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Vicarious stigma shows how indirect stigmatizing experiences can lead people living with HIV (PLWH) to feel discriminated against. We enrolled 350 PLWH, who were administered a 17-item questionnaire to investigate a subjective experience of stigma experienced in the hospital care setting. We found that at least once 215 PLWH (61.4%) did not want the HIV exemption indicated on the prescription for a specialist medical visit, 232 PLWH (66.3%) never used their HIV-related exemption to make a specialist medical visit, 230 PLWH (65.7%) avoided undergoing a medical assessment outside the infectious disease clinics and 241 patients (68.9%) felt unwelcome during a specialist medical visit. Moreover, 241 patients (61.1%) had heard at least once stories of health workers who did not want to touch PLWH, 213 patients (60.9%) had heard stories at least once of PLWH who had been mistreated by hospital staff, 180 patients (51.4%) had at least once heard stories about PLWH being refused treatment and services and 257 patients (73.4%) had at least once heard stories about health workers talking publicly about PLWH. This is a little explored area, especially regarding the vicarious stigma faced by PLWH. Our findings indicate the importance of combating HIV-related stigma for the wellbeing of PLWH. [ABSTRACT FROM AUTHOR]

Objectives : Petrous bone cholesteatoma (PBC) is a rare condition of the petrous portion of the temporal bone. Treatment of choice consists of radical surgical removal, paying attention to protect the facial nerve and inner ear as far as possible. The aim of the present study was to evaluate the efficacy of modified translabyrinthine techniques in preserving hearing function and the use of the adjuvant endoscopic techniques in a group of PBC patients. Methods : This study comprised 16 cases of PBCs surgically treated in our Department. Pre- and post-operative hearing status was assessed with pure tone audiometry and speech discrimination and graded according to the Gardner- Robertson classification system. Facial function was based on the House Brackman (HB) classification. PBCs were grouped using Sanna's classification. The choice of surgical technique was based on the above findings together with preoperative evidence. Post-operative follow-up ranged from 1 to 10 years and also included Computed Tomography and Magnetic Resonance Imaging assessment. Results : PBCs were classified as follows: 37.5% infralabyrinthine; 43.75% supralabyrinthine; and 18.75% massive. Preservation of the bone conduction threshold was feasible in 62.5% of patients. For supralabyrinthine PBCs a subtotal petrosetomy was performed in all cases and hearing preservation was possible in 57% of them: an adjuvant endoscopic approach was performed in 43%. Infralabyrinthine PBCs were treated using a modified translabyrinthine approach with preservation of bone conduction in 83% of patients; an adjuvant endoscopic approach was performed in 50% cases. One patient with a massive cholesteatoma was treated by modified translabyrinthine approach, preserving a serviceable level of hearing. In all massive cases, an adjuvant endoscopic approach was performed. In 2 patients with preoperative palsy, facial nerve function showed an improvement. The follow-up period revealed evidence of limited recurrence at CT imaging in 2 patients. Conclusions : The introduction of modified surgical approaches, able to preserve the anatomical-functional structures, have shown an improvement of post-operative hearing outcomes. [ABSTRACT FROM AUTHOR]

Background: Lifestyle interventions halt the progression of prediabetes to frank type 2 diabetes (T2D). However, the feasibility of a diabetes prevention program promoting tailored interventions on a national scale and conducted by primary care physicians is unclear. Methods: General practitioners located in ten different regions throughout Italy enrolled random subjects without known metabolic diseases to identify individuals with prediabetes and prescribe them an intervention based on physical activity. Using a simple stepwise approach, people referring to their primary care physician for any reason were screened for their diabetes risk with a web-based app of the Findrisc questionnaire. Those at risk for T2D, i.e., with a Findrisc score >9, were invited to come back after overnight fasting to measure fasting glycaemia (FG). Those with 100 ≤ FG < 126 mg/dL were considered as people with prediabetes and compiled the Physical Activity Readiness Questionnaire (PAR-Q) to then receive a personalised prescription of physical activity. Results: Overall, 5928 people were enrolled and compiled the questionnaire. Of these, 2895 (48.8%) were at risk for T2D. Among these, FG was measured in 2168 subjects (participation rate 75%). The numbers of individuals with undetected prediabetes and T2D according to FG were 755 and 79 (34.8% and 3.6% of those assessing FG), respectively. Of the 755 subjects in the prediabetes range, 739 compiled the PAR-Q and started a personalised program of physical activity (participation rate 97%). Physicians involved in the study reported a mean of 6 min to perform the screening. Conclusions: Overall, these data suggest the feasibility of a national diabetes prevention program developed by general practitioners using a simple stepwise approach starting from a web app to intercept individuals with prediabetes. [ABSTRACT FROM AUTHOR]

Summary: Frailty fractures place a significant socioeconomic burden on the health care system. The Italian Society of Orthopaedics and Traumatology (SIOT) is proceeding to fracture liaison service (FLS) model accreditation in several Italian Fracture Units (FUs), which provides a multidisciplinary approach for the management of the fragility fracture patient. Introduction: Osteoporosis and the resulting fragility fractures, particularly femoral fractures, place significant socioeconomic burdens on the health care system globally. In addition, there is a general lack of awareness of osteoporosis, resulting in underestimation of the associated risks and suboptimal treatment of the disease. The fracture liaison service (FLS) represents an exemplary model of post-fracture care that involves a multidisciplinary approach to the frail patient through the collaboration of multiple specialists. The purpose of this article is to highlight the path undertaken by the Italian Society of Orthopaedics and Traumatology (SIOT) for the purpose of certification of numerous FLS centers throughout Italy. Methods: SIOT is proceeding with international FLS accreditation in several Italian Fracture Units (FUs), following the creation of a model that provides specific operational and procedural steps for the management of fragility fractures throughout the country. FUs that decide to join the project and implement this model within their facility are then audited by an ACCREDIA-accredited medical certification body. Results: The drafted FLS model, thanks to the active involvement of a panel of experts appointed by SIOT, outlines a reference operational model that describes a fluid and articulated process that identifies the procedure of identification, description of diagnostic framing, and subsequent initiation of appropriate secondary prevention programs for fractures of individuals who have presented with a recent fragility fracture of the femur. Conclusion: Accreditation of this prevention model will enable many facilities to take advantage of this dedicated diagnostic-therapeutic pathway for the purpose of fracture prevention and reduction of associated health and social costs. [ABSTRACT FROM AUTHOR]

