Search

Simple Summary: This work addressed the age-old problem of buffalo brucellosis in the province of Caserta; this infection has repercussions both on public health (disease transmissible to humans) and on the economy of the DOP (Protected Designation of Origin) buffalo mozzarella dairy supply chain. This disease has persisted for years in the Caserta area, and numerous resources have been invested but to no avail. The aim of the work was to identify the main causes of the persistence of the contagion in order to act on them and improve the use of public funds. The study showed that the infection persists in the same companies and that it has most likely never moved away from them and is always present in the same areas where the companies are close to each other, and the disease has spread from one company to another due to the absence of disease surveillance and quarantine measures. In fact, companies that have had a previous history of infection and/or are close to other infected companies have a greater probability of contracting the infection. Bovine and bubaline brucellosis is still present in some regions of Italy. Although control and eradication measures have been implemented for several years, the brucellosis situation remains problematic in the Campania region. The infection is present in the provinces of Salerno and Caserta, with the latter experiencing a drastic increase in the prevalence and incidence of infection in buffalo species (Bubalus bubalis) in recent years. The brucellosis eradication plan in Italy is subject to the European co-financing system, and failure to achieve the objectives of the plan has resulted in economic cuts for the Campania Region for years. This study aimed to evaluate the possible risk factors associated with the spread and persistence of brucellosis infection on buffalo farms in the Province of Caserta. The results of official controls carried out from 2015 to 2020 on the buffalo farms of the Province were analyzed. Statistical analysis was performed by means of the R software (version 4.1.0) on a final dataset consisting of 4583 observations. The possible association between covariates and outcome (presence/absence of infection) was evaluated (T-Fisher and Wilcoxon). A logistic regression model with mixed effects was carried out. The study shows that the risk of infection is statistically associated with the density of farms per square km and previous notifications of abortions on the same farms. Furthermore, animal movements constitute a risk factor for the permanence of infection over time (OR > 1), and herds already infected prior to 2015 were seen to have an almost three-fold higher risk of developing the disease (OR = 3.35). [ABSTRACT FROM AUTHOR]

Background: After a huge efficacy of imatinib in treating patients with gastrointestinal stromal tumors (GISTs) was proven, a maximum effort was made to make a differential diagnosis between GISTs and gastrointestinal leiomyosarcomas (GI‐LMS), showing the latter to be an extremely rare tumor entity. Limited data on GI‐LMS biology, clinical behavior and drug‐sensibility are available, and the clinical decision‐making in this subgroup of patients is usually challenging. Methods: We conducted a multicenter, retrospective observational study on patients with diagnosed GI‐LMS from 2004 to 2020 within six high‐volume referral centers in Italy. Results: Thirty‐three patients had diagnosis of KIT‐negative GI‐LMS confirmed by sarcoma‐expert pathologist. The most common site of origin was the intestine. Twenty‐two patients had localized disease and underwent surgery: with a median follow‐up of 72 months, median disease‐free survival was 42 months. Overall survival (OS)‐rate at 5 years was 73% and median OS was 193 months. Five out of 10 patients with local relapse received a salvage surgery, and 2/5 remained with no evidence of disease. Thirteen patients received neoadjuvant (6) or adjuvant (7) chemotherapy, and 2/13 patients remained free from relapse. The median OS for patients with metastatic LMS was 16.4 months. Conclusion: GI‐LMS is very rare and extremely aggressive subgroup of sarcomas with a high tendency to systemic spread. Localized GI‐LMS at diagnosis may be cured if treated with adequate surgery with or without (neo) adjuvant chemotherapy, while de‐novo metastatic disease appeared to have a poor prognosis. Clinical effort to understand GI‐LMS biology and clinical behavior and to develop active treatment strategy, especially for metastatic‐disease, is warranted. [ABSTRACT FROM AUTHOR]

Background: People with epilepsy have a higher prevalence of behavioral and neuropsychiatric comorbidities compared to the general population and those with other chronic medical conditions, although the underlying clinical features remain unclear. The goal of the current study was to characterize behavioral profiles of adolescents with epilepsy, assess the presence of psychopathological disorders, and investigate the reciprocal interactions among epilepsy, psychological functioning, and their main clinical variables. Methods: Sixty-three adolescents with epilepsy were consecutively recruited at the Epilepsy Center, Childhood and Adolescence Neuropsychiatry Unit of Santi Paolo e Carlo hospital in Milan (five of them were excluded) and assessed with a specific questionnaire for psychopathology in adolescence, such as the Questionnaire for the Assessment of Psychopathology in Adolescence (Q-PAD). Q-PAD results were then correlated with the main clinical data. Results: 55.2% (32/58) of patients presented at least one emotional disturbance. Body dissatisfaction, anxiety, interpersonal conflicts, family problems, uncertainty about the future, and self-esteem/well-being disorders were frequently reported. Gender and poor control of seizures are associated with specific emotional features (p < 0.05). Conclusions: These findings highlight the importance of screening for emotional distress, recognition of the impairments, and provision of adequate treatment and follow-up. A pathological score on the Q-PAD should always require the clinician to investigate the presence of behavioral disorders and comorbidities in adolescents with epilepsy. [ABSTRACT FROM AUTHOR]

This work measures the total economic impact, with a special focus on the agri-food sector, of the Summer Jamboree, the largest international music festival of its kind taking place in a small town in central Italy mainly known for its beaches and seaside activities. The aim was to understand how and to what extent a large-scale event can bring benefits to the territory and the rural development of an area with a great, though only partially exploited, tourism potential. To this end, we used an input–output model fed by a sample survey carried out among the visitors and by the balance sheet data of the festival organizers. In order to obtain accurate and not overinflated estimated expenditures, we asked visitors to self-report their motivation for attending the area (seaside tourism vs. festival), and then used their motivation as a weight to revise expenditures, thus providing a novel approach in impact assessment studies. The results show that the total economic impact reaches €28.8 million, triggered by a direct impact that, in the agroindustrial sector alone, amounts to €9 million. In addition, for 1€ public money invested in this event, 6.3€ is generated in the primary sector and in the food sector alone. Additionally, the estimated value of the sale of typical products amounts to €1.3 million. Hence, under certain conditions, major cultural events can bring significant benefits to the development of the territory, enhancing the whole agri-food value chain and favoring a more even distribution of the capital generated. This study is an important contribution to the literature, as it encourages the development of studies focusing on the specific spillovers of tourism, not necessarily rural, on the agricultural, rural, and food sectors, which should interact more frequently with the economic system in general and with the touristic sector as well. [ABSTRACT FROM AUTHOR]

Foodborne infections cause illness and death every year worldwide. The aim of this study was to describe trends in 2013–2019 in the occurrence of human cases of salmonellosis, campylobacteriosis, listeriosis, and hepatitis A in the Campania region. Human case data were provided by the National Surveillance System of disease and were grouped by year, province, age group, and sex. Moreover, the number of people hospitalized was recorded. In the Campania region, the total number of confirmed human cases for the diseases investigated was 1924, with Hepatitis A and the Salmonellosis as the first most reported (1009 and 825 cases, respectively). The incidence rates of gastroenteritis under study were lower than those in Italy and European Union in the same period, with the exception of Hepatitis A whose incidence was higher than that recorded in Italy. Data on hospitalizations pointed out the onset of severe forms of infection also for listeriosis and campylobacteriosis, whose incidence was very low (27 and 63 cases, respectively). Unfortunately, no information on the foods implicated is available. Although probably underestimated, gastroenteritis due to foodborne agents still represents a burden in Campania, and continuous monitoring and implementation of the currently available regional surveillance system is required. [ABSTRACT FROM AUTHOR]

