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The estimation of the slope (b -value) of the frequency–magnitude distribution of earthquakes is based on a formula derived by Aki decades ago, assuming a continuous exponential distribution. However, as the magnitude is usually provided with a limited resolution, its distribution is not continuous but discrete. In the literature, this problem was initially solved by an empirical correction (due to Utsu) to the minimum magnitude, and later by providing an exact formula such as that by Tinti and Mulargia, based on the geometric distribution theory. A recent paper by van der Elst showed that the b -value can be estimated also by considering the magnitude differences (which are proven to follow an exponential discrete Laplace distribution) and that in this case the estimator is more resilient to the incompleteness of the magnitude data set. In this work, we provide the complete theoretical formulation including (i) the derivation of the means and standard deviations of the discrete exponential and Laplace distributions; (ii) the estimators of the decay parameter of the discrete exponential and trimmed Laplace distributions and (iii) the corresponding formulas for the parameter b. We deduce (iv) the standard 1 σ intervals for the estimated b. Moreover, we are able (v) to quantify the error associated with the Utsu minimum-magnitude correction. Furthermore, we have discussed the formulas to produce statistically independent magnitude differences. We tested extensively the b -value estimators on simulated synthetic data sets including complete catalogues as well as catalogues affected by a strong incompleteness degree such as aftershock sequences where the incompleteness is made to vary from one event to the next. We have also analysed the real aftershock sequence of the 30/10/2016 Norcia (central Italy) to integrate the finding of the simulations. To judge the performance of the various estimators we have introduced an index p that can be seen as a non-parametric extension of the Student's t index. The main outcomes of this paper are that (1) the b -value estimators devised for continuous magnitude data are not adequate for binned magnitudes, (2) for complete data sets, estimators based on magnitudes and on magnitude differences provide substantially equivalent results, (3) for incomplete magnitude data sets, estimators based on magnitude differences provide better results and (4) for incomplete aftershock sequences there is no evidence that methods based on positive magnitude differences are superior than other methods using differences. This conclusion is further confirmed by our analysis of the above-mentioned Norcia seismic sequence. This last finding contrasts with the van der Elst's claim that the so called |${{b}_ + }$| method is the most adequate to treat real aftershock sequences. [ABSTRACT FROM AUTHOR]

In this paper, we gather and take stock of the results produced by the Operational Earthquake Forecasting (OEF) system in Italy, during its first 10 yr of operativity. The system is run in real-time: every midnight and after each M L 3.5+ event, it produces the weekly forecast of earthquakes expected by an ensemble model in each cell of a spatial grid covering the entire Italian territory. To evaluate the performance skill of the OEF-Italy forecasts, we consider here standard tests of the Collaboratory for the Study of Earthquake Predictability, which have been opportunely adapted to the case of the overlapped weekly OEF forecasts; then we also adopt new performance measures borrowed from other research fields, like meteorology, specific to validate alarm-based systems by a binary criterion (forecast: yes/no; occurrence: yes/no). Our final aim is to: (i) investigate possible weaknesses and room for improvements in the OEF-Italy stochastic modelling, (ii) provide performance measures that could be helpful for stakeholders who act through a boolean logic (making an action or not) and (iii) highlight possible features in the Italian tectonic seismic activity. [ABSTRACT FROM AUTHOR]

Estimation of local seismic response plays a key role in assessing local seismic hazard and particularly in the design of shaking scenarios. Modelling local seismic response involves knowing of the shear wave velocity (VS) and quality factor (QS) profiles for the site in question. The many techniques that have been developed to assess VS in surface deposits produce reliable measurements of VS , but these rarely correspond to direct measurements of QS. The latter is often considered through damping measures from laboratory tests on small-scale soil samples, which can provide information primarily on intrinsic attenuation, neglecting the contribution of scattering effects. In this paper, using seismic recordings obtained at the surface and in boreholes at 100 m depth, we estimate an average value of QS of some characteristic alluvial deposits of the Po Plain (northern Italy). Data come from a microseismic network which sampled an almost uniform lithology in the central Po Plain and consisted of three surface and four borehole stations with an interstation distance of about 2 km. The average value of QS of the shallowest 100 m of the sedimentary strata, Q S ,100, is estimated by considering: (1) the high-frequency attenuation of seismic waves due to propagation through the corresponding stratigraphy and (2) the interference between incident and surface-reflected waves observed at borehole stations. We parametrize the first through |$\Delta k_{0_{ {100}}}$|⁠ , the difference between the values of the spectral decay parameter kappa (k) estimated at the surface and at the boreholes depth, respectively. We use the second in order to compute V S ,100, the time-averaged VS referred to the uppermost 100 m stratigraphy. We obtain: |$\Delta k_{0_{ {100}}} = (11 \pm 3)\,$|  ms, |${V_{S,100}} \, =\, (309\, \pm \, 11)\,$| m s−1 and |${Q_{S,100}} \, =\, 31 \pm 10$|⁠. At the surface, the estimated values of the site-specific kappa, k 0, are found to range from 75 to 79 ms. As expected, these results are in good agreement with studies performed in other sites characterized by sandy or clayey lithologies, and can be usefully used in site response analysis at sites where the rigidity is mainly controlled by lithostatic pressure. [ABSTRACT FROM AUTHOR]

In this paper we deal with statistical features of earthquakes, seeking possible correlations between the Gutenberg–Richter magnitude distribution and the short-term clustering in an area of the Central Apennines, Italy, where significant seismicity with earthquakes exceeding magnitude 6.0 has been repeatedly observed from 1990 to the present. For this purpose, a recently developed version of the ETAS model, incorporating a 3-D spatial triggering kernel, has been adopted. Our analysis has been carried out representing the b -value and the probability of independence of events on six vertical cross-sections suitably related to the seismic structures that are considered responsible of the seismicity observed in the study area. The results of the statistical analysis of the seismicity in the study area have shown a clear distinction between the western normal low-angle fault system, characterized by eastward dip and the eastern normal fault systems, with westward dip. In the former (Etrurian Fault System ; EFS) we found seismicity with a high b -value and high probability of independence, that is a scarce capacity of producing clusters and strong aftershock sequences. The eastern fault systems of our study area are distinguishable in two main distinct systems, which generated two strong seismic sequences in 1997 and 2016–2017. In the former (Colfiorito) sequence the seismicity showed a very low b -value and a modest probability of independence, while in the latter (Central Italy) sequence the b -value was significantly higher and the probability of independence had extremely low values (manifesting a high level of clustering). The much higher b -value of the EFS than the other extensional sources could be caused by its peculiar seismotectonic role of discontinuity at the base of the normal active faulting, and its reduced capacity of accumulating stress. This circumstance may be interpreted by a difference in the rheological properties of these fault systems, possibly also in relation to their present status in the earthquake cycle and the presence of strong aftershock sequences. [ABSTRACT FROM AUTHOR]

Legal medical doctors (LMDs) expertise encompasses a wide range of responsibilities. Work-related stress amongst LMDs is an extremely relevant factor, which affects the quality of LMDs life and work. Whilst it is a better-known problem abroad, this issue is poorly debated in Italy, as demonstrated by this literature analysis. The aim of this paper is to better understand the main sources of stress in the practice of legal medicine in Italy, highlighting the need for systematic psychological support. The risks of work-related stress for the social and health professions are well known in literature. In Italy, however, due to a series of complex circumstances and cultural and research delays, forensic practitioners often seem to be excluded from these kinds of complex issues. The authors, after a series of considerations drawn from a review of the literature and from experience in the forensic and medical field, point out how work in this area entails risks for workers, on par with all others belonging to the helping and social-health professions. They conclude their contribution with a series of proposals for appropriate protocols to cope with such problems for workers in the forensic and medical field. Key points Work-related risks for the social and health professionals are widely recognized in the literature. Although legal medical doctors are often thought to be safe from these types of issues, significant risks exist for this category as well. It is important to create appropriate protocols to address outcomes for legal medical doctors. [ABSTRACT FROM AUTHOR]