Cabotegravir and rilpivirine are the first drugs to be approved as injectable therapy to treat individuals with HIV. Despite encouraging results, the guidelines specify strict criteria for eligibility that could limit the feasibility of this strategy. We collected the clinical data of HIV‐positive patients who were being treated at a single, third‐level center in Italy. All patients were on stable therapy and showed suppressed viral load on their most recent analyses. We performed a cross‐sectional analysis of the clinical and viro‐immunological characteristics of this population and excluded patients who had previous virological failures, resistance‐associated mutations (RAMs) to rilpivirine or integrase inhibitors in the historical genotype, hepatitis B infection, absence of previous genotypes, and the coexistence of HIV‐subtype A and obesity. Our aim was to evaluate the proportion of patients who could be eligible for switching to this strategy. one thousand seven hundred fifty‐two patients were eligible. One hundred and forty‐eight were excluded because of a detectable viral load. With regard to the exclusion criteria, 48 patients had coinfection with hepatitis B virus, and 744 had a history of previous virological failures. Of the 896 patients with at least one genotypic resistance test, 161 had one or more RAMs to rilpivirine and 3 had RAMs to cabotegravir. None of the patients presented the combination of obesity and the A viral subtype. Overall, 31.2% of the patients were ineligible for cabotegravir–rilpivirine, and the proportion increased to 47.3% when we considered only patients with all available information concerning resistance tests. Approximately half of our cohort of patients did not fulfill the criteria and even more patients were potentially ineligible for cabotegravir–rilpivirine due to the lack of genotypic resistance tests. Also, fertile women had to be excluded due to the lack of data about this combination during pregnancy and breastfeeding. [ABSTRACT FROM AUTHOR]

The Marchesa Luisa Casati has become a perennial muse of fashion designers in recent decades, from haute couture to High Street brands. Collections inspired by the Marchesa link to her background and the history of the spaces that she inhabited. Casati was born in Italy but lived and traveled between France, Italy and Britain, among other countries, where the cachet of her name has been combined with that of the fashion houses citing her as an inspiration. Despite her enduring reputation as an avant-garde style icon and a singular dresser who was just as likely to wear elaborate costumes as nothing at all, her engagement with fashion was not always as visibly eccentric as her posthumous impact suggests. Nor was it strictly within the binary of fashion and "anti-fashion". Casati was at once a "disruptive" body and a conventionally stylish one. Popular memory has focused on the more "spectacular" and stylized elements of her esthetic. Archival evidence and artistic representation demonstrate how Casati constructed a wardrobe that melded the conventional and shocking, and how fashion played a role in the emergence of her chimerical public persona. [ABSTRACT FROM AUTHOR]

Simple Summary: In the early sixties, free ranging red deer (Cervus elaphus, L.) were absent in Piedmont. Human-driven translocations and spontaneous migration of red deer from Switzerland and France resulted in the successful redistribution of this wild ungulate. In parallel, host-specific parasites harbored by red deer populations disappeared in the same area until the restoration of red deer in north-western Italy. The parasitic community has been enriched with at least two species-specific taxa, Onchocerca jakutensis and Pharyngomyia picta, suggesting that the recovery of parasitic biodiversity could be included amongst future conservation goals of this intensively managed game. Red deer (Cervus elaphus) populations in north-western Italy have been remodeled in recent decades. Multiple translocations and the spontaneous migration from Switzerland and France resulted in the successful redistribution of the red deer after human-driven extirpation during the 18th century. The scarcely diverse parasitic community harbored by these cervids has been enriched with two species-specific taxa, Onchocerca jakutensis and Phayigomyia picta, suggesting that the recovery of parasitic biodiversity could be included amongst future conservation goals of this intensively managed game. Nodular onchocercosis was reported in three red deer populations since 2011, while nasal bots were reported since 2018. Hypoderma spp. larvae were identified for the first time in 1989, then a second record was made in 2014 in the province of Biella, where a yearling male in poor condition infested with Hypoderma diana was observed. In the perspective that the restoration of species-specific parasite communities of native mammals in Europe is increasingly perceived as a conservation target, with similar dignity as the conservation of their hosts, baseline data presented in this communication may give new insights for future parasite conservation efforts. [ABSTRACT FROM AUTHOR]

Two hundred two people living with HIV (PLWH) selected from outpatients at the Infectious Disease Institute, Fondazione Policlinico Universitario A. Gemelli IRCCS, in Rome (Italy) were consecutively enrolled from May to July 2021. We used an anonymous telephone questionnaire to investigate opinions of PLWH about combined antiretroviral (ARV) therapy and long-acting (LA) formulations of ARVs. All invited participants completed the questionnaire (100%). We found that most PLWH evaluated taking HIV pills for the rest of their life as a continuous, but undemanding commitment (61.4%; n = 124), although they were willing to stop the daily intake of HIV drugs (78.2%, n = 158). Moreover, most PLWH were unaware of the existence of LA therapies at the time of the investigation (60.4%, n = 122). Almost half the PLWH evaluated the need for injections in the hospital as an obstacle (51.4%, n = 104). Regarding the preference between monthly injections and taking pills everyday, most PLWH (68.8%, n = 139) stated that the injection was more advantageous than pills even if they had some pain/swelling at the injection site. The concern about LA therapy indicated most by PLWH was the possible lower efficacy of the drug (83.7%, n = 169). Regarding the possible benefits of LA therapy, those reported most by PLWH were feeling freer because they did not have to remember to take pills everyday (68,8%, n = 139). In conclusion, to date, PLWH in our cohort seem willing to accept LA therapy, but still show some concern about the efficacy of the new therapy and the obligation to come to the hospital to receive it. Thus, clinicians must take into account the needs of their patients and help them overcome their concerns to facilitate the transition to this new therapeutic modality. Clinical Trial Registration Number ID: 2424. [ABSTRACT FROM AUTHOR]

In late summer 2020, a widespread mortality event severely affected colonies of the Mediterranean endemic orange coral Astroides calycularis in the Pelagie Islands (Strait of Sicily, southern Mediterranean Sea).The degree of the mortality impact at seven study sites of the archipelago (five within the Pelagie Islands Marine Protected Area) was quantified by estimating the proportion of affected colonies in populations of A. calycularis.Five of the seven surveyed sites revealed a low degree of impact, but Punta Ruperta and Cala Creta (both on the island of Lampedusa) showed a medium impact with values of 32.3% and 30.5% of affected colonies respectively.The 2020 mortality event coincided with a longer lasting and warmer anomalous summer period, with sea surface water reaching the highest temperatures recorded in the last decade across the archipelago.Given the alarming climatic predictions for the near future, new mortality events could occur, causing potentially new local extinctions in the Mediterranean Sea. In this context, the role of marine protected area management becomes crucial to detect mortality events of vulnerable species. [ABSTRACT FROM AUTHOR]

This paper investigates the factors which explain public attitudes to welfare chauvinism in Italy. The notion of 'welfare chauvinism' refers to the idea that foreigners, considered as out-groups, should have limited or even no access to domestic social security benefits. We focus on the role played by individual transnationalism: i.e. direct and indirect ties and connections with people and cultures of other European countries. We postulate that transnationalism dilutes fears and anxieties, fostering pro-opening attitudes. We test the research hypotheses by using original survey data collected during the 2018 Italian elections, in which the issues of welfare benefits and immigration shaped the election campaign. [ABSTRACT FROM AUTHOR]