After fifty years of spread in the European continent, the African swine fever (ASF) virus was detected for the first time in the north of Italy (Piedmont) in a wild boar carcass in December, 2021. During the first six months of the epidemic, the central role of wild boars in disease transmission was confirmed by more than 200 outbreaks, which occurred in two different areas declared as infected. The virus entered a domestic pig farm in the second temporal cluster identified in the center of the country (Lazio). Understanding ASF dynamics in wild boars is a prerequisite for preventing the spread, and for designing and applying effective surveillance and control plans. The aim of this work was to describe and evaluate the data collected during the first six months of the ASF epidemic in Italy, and to estimate the basic reproduction number (R0) in order to quantify the extent of disease spread. The R0 estimates were significantly different for the two spatio-temporal clusters of ASF in Italy, and they identified the two infected areas based on the time necessary for the number of cases to double (td) and on an exponential decay model. These results (R0 = 1.41 in Piedmont and 1.66 in Lazio) provide quantitative knowledge on the epidemiology of ASF in Italy. These parameters could represent a fundamental tool for modeling country-specific ASF transmission and for monitoring both the spread and sampling effort needed to detect the disease early. [ABSTRACT FROM AUTHOR]

In recent years, a rapid increase in the adoption of renewable energy sources and in the transition from a centralized electricity generation system to an increasingly distributed one has occurred. Within this scenario, in line with the European directives for achieving the objectives in the field of energy transition and climate change, energy communities are seen as potential contributors. The purpose of this work is to analyze the application potential of the energy community concept associated with district heating networks, leading to better overall energy-economic performance. This was demonstrated for a specific energy community in Italy, and it can be achieved by maximizing internal energy sharing—resulting from the electricity surplus generated by the photovoltaic system—and adopting different strategies that include heat pumps in order to maximize self-consumption and self-sufficiency, as well as to evaluate the most efficient investment in economic terms by exploiting the incentive tariff on shared energy. The results show that the performance of the system can be improved with the proposed design, achieving a significant reduction in the system's energy demand, emissions and costs: compared to the reference case, the use of photovoltaics reduces primary energy demand by approximately 11%, while the addition of the energy community configuration allows emissions to be reduced by nearly 12%, with no additional investment. [ABSTRACT FROM AUTHOR]

Background: Chronic cough (CC) is a burdensome health problem in adult and older people, with a major impact on quality of life. Its management is often troublesome, and many guidelines have been released. Notwithstanding, a proportion of cases still do not reach a definite diagnosis and resolutive treatment. A coordinated approach between different specialists would be highly recommended, but its implementation in clinical practice suffers from the lack of shared protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues. Aims: To develop evidence-based recommendations for the management of adults with CC. Methods: A 12-member expert task force of general practitioners, geriatricians, pneumologists, allergologists, otorhynolaringologists and gastroenterologists was established to develop evidence-based recommendations for the diagnostic and therapeutic approach to subjects with CC. A modified Delphi approach was used to achieve consensus, and the US Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence. Results: A total of 56 recommendations were proposed, covering 28 topics and concerning definitions and epidemiology, pathogenesis and etiology, diagnostic and therapeutic approach along with the consideration of specific care settings. Conclusion: These recommendations should ease the management of subjects with CC by coordinating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities. [ABSTRACT FROM AUTHOR]

Northern Italy was the most affected by CoViD-19 compared to other Italian areas and comprises zones where air pollutants concentration was higher than in the rest of Italy. The aim of the research is to determine if particulate matter (PM) has been the primary cause of the high CoViD-19 spread rapidity in some areas of Northern Italy. Data of PM for all the 41 studied cities were collected from the local environmental protection agencies. To compare air quality data with epidemiological data, a statistical analysis was conducted identifying the correlation matrices of Pearson and Spearman, considering also the possible incubation period of the disease. Moreover, a model for the evaluation of the epidemic risk, already proposed in literature, was used to evaluate a possible influence of PM on CoViD-19 spread rapidity. The results exclude that PM alone was the primary cause of the high CoVid-19 spread rapidity in some areas of Northern Italy. Further developments are necessary for a better comprehension of the influence of atmospheric pollution parameters on the rapidity of spread of the virus SARS-CoV-2, since a synergistic action with other factors (such as meteorological, socio-economic and cultural factors) could not be excluded by the present study. [ABSTRACT FROM AUTHOR]

Background: In December 2019 an outbreak of Severe Acute Respiratory Syndrome Coronavirus 2 was first observed in Wuhan, China. The virus has spread rapidly throughout the world creating a pandemic scenario. Several risk factors have been identified, such as age, sex, concomitant diseases as well as viral load. A key point is the role of asymptomatic people in spreading SARS-CoV-2. An observational study in Southern Italy was conducted in order to elucidate the possible role of asymptomatic individuals related to their viral loads in the transmission of the virus within two nursing facilities. Methods: Oro-nasopharyngeal swabs from 179 nursing health care workers and patients were collected. SARS-CoV-2 RT-qPCR was performed and viral loads were calculated by using standard curve. A statistical correlation between viral loads, the presence/absence of symptoms, age and sex variables was investigated. Results: SARS-CoV-2 was confirmed in the 50.8 % (n = 91) of the cases. Median age of positive individuals resulted higher than negative ones. Over 65 year as well as female individuals showed higher susceptibility to SARS-CoV-2 infection, OR = 3.93 and 2.86, respectively. Among 91 tested positive, the 70.3 % was symptomatic while the 29.7 % was asymptomatic. Median viral loads of asymptomatic individuals were found statistically significant higher than symptomatic ones (p = 0.001), while no influence was observed in age and sex variables. The presence of comorbidities was 8.9 folds higher in patients who showed and developed symptoms compared to non-symptomatic ones. Moreover, higher viral loads were found in patients who remained asymptomatic than pre-symptomatic (p = 0.022). Conclusions: A range from 9.2 to 69 % of confirmed SARS-CoV-2 cases remains asymptomatic, moreover, sporadic transmissions from asymptomatic people are reported, that makes their involvement an important issue to take into account in the spreading control of the virus. An asymptomatic clinical course was observed in the 29.7 % of positive individuals, moreover, median viral loads resulted to be statistically significant when compared to symptomatic ones. Surely, such a relevant frequency should not be ignored in relation to the spread of the disease in an environment which has not only important intrinsic (age, sex, concomitant diseases) but also extrinsic factors such as high population density and close contacts. [ABSTRACT FROM AUTHOR]