Etizolam is a benzodiazepine (BZD). Etizolam is structurally different from BZDs as a thiophene replaces the benzene ring and a triazole ring is fused to the diazepine ring, but etizolam's pharmacological profile is similar. Etizolam has been used to treat anxiety and panic disorders, to reduce depressive and somatization symptoms and to induce muscle relaxation. Etizolam is used recreationally due to its reinforcing and sedative effects. Etizolam is available in tablet or powder form or administered on blotter paper that can be placed on the tongue for oral absorption. Etizolam metabolizes into two major metabolites: α-hydroxyetizolam and 8-hydroxyetizolam, and all three compounds can be detected in different biological specimens using various common analytical techniques such as immunoassay, chromatography and mass spectrometry. Etizolam is a controlled drug in many countries around the globe but is approved for medical use in some countries, such as Japan, South Korea and Italy. This work is a collation and review of available literature on etizolam to help improve the fundamental understanding of its toxicology, outline best analytical practice, and aid interpretation of toxicology results. [ABSTRACT FROM AUTHOR]

Following the M w 3.9 earthquake that occurred in the Ischia island (Naples, southern Italy) on 21 August 2017, the local monitoring seismic network was significantly improved in terms of both number of stations and instrumentation performance. Due to the huge amount of collected seismic ambient noise data, in this paper we present a first 3-D shear wave velocity model of the island retrieved from the inversion of horizontal-to-vertical spectral ratio curves by fixing the shear wave velocities (Vs) and modifying the thicknesses to get the corresponding 1-D Vs models. We are confident about the robustness of the attained models since the inversion process provided a good convergence towards the best-fitting solutions. Then, a first 3-D velocity model was obtained by contouring all the 1-D models obtained for the selected seismic stations to highlight possible lateral variations of the layer thicknesses and to reconstruct the morphology of the deeper interface characterized by a high-impedance contrast. A good correspondence between the 3-D Vs model and the geological features of the island was observed, especially in the northern sector where most of the stations are installed. In particular, the top of the high-impedance contrast interface appears deeper in the northern coastal areas and shallower in the central sector. This result agrees with the structural settings of the island likely due to the resurgence of Mount Epomeo. [ABSTRACT FROM AUTHOR]

In the wake of the Covid-19 pandemic, public private partnerships (PPP) can prove useful to close the healthcare investment gap and accelerate long-term recovery, by matching public and private money. Despite their extensive application in the delivery of major infrastructure projects globally, their performance remains contested. Drawing on a unique set of data of PPP contracts for healthcare investments in Italy, the paper explores the antecedents (namely, policies, institutions, and contracts), that have influenced the capacity of PPP contracts to deliver performance, measured in terms of value for money (VfM), and contract stability. Results show that although explicit policy goals have a clear contribution, VfM can benefit from competent central PPP institutions, which should play a hands-on role in the planning, design, and project management activities. At the same time, centralised PPP units, if not combined with local competent authorities and strong governance mechanisms, may increase the risk of contract renegotiation. [ABSTRACT FROM AUTHOR]

The sustainability of the Italian government debt has been under close scrutiny since the launch of the Euro Area, and even more so after the Global Financial Crisis. The Covid-19 crisis in 2020 has depressed the Italian economy further and negatively affected the government budget. Despite the rebound in 2021, the state of the economy and government debt in Italy remain precarious. Building on Pasinetti's work, this paper examines the sustainability of the Italian government debt through a medium-scale, stock-flow consistent, structural macroeconometric model. The model has been coded and calibrated using the R package Bimets developed by the Bank of Italy. Our findings show that the Italian government debt is unlikely to enter a sustainable trajectory in the next few years. While the Next Generation EU and the other fiscal and monetary measures are helping the Italian economy to recover, in the coming years, a greater effort on the part of the European authorities—including an intervention of the ECB in controlling the yield curve—seems necessary to stabilize the debt to GDP ratio in Italy. [ABSTRACT FROM AUTHOR]

In the face of the complexities of problem-solving, experts are gaining centrality in policymaking (Weiss, 1979). At the same time, they are increasingly challenged in their legitimacy, which is not only technical but also political. Challenges to the legitimacy of experts suggest that other types of legitimacy are important for policymaking. Issues of legitimacy are particularly important for sound policymaking when the authority of experts and the value of evidence are contested and when the debate over policy solutions is particularly conflictual and ideological. In this paper, I use three exploratory cases of the use of expertise in education policy in Italy to show how policymakers design different advisory committees to enhance different types of legitimacy (epistemic, bureaucratic, and political). The findings suggest that while policymakers design advisory committees primarily to meet their legitimacy needs, the legitimacy of a decision requires different types of sources to generate consent and to allow for the impact of expertise. [ABSTRACT FROM AUTHOR]

SUMMARY: We estimate the b-value parameter of the Gutenberg–Richter law for earthquake magnitudes in the early stage of the Costa Marchigiana (Italy) seismic sequence, starting on 2022 November 9, with an ML 5.7 event in the Adriatic sea. In particular, we estimate both the completeness magnitude Mc and the b-value within the first 4 and 7 d after the initial strong event in the sequence. Our work represents a practical example of b-value estimation in 'true' real time, that is, during the seismic sequence, and its possible interpretation in terms of short-term forecasting. We highlight some critical issues to consider both in estimating/intepreting the b-value, and in evaluating the real time estimation of Mc. These issues are mainly due to the fact that preliminary catalogues available in real time are quite different from the revised ones, which are usually delivered after a few months. The criticalities are linked to the raw data recorded at an early-stage, an unreliable evaluation of the Mc with statistical approaches, the Short Term Aftershock Incompleteness entailed after the initial strong event, and the magnitude binning. Our results show that real time estimation of the b-value can give insights into the evolution of an ongoing seismic sequence, when attention is paid to data quality and quantity. [ABSTRACT FROM AUTHOR]

Background: Healthcare associated foodborne outbreaks (HA-FBO) can result from exposure to contaminated food in premises where highly vulnerable patients are cared, including hospitals and nursery homes. The probability of developing severe foodborne diseases such as invasive listeriosis is much higher for susceptible populations. There is limited knowledge on the data on food exposures that could be used to investigate HAFBOs. There is also lack of data relating to specific policies in the health facilities aimed to prevent the administration of potentially risky foods, possibly bringing them from home. Methods: This study was in the framework of One Health EJP Project NOVA. A semistructured questionnaire was administered to 4 general hospitals, 1 specialist clinic and 3 nursing homes located in the Abruzzo and Molise regions, Italy. The questionnaire included 25 questions in 3 sections (I. General organization of the catering service; II. Food menu data; III. Food from home). Results: In most facilities (75%) external catering companies used inhouse kitchens. Trace-back of food to individual patients was possible in 5 premises out of 8 (62.5%), but only in 1 nursery home out of 3 (33.3%). Data were collected in electronic format (hospitals) or paper (nursery homes) and stored 1-12 months. Food at risk of Listeria monocytogenes were not excluded from the menus, such as pre-sliced cooked meat products (served in 4 out of 8 premises, 50%), smoked fish (20%), soft cheese (20%). The consumption of food brought from home was possible in ‘‘special occasions’’, mostly in the nursery homes (66.6%). Conclusions: In case of HA-FBO it could be difficult to trace back the food particularly in the nursery homes where food data are not individually collected and usually on paper. More studies are needed in order to understand the effective exposure to foodborne pathogens, given that some types of foods considered by EFSA as at high risk of microbial contamination are commonly served. Key messages: · Served food could not be traced back to the patient mostly in nursery homes. · Foods at risk of Listeria monocytogenes contamination are commonly served to patients and residents. [ABSTRACT FROM AUTHOR]

We study the financial and real effects of political risk shocks for Italy, Spain, Ireland, Portugal and Greece between 2008 and 2019. We build an instrument for these shocks using the changes of the sovereign yield spread around political and policy dates, and estimate their effects in the context of local projection. We show that adverse political risk shocks have negative effects on domestic financial markets and in some countries generate spillovers on the spreads of other eurozone economies. Moreover, in Italy populism-related political risk shocks have a larger effect on financial markets and they harm the real economy. [ABSTRACT FROM AUTHOR]

Environmental health literacy (EHL) is a rather recent concept that applies health literacy skills to environmental issues. Research in this field is still at the beginning, and there is currently no existing tool in the literature designed to comprehensively assess individual general EHL among university students. The aim of our study is to fill this gap through the validation of the Environmental Health Literacy Index (EHLI) in such a target group. We adapted a previously administered survey, originally completed by 4778 university students from various Italian universities. Starting from the original questionnaire, our methodology involved a three-round item selection process, followed by a comprehensive evaluation of the instrument's psychometric properties. The EHLI consists of 13 Likert-type items, covering three primary domains of health literacy: functional (six items), interactive (three items), and critical (four items). The Cronbach's alpha coefficient is 0.808 for the global scale, while it stands at 0.888 for the functional, 0.795 for the critical, and 0.471 for the interactive components. The area under the receiver operating characteristic curve reached a value of 0.643. Spearman correlation analysis revealed a significant yet slight correlation between EHLI and both functional health literacy score and the extent of pro-environmental behaviors adoption. Our study serves as an important initial step in developing a tool able to evaluate the EHL of university-aged individuals. Further research efforts may improve the questionnaire's validity and completeness, as well as to explore its applicability to different age groups. [ABSTRACT FROM AUTHOR]