During the coronavirus disease of 2019 (COVID-19) emergency, in the pediatric surgical setting, it has been essential to avoid and contain infections as well as to protect both the patients and the surgical team. During this emergency, procedures and workflow were adapted to provide the safest possible environment for both the surgical team and the patients. Pediatric surgical activities were reorganized during the COVID-19 pandemic at the "Vittore Buzzi" Children's Hospital, which is a pediatric/maternal hospital located in Milan (Lombardy Region), Italy. Resources were optimized in order to maintain high levels of care and quality of assistance. During the COVID-19 emergency, the pediatric surgical department at the "Vittore Buzzi" Children's Hospital became an acute care surgical service. For the reorganization of surgical activities, institutional protocols were adapted in order to preserve the pediatric-specific characteristics of our service; five crucial points were specifically addressed. The pediatric surgical procedures carried out during the initial two months of the Italian lockdown are also reported. Continuity of care was maintained for children affected by severe diseases, such as tumors and neurosurgical conditions, whose treatment could not be deferred. Telemedicine and telecommunication were adopted as quick-support modalities for preand post-operative care. This reorganization allowed us to preserve the "pediatric specificity" and all care-related procedures offered at this high-quality/high-volume surgical care referral center. [ABSTRACT FROM AUTHOR]

Soil erosion is one of the biggest environmental problems throughout European Union causing considerable soil losses. Vegetation cover provides an important soil protection against runoff and soil erosion. To this aim, unlike annual crops, perennial plants have the advantage of covering soil for a longer time and reducing soil erodibility thanks to SOM increase due to litter effect and to reduction of soil disturbance (no-tillage). Two experiments were carried out in marginal hilly areas (10% slope) of Southern Italy: i) long-term experiment in which it was evaluated the effect of two fertilization doses (N: 100 and 50 kg N ha-1 from urea) on Arundo donax L. biomass production as well as its effect on soil erosion; ii) three-year experiment to evaluate the soil cover capacity of the giant reed by analysing the plant leaf area index (LAI). Results of the two experiments showed a good soil protection of Arundo donax L. that reduced soil losses by 78% as compared to fallow and showed soil erosion reduction not different from permanent meadow thanks to the soil covering during the period with the highest rain erosivity and to the reduction in soil erodibility. The protective effect of Arundo donax L. from rain erosivity was also confirmed by LAI analysis that showed a good soil covering of giant reed in the above mentioned period, even during the initial yield increasing phase following crop transplant. According to biomass yield, from the fifteen year of cultivation in a low fertile inland hilly area of Southern Italy, giant reed was characterized by a yield-decreasing phase that resulted postponed as compared to more fertile environments thus ensuring a longstanding soil protection from soil erosion. In addition, the higher nitrogen fertilization dose (100 kg ha-1 of N) allowed interesting biomass yield as compared to the lower dose (50 kg N ha-1) and kept constant SOC along the year of experimentation due to an improved contribution of leaf fall, root exudates and root turnover to soil. [ABSTRACT FROM AUTHOR]

The risks for human health and the ecosystem due to potentially toxic elements (PTEs) were investigated in a farmland classified as potentially contaminated by Cr and Zn by analysing native vegetation and relative rhizo-soils. Rhizo-soils of different plant species were found to be enriched by Cr and Zn as well as by elements omitted from official environmental characterization, namely Cd, As and Pb. The ecological risk index (ERI) had a mean value of 510, indicating high to "very high" risk in different habitats. ERI above the very high risk threshold characterized the rhizo-soils of Lolium perenne , Erigeron sumatrensis , Oloptum thomasii and Amaranthus retroflexus. Two of these plant species (E. sumatrensis and A. retroflexus) are exotic in Italy and accumulated Cd in the shoots above the EU threshold for forage, suggesting a potential risk of Cd transfer to the food chain. Hence, this element was found to contribute most to the ERI. Cynodon dactylon was recognized as the most suitable plant species for the phytostabilization of the contaminated site, as it showed the highest bioavailable Cd accumulation in roots coupled with the highest frequency and soil-cover capacity during spring-summer, when the risk of soil resuspension is generally more intense. Image 1 • Pollutants from industrial activities are the main threat for humans and ecosystems. • Analyzing wild flora can help in contaminated soil characterization and remediation. • As, Cd and Pb in soils bared a potential risk but Cd was the most hazardous element. • Cd accumulation in shoots suggests the risk of transfer to food chain. • Cynodon dactylon was the best plant for phytostabilization and site securing. In a soil polluted by tannery wastes, Cr and Zn did not pose environmental and sanitary risks, while Cd was the most dangerous element. Cynodon dactylon was the most suitable species for remediating the site. [ABSTRACT FROM AUTHOR]

Normative democratic theory requires political actors in parliament and government to represent not only the citizens' policy preferences, but also their issue priorities. This article investigates Italian dynamic agenda representation – the transmission of public priorities into the policy priorities of the Italian political system. To assess the public's policy priorities, data on the Most Important Problem from the Eurobarometer polls are used, while the legislative agendas of the members of parliament (MPs) and government are built following the rules of the Comparative Agendas Project. The results of longitudinal analyses across 10 policy areas and 20 semesters (2003–13) suggest a persistent link between the public's agenda and the prioritization of legislation by the Italian parliament, majority MPs, and government. Contrary to expectations, the opposition does not seem to be responsive to public opinion policy problems when introducing bills. [ABSTRACT FROM AUTHOR]

The results of experiments carried out in the National Interest Priority Site (NIPS) Agro Aversano-Litorale Domizio in Campania (southern Italy) within the framework of the project ECOREMED (LIFE11 ENV/IT/275) are used as a basis for reporting the main threats to soil fertility. In this paper we focus on soil degradation and contamination due to illegal waste disposal and burning, widespread phenomena in the NIPS in question, evaluating different options for soil remediation with agriculturebased techniques in light of their impact on the ecosystem services of soils. Bioremediation and assisted phytoremediation are recognized as the best options for protecting human health and enhancing environmental quality, maintaining agricultural soil functions with the application of relatively low-cost protocols. The purpose of agriculture-based remediation techniques is threefold: i) make the area in question safe, interrupting exposure to contaminant pathways through ecological structures such as dense reed plantations or dense turfgrass combined with high-density tree rows for reducing ground wind speed; ii) remediation, aiming to reduce the bioavailable fraction of potentially toxic elements (PTEs); iii) environmental restoration, to improve environment and landscape quality of degraded, but not contaminated land. The technical steps for carrying out phytoremediation projects and the results of their application are described for the following case studies monitored in Campania: i) agricultural soil contaminated by bioavailable Cd (San Giuseppiello site in Giugliano); ii) industrial soil heavily contaminated by Pb and Cd (Ecobat site in Marcianise); iii) agricultural soils potentially contaminated by non-bioavailable PTEs and organic pollutants (Giugliano and Trentola-Ducenta sites); iv) physically degraded soil (Teverola site). In all the case studies phytoremediation proved a low-cost tool to reduce risks for human health and enhance environmental quality, whilst maintaining soil fertility and improving ecosystem services. [ABSTRACT FROM AUTHOR]