• Irrigation suspension lead to a decrease of C assimilation and leaf transpiration • Plants could recover from drought stress as soon as water was re-supplied • Wilting point was between −1.8 and −2.0 MPa in all soils but sandy-clay-silt where it was −0.49 MPa • Soil matric potential at field water capacity ranged between −20 and −50 kPa in all soils but silt soil (−145 kPa) Correct water management of golden kiwifruit vines, besides being essential for reaching high yield and fruit quality, is also fundamental to keep plants healthy and avoid useless water loss. The objectives of this trial were to: 1) assess the water retention curve in typical soils for the kiwifruit production in Italy; 2) evaluate the response of potted Zezy002 plants to the variation of soil moisture, in term of leaf gas exchange and stem water potential. Plants grown on each soil were divided into two groups: 3 plants were irrigated maintaining soil water at field capacity (control); 4 plants were subjected to water stress as follows: irrigation rate was reduced 50 % of the evapotranspiration rate for one week, then irrigation was suspended. Two days after water suspension, 2 of the 4 stressed plants were irrigated as for the control plants (recovery), the other 2 vines were not irrigated (stress). Each pot was provided with a chalk potentiometric probe so that soil matric potential was constantly monitored. During the experiment leaf gas exchange and stem water potential were daily measured. After irrigation stop, a decrease of net photosynthesis, transpiration and stomatal conductance were observed, on the other hand, intercellular CO 2 concentration showed the opposite trend. Specific behavior has been detected for the two loam soils tested (here labelled as "sand-clay-silt" and "silt" soils). At wilting point, established when plant photosynthetic activity stopped, soil matric potential, measured by chalk probes, ranged between -1.8 and -2.0 MPa in all soils with the exception of "sandy-clay-silt", where it was -0.49 MPa. Soil matric potential at field water capacity ranged between -20 and -50 kPa in all soils with the exception of "silt" soil (-140 kPa). This peculiar behavior will be likely due to specific pore size distribution or poor-connected pores, however further investigations are needed. [ABSTRACT FROM AUTHOR]

[Display omitted] The Utstein Based-ROSC (UB-ROSC) score has been developed to predict ROSC in OHCA victims. Aim of the study was to validate the UB-ROSC score using two Utstein-based OHCA registries: the SWiss REgistry of Cardiac Arrest (SWISSRECA) and the Lombardia Cardiac Arrest Registry (Lombardia CARe), northern Italy. Consecutive patients with OHCA of any etiology occurring between January 1st, 2019 and December 31st 2021 were included in this retrospective validation study. UB-ROSC score was computed for each patient and categorized in one of three subgroups: low, medium or high likelihood of ROSC according to the UB-ROSC cut-offs (≤−19; −18 to 12; ≥13). To assess the performance of the UB-ROSC score in this new cohort, we assessed both discrimination and calibration. The score was plotted against the survival to hospital admission. A total of 12.577 patients were included in the study. A sustained ROSC was obtained in 2.719 patients (22%). The UB-ROSC model resulted well calibrated and showed a good discrimination (AUC 0.71, 95% CI 0.70–0.72). In the low likelihood subgroup of UB-ROSC, only 10% of patients achieved ROSC, whereas the proportion raised to 36% for a score between −18 and 12 (OR 5.0, 95% CI 2.9–8.6, p < 0.001) and to 85% for a score ≥13 (OR 49.4, 95% CI 14.3–170.6, p < 0.001). UB-ROSC score represents a reliable tool to predict ROSC probability in OHCA patients. Its application may help the medical decision-making process, providing a realistic stratification of the probability for ROSC. [ABSTRACT FROM AUTHOR]

Turfgrass is a major vegetation type in urban and peri-urban areas. Being high maintenance ecosystems, turfs can contribute substantially to urban climate change. The object of this study was to evaluate the contribution to GHG emissions by urban turfgrasses in Mediterranean conditions (Tuscany, central Italy). CO2 and CH4 emission fluxes from a mature stand of tall fescue and bermudagrass were evaluated, by static chambers method, for the assessment of C emission under different nitrogen fertilization rates (0 - 50 - 150 kg N ha-1 ). Both species showed a correlation between N fertilization rate and CO2 emissions, whilst, no correlation was observed for CH4. In the case of tall fescue, cumulative CO2 emissions were significantly higher with 150 kg N ha-1 and no differences were observed between 0 and 50 kg N ha-1 . As for bermudagrass differences were found between control and other treatments but no differences were observed on cumulative CO2 emissions between 50 and 150 kg N ha-1 . In both species, N fertilization did not affect CH4 emissions. Results indicate that both N rate and turfgrass species influence C emissions, for this reason they should be considered in the management of green areas in the climatic transition zone. [ABSTRACT FROM AUTHOR]

This article proposes a theoretical framework for the study of the political and, above all, institutional dimensions of autonomism. In doing so, it points out the differences between autonomism and regionalism, the former being a variety of the latter, and between autonomism and federalism, with which autonomism shares some features. With this in view, the article offers a closer analysis of the forms and logics of the de jure asymmetry that characterises autonomism as an institutional arrangement. Autonomism is then used to interpret the historical evolution and recent development of Italian regionalism. The launch of differentiated regionalism in Italy constitutes an autonomist turning point, following the abandonment of federalism as a path towards institutional reform. Autonomism, unlike federalism, starts with the recognition of regional diversity, and is characterised by an open and very asymmetric distribution of power, as well as bilateral relations between individual regions and the State. The article concludes by reflecting on the innovative potential and critical aspects of an autonomist renewal of Italian regionalism. [ABSTRACT FROM AUTHOR]

Background: Although elderly patients (≥70 years) represent 30% of new diagnoses of soft tissue sarcoma (STS), they are underrepresented in clinical trials and are often unfit to receive standard anthracycline-based chemotherapy. Trabectedin is registered as a second-line treatment for advanced STS and is characterized by a favorable safety profile.Methods: The aim of this single-arm, phase 2 study was to investigate trabectedin (scheduled dose, 1.3-1.5 mg/m2 ) as a first-line treatment in elderly patients with advanced stage STS who are inoperable and are unfit to receive standard anthracycline-based chemotherapy. The coprimary endpoints were progression-free survival at 3 months (PFS3) and the rate of clinically limiting toxicities (CLTs). We also conducted an ancillary study on pharmacokinetics.Results: Twenty-four patients (12 men and 12 women) with a median age of 79 years (interquartile range [IQR], 74-83 years) were enrolled. The histological subtype was leiomyosarcoma in 46%, liposarcoma in 33%, and other histotypes in 21%. The median number of trabectedin courses was 4 (IQR, 3-6), with 7 patients (29%) receiving ≥6 cycles. Eight patients (33%) required dose reductions. The most frequent grade 3/4 adverse events were neutropenia in 9 patients (38%), fatigue in 5 patients (21%), and aminotransferase elevation in 5 patients (21%). PFS3, median PFS, and overall survival were 71% (80% CI, 57%-81%), 4 months, and 12 months, respectively. Ten patients (42% [80% CI, 28%-57%]) experienced CLTs. Trabectedin Cmax , half-life, clearance, and distribution volume were 1.28 ng/mL (standard deviation [SD], 0.58 ng/mL), 26.70 hours (SD, 9.09 hours), 39.98 L/h/m2 (SD, 14.08 L/h/m2 ), and 1460 L/m2 (SD, 561 L/m2 ), respectively.Conclusion: Trabectedin can be administered safely to elderly patients with STS who are unfit to receive anthracyclines. Pharmacokinetics in the elderly population was superimposable to historical data. [ABSTRACT FROM AUTHOR]

Toxoplasmosis is a zoonotic food-borne disease caused by Toxoplasma gondii , a land-derived protozoan parasite that infects a broad range of terrestrial and aquatic hosts. T. gondii may reach coastal waters via contaminated freshwater runoff and its oocysts may enter into the marine food web. Marine invertebrates as mussels being filter feeders are exposed and may concentrate T. gondii oocysts representing a potential source of infection for animals and humans. The present works investigated the prevalence, parasite burden and genotypes of T. gondii in the Mediterranean mussels (Mytilus galloprovincialis) from southern Italy. We sampled a total of 382 individual Mediterranean mussels from May to August 2018 from seven production sites in the Gulf of Naples (Campania region). An additional sample including 27 farmed Mediterranean mussels was obtained in February 2018 from a mollusk depuration plant in Corigliano Calabro (Calabria region). T. gondii DNA was detected in 43 out of 409 (10.5%) Mediterranean mussels from seven out of eight sampling sites. The number of T. gondii copies/g in the digestive gland ranged from 0.14 to 1.18. Fragment analysis of Short Tandem Repeats (STRs) at 5 microsatellite loci was performed from 10 T. gondii PCR positive samples revealing the presence of five distinct genotypes including one corresponding to type I and four atypical genotypes. These findings suggest potential implications of epidemiological importance for human and animal health because both type I and atypical genotypes could be highly pathogenic. [ABSTRACT FROM AUTHOR]