The aim of this study was to describe the goals, activities, and methods of EUMOVE project in developing a set of resources targeting both primary and secondary schools that allow the entire educational community to promote healthy lifestyles (HL). The EUMOVE project is an Erasmus+ program based in the Creating Active Schools (CAS) framework. The project lasted 3 years and was developed by 14 academic and non-governmental institutions from Spain, Portugal, France, Italy, and the UK. EUMOVE was divided into three phases. In the first phase, several work packages were carried out aimed to ensure the coordination/management of the project activities. In the second phase, seven educational resources strengthened by rigorous scientific research were developed to promote HL from schools. During the last phase, all the resources were disseminated through scientific seminars, workshops with families and teachers, and the online promotion by the non-governmental institutions of each country. The EUMOVE project developed and promoted a smartphone APP, video/activity repository of physically active lessons, active break virtual platform, learning units, and parent/teachers/school-leaders' guidelines to promote physical activity, active commuting, active school playgrounds, healthy diet, and sleep habits. To our knowledge, EUMOVE is the first European project to provide a set of practical tools based on scientific evidence to help schools or future school-wide interventions implement a paradigm shift based on the CAS framework for the promotion of HL. Future research will need to investigate the implementation, effectiveness, and scalability of this proposal. [ABSTRACT FROM AUTHOR]

This article aims to estimate fiscal multipliers in Italy by assessing the effect of an increase in government expenditure and taxes on the Gross Domestic Product (GDP). By applying structural vector autoregressive modelling to Italian quarterly data for the 1995–2019 period, I show that expansionary fiscal policies produce positive effects on the GDP level. Estimated spending multipliers are higher than 1, and when government investment and consumption are compared, findings show that government investment has a larger effect on GDP than government consumption. Estimated tax multipliers are lower than 1, and tax-based policies are less effective in stimulating GDP than expenditure-based fiscal plans. My findings strongly support the Keynesian perspective and indicate that Italy should increase public investments considerably in order to foster economic growth. [ABSTRACT FROM AUTHOR]

Background Primary hyperoxaluria (PH) is a rare, severe genetic disorder, characterized by increased urinary excretion of calcium oxalate, which is responsible for kidney damage and systemic clinical manifestations. Since the year 2020, a new molecule, lumasiran, based on RNA interference (RNAi) technology, has been added to the traditional therapeutic approach. The aim of this analysis was to define the baseline characteristics of a PH1 pediatric population treated with lumasiran in a compassionate-use program setting, and to evaluate the medium-term efficacy of this drug in the routine clinical setting. Methods A retrospective observational analysis was conducted in nine pediatric patients (male:female 5:4; median age at lumasiran start 1.9 years, range 0–14.1). Data concerning oxalate concentration in plasma and urine, kidney stones events, ultrasound and kidney function were collected during the study period (follow-up, mean ± standard deviation: 15.3 ± 5 months). Results In this analysis, a reduction in the urinary oxalate to creatinine ratio (reduction range within the sixth month of treatment from 25.8% to 69.6%, median 51.2%) as well as plasma oxalate concentration under the limit of supersaturation of oxalate in all the patients. Only one patient presented new stone events; kidney ultrasonographic findings related to nephrocalcinosis remained stable in eight out of nine patients. Glomerular filtration rate remained stable during treatment. No adverse events related to lumasiran were noted. Conclusion Data from this analysis support the efficacy and safety of lumasiran in a pediatric clinical setting, especially if administrated in early life. [ABSTRACT FROM AUTHOR]

Advancements in genomics have significant implications for public health, making citizens' education vital for informed decision-making. Based on two literature reviews' findings and a survey conducted with experts from the Italian Network of Genomics in Public Health, we conducted a pilot survey on Italian citizens' attitudes, knowledge and educational needs toward genetic testing and omics sciences. Our results demonstrate a widespread interest in genetic testing and uncertainties regarding associated risks, with 99% of participants acknowledging insufficient knowledge of genetic testing. There is an urgent need for educational tools to improve citizens' literacy and engagement in this rapidly evolving field. [ABSTRACT FROM AUTHOR]

Background Disability does not simply affect the health status of the individual who directly experiences that condition, but it has important consequences on the health and well-being of the other family members as well. Focusing on Italy, an extremely interesting test-bed due to its strong familialist welfare regime, we show significant spillover effects of children's disability on parental health and well-being. Methods We use data from a nationally representative household survey on almost 13 000 mothers and fathers and adopt a multivariate regression setting providing evidence that the disability of a child is negatively associated with parents' health and life satisfaction. Results Parents of a disabled child report lower levels of general and mental health, as well as lower levels of well-being compared with parents with a healthy child. Strong heterogeneity by gender and socio-economic characteristics is observed, with mothers being more affected by the disability status of the child than fathers. The estimated coefficients suggest that education remains an important protective factor even for parents of a disabled child. Conclusion This study claims and documents that child disability is an overlooked source of health disadvantage for parents. Such disadvantage is especially relevant for mothers and lower-educated parents, evidence that suggests the importance of taking an intersectional approach to study health disparities. [ABSTRACT FROM AUTHOR]

Background Molecular-driven oncology allows oncologists to identify treatments that match a cancer's genomic profile. Clinical trials are promoted as an effective modality to deliver a molecularly matched treatment. We explore the role of geographical accessibility in Italy, and its impact on patient access to clinical trials. Material and Methods We retrospectively reviewed molecular data from a single-institutional case series of patients receiving next-generation sequencing testing between March 2019 and July 2020. Actionable alterations were defined as the ones with at least one matched treatment on Clinicaltrials.gov at the time of genomic report signature. We then calculated the hypothetical distance to travel to reach the nearest assigned clinical trial. Results We identified 159 patients eligible for analysis. One hundred and one could be potentially assigned to a clinical trial in Italy, and the median distance that patients needed to travel to reach the closest location with a suitable clinical trial was 76 km (interquartile range = 127.46 km). Geographical distribution of clinical trials in Italy found to be heterogeneous, with Milan and Naples being the areas with a higher concentration. We then found that the probability of having a clinical trial close to a patient's hometown increased over time, according to registered studies between 2015 and 2020. Conclusions The median distance to be travelled to the nearest trial was generally acceptable for patients, and trials availability is increasing. Nevertheless, many areas are still lacking trials, so efforts are required to increase and homogenize the possibilities to be enrolled in clinical trials for Italian patients with cancer. [ABSTRACT FROM AUTHOR]

Background: After rising for years, vaccination rates in Italy fell until 2015 because of unfounded safety concerns, abetted by some government and court actions. Public education and a 2017 law on mandatory vaccination have boosted rates since then. So far only a few papers have examined the correlation between beliefs and attitudes towards vaccines and the level of trust in the scientific community regarding vaccinations in the general population. Methods: Data were extracted from the Italian section of the last two editions of the European Social Survey (ESS), the first carried out between September and November 2017, the latter between December 2018 and March 2019. A descriptive analysis was conducted using survey data. In the two editions respectively 2,626 and 2,745 persons were interviewed. The main outcomes assessed was comparing the two surveys, so as to highlight the key changes in public opinion on vaccines. Results: In the 2017 edition, 19% of the respondents believed in the harmfulness of vaccines, out of them 29% did not even have trust in the scientific community while those confident in the safety of vaccines were 50%. In the 2019 survey, the proportion of those who believed vaccines to be harmful fell to 15%, the undecided rose to 15%, those opposed to the idea that vaccines are harmful became 63%, not responding people were 8%. Correspondingly, trust in the scientific community about vaccines has increased from 57% in the first survey to 70% in the last one. Conclusions: The scientific community and research bodies in the last years, in support of the Ministry of Health, have made a huge effort in the public debate on vaccines. This might play a role in increasing the public confidence in the safety of vaccines and the adherence to vaccination campaigns, changing the climate with regard to vaccination in general. Key messages: Italians changed their opinions on vaccines between two ESS surveys. The scientific community had a relevant role in the public debate on vaccines. [ABSTRACT FROM AUTHOR]