Aims: The most recent European guidelines have proposed new definitions of pulmonary hypertension (PH) in left heart disease, to better approach the characteristics required to reflect the presence of pulmonary vascular disease. The purpose of this study was to assess whether different haemodynamic definitions of post-capillary PH imply a different reversibility of PH in response to acute vasodilator administration in heart failure patients with reduced ejection fraction and PH (HFrEF-PH).Methods and Results: Right heart catheterization and reversibility testing was performed in 156 HFrEF-PH patients. Patients were classified as combined post-capillary and pre-capillary pulmonary hypertension (Cpc-PH) vs. isolated post-capillary pulmonary hypertension (Ipc-PH) and on the basis of diastolic pulmonary gradient (DPG) ≥ 7 vs. < 7 mmHg or of transpulmonary gradient (TPG) >12 vs. ≤12 mmHg. After vasodilator administration, Cpc-PH patients showed a greater per cent improvement in pulmonary vascular resistance (PVR), DPG and TPG as compared with Ipc-PH patients (all Pint < 0.001); only pulmonary compliance (PCa) improved less in Cpc-PH than in Ipc-PH patients (Pint = 0.007). However, despite vasodilatation, Cpc-PH patients remained in an unfavourable portion of the inverse hyperbolic relationship between PVR and PCa. The number of patients in whom PVR was reduced below 2.5 wood units was similar in Cpc-PH, DPG ≥7 mmHg and TPG >12 mmHg groups (28.3, 26.7 and 18.9%, respectively).Conclusion: Although substantial improvements in PVR, DPG and TPG were observed in Cpc-PH patients after acute vasodilator administration, this response was associated with persistent abnormalities in the PVR vs. PCa relationship. The link between baseline right heart haemodynamics and pulmonary vascular disease remains elusive. [ABSTRACT FROM AUTHOR]

Aim: Primary endpoint was to report polypharmacy distribution in the general population vs ≥65 years old people and to examine the frequency of drug-drug interactions (DDIs) in the Health Local Unit of Palermo, Italy, in relationship with patients' age. Methods: Drug prescription data for the year 2014 were extracted from the database of the Local Health Unit of Palermo Province, Italy. Patients were divided into five age groups (0-13, 14-64, 65-69, 70-74, and ≥75 year old). The detection of potential DDIs in polypharmacy profiles was performed with NavFarma software (Infologic srl, Padova, Italia), with DDI classification provided by tool Micromedex Drug Reax (Truven Health Analitics, Michigan, USA). Results: We analyzed data of 1,324,641 patients, and 15,801,191 medical prescription were recorded; of these, 11,337,796 regarded chronic conditions. The drug prescriptions reached the highest values in the 65-69 and 70-74 age groups ( p = 0.005 and p = 0.008 vs age 14-64 respectively). An overall amount of 6,094,373 DDIs were detected, of which 47,173 were contraindicated. Median number of DDIs was higher in 65-69 and 70-74 age groups ( p = 0.008 and p = 0.012 vs age 14-64, respectively). Regarding contraindicated DDIs a significant difference was detected comparing 14-64 vs ≥65 age groups ( p = 0.010 vs 65-69 group, p = 0.005 vs 70-74 group and ≥75 group). Conclusions: Polypharmacy is a phenomenon acquiring increasing dimensions also in our province. It interests particularly the older subjects, and assumes a dramatic accent when it is put in relationship with the frequency of DDIs. A proactive vigilance about potential life threatening drug interactions is mandatory. [ABSTRACT FROM AUTHOR]

Coronary care units, initially developed to treat acute myocardial infarction, have moved to the care of a broader population of acute cardiac patients and are currently defined as Intensive Cardiac Care Units (ICCUs). However, very limited data are available on such evolution. Since 2008, in Italy, several surveys have been designed to assess ICCUs’ activities. The largest and most comprehensive of these, the BLITZ-3 Registry, observed that patients admitted are mainly elderly males and suffer from several comorbidities. Direct admission to ICCUs through the Emergency Medical System was rather rare. Acute coronary syndromes (ACS) account for more than half of the discharge diagnoses. However, numbers of acute heart failure (AHF) admissions are substantial. Interestingly, age, resources availability, and networking have a strong influence on ICCUs’ epidemiology and activities. In fact, while patients with ACS concentrate in ICCUs with interventional capabilities, older patients with AHF or non-ACS, non-AHF cardiac diseases prevail in peripheral ICCUs. In conclusion, although ACS is still the core business of ICCUs, aging, comorbidities, increasing numbers of non-ACS, technological improvements, and resources availability have had substantial effects on epidemiology and activities of ICCUs. The Italian surveys confirm these changes and call for a substantial update of ICCUs’ organization and competences. [ABSTRACT FROM AUTHOR]

Toxinogenic Clostridium difficile infection (CDI) is a leading cause of infectious diarrhea. In this retrospective cohort study the molecular epidemiology of hospital-acquired and community-associated CDI was investigated in patients admitted to a tertiary care hospital. CD in stools samples was revealed by a two steps diagnostic algorithm, firstly screening for positivity to GDH antigen and thereafter RT-PCR analysis. Increased CDI incidence was observed ranging from 1.70episodes/10000patient-days in the 1st year, to 2.62 in the 2nd year, mostly hospitalized in the medicine wards, followed by outpatients (5.74 and 5.12episodes/10.000patient-days respectively). CDI positive were older than CDI negative patients and presented increased trend of diarrhea episodes as the patients' age increased. RT-PCR positive patients (n° = 314) were classified according to the CD toxin producing genes in three groups (1–3, carrying tcdB, both tcdB and cdt , and the two genes plus the deletion Δ117 of tcdC , respectively). The incidence of the group 2 and 3 increased statistically with the age of the patients showing correlation with the gender. Higher frequency of patients belonging to group 1 and group 3 was observed in the medical wards. Of note was the high incidence of group 3 in outpatients. Interestingly, patients with previous health care contacts had higher risk (RR = 1.88) of being infected by CD strains with higher toxicity than community patients. Recurrence rate was 15.9%. In conclusion the knowledge of the toxigenic profiles and of their relationships to gender, age and wards distribution may help the clinicians in the clinical management of the disease. [ABSTRACT FROM AUTHOR]

The eight hundred Chinese and Japanese ceramics, donated to the city of Pesaro by Vittoria Toschi Mosca and now housed in the Musei Civici, are little known and have remained in storage for more than sixty years despite being one of the largest collection of export porcelain in Italy. This paper introduces an ongoing research project into their history and heralds their study and publication. [ABSTRACT FROM AUTHOR]