Background: Altered serum magnesium (Mg) level in the human body has been hypothesized to have a role in the prediction of hospitalization and mortality; however, the reported outcomes are not conclusive. Aims: The present study aimed to analyze the relationship between serum Mg and in-hospital mortality (IHM) in patients admitted to the medical ward of two hospitals in the Veneto region (Italy). Methods: Patients > 18 years hospitalized in the medical wards of the hospitals of Vittorio Veneto and Conegliano, Italy (from January 12, 2011, through December 27, 2016) with at least one measurement of serum Mg were included in the study. A logistic regression model was used to assess the unadjusted and adjusted (by age, gender, Charlson Comorbidity index, discharge diagnosis' class) association of serum Mg and IHM. Results: In total 5024 patients were analyzed, corresponding to 6980 total admissions. The unadjusted analysis showed that IHM risk was significantly higher with 0.2 mg/dl incremental serum Mg level change from 2.4 mg/dl to 2.6, (OR 1.71 95% CI 1.55–1.89) and with 0.2 mg/dl change from serum Mg level of 1.4 mg/dl to 1.2 mg/dl, (OR 1.28 95% CI 1.17–1.40). Such results were confirmed at adjusted analysis. Discussion: Present findings have relevant implications for the clinical management of patients suffering from medical conditions, highlighting the need for analyzing Mg concentration carefully. Conclusions: Serum Mg levels seem to be a good predictor of IHM. [ABSTRACT FROM AUTHOR]

To investigate the activity of regorafenib in advanced solitary fibrous tumour (SFT). An Italian monocentric investigator-initiated exploratory single-arm Phase II trial was conducted of regorafenib in adult patients with advanced and progressive SFT, until progression or limiting toxicity. Prior treatment with antiangiogenics was allowed. Primary and secondary end-points were: overall response rate (ORR) by Choi criteria, and ORR by RECIST, progression-free survival (PFS), overall survival (OS). From January 2016 to February 2021, 18 patients were enroled [malignant-SFT = 13; dedifferentiated-SFT (D -SFT) = 4; typical-SFT (T-SFT) = 1]. Fourteen patients were pre-treated, in 12 cases with antiangiogenics (median [m-] lines of treatment = 3). Sixteen patients were evaluable for response (one screening failure; one early discontinuation). Six/16 (35.2%) required a definitive dose reduction. ORR by Choi was 37.5% (95% CI: 15.2–64.6), with 6/16 (37.5%) partial responses (PR), 6/16 (37.5%) stable disease (SD) and 4/16 (25%) progressions; 5/6 responses occurred in patients pre-treated with antiangiogenics. No responses were detected in D -SFT. Best RECIST responses were: 1/16 (6.2%) PR, 12/16 (75%) SD, 3/16 (18.8%) progressions. At 48.4 month m-FU, m-PFS by Choi was 4.7 (inter-quartile range: 2.4–13.1) months, with 31.2% patients progression-free at 1 year. Regorafenib showed activity in SFT, with 30% patients free-from-progression at one year. Responses were observed also in patients pretreated and refractory to another antiangiogenic agents. However, ORR and m-PFS were lower than reported with other antiangiogenics, and this was possibly due to discrepancies in the patient population and the high-rate of dose reductions. • Regorafenib (R) is active in advanced, progressive solitary fibrous tumour (SFT). • R activity was seen in typical-/malignant-SFT but not in dedifferentiated-SFT. • R was effective also in cases refractory to previous antiangiogenic agents. [ABSTRACT FROM AUTHOR]

Introduction: Best medical treatments of ischemic stroke are admission to stroke unit, intravenous thrombolysis and, in selected cases, thrombectomy. Time from symptom onset to interventions is the best predictor of clinical outcome. In order to verify the effectiveness of an active education programme of awareness on the knowledge of stroke, we performed a local campaign "on the field".Subjects and Methods: We selected 101 subjects from the general population who took part in the "stroke awareness campaign" organised by the Italian Association for the fight against stroke (A.L.I.Ce). Mean age was 59 years (50% female; 50% male); 55% of the sample reported a high level of education (> 8 years: high school or university degree). After a short multiple-choice questionnaire, we administered a face-to-face standard educational protocol (15 min). The efficacy of that educational intervention was then verified after a period of 12 months, by telephone interview.Results: There was improvement both in the definition of stroke (66% vs. 92%, p < .001) and in recognizing symptoms and signs (19% vs. 72%, p < .001). Knowledge of the importance of stroke unit in the acute treatment of stroke did not improve, as it was already high on baseline (92% vs. 97%, p: n.s.). The improvement was evident in particular in younger and higher educated people, without difference in gender. There was no difference based on risk factor profiles of participants.Conclusions: Our results suggest that a personalised education can improve knowledge on stroke symptoms and signs, independently of gender and personal risk factors. The results should be verified in larger and less selection population. [ABSTRACT FROM AUTHOR]

This article analyses the Italian National Strategy for Inner Areas (NSIA) as a new policy for local development only partially linked to the European cohesion policy. It focuses on its innovative contents (vision, governance and methodology), and mainly on the transfer of innovation to lower levels of government and between local administrations. As an empirical study of policy transfer and policy innovation in a system of multilevel governance it shows an unexpected transfer of the NSIA methodology to another policy field: that of post-earthquake reconstruction in Central Italy. The article concludes by applying the typology of policy transfer developed in its first part to the analysis of the case-study as a whole. [ABSTRACT FROM AUTHOR]

Animal manure is one of the diffusion routes of heavy metals and metalloids into the environment, where the soil can accumulate them. Heavy metals and metalloids can then be released into groundwater sources, be absorbed by crops, and enter the food chain with negative effects for human and animal health. The aim of this study was to evaluate the concentration of heavy metals and mineral nutrients from modern animal rearing systems in order to develop effective strategies to increase the sustainability. Samples of feed (n = 24: n = 16 from swine, n = 8 from cattle), faeces (n = 120: n = 80 from swine, n = 40 from cattle) and water (n = 8), were collected from eight typical intensive swine and cattle farms located in northern Italy. All samples were analysed for the humidity and the principal components. The samples were also dried, mineralised, and analysed by ICP-MS to detect the following elements: Na, Mg, K, Ca, Cr, Mn, Fe, Co, Ni, Cu, Zn, As, Se, Mo, Cd, and Pb. The swine diets represented the highest amounts of Zn and Cu, with an average concentration for the finishing and weaning phases of Zn: 1737.9 ± 301.3; 821.7 ± 301.3; Cu: 133.8 ± 11.6; 160.1 ± 11.6 mg/kg as fed, respectively. The faecal content reflected the heavy metal composition from feed. The average content of cattle diets of Zn and Cu did not result higher than the maximum permitted levels. We observed that the swine manure represented the sources of Zn and Cu output into the environment. The Zn and Cu content should be monitored strictly in line with agroecology principles. Evaluation of the role of zinc and copper in animal production. Increase the sustainability of farms. Consider the feed as major route of HMs in livestock. [ABSTRACT FROM AUTHOR]