Background Missed opportunities constitute a main driver of suboptimal seasonal influenza vaccination (SIV) coverage in older adults. Vaccine co-administration is a way to reduce these missed opportunities. In this study, we quantified missed opportunities for SIV, identified some of their socio-structural correlates and documented SIV co-administration patterns. Methods In this registry-based retrospective cohort study, we verified the SIV status of all subjects aged ≥65 years who received at least one dose of coronavirus disease 2019 (COVID-19), pneumococcal or herpes zoster vaccines during the 2022/23 influenza season. The frequency of concomitant same-day administration of SIV with other target vaccines was also assessed. Results Among 41 112, 5482 and 3432 older adults who received ≥1 dose of COVID-19, pneumococcal and herpes zoster vaccines, missed opportunities for SIV accounted for 23.3%, 5.0% and 13.2%, respectively. Younger, male and foreign-born individuals were generally more prone to missing SIV. The co-administration of SIV with other recommended vaccines was relatively low, being 11.0%, 53.1% and 17.1% in COVID-19, pneumococcal and herpes zoster cohorts, respectively. Conclusions A sizeable proportion of older adults who received other recommended vaccines during the last influenza season did not receive SIV. This share of missed opportunities, which are subject to some social inequalities, may be addressed by increasing vaccine co-administration rates and implementing tailored health promotion interventions. [ABSTRACT FROM AUTHOR]

Background The European Union has used Healthy Life Years (HLY) as an indicator to monitor the health of its aging populations. Scholarly and popular interest in HLY across countries has grown, particularly regarding the ranking of countries. It is important to note that HLY is based on self-assessments of activity limitations, raising the possibility that it might be influenced by differences in health reporting behaviours between populations, a phenomenon known as differential item functioning (DIF). Methods We estimated DIF-adjusted HLY at age 50 for Belgium, France, Germany, Greece, Italy, the Netherlands, Spain, and Sweden to determine the extent to which differences in HLY might be influenced by reporting heterogeneity across countries. We used anchoring vignettes, taken from the 2004 Survey of Health, Ageing and Retirement in Europe, to estimate DIF-adjusted prevalence rates of activity limitations measured by the Global Activity Limitations Indicator (GALI). The Sullivan method was used to calculate DIF-adjusted HLY. Results Changes in HLY before and after adjustment ranged from a 1.20-year decrease for men in Italy to a 1.61-year increase for women in Spain. Adjustment for DIF produced changes in the rankings of the countries by HLY, with upward and downward movements of up to three positions. Conclusion Our results show that DIF is likely to affect HLY estimates, thereby posing a challenge to the validity of comparisons of HLY across European countries. The findings suggest that HLY should be used to monitor population health status within a country, rather than to make comparisons across countries. [ABSTRACT FROM AUTHOR]

Background Sex differences for cardiovascular (CV) risk and outcomes in chronic kidney disease (CKD) patients not on dialysis have been scarcely or never investigated. We therefore studied this important aspect in a cohort of CKD stage 2–5 in the south of Italy. Methods We tested the relationship between sex and fatal and non-fatal major CV events in a cohort of 759 stage 2–5 CKD patients followed up for a median time of 36 months. Results Out of 759 patients, 455 were males (60%) and the remaining 304 patients were females (40%). During the follow-up, 42 patients died, and 118 had fatal and non-fatal CV events. On univariate Cox regression analyses, the male sex failed to be associated with all-cause mortality but was strongly related to the incidence rate of fatal and non-fatal major CV events [hazard ratio (HR) 1.75, 95% confidence interval (CI) 1.18–2.60, P  = .006]. Data adjustment for a series of major potential confounders did not materially affect the strength of this relationship (HR 1.78, 95% CI 1.03–3.09). Further analysis testing the effect of age on major CV outcomes by sex showed an effect modification by this risk factor on the same outcome (P  = .037) because the HR of male versus female CV events increased progressively with aging. Conclusion Male patients in stage G2–5 CKD had a higher risk for CV events compared with female patients. Age was shown to be a risk modifier for the association between sex and CV events and this risk increased linearly across a wide age spectrum in CKD patients. [ABSTRACT FROM AUTHOR]

Background Progression of chronic kidney disease (CKD) has proven to be faster in men than in women. Whether the same holds true for cardiovascular risk remains ill-defined. Methods We conducted a pooled analysis of four cohort studies from 40 nephrology clinics in Italy including patients with CKD [estimated glomerular filtration rate (eGFR) <60 mL/min/1.73 m2 or higher if proteinuria >0.15 g/day]. The aim was to compare multivariable-adjusted risk (hazard ratio, 95% confidence interval) of a composite cardiovascular endpoint (cardiovascular death and non-fatal myocardial infarction, congestive heart failure, stroke, revascularization, peripheral vascular disease and non-traumatic amputation) in women (n  = 1192) versus men (n  = 1635). Results At baseline, women had slightly higher systolic blood pressure (SBP) as compared with men (139 ± 19 vs 138 ± 18 mmHg, P  = .049), lower eGFR (33.4 vs 35.7 mL/min/1.73 m2, P  = .001) and lower urine protein excretion (0.30 g/day vs 0.45 g/day in men, P  < .001). Women did not differ from men in age and prevalence of diabetes, while having a lower prevalence of cardiovascular disease, left ventricular hypertrophy and smoking habit. During a median follow-up of 4.0 years, 517 fatal and non-fatal cardiovascular events were registered (199 in women and 318 in men). The adjusted risk of cardiovascular events was lower in women (0.73, 0.60–0.89, P  = .002) than in men; however, the cardiovascular risk advantage of women progressively diminished as SBP (as continuous variable) increased (P for interaction = .021). Similar results were obtained when considering SBP categories: when compared with men, women had lower cardiovascular risk for SBP <130 mmHg (0.50, 0.31–0.80, P  = .004) and SBP 130–140 mmHg (0.72, 0.53–0.99, P  = .038), while no difference was observed for SBP >140 mmHg (0.85, 0.64–1.11, P  = .232). Conclusions Higher BP levels abolish the cardiovascular protection seen in female vs male patients with overt CKD. This finding supports the need for higher awareness of hypertensive burden in women with CKD. [ABSTRACT FROM AUTHOR]

Sustainable Forest Management (SFM) is a key objective of the European Forest Strategy. One of the most important aspects to be considered to achieve this fundamental goal is the implementation of Sustainable Forest Operations (SFOs). This study aims to investigate how and to what extent forest logging and silvicultural treatments affect soil physicochemical properties in the context of Mediterranean forestry by summarizing the results of 55 field studies, performed within the development of Master's and PhD theses, carried out in Italy over the last 15 years. In order to define reliable and scalable conclusions, and going beyond the typical case-study approach, we applied a data synthesis under the meta-analytic framework summarizing the results of the studies analyzed. The results show that disturbance triggered by the silvicultural treatments (meant as an alteration of canopy cover as a consequence of the removal of some trees) is much lower than that caused by forest logging, in particular passage of forest vehicles and woody loads. Furthermore, as expected, a clear relationship was observed between the impacts on soil physicochemical properties and biological impacts. Based on our results we recommend that ground-based extraction on slopes steeper than 20 per cent should be limited, extending the applications of skyline systems or winch-assisted extraction. Interestingly, different conditions of terrain roughness showed variable effects on the magnitude of impacts, suggesting the need for future dedicated studies on this topic. The application of machineries specifically developed for the forestry sector showed better performance than lower levels of mechanizations, confirming what was reported in previous literature on the topic. However, the major finding from this study clearly shows that the way in which extraction is carried out is the major factor causing soil disturbance. [ABSTRACT FROM AUTHOR]