Purpose – The purpose of this paper is to detect how Value for Money (VfM) in Italian Project Finance (PF) investments can be enhanced and challenging criticalities minimized, with a synergistic interaction of macroeconomic, legal and institutional actions. Design/methodology/approach – Analysis of VfM quantitative key drivers, within a public-private partnership (PPP) framework with specific reference to a recession context, with infrastructural capital rationing implications. Empirical evidence is given by an Italian PF healthcare model, testing the impact of legal and macroeconomic changes. Findings – Deleverage, ignited by W-shaped recession, disinflates PPP investments, so forcing to innovative and penniless solutions. Unreliable and short-sighted legislation and consequent unfriendly business climate may frighten investors, so decreasing competition and VfM. Research limitations/implications – VfM sensitivity to macroeconomic and legal/institutional parameters is too wide and capriciously erratic to be comprehensively modeled. Tips for further research include pro-growth tax and budgetary policies, risk minimization issues and other synergistic targets. Practical implications – Guidance to regulators to fine tune legal and institutional tools, so as to create a stable, business friendly environment. Recessions may be softened by sensitive policymaking, or exacerbated by short-sighted ignorance and lack of strategic focus. Originality/value – Unprecedented analysis of legal and macroeconomic changes on VfM in Italian PF investments, with original tips for VfM optimization, in a comprehensive PPP framework. [ABSTRACT FROM AUTHOR]

The essay intends to find out why although many studies have focused on the three-year revolutionary period in Italy from 1796–1799, the Cisalpine Republic has never been studied in the same detail as the Neapolitan Republic. In reconstructing these events, the two republics are regularly presented in opposing terms. The Cisalpine Republic is portrayed as exemplifying subordination to the military protectorate and politics of France, while the Neapolitan Republic is put forward as the shining example of revolutionary resistance within Italy at the time. The essay intends to underline why the nineteenth and the twentieth century historiography has negatively and prejudicially judged the political experience of the Cisalpine Republic. [ABSTRACT FROM AUTHOR]

Human exposure assessment to deoxynivalenol (DON), aflatoxin B1 (AFB1), fumonisin B1 (FB1), zearalenone (ZEA) and ochratoxin A (OTA) can be performed by measuring their urinary biomarkers. Suitable biomarkers of exposure for these mycotoxins are DON + de-epoxydeoxynivalenol (DOM-1), aflatoxin M1 (AFM1), FB1, ZEA + α-zearalenol (α-ZOL) + β-zearalenol (β-ZOL) and OTA, respectively. An UPLC-MS/MS multi-biomarker method was used to detect and measure incidence and levels of these biomarkers in urine samples of 52 volunteers resident in Apulia region in Southern Italy. The presence of ZEA + ZOLs, OTA, DON, FB1 and AFM1 were detected in 100%, 100%, 96%, 56% and 6%, of samples, respectively. All samples contained biomarkers of two or more mycotoxins. The mean concentrations of biomarkers ranged from 0.055 ng/mL (FB1) to 11.89 ng/mL (DON). Urinary biomarker concentrations were used to estimate human exposure to multiple mycotoxin. For OTA and DON, 94% and 40% of volunteers, respectively exceeded the tolerable daily intake (TDI) for these mycotoxins. The estimated human exposure to FB1 and ZEA was largely below the TDI for these mycotoxins for all volunteers. [ABSTRACT FROM AUTHOR]

Involvement of health personnel in a medical audit can reduce the number of errors in laboratory medicine. The checked control of point of care testing (POCT) could be an answer to developing a better medical service in the emergency department and decreasing the time taken to report tests. The performance of sanitary personnel from different disciplines was studied over an 18-month period in a children's hospital. Clinical errors in the emergency and laboratory departments were monitored by: nursing instruction using specific courses, POCT, and external quality control; improvement of test results and procedural accuracy; and reduction of hemolyzed and nonprotocol-conforming samples sent to the laboratory department. In January 2012, point of care testing (POCT) was instituted in three medical units (neonatology, resuscitation, delivery room) at the Children's Hospital in Trieste, northeast Italy, for analysis of hematochemical samples. In the same period, during the months of January 2012 and June 2013, 1,600 samples sent to central laboratory and their related preanalytical errors were examined for accuracy. External quality control for POCT was also monitored in the emergency department; three meetings were held with physicians, nurses, and laboratory technicians to highlight problems, ie, preanalytical errors and analytical methodologies associated with POCT. During the study, there was an improvement in external quality control for POCT from -3 or -2 standard deviations or more to one standard deviation for all parameters. Of 800 samples examined in the laboratory in January 2012, we identified 64 preanalytical errors (8.0%); in June 2013, there were 17 preanalytical errors (2.1%), representing a significant decrease (P<0.05, χ2 test). Multidisciplinary management and clinical audit can be used as tools to detect errors caused by organizational problems outside the laboratory and improve clinical and economic outcomes. [ABSTRACT FROM AUTHOR]

Autism spectrum disorders (ASDs) include three main conditions: autistic disorder (AD), pervasive developmental disorder, not otherwise specified (PDD-NOS), and Asperger syndrome. It has been shown that many genes associated with ASDs are involved in the neuroligin-neurexin interaction at the glutamate synapse: NLGN3, NLGN4, NRXN1, CNTNAP2, and SHANK3. We screened this last gene in two cohorts of ASD patients (133 patients from US and 88 from Italy). We found 5/221 (2.3%) cases with pathogenic alterations: a 106 kb deletion encompassing the SHANK3 gene, two frameshift mutations leading to premature stop codons, a missense mutation (p.Pro141Ala), and a splicing mutation (c.1820-4 G>A). Additionally, in 17 patients (7.7%) we detected a c.1304+48C>T transition affecting a methylated cytosine in a CpG island. This variant is reported as SNP rs76224556 and was found in both US and Italian controls, but it results significantly more frequent in our cases than in the control cohorts. The variant is also significantly more common among PDD-NOS cases than in AD cases. We also screened this gene in an independent replication cohort of 104 US patients with ASDs, in which we found a missense mutation (p.Ala1468Ser) in 1 patient (0.9%), and in 8 patients (7.7%) we detected the c.1304+48C>T transition. While SHANK3 variants are present in any ASD subtype, the SNP rs76224556 appears to be significantly associated with PDD-NOS cases. This represents the first evidence of a genotype-phenotype correlation in ASDs and highlights the importance of a detailed clinical-neuropsychiatric evaluation for the effective genetic screening of ASD patients. [ABSTRACT FROM AUTHOR]