This paper reports on the results about the chemical pollution pressure in the Gulf of Naples and nearby coastal areas. Farmed mussels were analysed for the presence of polycyclic aromatic hydrocarbons (PAHs). The results documented a decreasing trend in the PAHs levels respect to the past years. The Bay of Pozzuoli remains as the most contaminated site within the Lucrino area with the highest reported number of samples exceeding the benzo(a)pyrene and PAHs sum limits. All the samples with concentrations above the European regulatory limit were collected in the winter period illustrating a seasonal trend of PAHs distribution in mussels during the 4 years investigated. [ABSTRACT FROM AUTHOR]

The consumption habits of 766 Italian shooters (96% males, 4% females), on average 52 years old, have been investigated, in Italy, through the distribution of questionnaires delivered during shooters’ attendance to training and teaching courses, in compliance with 853/2004/EC Regulation provisions on food hygiene. The most consumed wild species recorded were pheasant > woodcock > choke among feathered animals, and wild boar > hare > roe deer among mammals, respectively. An average of 100–200 g game per serving (four servings per month) was consumed, with highest intakes of 3000 g per month; meat, liver, and heart were the preferred food items. Mammalian and feathered game was regularly consumed with friends and relatives in 83% and in 60% of cases, respectively. Accounting for an inventoried population of 751,876 shooters in Italy, it is estimated that there is regular consumption of wild game in around the 3% of the Italian population. More than 80% of responders were aware of health risks related to game handling and to food safety issues. Due to the occurrence in wild boar meat and liver of the heavy metal cadmium (Cd), the persistent organic pollutant perfluorooctan sulphonic acid (PFOS), and the radionuclide137cesium (137Cs), it was possible to demonstrate the usefulness of such a food consumption database for intake assessment in this sensitive group of consumers. In high consumers of wild boar, threshold concentrations for intakes have been estimated in the ranges of 48–93 ng g–1for Cd, 35–67 ng g–1for PFOS and 0.20–0.34 Bq kg–1for137Cs. [ABSTRACT FROM AUTHOR]

Introduction: Bone and muscle tissues are in a close relationship. They are linked from a biological and functional point of view and both are related to an increased fracture risk in the elderly. The aging process is involved in the loss of functionality of both bones and muscles. In particular, aging-induced decline in muscle size and quality accompanies catabolic alterations in bone tissue; furthermore, age-related changes in bone alter its response to muscle-derived stimulation. The increased fracture risk in individuals with sarcopenia and osteoporosis is due to the decline of muscle mass and strength, the decrease in bone mineral density (BMD) and limited mobility. In this study, we investigated the role of sarcopenia and the main age-related bone diseases, osteoporosis (OP) and osteoarthritis (OA).Methods: Muscular performance status was evaluated using the Physical Activity Scale for the Elderly (PASE) test in 27 female patients with OP who underwent total hip arthroplasty for hip fracture, and in 27 age-matched female patients with OA who underwent total hip arthroplasty. Dual-energy X-ray absorptiometry (DEXA) was performed and the T-score values were used to discriminate between OP and OA patients. Body Mass Index (BMI) was calculated. As part of a multiparametric model of evaluation, biopsies of vastus lateralis muscle were analysed by immunohistochemical reaction to find a correlation with the above mentioned functional index.Results: The PASE test showed that the OP patients had a low or moderate level of physical activity before fracture occurred, whereas the OA patients had more intensive pre-fracture physical performances. Histological analysis showed that osteoporosis is characterised by a preferential type II fibre atrophy; in particular, data correlation showed that lower PASE test scores were related to lower diameter of type II fibres. No correlation was found between bone mineral density (BMD) and PASE test results.Discussion and Conclusion: Osteoporosis is closely related to sarcopenia before and after fracture. Bone remodelling is influenced by muscle morphological and functional impairment and sarcopenia is considered one of the major factors for functional limitation and motor dependency in elderly osteoporotic individuals. Therefore, physical activity should be strongly recommended for OP patients at diagnosis. [ABSTRACT FROM AUTHOR]

The study investigated self-concept in food-allergic youths and matched healthy controls. Global and domain-specific self-concepts were assessed in 154 participants (9–19 years) using the Multidimensional Self-Concept Scale. Statistical analysis assessed differences between the two samples and effects of asthma, dermatitis, age, and gender among patients. Significant differences were found for Total Scale score and for Competence and Physical scores. Patients showed clinically problematic self-concepts in Global, Competence, and Family domains. Age was found to be associated with the Total score. Health professionals should consider food-allergic patients’ personality development. Further studies could examine disease-specific consequences and interventions. [ABSTRACT FROM AUTHOR]

Evidence suggests that task-based training approaches can improve the performance of children with handwriting difficulties. The present case study tests the efficacy of the Handwriting Task Program (HTP). Three male children (9–10 yr. old) with poor handwriting skills and different developmental disorders participated in the HTP, twice per week, for 13 wk. Handwriting legibility was assessed through the Concise Evaluation Scale for Children's Handwriting, and fine motor performance and handwriting speed were evaluated at pre- and post-treatment with the Visual Motor Integration Test and the Battery for the assessment of writing skills of children from 7 to 13 yr. old. The results showed that motor efficiency and global handwriting quality improved in all the children, although some handwriting difficulties still persisted in one child with Developmental Coordination Disorder (DCD). Further study may confirm on a larger sample that a visual-spatially based training may improve the handwriting legibility of children with DCD. [ABSTRACT FROM AUTHOR]

Rationale, aims and objectives Heart failure ( HF) is a concerning public health burden in Western society because, despite the improvement of medical treatments, it is still associated with adverse outcomes (high morbidity and mortality), resulting in one of the most expensive chronic disease in Western countries. Hospital admission particularly is the most expensive cost driver among the several resources involved in the management of HF. The aim of our study was to investigate the cost of hospitalization before and after the enrolment to a new strategy ( GISC) in the management of patients with HF. Methods We enrolled a cohort of 90 patients. Patients were eligible to the study if they were hospitalized with a new diagnosis of HF or a diagnosis of decompensated HF. The enrolment to the study corresponded to the enrolment to the GISC intervention. We calculated the cost for every hospital admission at 6 and 12 months before and after the enrolment using the tariff paid for the diagnosis-related group. Results Comparing per-patient cumulative cost before and after the enrolment, we showed that patient's hospitalization was less expensive after the enrolment to the GISC intervention. The strategy resulted in an average cumulative estimated saving of €439 322.00 (95% CI €413 890.70; €464 753.40) at 6 months and of €832 276.80 (95% CI €786 863.70; €877 690.00) at 12 months after the enrolment. Conclusions We found out that the intervention was a cost-saving strategy for follow-up of the patients suffering from HF at 6 and 12 months after the enrolment compared with hospitalizations' cost before the recruitment. [ABSTRACT FROM AUTHOR]