Background This study aimed to compare the cost-effectiveness of coronavirus disease 2019 (COVID-19) mass testing, carried out in November 2020 in the Italian Bolzano/Südtirol province, to scenarios without mass testing in terms of hospitalizations averted and quality-adjusted life-year (QALYs) saved. Methods We applied branching processes to estimate the effective reproduction number (Rt) and model scenarios with and without mass testing, assuming Rt = 0.9 and Rt = 0.95. We applied a bottom-up approach to estimate the costs of mass testing, with a mixture of bottom‐up and top‐down methodologies to estimate hospitalizations averted and incremental costs in case of non-intervention. Lastly, we estimated the incremental cost-effectiveness ratio (ICER), denoted by screening and related social costs, and hospitalization costs averted per outcome derived, hospitalizations averted and QALYs saved. Results The ICERs per QALY were €24 249 under Rt = 0.9 and €4604 under Rt = 0.95, considering the official and estimated data on disease spread. The cost-effectiveness acceptability curves show that for the Rt = 0.9 scenario, at the maximum threshold willingness to pay the value of €40 000, mass testing has an 80% probability of being cost-effective compared to no mass testing. Under the worst scenario (Rt = 0.95), at the willingness to pay threshold, mass testing has an almost 100% probability of being cost-effective. Conclusions We provide evidence on the cost-effectiveness and potential impact of mass COVID-19 testing on a local healthcare system and community. Although the intervention is shown to be cost-effective, we believe the initiative should be carried out when there is initial rapid local disease transmission with a high Rt, as shown in our model. [ABSTRACT FROM AUTHOR]

Background Untimely social interventions prolong hospitalizations, suggesting discharge planning should begin early. This study aimed to create a tool to identify, already in Emergency department, patients at risk of complex discharge for social reasons. Methods We developed the Risk Assessment of Complex Discharge Index (RACDI). In Emergency department, we administered RACDI to patients destined to hospitalization. We calculated sensitivity and specificity of RACDI in identifying patients who need a social intervention. RACDI was compared with simplified BRASS. A multivariable logistic regression explored social intervention predictors (P -value < 0.05). Results RACDI was administered to 296 patients. There were significant associations between classes of risk defined by RACDI or by simplified BRASS and social intervention. The sensitivity of RACDI and simplified BRASS was, respectively, 0.59 and 0.43; the specificity 0.81 and 0.83. Chances of social intervention were higher for patients at high risk with RACDI (adjOR:3.13, 95% CI: 1.23–8.00, P  = 0.017). Conclusions The reduced items and mostly dichotomous answers made RACDI a tool easy to be used in daily practice. RACDI helps in classifying patients needing discharge planning for social care and is a starting point to standardize the evaluation of social context early in hospitalization. Further work is needed to overcome limitations and assess additional outcomes. [ABSTRACT FROM AUTHOR]

We provide new results from a controlled-source seismic experiment on the deepest part of the Val Sesia crust–mantle section of the Ivrea–Verbano zone (IVZ) in the Italian Alps. The IVZ is a tilted, almost complete section through the continental crust and exposes gabbros and peridotites in the structurally deepest level, coinciding with high-resolution gravity anomalies imaging the Ivrea geophysical body. The seismic experiment SEIZE (SEismic imaging of the Ivrea ZonE) was conducted along two crossing profiles: an NNE-SSW profile of ∼11 km length and an E-W profile of ∼16 km length. 432 vibration points were recorded with 110 receivers resulting in 24   392 traveltime picks. Inversion methods using Markov chain Monte Carlo techniques have been used to derive an isotropic 3-D P -wave velocity model based on first break traveltimes (refracted phases) from controlled source seismic data. Resulting seismic P -wave velocities (Vp) range from 4.5 to 7.5 km s−1, with an expected general trend of increasing velocities with depth. A sharp velocity change from low Vp in the West to high Vp in the East marks the Insubric Zone (ISZ), the Europe–Adria plate boundary. The most prominent feature of the 3-D tomography model is a high-velocity body (Vp increases from 6 to 7.5 km s−1) that broadens downwards. Its pointy shape peaks the surface East of Balmuccia at a location coincident with the exposed Balmuccia peridotite. Considering rock physics, high-resolution gravity and other geophysical data, we interpret this high-velocity body as dominantly composed of peridotite. The dimension of this seismically imaged peridotite material is far bigger than interpreted from geological cross-sections and requires a revision of previous models. The interpretation of ultramafic bodies in the IVZ as fragments of mantle peridotites interfingered in the crust during pre-Permian accretion is not supported by the new data. Instead, we revive a model that the contact between the Balmuccia peridotite and the Permian mafic magmas might represent a fossil continental crust–mantle transition zone. [ABSTRACT FROM AUTHOR]

We present the results from a fully unconstrained moment tensor inversion of induced seismic events in a complex and high seismic hazard region (Val d'Agri basin, Southern Italy). The study area hosts two well-documented cases of induced microseismicity linked to (i) a wastewater injection well of a giant oilfield (the largest in onshore Europe), and (ii) severe seasonal level changes of an artificial lake. In order to gather information on the non-double-couple components of the source and to better understand the rupture mechanisms, we analyse seismic events recorded during daily injection tests in the disposal well. The computed moment tensors have significant non-double-couple components that correlate with the well-head injection pressure. The injection parameters strongly influence the rupture mechanism that can be interpreted as due to the opening/closing of a fracture network inside a fault zone of a pre-existing thrust fault. For the case of the reservoir-induced seismicity, no direct correlations are observed with the loading/unloading of the reservoir. [ABSTRACT FROM AUTHOR]

The Every Earthquake a Precursor According to Scale (EEPAS) forecasting model is a space–time point-process model based on the precursory scale increase (⁠|$\psi $|) phenomenon and associated predictive scaling relations. It has been previously applied to New Zealand, California and Japan earthquakes with target magnitude thresholds varying from about 5–7. In all previous application, computations were done using the computer code implemented in Fortran language by the model authors. In this work, we applied it to Italy using a suite of computing codes completely rewritten in Matlab. We first compared the two software codes to ensure the convergence and adequate coincidence between the estimated model parameters for a simple region capable of being analysed by both software codes. Then, using the rewritten codes, we optimized the parameters for a different and more complex polygon of analysis using the Homogenized Instrumental Seismic Catalogue data from 1990 to 2011. We then perform a pseudo-prospective forecasting experiment of Italian earthquakes from 2012 to 2021 with M w ≥ 5.0 and compare the forecasting skill of EEPAS with those obtained by other time independent (Spatially Uniform Poisson, Spatially Variable Poisson and PPE: Proximity to Past Earthquakes) and time dependent [Epidemic Type Aftershock Sequence (ETAS)] forecasting models using the information gain per active cell. The preference goes to the ETAS model for short time intervals (3 months) and to the EEPAS model for longer time intervals (6 months to 10 yr). [ABSTRACT FROM AUTHOR]

During the COVID-19 pandemic, the use of social media offered a possible way to address the difficulties of social relationships for people with autism spectrum disorder (ASD), as well as a way to ease the problems of their caregivers. To gather information on the feasibility of this solution, we conducted an online questionnaire about the first lockdown period in Italy (March–May 2020) with 29 caregivers of ASD individuals. The questionnaire investigated their living conditions, the way time was spent during isolation, the availability of technological equipment, the perceived level of anxiety and the perceived utility of social media. The results showed that the difficulties of using social media had not been overcome, even at this time of greatest need. However, caregivers who take care of ASD people with high levels of anxiety perceived social media as more useful. This result invites further reflection on how to implement social media effectively for people with ASD. [ABSTRACT FROM AUTHOR]

Objectives We aimed at estimating the incidence and prevalence of SLE in northeastern Italy over the period 2012–20. Methods A retrospective population-based study was conducted in Veneto Region (4.9 million people) using the population registry, an administrative health database where all residents are recorded. Between 2012 and 2020, SLE prevalence was defined by a healthcare co-payment exemption for SLE (national registry code 028) or any hospital diagnosis of SLE (International Classification of Disease , Ninth Revision, Clinical Modification 710.0), whichever came first. Incident SLE was defined from 2013 to 2020 to exclude prevalent cases. Standardized incidence and prevalence rates were reported by age and sex. Results During the study period, we identified 4283 SLE patients (85% female), with 1092 incident cases. Across the study period, SLE standardized point prevalence increased from 63.5 (95% CI 61.2, 65.8) to 70.6 (95% CI 68.3, 73.0) per 100 000 residents, corresponding to an annual increment of 1.14% (P  < 0.0001). The highest prevalence was observed in females aged 60–69 years. SLE incidence corresponded to 2.8 per 100 000 person-years (95% CI 2.6, 2.9), with an annual decline of 7.3% (P  < 0.0001). Incidence was 5-fold higher in females (female-to-male incidence rate ratio: 5.00, 95% CI 4.25, 5.87; P  < 0.0001), with a peak among women aged 30–39 years. At diagnosis, women were significantly younger (45 years, IQR 33–58) than men (52 years, IQR 38–64). Conclusions Over the last decade, SLE prevalence has increased, while incidence has stably declined. In view of the introduction of new high-cost drugs, a clear definition of the epidemiology of SLE is crucial for all healthcare stakeholders. [ABSTRACT FROM AUTHOR]