The effect of triazole-based treatments on Fusarium head blight (FHB), grain yields and the accumulation of deoxynivalenol (DON) in harvested wheat kernels was evaluated by means of twenty multi-site field experiments performed during five consecutive growing seasons (from 2004-2005 to 2008-2009) in Italy. Fungicide treatments were carried out on different cultivars of common wheat (cv. Serio, Blasco, Genio and Savio) and durum wheat (cv. Orobel, Saragolla, San Carlo, Levante, Duilio, Karur and Derrik) after artificial inoculation with a mixture of toxigenic Fusarium graminearum and F. culmorum strains. The application of fungicides containing prothioconazole (Proline® or Prosaro®) at the beginning of anthesis (BBCH 61) resulted in a consistent reduction of FHB disease severity (by between 39 and 93%) and DON levels in wheat kernels (by between 40 and 91%) and increased wheat yields (from 0.4 to 5.6 t ha-1, average 2.2 t ha-1), as compared to the untreated/inoculated control. Fungicides containing tebuconazole (Folicur® SE) and cyproconazole plus prochloraz (Tiptor® Xcell) showed a reduced effectiveness compared with prothioconazole-based treatments. All fungicide treatments were more effective in reducing DON and increasing grain yields of common wheat than durum wheat. Results showed that the application of fungicides containing prothioconazole at the beginning of anthesis provided a strong reduction of FHB disease, allowing both an increase in grain yields and a considerable reduction of DON content in wheat kernels. [ABSTRACT FROM AUTHOR]

The seasonal variation of section stable isotopes signature of carbon (δ13C) in Lake Maggiore during 2008 was related to seasonal variation of the lake phytoplankton community, investigated in terms of phytoplankton taxonomic groups, morph-functional groups (MBFG), cell size classes and cell shape classes. Three open water stations were selected to reflect truly pelagic, influenced by littoral and riverine carbon sources; phytoplankton samples were collected from two water depths, 0-20 m and 25-50 m. Among stations differences in δ13C signatures of section were statistically non significant, confirming that allochthonous input may become important only after exceptional rainfall events. Nonparametric multiplicative regression (NPMR) was utilized to identify among the phytoplankton parameters (taxonomic groups, MBFG, cell shapes, cell sizes) which were the best predictors of the δ13C variation. Bacillariophyceae and two morph-functional groups, Group 6 (non-flagellated organisms with siliceous exoskeletons) and Group 3 (large filamentous algae with aero topes) were statistically significant. Non-metric multidimensional scaling (NMS) ordination was used to investigate differences in phytoplankton samples and their relationship with δ13C variation. When morphological and functional phytoplankton traits were superimposed, the NMS ordination showed that cylinder cells (for cell shape classes), class 500-2000 µm³ (for cell size classes) and Group 6 (for MBFG) were the most related to δ13C variation. Our study confirms that the variation in the pelagic δ13C section most probably reflects changes in phytoplankton carbon isotopic signature, consequent to changes in availability of carbon sources depending on the season and due to different isotopic fractionation of phytoplankton taxonomic groups. Statistical investigations have allowed us to investigate the potential role of phytoplankton morphological and functional traits in the seasonal variation of δ13C and to suggest their importance in the interpretation of natural stable isotopes studies in lake ecosystems. [ABSTRACT FROM AUTHOR]

The article elaborates on the results of a trial study on the effectiveness of three types of drug-eluting stents (DES) in type 2 diabetes patients in Naples, Italy. It addresses the factors that are used in the study including the methods used to assess the three types of DES in the study which are elective sirolimus-eluting stent (SES), paclitaxel-eluting stent (PES), and zotarolimus-eluting stent and the microvascular side effects to which the patients were tested to. It shows that ZES performed poorly among the three.

The article focuses on the constitution of a new General Office for Aerial Space and Meteorology as projected by General Office for Meteorology head General Massimo Capaldo on May 1, 2006 in Italy. It states that the purpose for the establishment of the new office is due to economic factors. It tells that dissemination of forecasts for the air force and national civil protection and to safeguard life at sea are the tasks of the new established office. It also presents the history of the aerial space and meteorology office to fully understand the change, and lays recent developments, national and regional services, and Italian meteorology consequences.

A sensitive, accurate and precise method for the simultaneous determination of nivalenol (NIV), deoxynivalenol (DON), T-2 toxin (T-2) and HT-2 toxin (HT-2) in different food matrices, including wheat, maize, barley, cereal-based infant foods, snacks, biscuits and wafers, has been developed. The method, using liquid chromatography coupled with atmospheric pressure chemical ionization triple quadrupole mass spectrometry (LC-APCI-MS/MS), allowed unambiguous identification of the selected trichothecenes at low µg per kg levels in such complex food matrices. A clean-up procedure, based on reversed phase SPE Oasis® HLB columns, was used, allowing good recoveries for all studied trichothecenes. In particular, NIV recoveries significantly improved compared to those obtained by using Mycosep® #227 columns for clean-up of the extracts. Limits of detection in the various investigated matrices ranged 2.5-4.0 µg kg-1 for NIV, 2.8-5.3 µg kg-1 for DON, 0.4-1.7 µg kg-1 for HT-2 and 0.4-1.0 µg kg-1 for T-2. Mean recovery values, obtained from cereals and cereal products spiked with NIV, DON, HT-2 and T-2 toxins at levels from 10 to 1000 µg kg-1, ranged from 72 to 110% with mean relative standard deviation lower than 10%. A systematic investigation of matrix effects in different cereals and cereal products was also carried out by statistically comparing the slopes of standard calibration curve with matrix-matched calibration curve for each of the four toxins and the eight matrices tested. For seven of the eight matrices tested, statistically significant matrix effects were observed, indicating that, for accurate quantitative analysis, matrix-matched calibration was necessary. The method was applied to the analysis of 57 samples of ground wheat originated from South Italy and nine cereal food samples collected from retail markets. [ABSTRACT FROM AUTHOR]

The artciel discusses that the beginning of the COVID 19 outbreak, a number of guidelines and recommendations have been released on how to best readapt clinical activities, including breast cancer care. It mentions that the COVID 19 outbreak, a number of guidelines and recommendations have been released on how to best readapt clinical activities, including breast cancer care.

The occurrence of patulin was investigated in 100 conventional and 69 organic fruity foodstuffs samples commercially available in Italy by using an HPLC method with a limit of quantification of 0.5?µg?kg -1 . Patulin was detected in 26 (26%) conventional and 31 (45%) organic products with a significantly higher ( p <0.01) mean concentration in the organic products (4.78 vs. 1.15?µg?kg -1 ). Mean patulin concentrations in conventional apple juices, pear juices, other juices and fruits purees were 3.14, 0.22, 0.19, 0.11?µg?kg -1 , respectively, and 7.11, 11.46, 2.10, 0.18?µg?kg -1 in the relevant organic products. Four samples of juices (one conventional and two organic apple, and one organic pear) contained patulin at concentrations above the limit of 50?µg?kg -1 , four at concentrations between 10 and 25?µg kg -1 , and the remaining ones below 10?µg?kg -1 . Patulin was detected (<1?µg?kg -1 ) in only three of the 23 fruity baby food samples tested (homogenized fruits, 11 conventional and 12 organic). Based on the available data on Italian intakes of fruit juices, the estimated daily intakes of patulin, were 0.38 and 1.57?ng?kg -1 body weight (bw) from conventional and organic products, respectively. Estimated daily intakes of patulin for children were higher, 3.41?ng?kg -1 bw from conventional and 14.17?ng?kg -1 bw from organic products, but largely below the provisional maximum tolerable daily intake (PMTDI) of 400?ng?kg -1 bw. Patulin was also found in two samples of organic apple vinegar (<5?µg?kg -1 ) and in fresh apples with rotten spots (12 out of 24 samples) with maximum levels at 16?402 and 44?572?µg?kg -1 for conventional and organic apples, respectively. [ABSTRACT FROM AUTHOR]

Describes the operation of a geophysical interferometer installed beside the Gran Sasso Tunnel on the highway connecting Rome to Teramo in Central Italy and in the vicinity of an underground laboratory for Particle Physics and Astrophysics. Description of the apparatus; Optical setup of the interferometer; Retrieval of tidal frequencies.