A valid tool that contributes to the diagnosis of Developmental Coordination Disorder (DCD) is represented by the Developmental Coordination Disorder Questionnaire 2007 (DCDQ'07). Recently we developed the Italian version of DCDQ (DCDQ-Italian). The aim of this study was to further analyze the psychometric properties in a sample of Italian school children aged 5-12 years and to establish cut-off scores with respect to age groups. A total of 698 parents completed the DCDQ-Italian and 45 of them repeated it after 2 weeks for test-retest reliability. One hundred and seventeen children were tested using the Movement Assessment Battery for Children. Confirmatory factor analysis supported this version to be consistent with the original. Cronbach's alpha for the total score was 0.89 and test-retest reliability was 0.88. Two-ways ANOVA for total and single subscales showed a significant main effect for age group only and not for gender. Sensitivity and specificity for our community based sample were 59% and 65% respectively, considering the cut-off scores for the 15th percentile of M-ABC and increasing when age groups were taken into account (ROC curve=0.62). The agreement with the original was good if 15th is considered. This is the first study on the psychometric property of DCDQ in a community sample of Italian children. The DCDQ-Italian could be used as a screening tool for motor coordination difficulties in Italian children. Slight differences in cut-offs should be considered when using this version. [ABSTRACT FROM AUTHOR]

Abstract: Although the effects of hailstorms usually interest limited areas, the damages can be severe. These, damages can be potentially reduced by a reliable hailstorm forecast. In Italy, only few regions have a network for monitoring hail events, the coverage of these networks is limited to small areas, and long-term and nationwide time series of hail events are not available, therefore the chances of improving the quality of the hail forecast are severely reduced. The aim of the present study is to collect data and information from different sources on hailstorms in order to evaluate the annual hailstorm frequency in Italy. In order to obtain more complete information about the hail distribution, different datasets have been used: i) daily information about hailstorm occurrence at fixed meteorological stations from the NCDC dataset; ii) events information (date, location, and hailstone size) obtained using hailstorm reports available from different agencies. In this study the hail events are classified according to the hailstone size, then a statistical approach is used in order to evaluate the mean annual frequency of the events at the municipality scale for each hailstone size class. The atmospheric parameters, known as hailstorm precursors, are estimated using the NCEP/NCAR daily reanalysis at 2.5degree horizontal resolution. As a final result, this study presents a step forward towards a climatology of hail frequency in Italy at municipality scale for the period 1971–2009. [Copyright &y& Elsevier]

In this study, we simulate a transgenic rice crop highly infested with red rice to examine transgene transfer from a transgenic line ( A2504) resistant to glufosinate ammonium to cohabitant red rice. The red rice was sown along with the transgenic line at the highest density found in naturally infested crops in the region. Agricultural practices similar to those used to control red rice infestation in northern Italy rice fields were used to reproduce the local rice production system. During the first 2 years, the field was treated with herbicide at the appropriate time; in the first year the dosage of herbicide was three times the recommended amount. In this first year, detectable red rice plants that escaped herbicide treatment were manually removed. Nevertheless, two herbicide-resistant hybrid plants (named 101 and 104) were identified in the experimental field during the second year of cultivation. Phenotypic and molecular characterisation suggests the hybrid nature of these two plants, deriving from crossing events involving A2504, respectively, with red rice (plant 101) and the buffer cultivar Gladio (plant 104). The progeny of two subsequent generations of the two plants were examined and the presence of the transgene detected, indicating stable transfer of the transgene across generations. In conclusion, despite control methods, red rice progeny tolerant to the herbicide can be expected following use of transgenic rice and, consequently, difficulties in controlling this weed with chemicals will emerge in a relatively short time. [ABSTRACT FROM AUTHOR]

Since the mid-1990s, Italy has made significant steps towards federalism, decentralizing political, fiscal and administrative powers, also by means of a major constitutional reform. Yet, 20 years after the beginning of this process, the country is experiencing problems in finalizing these reforms towards a stable federal architecture. This article examines Italy as a case of failed federalization. Adopting a long-term focus inspired by the ‘gradual institutional change’ approach, we argue that federalization has been trapped between a rather anomalous (and pathological) alliance between a persistent centralism, which prevailed when Italy was born as a state in 1861, and an ever-present strong tradition of localism. This approach allows us to show the very incremental nature of institutional change and to map changes and continuities along the 150 years of the Italian state, identifying both political and cultural factors that help to explain this unfulfilled journey towards federalism. [ABSTRACT FROM PUBLISHER]

Results show that the year-to-year quality variation of wines produced in North and Central Italy depends on the large-scale climate variability, and that the wine quality improvement in the last four decades is partially due to an increase of temperature and to a decrease of precipitation in West and Central Mediterranean Europe (WME; CME). In addition, wine quality is positively correlated with air temperature throughout the entire active period of the grapevine, weakly negatively correlated with precipitation in spring, and well negatively correlated in summer and fall. The month-to-month composites of the NAO anomaly show that, in years of good quality wine, this anomaly is negative in late spring, oscillates around zero in summer, and is positive in early fall; while, in years of bad quality wine, it is positive in late spring and summer, and negative in early fall, i.e. its polarity has an opposite sign in spring and fall in good versus bad years. The composite seasonal maps show that good wines are produced when the spring jet stream over the Atlantic diverts most of the weather perturbations towards North Europe, still providing a sufficient amount of rainwater to CME; when summer warming induced by southerly winds is balanced by the cooling induced by westerly winds; and when a positive geopotential anomaly over WME shelters CME from fall Atlantic storms. Bad quality wines are produced when the jet stream favors the intrusion of the Atlantic weather perturbations into the Mediterranean. Results suggest that atmospheric pattern persistencies can be used as precursors for wine quality forecast. [ABSTRACT FROM AUTHOR]

Background: The economic and social costs of obesity are estimated to be considerable, particularly for inpatient care. The aim of this study was to compare the hospitalization rates of individuals with severe (body mass index [BMI] ≥40 kg/m²) or complicated (BMI ≥30 kg/m²) obesity with those of the general population in two regions of Northwest Italy, and to describe absolute costs of hospitalization and their determinants. Methods: Between 1996 and 2002, 6,516 patients who were admitted for the first time to a hospital offering a nutritional rehabilitation programme for obesity were enrolled and followed-up (mean follow-up time: 7.3 years). Standardized hospitalization rates (SHRs) were computed by sex for all-cause and cause-specific hospitalization. The general population of the two regions was used as the reference population. The annual cost of hospitalization was estimated for the study cohort only at the individual level, and its association with different determinants was assessed using a multivariable linear model for longitudinal data. Results: SHRs of the study cohort versus the general population increased for all-cause hospitalization (males: 3.53, 95% CI 3.45-3.61; females: 3.22, 95% CI 3.18-3.26) as well as for most obesity-related conditions. The absolute median annual cost of hospitalization was 2,436 euros for males and 2,293 euros for females. Older age at cohort enrolment, BMI ≥40 kg/m², waist circumference above the median (males: 1.26 metres; females: 1.13 metres), and the presence of co-morbidities, such as cardiovascular diseases, respiratory diseases, cancer, diseases of the musculoskeletal system and connective tissue, and mental disorders, significantly increased the absolute median annual costs of hospitalization. Conclusions: The economic consequences of high hospitalization rates in obese individuals are relevant. Reducing the occurrence of co-morbidities among obese persons may be one important goal, not only for clinical reasons, but also from a public health point of view. [ABSTRACT FROM AUTHOR]