Background: Mental health, particularly among young adults, has been severely affected during the COVID-19 pandemic, partially because of both forced social isolation measures and loneliness. Numerous papers on the short-term consequences of lockdown measures reported high psychological distress, as well as an increase of depressive and anxiety symptoms and psychotropic drug use. This study evaluated potential risk and protective factors, such as resilience, loneliness, social and family context, in order to detect vulnerable individuals. Methods: This prospective longitudinal study was carried out in a two phase survey: the first one, during lockdown in Spring 2020 (T1), and, the second one, in Summer 2020 (T2), when restrictive measures were slackened. The main outcomes included the Resilience Scale for Adults (RSA) and the University of California Los Angeles (UCLA) Loneliness Scale. The secondary outcomes included mental health care needs (MHCN), use of psychotropic drugs and family and social contacts. Results: This study evaluated risks and protective factors in mental health in 825 emerging adults aged from 18 to 25 years old in Belgium and in Italy. Participants were divided into three groups according to their MHCN before and after lockdown measures. 5% of the participants experienced an increase in MHCN at T1, including the start of a psychotropic treatment. At T1, statistically significant differences were found in mean RSA total scores and RSA Perception of Self scores between groups. At T2, the group who experienced an increase in MHCN displayed a significant decrease of mean loneliness scores compared with the other groups. This decrease is linearly correlated with resilience competencies. Conclusions: The COVID-19 pandemic and its associated restrictive measures cause a negative impact on youth’s mental health, particularly among vulnerable individuals. Resilience and social contacts are protective factors that need to be taken into account. [ABSTRACT FROM AUTHOR]

Selective migration does not necessarily imply a unique unidirectional or 'synchronized' flow from the poorer to the richer regions. Indeed, migration is selective to individual characteristics of migrants, but also places. Therefore, it is likely that migrants with different skill levels, age, and gender select different destinations—irrespective of regional disparities—with a greater degree of synchronization by similar individuals. The article explores these processes in Italy using inter-provincial migration flows (NUTS3) data for the years 1975, 1985, 1995, and 2005 and dividing migrants into 18 categories based on their human capital (proxied by education), age, and gender. Findings confirm the hypothesis of selective migration flows with clear-cut differences in choosing locations according to individual characteristics. [ABSTRACT FROM AUTHOR]

Understanding mechanical processes occurring on faults requires detailed information on the microseismicity that can be enhanced today by advanced techniques for earthquake detection. This problem is challenging when the seismicity rate is low and most of the earthquakes occur at depth. In this study, we compare three detection techniques, the autocorrelation FAST, the machine learning EQTransformer, and the template matching EQCorrScan, to assess their ability to improve catalogues associated with seismic sequences in the normal fault system of Southern Apennines (Italy) using data from the Irpinia Near Fault Observatory (INFO). We found that the integration of the machine learning and template matching detectors, the former providing templates for the cross-correlation, largely outperforms techniques based on autocorrelation and machine learning alone, featuring an enrichment of the automatic and manual catalogues of factors 21 and 7, respectively. Since output catalogues can be polluted by many false positives, we applied refined event selection based on the cumulative distribution of their similarity level. We can thus clean up the detection lists and analyse final subsets dominated by real events. The magnitude of completeness decreases by more than one unit compared to the reference value for the network. We report b -values associated with sequences smaller than the average, likely corresponding to larger differential stresses than for the background seismicity of the area. For all the analysed sequences, we found that main events are anticipated by foreshocks, indicating a possible preparation process for main shocks at subkilometric scales. [ABSTRACT FROM AUTHOR]

In this study, we investigate the correlation between the residuals of a neGMM (non-ergodic Ground Motion Model) and the physics-based parameters obtained using a non-parametric GIT approach (Generalized Inversion Technique) to lay the groundwork for the implementation of an ad-hoc FAS (Fourier Amplitude Spectra) neGMM for the Central Italy region. This region is particularly suitable for data-driven methodologies as those applied in this work because of the large amount of available data due to the recent multiple main shock–aftershock sequences occurred in this area. Both neGMM and GIT models are developed for Fourier spectra in the frequency range between 0.5 and 25 Hz and using the same reference sites. The comparison of the non-ergodic terms with the source, path and site spectral parameters provides interesting results. First, we find a strong correlation between the source parameters, stress drop Δσ and decay |${k}_{\mathrm{ source}}$| and the source neGMM corrective terms (the combination of the between-event δBe and the location-to-location terms δL2L). This correlation is frequency dependent and, at high frequency, is remarkably positive for Δσ and negative for |${k}_{\mathrm{ source}}$|⁠. Concerning the attenuation terms, the path-to-path residuals (δP2P) are clearly associated with the deviations from the regional Q estimates obtained from GIT analysis. This indicates that the neGMM properly captures the properties of the anelastic attenuation and that the corrective terms δP2P can be used to account for differences in travel paths across different crustal domains. Finally, adopting the same reference sites for neGMM and non-parametric GIT, we observe that the systematic site terms (δS2Ss) and the GIT-derived amplification functions are in good agreement. The next step for an appropriate modelling is to identify the physical parameters (e.g. VS,30 and |${k}_0$|⁠) describing the empirical amplification curves to be introduced as explanatory variables in the ground motion model. [ABSTRACT FROM AUTHOR]

The reproductive success of flowering plants with generalized pollination systems is influenced by interactions with a diverse pollinator community and abiotic factors. However, knowledge about the adaptative potential of plants to complex ecological networks and the underlying genetic mechanisms is still limited. Based on a pool-sequencing approach of 21 natural populations of Brassica incana in Southern Italy, we combined a genome-environmental association analysis with a genome scan for signals of population genomic differentiation to discover genetic variants associated with the ecological variation. We identified genomic regions putatively involved in the adaptation of B. incana to the identity of local pollinator functional categories and pollinator community composition. Interestingly, we observed several shared candidate genes associated with long-tongue bees, soil texture, and temperature variation. We established a genomic map of potential generalist flowering plant local adaptation to complex biotic interactions, and the importance of considering multiple environmental factors to describe the adaptive landscape of plant populations. [ABSTRACT FROM AUTHOR]

Background The known risks and benefits of native kidney biopsies are mainly based on the findings of retrospective studies. The aim of this multicentre prospective study was to evaluate the safety of percutaneous renal biopsies and quantify biopsy-related complication rates in Italy. Methods The study examined the results of native kidney biopsies performed in 54 Italian nephrology centres between 2012 and 2020. The primary outcome was the rate of major complications 1 day after the procedure, or for longer if it was necessary to evaluate the evolution of a complication. Centre and patient risk predictors were analysed using multivariate logistic regression. Results Analysis of 5304 biopsies of patients with a median age of 53.2 years revealed 400 major complication events in 273 patients (5.1%): the most frequent was a ≥2 g/dL decrease in haemoglobin levels (2.2%), followed by macrohaematuria (1.2%), blood transfusion (1.1%), gross haematoma (0.9%), artero-venous fistula (0.7%), invasive intervention (0.5%), pain (0.5%), symptomatic hypotension (0.3%), a rapid increase in serum creatinine levels (0.1%) and death (0.02%). The risk factors for major complications were higher plasma creatinine levels [odds ratio (OR) 1.12 for each mg/dL increase, 95% confidence interval (95% CI) 1.08–1.17], liver disease (OR 2.27, 95% CI 1.21–4.25) and a higher number of needle passes (OR for each pass 1.22, 95% CI 1.07–1.39), whereas higher proteinuria levels (OR for each g/day increase 0.95, 95% CI 0.92–0.99) were protective. Conclusions This is the first multicentre prospective study showing that percutaneous native kidney biopsies are associated with a 5% risk of a major post-biopsy complication. Predictors of increased risk include higher plasma creatinine levels, liver disease and a higher number of needle passes. [ABSTRACT FROM AUTHOR]

