in no case were severe side-effects verified., Conclusion: Desmopressin is a safe drug with a low incidence of side-effects.

Except for a few particular conditions, the diagnostic evaluation of hyperprolactinemia is easy since the routine use of magnetic resonance imaging (MRI) scan has permitted to identify even small microadenomas. Other conditions include the identification of large PRL molecular complex, dimers, trimers or polymers of PRL, called "big or big-big PRL", and of PRL autoantibodies and the biochemical finding of "high dose PRL hook effect". Finding elevated serum PRL levels should be considered as the beginning and not the conclusion of a diagnostic evaluation: first, a careful anamnesis should exclude possible physiologic, pharmacologic and organic causes of hyperprolactinemia; second, possibly one laboratory only, undergoing regularly quality controls, should analyze blood samples; serial serum PRL measurements at 0, 30, 60 min is a valuable and simple measure to identify stress-related hyperprolactinemia. In the past two decades several pharmacological tests were used in order to distinguish between small microprolactinomas and "non-tumoral hyperprolactinemia": the controversial results of these tests together with the availability of MRI has excluded all pharmacological tests in the work-up of hyperprolactinemia. MRI is preferred to computed tomography (CT) due to its better definition of very small lesions in the pituitary sella and better anatomical definition prior to surgery. Finally, once the diagnosis of prolactinoma is suspected, patients should be referred to a specialist centre for further assessment and treatment.