We report the results of the first three trials of an external quality control ( EQC) programme performed in 71 laboratories executing semen analysis in Tuscany Region (Italy). At the end of the second trial, participants were invited to attend a teaching course illustrating and inviting to adhere to procedures recommended by WHO (V edition). Results of the first three trials of the EQC documented a huge variability in the procedures and the results. The highest variability was found for morphology ( CV above 80% for all the trials), followed by count ( CV of about 60% for all the trials) and motility ( CV below 30% for all the trials). When results of sperm count and morphology were divided according to the used method, mean CV values did not show significant differences. CV for morphology dropped significantly at the third trial for most methods, indicating the usefulness of the teaching course for morphology assessment. Conversely, no differences were observed after the course for motility and for most methods to evaluate count, although CV values were lower at the second and third trial for the laboratories using the Burker cytometer. When results were divided according to tertiles of activity, the lowest mean bias values (difference between each laboratory result and the median value of the results) for count and morphology were observed for laboratories in the third tertile (performing over 200 semen analysis/year). Of interest, mean bias values for concentration dropped significantly at the third trial for low activity laboratories. In conclusion, lack of agreement of results of semen analysis in Tuscany is mainly because of the activity and the experience of the laboratory. Our study points out the importance of participating in EQC programmes and periodical teaching courses as well as the use of WHO recommended standardized procedures to increase precision and to allow the use of WHO reference values. [ABSTRACT FROM AUTHOR]

Summary: We demonstrated that osteoporosis is associated with a preferential type II muscle fiber atrophy, which correlates with bone mineral density and reduced levels of Akt, a major regulator of muscle mass. In osteoarthritis, muscle atrophy is of lower extent and related to disease duration and severity. Introduction: Osteoarthritis (OA) and osteoporosis (OP) are associated with loss of muscle bulk and power. In these diseases, morphological studies on muscle tissue are lacking, and the underlying mechanisms of muscle atrophy are not known. The aim of our study was to evaluate the OP- or OA-related muscle atrophy and its correlation with severity of disease. Muscle levels of Akt protein, a component of IGF-1/PI3K/Akt pathway, the main regulator of muscle mass, have been determined. Methods: We performed muscle biopsy in 15 women with OP and in 15 women with OA (age range, 60-85 years). Muscle fibers were counted, measured, and classified by ATPase reaction. By statistical analysis, fiber-type atrophy was correlated with bone mineral density (BMD) in the OP group and with Harris Hip Score (HHS) and disease duration in the OA group. Akt protein levels were evaluated by Western blot analysis. Results: Our findings revealed in OP a preferential type II fiber atrophy that inversely correlated with patients' BMD. In OA, muscle atrophy was of lower extent, homogeneous among fiber types and related to disease duration and HHS. Moreover, in OP muscle, the Akt level was significantly reduced as compared to OA muscles. Conclusions: This study shows that in OP, there is a preferential and diffuse type II fiber atrophy, proportional to the degree of bone loss, whereas in OA, muscle atrophy is connected to the functional impairment caused by the disease. A reduction of Akt seems to be one of the mechanisms involved in OP-related muscle atrophy. [ABSTRACT FROM AUTHOR]

Background: It has been documented that variations exist in breast cancer treatment despite wide dissemination of clinical practice guidelines. The aim of this population-based study was to evaluate the impact of regional guidelines (Piedmont guidelines, PGL) for breast cancer diagnosis and treatment on quality-of-care indicators in the Northwestern Italian region of Piedmont. Methods: We included two samples of women aged 50-69 years with incident breast cancer treated in Piedmont before and after the introduction of PGL: 600 in 2002 (pre-PGL) and 621 in 2004 (post-PGL). Patients were randomly selected among all incident breast cancer cases identified through the hospital discharge records database. We extracted clinical data on breast cancer cases from medical charts and ascertained vital status through linkage with town offices. We assessed compliance with 14 quality-of-care indicators from PGL recommendations, before and after their introduction in clinical practice. Results: Among patients with invasive lesions, 77.1% (N = 368) and 77.5% (N = 383) in the pre-PGL and post-PGL groups, respectively, received breast conservative surgery (BCS) as a first-line treatment. Following BCS, 87.7% received radiotherapy in 2002, compared to 87.9% in 2004. Of all patients at medium-to-high risk of distant metastasis, 65.5% (N = 268) and 63.6% (N = 252) received chemotherapy in 2002 and in 2004, respectively. Among the 117 patients with invasive lesions and negative estrogen receptor status in 2002, hormonal therapy was prescribed in 23 of them (19.6%). The incorrect prescription of hormonal therapy decreased to 10.8% (N = 10) among the 92 estrogen receptor-negative patients in 2004 (p < 0.01). Compliance with PGL recommendations was already high in the pre-PGL group, although some quality-of-care indicators did not reach the standard. In the pre/post analysis, 8 out of 14 quality-of-care indicators showed an improvement from 2002 to 2004, but only 4 out of 14 reached statistical significance. We did not find any change in the risk of mortality in the post-PGL versus the pre-PGL group (adjusted hazard ratio 0.94, 95%CI 0.56-1.56). Conclusions: These results highlight the need to continue to improve breast cancer care and to measure adherence to PGL. [ABSTRACT FROM AUTHOR]

Background The aim of the study is to identify which types of injuries are responsible for a major component of the health burden in a population-based children cohort in North-Eastern Italy. Methods All children (1-13 years) residing in Veneto region, who were hospitalized in 2008 with a International Classification of Diseases, ninth edition, Clinical Modification (ICD-9-CM) code for injury in the first diagnostic field were considered. The outcome was defined as the difference in hospital use in the 12 months following the injury and it was compared to the year preceding the injury occurrence. We computed hospitalization rates by gender, age class and injury type. Results Hospitalization rates for injury are highest in males, especially among school-aged children. Rates for intracranial injury exhibit a more pronounced decline with age in females, whereas a more marked rise in upper limb fracture rates among school-aged males is observed. Overall, 3 days of hospital stay per child are attributable to injury. Burns, skull fracture and a high injury severity are associated with a greater number of additional inpatient days. Conclusions The impact of specific injury types on health services utilization varies with gender, age and severity. These observed patterns contribute to build a clearer picture of this leading global public health problem and deserve more attention in planning preventive strategies and resource allocation. [ABSTRACT FROM AUTHOR]

Abstract: Marano and Grado lagoons are polluted by mercury from the Isonzo River and a chlor-alkali plant, yet despite this contamination, clam cultivation is one of the main activities in the region. Four stations (MA, MB, MC and GD) were chosen for clam seeding and surficial sediments were monitored in autumn, winter and summer to determine the Hg detoxifying role of bacteria. Biotransformation of Hg species in surficial sediments of Marano and Grado lagoons was investigated while taking into consideration the speciation of organic matter in the biochemical classes of PRT (proteins), CHO (carbohydrates) and LIP (lipids), water-washed cations and anions, bacterial biomass, Hg-resistant bacteria, some specific microbial activities such as sulfate reduction rates, Hg methylation rates, Hg-demethylation rates, and enzymatic ionic Hg reduction. MeHg in sediments was well correlated with PRT content, whereas total Hg in sediments correlated with numbers of Hg-resistant bacteria. Correlations of the latter with Hg-demethylation rates in autumn and winter suggested a direct role Hg-resistant bacteria in Hg detoxification by producing elemental Hg (Hg0) from ionic Hg and probably also from MeHg. MeHg-demethylation rates were ∼10 times higher than Hg methylation rates, were highest in summer and correlated with high sulfate reduction rates indicating that MeHg was probably degraded in summer by sulfate-reducing bacteria via an oxidative pathway. During the summer period, aerobic heterotrophic Hg-resistant bacteria decreased to <2% compared to 53% in winter. Four Hg-resistant bacterial strains were isolated, two Gram-positive (Staphylococcus and Bacillus) and two Gram-negative (Stenotrophomonas and Pseudomonas). Two were able to produce Hg0, but just one contained a merA gene; while other two strains did not produce Hg0 even though they were able to grow at 5μgml of HgCl2. Lagoon sediments support a strong sulfur cycle in summer that controls Hg methylation and demethylation. However, during winter, Hg-resistant bacteria that are capable of degrading MeHg via the mer-catalyzed reductive pathway increase in importance. [Copyright &y& Elsevier]