Background Idiopathic calcium nephrolithiasis (ICN) is a common condition with a complex phenotype influenced by both environmental and genetic factors. In our study we investigated the association of allelic variants with the history of nephrolithiasis. Methods We genotyped and selected 10 candidate genes potentially related to ICN from 3046 subjects participating in the INCIPE survey cohort (Initiative on Nephropathy, of relevance to public health, which is Chronic, possibly in its Initial stages, and carries a Potential risk of major clinical End-points), a study enrolling subjects from the general population in the Veneto region in Italy. Results Overall, 66 224 variants mapping on the 10 candidate genes were studied. A total of 69 and 18 variants in INCIPE-1 and INCIPE-2, respectively, were significantly associated with stone history (SH). Only two variants, rs36106327 (chr20:54 171 755, intron variant) and rs35792925 (chr20:54 173 157, intron variant) of the CYP24A1 gene were observed to be consistently associated with ICN. Neither variant has been previously reported in association with renal stones or other conditions. Carriers of CYP24A1 variants showed a significant increase in the ratio of 1,25 (OH)2 vitamin D to 25 (OH) vitamin D compared with controls (P  = .043). Although not associated with ICN in this study, the rs4811494 CYP24A1 variant that was reported to be causative of nephrolithiasis was very prevalent in heterozygosity (20%). Conclusion Our data suggest a possible role for CYP24A1 variants in the risk of nephrolithiasis. Genetic validation studies in larger sample sets will be necessary to confirm our findings. [ABSTRACT FROM AUTHOR]

The Gutenberg–Richter b -value is thought to be a proxy of stress conditions in the crust and therefore able to locate asperities as zones of stress concentration responsible for the nucleation of strong events. The scientific literature contains a broad range of case studies showing precursory drops of b , just before the occurrence of strong events, and subsequent rises, during the early part of aftershocks sequences. Translating these results into hazard assessment, the b -value has assumed the status of a candidate precursor to the occurrence of an imminent large event. This issue is analysed here for three major seismic sequences that occurred recently in Italy. In comparison to previous studies, this investigation indicates that the variability of b may not be a reliable indicator of stress or a significant precursor in these examples, and instead may be assigned to a combination of chance, inhomogeneities in the data and inefficiencies in estimation methodologies. Consequently, extreme caution is required when we interpret b -values both as a proxy of physical processes involved in a seismic sequence and as a precursor to the occurrence of imminent strong events. [ABSTRACT FROM AUTHOR]

Background the mySupport advance care planning intervention was originally developed and evaluated in Northern Ireland (UK). Family caregivers of nursing home residents with dementia received an educational booklet and a family care conference with a trained facilitator to discuss their relative's future care. Objectives to investigate whether upscaling the intervention adapted to local context and complemented by a question prompt list impacts family caregivers' uncertainty in decision-making and their satisfaction with care across six countries. Second, to investigate whether mySupport affects residents' hospitalisations and documented advance decisions. Design a pretest–posttest design. Setting in Canada, the Czech Republic, Ireland, Italy, the Netherlands and the UK, two nursing homes participated. Participants in total, 88 family caregivers completed baseline, intervention and follow-up assessments. Methods family caregivers' scores on the Decisional Conflict Scale and Family Perceptions of Care Scale before and after the intervention were compared with linear mixed models. The number of documented advance decisions and residents' hospitalisations was obtained via chart review or reported by nursing home staff and compared between baseline and follow-up with McNemar tests. Results family caregivers reported less decision-making uncertainty (−9.6, 95% confidence interval: −13.3, −6.0, P  < 0.001) and more positive perceptions of care (+11.4, 95% confidence interval: 7.8, 15.0; P  < 0.001) after the intervention. The number of advance decisions to refuse treatment was significantly higher after the intervention (21 vs 16); the number of other advance decisions or hospitalisations was unchanged. Conclusions the mySupport intervention may be impactful in countries beyond the original setting. [ABSTRACT FROM AUTHOR]

The liquid line of descent from trachyte to pantellerite is controlled primarily by fractional crystallization of alkali feldspar, with whole-rock compositions following a fractionation path along the 'thermal valley' in the peralkaline haplogranite system Qz-Ab-Or-Ac-Ns and terminating at a minimum on the feldspar-quartz cotectic. Although whole-rock compositions for different pantelleritic suites follow nearly identical paths in a Qz-Ab-Or projection that terminate near the experimental minimum (Qz40.5Or34.5Ab25 at 100 MPa, projected from Ac-Ns), matrix glass from samples with near-minimum compositions record extreme differentiation and form a 'cotectic delta' beyond the terminus of the 'thermal valley'. Although each glass trend shows a continuing increase in Zr to >3000 μg/g, the most evolved compositions in each suite differ in peralkalinity (mol [Na + K] / Al) and in the proportions of FeOT, Qz, Ab, Or, and other components, which are related to subtle variations in the mafic phases controlled mainly by differences in oxygen fugacity (f O2) and pressure (P). To determine the controls over mafic mineral crystallization in pantelleritic magmas and the various paths these suites take beyond the apparent (whole-rock) minimum, amphibole-phyric suites from the ~159 ka Cala dell'Altura and Cala Gadir volcanic centres and the ~8–10 ka Cuddia Mida volcanic centre on Pantelleria have been analyzed and compared with each other and with the well-characterized and amphibole-free, compositionally zoned Green Tuff, the ~46 ka caldera-forming ignimbrite of the Cinque Denti caldera. Differences between the extended fractionation trends may be ultimately attributed to variations in oxygen fugacity, depth of emplacement, and water saturation. Shallower (lower pressure) magma reservoirs such as the one for the Green Tuff are water-saturated and undergo degassing, which leads to an increase in relative oxygen fugacity. Deeper (higher pressure) magma reservoirs remain water-undersaturated and retain water in the melt, which both maintains lower relative oxygen fugacities and enables the crystallization of amphibole. Amphibole formation appears to require melt water contents >4 wt%, low oxygen fugacity (<ΔNNO-1.5), and low temperatures (<700°C), although fluorine may stabilize it at higher temperatures in some rocks. [ABSTRACT FROM AUTHOR]

A total of 120 Nellore bulls, [initial body weight (BW) = 307 ± 11.6 kg and 12 mo of age] were allocated into 12 collective pens (10 bulls per pen) in a commercial feedlot to evaluate the effects of a specific blend of tannin and saponins on enteric methane (CH4) emissions. The study was a completely randomized design, in which pens were considered the experimental units (N = 6 pens per treatment) and were randomly allocated into one of two treatments: 1) Control (CON), a basal diet with monensin supplementation (25 mg/kg dry matter [DM]; Rumensin, Elanco Animal Health, Greenfield, IN, USA), or 2) Control + a specific blend of tannin and saponins (TAN; 0.7 g/kg DM; composed of quebracho and chestnut tannin extracts along with carriers from cereals rich in saponins; SilvaFeed BX, Silvateam, San Michele Mondovi, CN, Italy). After the adaptation period (20 d), the experiment was divided into two phases: growing phase (21 to 53 d; total of 33 d) and fattening phase (54 to 139 d; total of 86 d). Enteric methane emissions were estimated using the sulfur hexafluoride (SF6) tracer gas technique. Interactions between treatment and period (growing vs. fattening) were detected for daily CH4 emissions, in which animals fed TAN reduced CH4 emissions by 17.3% during the fattening period compared to bulls fed CON (P = 0.05). In addition, bulls fed TAN had lower CH4 emissions expressed by dry matter intake (DMI) during the fattening period compared to bulls fed CON (P = 0.06). The findings presented herein indicate that a specific blend of tannin and saponins can be used as a strategy to reduce enteric CH4 emissions and its intensity of Nellore bulls finished in feedlot systems under tropical conditions. [ABSTRACT FROM AUTHOR]

Background Oncologists are often concerned that talking about death with patients may hinder their relationship. However, the views of death held by patients have not been thoroughly investigated. This study aimed to describe the perception of death among patients with advanced cancer receiving early palliative care (EPC) and their caregivers. Material and Methods Qualitative and quantitative analyses were performed on 2 databases: (a) transcripts of open-ended questionnaires administered to 130 cancer patients receiving EPC with a mean age of 68.4 years and to 115 primary caregivers of patients on EPC with a mean age of 56.8; (b) texts collected from an Italian forum, containing instances of web-mediated interactions between patients and their caregivers. Results Quantitative analysis shows that: (a) patients and caregivers are not afraid of speaking about death; (b) patients and caregivers on EPC use the word "death" significantly more than patients on standard oncology care (SOC) and their caregivers (P  < .0001). For both participants on EPC and SOC, the adjectives and verbs associated with the word "death" have positive connotations; however, these associations are significantly more frequent for participants on EPC (verbs, P s < .0001; adjectives, P s < .003). Qualitative analysis reveals that these positive connotations refer to an actual, positive experience of the end of life in the EPC group and a wish or a negated event in the SOC group. Conclusions EPC interventions, along with proper physician-patient communication, may be associated with an increased acceptance of death in patients with advanced cancer and their caregivers. [ABSTRACT FROM AUTHOR]