Background: Use of hyaluronic acid-based products has become a valuable alternative to drug-based approaches in the treatment of recurrent aphthous stomatitis (RAS). The presented study aimed to investigate the effect of a barrier forming hyaluronic acid containing mouth wash or a topical gel formulation on the healing of RAS and patient's quality of life. Methods: For this single-center retrospective study, medical records of the Dental School of the University of Brescia were screened for adult and systemically health patients suffering from minor recurrent aphthous stomatitis (RAS) and treated with either a barrier forming, hyaluronic acid containing mouth wash (GUM® AftaClear® rinse) or a topical gel (GUM® AftaClear® gel) in 2015. All patients fulfilling the in−/exclusion criteria and presenting full data sets on lesion diameter, lesion color, as well as pain perception for baseline (day 0) and 4 and 7 days after treatment were enrolled into the presented study. Results: Out of 60 screened patients, a total of 20 patients treated with the Rinse formulation and 25 treated with the Gel formulation were eligible for the enrollment into this study. Both groups showed equal distribution in patient's age, sex and presented a similar mean lesion size (3.0 ± 1.0 mm), lesion color distribution as well as pain perception at baseline. All patients showed significant normalization of lesion color, reduction of pain, and lesion dimension within the course of their treatment. After 7 days, the mean percentage of lesion reduction was highly significant for both groups attaining 77.4 ± 30.1% in the Rinse group and 81.2 ± 23.1% in the Gel group with a complete lesion closure obtained in 60 and 56% of the cases, respectively. However, a significant (p < 0.05) higher percentage of lesions in the Gel group (72%) compared to the Rinse group (40%) showed an improvement in lesion size already after 3 days. Conclusions: Within the limitation of retrospective design, it can be concluded that both the barrier forming hyaluronic acid containing mouth rinse as well as the topical gel formulation are effective in the treatment of minor recurrent aphthous stomatitis (RAS), with a trend for an earlier healing onset for the topical Gel formulation. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to article "Breast conserving surgery using volume replacement with oxidized regenerated cellulose: a cosmetic outcome analysis," by S. Tanaka, N. Sato, H. Fujioka and colleagues is presented.

The notion of regional clusters of firms has been the subject of research for over a century. Recent research has increasingly reported evidence of cluster firms' growth, contrasting with the general assumption that being embedded in a cluster restrains the possibility for firm growth in terms of attitude, opportunities and resources. However, despite the recent research interest on those firms that have experienced growth, detaching from the cluster cliche of being small, local and homogeneous, little is known on the antecedents of such growth. In this paper, we use the lenses of firm-level entrepreneurship as a framework for analysing, comparing and generalising the empirical results of four case studies (Alessi, Illycaffe, Luxottica and Geox). We argue that local and non-local resources and competencies, together with firm capabilities of acquisition and recombination, are the main antecedents of the continuous process of opportunity recognition and exploitation, i.e., growth of cluster firms. [ABSTRACT FROM AUTHOR]

Fourier-transform-near infrared (FT-NIR) spectroscopy has been used to develop quantitative and classification models for the prediction of deoxynivalenol (DON) levels in durum wheat samples. Partial least-squares (PLS) regression analysis was used to determine DON in wheat samples in the range of <50-16,000 µg/kg DON. The model displayed a large root mean square error of prediction value (1,977 µg/kg) as compared to the EU maximum limit for DON in unprocessed durum wheat (i.e., 1,750 µg/kg), thus making the PLS approach unsuitable for quantitative prediction of DON in durum wheat. Linear discriminant analysis (LDA) was successfully used to differentiate wheat samples based on their DON content. A first approach used LDA to group wheat samples into three classes: A (DON ≤ 1,000 µg/kg), B (1,000 < DON ≤ 2,500 µg/kg), and C (DON > 2,500 µg/kg) (LDA I). A second approach was used to discriminate highly contaminated wheat samples based on three different cut-off limits, namely 1,000 (LDA II), 1,200 (LDA III) and 1,400 µg/kg DON (LDA IV). The overall classification and false compliant rates for the three models were 75%-90% and 3%-7%, respectively, with model LDA IV using a cut-off of 1,400 µg/kg fulfilling the requirement of the European official guidelines for screening methods. These findings confirmed the suitability of FT-NIR to screen a large number of wheat samples for DON contamination and to verify the compliance with EU regulation.

Fusarium langsethiae, formally described as a new species over a decade ago, has been identified as the main producer of HT-2 (HT2) and T-2 (T2) toxins in Europe in small cereal grains. Mycotoxin contamination caused by this Fusarium species can represent a food safety hazard that deserves further attention. In the present work, the mycotoxin profile in wheat cultures of F. langsethiae is presented with particular reference to the production of major type-A trichothecenes and their glucosyl derivatives. F. langsethiae isolates, representative of the major Italian wheat cultivation areas, were tested for the production of T2, HT2, diacetoxyscirpenol (DAS) and neosolaniol (NEO), and relevant glucosyl derivatives. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was used for the identification and chemical characterization of these metabolites. F. langsethiae isolates under investigation resulted to be potent producers of T2, HT2 and NEO. Furthermore, a well-defined set of isolates, all originating from Central Italy, produced also DAS. All isolates were found to be able to produce HT2 glucosyl derivatives, whereas only traces of T2 glucoside were detected in one sample. Furthermore, two mono-glucosyl derivatives of NEO and one mono-glucoside derivative of DAS were identified and characterized. The screening for the presence/absence of glucosylated trichothecenes in analyzed fungal extracts revealed a general co-occurrence of these derivatives with the parent toxin at levels that could be roughly estimated to account up to 37% of the relevant unconjugated toxin. This is the first report of the production of glucosylated trichothecenes by F. langsethiae cultured on small grains., (Copyright © 2013 John Wiley & Sons, Ltd.)

The potential risk of exposure to fumonisin B(2) (FB(2)) in the grape-wine chain has recently been revealed after a report of Aspergillus niger in grapes and its ability to produce FB(2) and FB(4). The occurrence of these two fumonisins in wine was investigated by LC/MS/MS in 51 market samples (45 red, five white and one rose wine) produced in various Italian regions. Nine samples of red wine were found to be contaminated by fumonisin B(2) at levels ranging from 0.4 to 2.4 ng/ml, while FB(4) was not detected in any of the tested samples. This is the first report on the natural occurrence of FB(2) in wine, indicating that, although at low levels, there is a potential risk of FB(2) exposure for the wine-consumer.