Abstract: A closed chlor-alkali plant (CAP) discharged Hg for decades into the Aussa River, which flows into Marano Lagoon, resulting in the large-scale pollution of the lagoon. In order to get information on the role of bacteria as mercury detoxifying agents, analyses of anions in the superficial part (0–1 cm) of sediments were conducted at four stations in the Aussa River. In addition, measurements of biopolymeric carbon (BPC) as a sum of the carbon equivalent of proteins (PRT), lipids (LIP), and carbohydrates (CHO) were performed to correlate with bacterial biomass such as the number of aerobic heterotrophic cultivable bacteria and their percentage of Hg-resistant bacteria. All these parameters were used to assess the bioavailable Hg fraction in sediments and the potential detoxification activity of bacteria. In addition, fifteen isolates were characterized by a combination of molecular techniques, which permitted their assignment into six different genera. Four out of fifteen were Gram negative with two strains of Stenotrophomonas maltophilia, one Enterobacter sp., and one strain of Brevibacterium frigoritolerans. The remaining strains (11) were Gram positive belonging to the genera Bacillus and Staphylococcus. We found merA genes in only a few isolates. Mercury volatilization from added HgCl2 and the presence of plasmids with the merA gene were also used to confirm Hg reductase activity. We found the highest number of aerobic heterotrophic Hg-resistant bacteria (one order magnitude higher) and the highest number of Hg-resistant species (11 species out of 15) at the confluence of the River Aussa and Banduzzi''s channel, which transport Hg from the CAP, suggesting that Hg is strongly detoxified [reduced to Hg(0)] at this location. [Copyright &y& Elsevier]

The article focuses on the most famous medieval illuminated manuscripts. These manuscripts were owned by Charles Emmanuel I, Duke of Savoy and Jean-Baptiste Serra of the Spinola family. Various artists have worked on it including Limbourg brothers, Barthélemy d'Eyck and Jean Colombe. These documents mainly portray the musical accompainment engaged for the wedding ceremony of Marie, the daughter of Jean Duke of Berry and Jean de Bourbon that took place in 1400 in Paris, France.

The morphological evolution of the Sciara del Fuoco, Stromboli, is described from a time series dataset formed by Digital Elevation Models and orthophotos derived by digitising historical contour maps compiled in 1868 and 1937 and by processing data from aerial surveys carried out between 1954 and 2009. All maps were co-registered in the same reference system and used to build a quantitative reconstruction of the morphological changes of the Sciara del Fuoco slope. The changes mainly relate to the emplacement of many lava flows and their successive erosion. A comparative quantitative analysis yields estimates of areas and volumes of the lava fields formed on the sub-aerial part of the Sciara del Fuoco during a number of effusive events between 1937 and 2001, some of them never assessed before. The results of the analysis constrain the interpretation of the evolution and the magnitude of the recent effusive activity at the Stromboli volcano. Despite some uncertainties due to widely spaced observation periods, the results integrate all available topographic knowledge and contribute to an understanding of the main characteristics of the recent effusive eruptive styles at Stromboli volcano. [ABSTRACT FROM AUTHOR]

Objectives To describe the clinical characteristics and in-hospital outcomes of older adults with tako-tsubo cardiomyopathy ( TTC). Design Partially retrospective, partially prospective observational study. Setting Eleven Italian referral cardiac centers included in the Tako-tsubo Italian Network. Participants One hundred ninety consecutive individuals with TTC (92.1% female, mean age 66) were divided into three groups according to age (<65, n = 78; 65-74, n = 61; ≥75, n = 51). Measurements Clinical findings and in-hospital outcomes were evaluated in each group. Results Participants aged 65 and older had a greater prevalence of hypertension ( P = .001) and a lower glomerular filtration rate ( P < .001), and those aged 65 to 74 had a greater prevalence of psychiatric disorders ( P = .01), ST-segment elevation on admission ( P = .01) and a cerebrovascular disease ( P = .003) than those younger than 65. Despite similar left ventricular ejection fraction ( LVEF) on admission ( P = .26), the oldest group had a lower LVEF at discharge ( P = .03). Inotropic agents were used more frequently in older adults ( P = .03). In-hospital composite adverse events (all-cause death, acute heart failure, life-threatening arrhythmias, stroke, and cardiogenic shock; P = .03) and overall complications ( P = .004) were more common in participants aged 75 and older. Overall in-hospital mortality was low (2.8%) but was more prevalent in participants aged 75 and older (6.3%). On multivariate analysis, age of 75 and older (hazard ratio ( HR) = 2.45, 95% confidence interval ( CI) = 1.28-5.82, P = .04) and LVEF on admission ( HR = 0.874, 95% CI = 0.81-0.95, P < .001) were the only independent predictors of in-hospital adverse events. Conclusion The clinical profile of participants aged 75 and older with TTC was different from that of those younger than 75 with TTC, and they had a higher in-hospital complication rate. [ABSTRACT FROM AUTHOR]

The data from continuous GPS stations located in central and northern Italy, installed with different criteria and planned for scientific or commercial aims, are analyzed to provide the actual crustal movements. The mean velocity of 185 sites have been used to describe both the horizontal and vertical displacement field: the results indicate that the outer part of the Apennine belt moves in a north-eastern direction significantly faster than the inner Tyrrhenian side of the same chain; both Alpine and Apenninic regions show a low uplift, while in the central and eastern sector of the Po Plain the subsidence rate is constant or, in some cases, is decreasing with respect to the values obtained from the last measurements, performed up to 2006 by means of both SAR and leveling techniques. Only the central part of the eastern Po Plain close to the Apennine border (Modena city area) seems to be characterized by an anomalous rate subsidence (15 mm/yr). [ABSTRACT FROM AUTHOR]

The article presents unpublished material concerning the musical concert conducted by Claude Debussy in the Turin International Exhibition of 1911.

The article discusses the forms and causes of the trend towards Federalism in Italy, with reference to writing by Italian political scientist Maria Serena Piretti. Topics discussed include the political history of the 1980s and 1990s, with reference to trends of decentralization and trends of globalization and European unification; the role of economic development, welfare, and public finance; and intersections between collective identity, nation building and the structures of federal government in Italy.

The purpose of this study was to analyse risk factors associated with the presence of pressure ulcer development in patients referred to several Italian hospitals, taking properly into account the within-hospital outcome correlation. We analysed data from a prevalence survey coordinated by the European Pressure Ulcer Advisory Panel on 12 000 hospitalized patients in Italy, collecting information on patient's risk, presence of ulcers and prevention measures. The article describes the bases which generalized estimating equations rely on as well as their statistical properties. The article compares different model specifications in the light of background knowledge of the survey data and model assumptions, and discusses the potential for this modelling approach to apply in similar statistical situations. In accordance with existing literature, factors associated with pressure ulcers in hospitalized patients were identified as Braden scale, age and assistance-connected aspects. Between-hospital variability seemed to be explained by the adopted degree of prevention (use of preventive equipment combined with a repositioning strategy). Modelling the covariance matrix or the scale argument of the correlated binary responses (presence/absence of pressure ulcers) by using moment estimators based on generalized estimating equations prevents optimistic inference and provides an important insight into the role of structural differences among hospitals. [ABSTRACT FROM AUTHOR]