Robustness of source parameter estimates is a fundamental issue in understanding the relationships between small and large events; however, it is difficult to assess how much of the variability of the source parameters can be attributed to the physical source characteristics or to the uncertainties of the methods and data used to estimate the values. In this study, we apply the coda method by Mayeda et al. using the coda calibration tool (CCT), a freely available Java-based code (https://github.com/LLNL/coda-calibration-tool) to obtain a regional calibration for Central Italy for estimating stable source parameters. We demonstrate the power of the coda technique in this region and show that it provides the same robustness in source parameter estimation as a data-driven methodology [generalized inversion technique (GIT)], but with much fewer calibration events and stations. The Central Italy region is ideal for both GIT and coda approaches as it is characterized by high-quality data, including recent well-recorded seismic sequences such as L'Aquila (2009) and Amatrice–Norcia–Visso (2016–2017). This allows us to apply data-driven methods such as GIT and coda-based methods that require few, but high-quality data. The data set for GIT analysis includes ∼5000 earthquakes and more than 600 stations, while for coda analysis we used a small subset of 39 events spanning 3.5 <  M w < 6.33 and 14 well-distributed broad-band stations. For the common calibration events, as well as an additional 247 events (∼1.7 <  M w < ∼5.0) not used in either calibration, we find excellent agreement between GIT-derived and CCT-derived source spectra. This confirms the ability of the coda approach to obtain stable source parameters even with few calibration events and stations. Even reducing the coda calibration data set by 75 per cent, we found no appreciable degradation in performance. This validation of the coda calibration approach over a broad range of event size demonstrates that this procedure, once extended to other regions, represents a powerful tool for future routine applications to homogeneously evaluate robust source parameters on a national scale. Furthermore, the coda calibration procedure can homogenize the M w estimates for small and large events without the necessity of introducing any conversion scale between narrow-band measures such as local magnitude (M L) and M w, which has been shown to introduce significant bias. [ABSTRACT FROM AUTHOR]

Background As a system of European Reference Networks (ERNs) emerges, the differences in quality of care for patients with rare cancers may increase at national level. We aimed to elucidate the processes and healthcare planning principles through which the reference centres (RCs) for rare cancers are embedded in national health systems. Methods We used a multiple case-study design based on the experiences of Czechia, Finland, France, Italy, Lithuania and Spain. Using sarcoma as an example of rare cancer, 52 semi-structured interviews were conducted during on-site visits, including a multidisciplinary group of professionals, Ministry of Health professionals, patient representatives and European policymakers. Results The comparative analysis showed substantial heterogeneity in the processes for formalizing RCs' status and in their levels of integration in the different health systems, but two models (centre-based and the network-based) can be envisaged at national level. RCs for rare cancers were legally established only in France and Spain. Expert clinicians cooperate in a structured way, using network mechanisms, in France and Italy, and these countries, plus Finland and Lithuania, had a referral system to facilitate patients' access from non-expert centres to RCs. Seven key healthcare planning principles in instituting RCs at the national level were identified. Conclusions The conditions governing patient access to treatment centres—whether RCs or not—are decided at the national level. It is advisable to progressively align the European and national levels so that the RCs that participate in the ERNs also play a significant role at the national level. [ABSTRACT FROM AUTHOR]

Background The aim of the present study was to compare the cross-sectional association between smoking and depressive symptoms among adolescents between Sweden and Italy, two countries historically characterized by different norms about tobacco use and different tobacco control efforts. Methods A cross-sectional study including 3283 adolescents 15–16 years of age participating in the Swedish KUPOL study and 1947 same-age adolescents from the Italian BE-TEEN study. Current smoking was defined as any smoking in the past 30 days. Depressive symptoms were assessed using the Centre for Epidemiological Studies Depression Scale for Children (CES-DC) and the internalizing score of the Strengths and Difficulties Questionnaire (SDQ). Country differences were explored in stratified and interaction analyses. Results Current smoking was associated with a 2- to 3-fold increased odds of depressive symptoms among Swedish adolescents using both CES-DC and SDQ internalizing scale. Among Italian adolescents, slightly lower increased odds of 1.5–2.5 for depressive symptoms with smoking were found using the CES-DC but not the SDQ scale. Both multiplicative and additive interactions for country were significant. The association between smoking and depressive symptoms was weaker among Italian compared with Swedish adolescents for both scores. Conclusions Countries with different tobacco norms and control show different associations between smoking and depressive symptoms in adolescence, probably due to different psychosocial profiles of smokers. These findings need to be considered when planning tobacco prevention programmes, e.g. by focusing on early detection of mental health distress among adolescents in settings with declining smoking prevalence and restrictive tobacco control environments. [ABSTRACT FROM AUTHOR]

In the 1970s, Ruditapes philippinarum was introduced to France at Arcachon Bay for aquaculture. At present, in Europe, R. philippinarum is often found in place of the native species Ruditapes decussatus. The aim of this study is to evaluate the distribution of these two species along the northern Mediterranean coastline using morphological and morphometric analysis. The sampling period was between June and December 2018. Among the 11 French sites, only 2 contained R. philippinarum , whereas only the indigenous species was present at the other sites. Genetic analyses were used to confirm species identity and to confirm this distribution. A site in Italy, Pialassa Baiona, was also added to the sample. This analysis of Ruditapes from multiple French sites and one Italian site highlights species-level differences in shell morphology between R. decussatus and R. philippinarum. The intraspecific morphometric analysis showed the presence of different groups depending on spatial scales (i.e. at the large scale, between the Mediterranean Sea and the Atlantic, and on the small scale, that is within the Berre lagoon in France. No relationship between morphometric and genetic variation was found. This suggests that the differences in the shell shape of Ruditapes are driven by local environmental conditions. [ABSTRACT FROM AUTHOR]

SUMMARY: A detailed rock magnetic study was conducted on ash samples collected from different products erupted during explosive activity of Mount Etna, Italy, in order to test the use of magnetic properties as discriminating factors among them, and their explosive character in particular. Samples include tephra emplaced during the last 18 ka: the benmoreitic Plinian eruptions of the Pleistocene Ellittico activity from marine core ET97-70 (Ionian Sea) and the basaltic Holocene FG eruption (122 BC), the Strombolian/Phreatomagmatic/sub-Plinian eruptions (namely, the Holocene TV, FS, FL, ETP products and the 1990, 1998 eruptions) collected from the slope of the volcano, and the Recent explosive activity (lava fountains referred to as ' Ash Rich Jets and Plumes ', or ARJP) that occurred in the 2001–2002 period, related to flank eruptions. Mössbauer spectrometry informs that a single magnetic mineral dominates the three groups, which are characterized by variable magnetic grain sizes and composition. Detailed rock-magnetic investigations, ranging from low temperature to high temperature remanence and susceptibility experiments, indicate that the more explosive products of the Plinian eruptions and ARJP activity tephra, are characterized by oxidized Ti-rich titanomagnetites, with dominant Curie Temperatures between 230 and 330 °C. The FG and ARJP tephra are also characterized by contrasting, yet overall higher, coercivity distributions and higher magnetizations and susceptibilities, including below room temperature. In contrast, most of the Strombolian/sub-Plinian eruptions have a magnetic signature dominated by less coercive magnetite and/or Ti-poor titanomagnetite. Magnetic differences observed between the Late Pleistocene and Holocene FG Plinian eruptions can be attributed to the different composition of the former eruptions, which were fed by more evolved magmas, whereas geochemical variations characterizing the products erupted in the last few decades can be responsible for the differences between the Holocene and recent Strombolian/sub-Plinian products. Importantly, detailed magnetic investigation of sideromelane and tachylite clasts, the two end members of the juvenile fraction extracted from the ash of the most explosive products, determines that the tachylite fraction is responsible for the magnetic signature of the Plinian FG and ARJP tephra, and is attributed to the intense fragmentation that characterizes these activities, likely resulting from undercooling processes. Moreover, the abundant superparamagnetic grains associated with these eruptive styles are believed to represent the nanolite fraction responsible for the increasing viscosity of these magmas, and to be responsible for their explosive character. The distinctive magnetic properties that characterize the tachylite-bearing tephra, representative of the fragmentation process that distinguishes the most explosive activities, provides a useful magnetic tool that can complement traditional volcanological investigations. [ABSTRACT FROM AUTHOR]