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Introduction: Mild traumatic brain injury (mTBI) represents a major public health concern and affects millions of people worldwide every year. Diagnosis mainly relies on clinical criteria and computed tomography (CT) scans. GFAP (glial fibrillary acidic protein) and UCH-L1 (ubiquitin carboxyl-terminal hydrolase-L1) have been recently studied as potential biomarkers of mTBI. This study retrospectively evaluated the possible use of these combined biomarkers as negative predictors for excluding brain injuries in patients with suspected mTBI in the emergency department. Methods: Adult patients (n = 130) enrolled at Tor Vergata University Hospital (Rome, Italy), consecutively registered at the triage of the emergency department between October 2022 and January 2023, with non-penetrating TBI and Glasgow Coma Scale (GCS) score of 13–15, were considered. All eligible patients underwent intracranial CT scans and blood tests, within 12 h after trauma, for GFAP and UCH-L1 serum concentrations. Results: Intracranial CT detected injuries in only seven patients (5%); GFAP and UCH-L1 tested positive in 96 patients and negative in 34 patients (74% vs. 26%). Combined biomarkers had a sensitivity equal to 1.00 (95% CI 0.64-1.00) and a negative predictive value (NPV) of 1.00 (0.99-1.00) in mTBI diagnosis with a negative CT. Conclusions: Combined laboratory tests for GFAP and UCH-L1 biomarkers might play a potential clinical role in avoiding unnecessary head CT scans after mTBI in emergency departments. [ABSTRACT FROM AUTHOR]

Background Platinum-based chemotherapy represents the standard first-line treatment for biliary tract cancers (BTC). Deficits in genes involved in the homologous recombination (HR) and DNA damage response (DDR) may confer higher sensitivity to platinum agents. Methods We retrospectively included patients affected by BTC from 2 Italian institutions. Inclusion criteria consist of the receipt of platinum-based chemotherapy in the metastatic setting and the availability of comprehensive genomic profiling using next-generation sequencing (NGS). Patients were included in the HRD-like group if demonstrated oncogenic or likely oncogenic alterations in HR-/DDR-genes. Clinical endpoints were compared between the HRD-like group and the non-HRD-like group. Results Seventy-four patients were included, of whom 25 (33%) in the HRD-like group and 49 (66%) in the non-HRD group. With a median follow-up of 26.04 months (interquartile-range [IQR] 9.41-29.27) in the HRD-like group and of 22.48 months (IQR 16.86-40.53) in the non-HRD group, no PFS difference emerged, with a mPFS of 5.18 months in the HRD-like group compared to 6.04 months in the non-HRD group (hazard ratio [HR], 1.017, 95% CI 0.58-1.78; P  = .95). No differences were observed in DCR (64% [95 CI 45%-83%] vs 73% [95 CI 61%-86%]; P  = .4), and CBR (45% [95% CI 28%-73%] vs 50% [95% CI, 37%-68%]; P  = .9) between the HRD-like group and non-HRD groups, respectively. Median OS did not statistically differ between the HRD-like group and non-HRD group (26.7 vs 18.0 months, respectively; HR, 0.670, 0.33 to 1.37, P  = .27). Conclusion HR-/DDR-genes, when assessed with regular tumor-only NGS panels, provide limited clinical validity to identify patients with BTC more likely to benefit from platinum-based chemotherapy. [ABSTRACT FROM AUTHOR]

The evaluation of the lumbopelvic region is a crucial point during postural assessment in childhood and adolescence. Photogrammetry (PG) and Spinal Mouse (SM) are two of the most debated tools to properly analyze postural alignment and avoid misleading data. This study aims to find out the best linear regression model that could relate the analytic measurements of the SM with one or more PG parameters in adolescents with kyphotic postures. Thirty-nine adolescents (female = 35.9%) with structural and non-structural kyphosis were analyzed (13.2 ± 1.8 years; 1.59 ± 0.12 m; 47.6 ± 11.8 kg) using the SM and PG on the sagittal plane in a standing and forward-bending position, allowing for the measurement of body vertical inclination, lumbar and pelvic alignment, trunk flexion, sacral inclination during bending, and hip position during bending. Lordosis lumbar angles (SM) were significantly (r = −0.379, r = −0.328) correlated with the SIPS-SIAS angle (PG) during upright standing, while in the bending position, the highest correlation appeared among the sacral–hip (SM) and the sacral tangent (ST_PG; r = −0.72) angles. The stepwise backward procedure was assessed to estimate the SM variability in the bending and standing positions. Only in the bending position did the linear regression model reach high goodness-of-fit values with two regressors (ST_PG η 2 = 0.504 , BMI η 2 = 0.252 ;  adjusted- R2 =0.558, p < 0.001, CCC = 0.972, r = 0.763). Despite gold-standard methods reducing error evaluation, physicians and kinesiologists may consider photogrammetry as a good method for spinal curve prediction. [ABSTRACT FROM AUTHOR]