Previous studies reported an association with multiple sclerosis (MS) of distinct HLA-class I markers, namely HLA-A*02, HLA-Cw*05 and MOG-142L. In this work, we tested the association with MS of A*02 and Cw*05 in 1273 Italian MS patients and 1075 matched controls, which were previously analyzed for MOG-142, and explored the relationship among these three markers in modulating MS risk. HLA-A*02 conferred a statistically robust MS protection (odds ratio, OR=0.61; 95% confidence intervals, CI=0.51-0.72, P<10(-9)), which was independent of DRB1*15 and of any other DRB1* allele and remained similar after accounting for the other two analyzed class I markers. Conversely, the protective effect we previously observed for MOG-142L was secondary to its linkage disequilibrium with A*02. Cw*05 was not associated considering the whole sample, but its presence significantly enhanced the protection in the HLA-A*02-positive group, independently of DRB1: the OR conferred by A*02 in Cw*05-positive individuals (0.22, 95% CI=0.13-0.38) was significantly lower than in Cw*05-negative individuals (0.69, 95% CI=0.58-0.83) with a significant (P=4.94 x 10(-5)) multiplicative interaction between the two markers. In the absence of A*02, Cw*05 behaved as a risk factor, particularly in combination with DRB1*03 (OR=3.89, P=0.0006), indicating that Cw*05 might be a marker of protective or risk haplotypes, respectively.

The natural occurrence of ochratoxin A in red wines has been widely reported by several authors, as well as a that of group of stilbenes including cis- and trans-resveratrols and related glucosylated forms. In the present study 112 samples of retail red wines were collected from northern (17), central (46), and southern (49) Italy and were analyzed for both ochratoxin A and resveratrol-related stilbenes. The mean levels of total resveratrols and total piceids were 3.14 and 5.80 mg/L, respectively, whereas the ochratoxin A mean level was 0.64 microg/L. The Merlot wines showed the highest mean value of total stilbenes, followed by Negroamaro and Negroamaro blend, Aglianico, and Syrah, all with mean levels of >10 mg/L. Ochratoxin A was detected in 70, 59, and 100% of wine samples from northern, central, and southern Italy, with mean levels of 0.12, 0.07, and 1.36 microg/L, respectively. The highest values of ochratoxin A were recorded in Negroamaro- and Primitivo-based wine samples from southern Italy, showing also the highest content of stilbenes. In wine samples from southern Italy, a positive correlation was obtained between levels of ochratoxin A and total stilbenes (r = 0.74) as well as between ochratoxin A and total resveratrols (r = 0.50) and between ochratoxin A and total piceids (r = 0.74). These results suggest that toxic levels of ochratoxin A in red wine may be, at some extent, counterbalanced by the beneficial effects of resveratrol derivatives. Further investigation should be warranted in this regard.

Healthcare is characterized by close collaboration and information sharing among many distinct actors, who co-operate for the patient care in different temporal moments, also at a distance. In this context, availability to care givers of all relevant patient health data and of specific healthcare co-operative work supporting tools is fundamental for best patient treatment. We designed and implemented He@lthCo-op, a web-based modular system supporting co-operative work and patient information secure sharing among healthcare personnel also from remotely located sites. He@lthCo-op enables easily gathering, storing, and accessing patient clinical and personal data anytime and from anywhere an Internet connection is available.

Economic losses of dairy products due to spoilage by yeasts have been increasing in European companies because of the reduced use of preservatives, packaging in modified atmospheres, or new formulations that do not strictly control the growth of these organisms. This study reports the results of a survey of yeast species and populations in 145 samples of cow and buffalo dairy products collected in some regions of Southern Italy. Yeasts were isolated from 74% and 57% of cow and buffalo products, respectively. Candida inconspicua was the predominant species in unripened products from cow's milk, while C. famata was detected in medium and long-term ripened dairy products, mostly in association with other yeasts and with moulds belonging to the genus Penicillium. For dairy products produced from buffalo milk, C. inconspicua was the most important yeast frequently isolated from dairy products. Total yeast populations ranged from 5 x 10(2) to 5 x 10(5) cfu/g, indicating a good hygienic quality of the products. The isolation of C. albicans from one stracciatella sample is noteworthy, as this yeast represents a potential contamination by human. Even though yeasts are considered as environmental contaminants, the occurrence of some of them in dairy products at high levels could represent a risk for human health, in particular for immunocompromised patients.

Ochratoxin A was determined in human serum samples, collected in the south of Italy in November 1992, using ion-pair liquid chromatography and fluorescence detection. The samples were collected from healthy people (65 subjects) as well as from people with different kidney disorders. Five different kinds of kidney disorders were represented: transplanted subjects (13), chronic glomerulonephritis (8), renal calculus or cyst (6), chronic renal failure (13), and subjects treated by dialysis (28). The mean and median concentrations of ochratoxin A in the healthy group was 0.53 and 0.44 ng/ml serum, respectively. The highest mean concentration was found in the group of patients treated by dialysis, 1.4 ng/ml serum. A higher incidence of samples containing > 0.44 ng ochratoxin A/ml serum was found in the dialysis group, compared to the other groups. Comparing the mean concentrations by Student's t-test, a significant difference was found between the mean concentrations of the healthy group and of the group of patients treated by dialysis (P < 0.01). No other significant differences were found when comparing the groups two at a time.

A limited survey of the natural occurrence of the major Alternaria mycotoxins, i.e. alternariol (AOH), alternariol methyl ether (AME), altenuene (ALT), altertoxin-I (ATX-I), and tenuazonic acid (TA) has been carried out on olives and related processing products (oil and husks). The toxigenicity of Alternaria strains isolated from olives and the possible mycotoxin transfer into the oil have also been investigated. Four out of 13 olive samples were contaminated by 2 to 4 Alternaria mycotoxins. The highest contamination was found in a badly damaged sample containing 2.9, 2.3, 1.4 and 0.3 mg/kg of AME, AOH, ALT and TA, respectively. No mycotoxins were detected in olive-oil destined for human consumption (6 samples) or olive-husks (3 samples) collected from oil-mills after the first pressing of olives. An oil sample produced in our laboratory by processing the most contaminated olive sample contained AME (0.79 mg/kg) and AOH (0.29 mg/kg). The estimated mycotoxin amount transferred into the oil was 4% for AME, 1.8% for AOH, and zero for ALT and TA (considering 15% the oil yield). Although Alternaria species, mostly A. alternata (Fr.) Keissler, were present at various extent on all the examined olive samples, mycotoxins were only detected in samples of physically damaged olives. The production of mycotoxins by A. alternata isolated from olives was much higher (up to 3 order of magnitude for TA) on rice cultures than on olive cultures.