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

Background: Integrase inhibitor (INSTI) use has been associated with greater weight gain (WG) among people living with HIV (PLWH), but it is unclear how this effect compares in magnitude to traditional risk factors for WG. We assessed the population attributable fractions (PAFs) of modifiable lifestyle factors and INSTI regimens in PLWH who experienced a ≥5% WG over follow-up. Methods: In an observational cohort study from 2007 to 2019 at Modena HIV Metabolic Clinic, Italy, ART-experienced but INSTI-naive PLWH were grouped as INSTI-switchers vs non-INSTI. Groups were matched for sex, age, baseline BMI and follow-up duration. Significant WG was defined as an increase of ≥5% from 1st visit weight over follow-up. PAFs and 95% CIs were estimated to quantify the proportion of the outcome that could be avoided if the risk factors were not present. Results: 118 PLWH switched to INSTI and 163 remained on current ART. Of 281 PLWH (74.3% males), mean follow-up was 4.2 years, age 50.3 years, median time since HIV diagnosis 17.8 years, CD4 cell count 630 cells/µL at baseline. PAF for weight gain was the greatest for high BMI (45%, 95% CI: 27–59, p < 0.001), followed by high CD4/CD8 ratio (41%, 21–57, p < 0.001) and lower physical activity (32%, 95% CI 5–52, p = 0.03). PAF was not significant for daily caloric intake (−1%, −9-13, p = 0.45), smoking cessation during follow-up (5%, 0–12, p = 0.10), INSTI switch (11%, −19-36; p = 0.34). Conclusions: WG in PLWH on ART is mostly influenced by pre-existing weight and low physical activity, rather than switch to INSTI. [ABSTRACT FROM AUTHOR]

An effective earthquake early warning system requires rapid and reliable earthquake source detection. Despite the numerous proposed epicenter localization solutions in recent years, their utilization within the Internet of Things (IoT) framework and integration with IoT-oriented cloud platforms remain underexplored. This paper proposes a complete IoT architecture for earthquake detection, localization, and event notification. The architecture, which has been designed, deployed, and tested on a standard cloud platform, introduces an innovative approach by implementing P-wave "picking" directly on IoT devices, deviating from traditional regional earthquake early warning (EEW) approaches. Pick association, source localization, event declaration, and user notification functionalities are also deployed on the cloud. The cloud integration simplifies the integration of other services in the architecture, such as data storage and device management. Moreover, a localization algorithm based on the hyperbola method is proposed, but here, the time difference of arrival multilateration is applied that is often used in wireless sensor network applications. The results show that the proposed end-to-end architecture is able to provide a quick estimate of the earthquake epicenter location with acceptable errors for an EEW system scenario. Rigorous testing against the standard of reference in Italy for regional EEW showed an overall 3.39 s gain in the system localization speed, thus offering a tangible metric of the efficiency and potential proposed system as an EEW solution. [ABSTRACT FROM AUTHOR]

HBV/HCV co-infection is common in HIV-1-infected prisoners. To investigate the characteristics of HIV co-infections, and to evaluate the molecular heterogeneity of HIV, HBV and HCV in prisoners, we carried-out a multicenter cross-sectional study, including 65 HIV-1-infected inmates enrolled in 5 Italian detention centers during the period 2017–2019. HIV-1 subtyping showed that 77.1% of inmates were infected with B subtype and 22.9% with non-B subtypes. Italian nationals were all infected with subtype B (93.1%), except two individuals, one infected with the recombinant form CRF72_BF1, and the other with the HIV-1 sub-subtype A6, both previously not identified in inmates of Italian nationality. Non-Italian nationals were infected with subtype B (52.6%), CRFs (36.8%) and sub-subtypes A1 and A3 (5.2%). HIV variants carrying resistance mutations to NRTI, NNRTI, PI and InSTI were found in 7 inmates, 4 of which were never exposed to the relevant classes of drugs associated with these mutations. HBV and/or HCV co-infections markers were found in 49/65 (75.4%) inmates, while 27/65 (41.5%) showed markers of both HBV and HCV coinfection. Further, Italian nationals showed a significant higher presence of HCV markers as compared to non-Italian nationals (p = 0.0001). Finally, HCV phylogenetic analysis performed in 18 inmates revealed the presence of HCV subtypes 1a, 3a, 4d (66.6%, 16.7% and 16.7%, respectively). Our data suggest the need to monitor HIV, HBV and HCV infections in prisons in order to prevent spreading of these viruses both in jails and in the general population, and to implement effective public health programs that limit the circulation of different genetic forms as well as of viral variants with mutations conferring resistance to treatment. [ABSTRACT FROM AUTHOR]

An aspect correlated with climate change is certainly represented by the alternation of severe floods and relevant drought periods. Moreover, there is evidence that changes in climate and land cover are inducing changes in stream channel cross-sections, altering local channel capacity. A direct consequence of a significant change in the local channel capacity is that the relationship between the amount of water flowing at a given point in a river or stream (usually at gauging stations) and the corresponding stage in that section, known as a stage–discharge relationship or rating curve, is changed. The key messages deriving from the present work are: (a) the more frequent and extreme the floods become, the more rapid the changes in the stream channel cross-section become, (b) from an operational point of view, the collection and processing of field measurements of the stage and corresponding discharge at a given section in order to quickly and frequently update the rating curve becomes a priority. It is, therefore, necessary to define a control system for acquiring hydrological data capable of keeping river levels and discharges under control to support flood early warnings and water management. The proposed stage–discharge management system is used by the Civil Protection Service of the Marche Region (east-central Italy) for the monitoring of river runoff in the regional watersheds. The Civil Protection Service staff performs stage–discharge field measurements using water level sensors and recorders (e.g., staff gauges, submersible pressure transducers, ultrasound and radar sensors) and a current meter, acoustic doppler velocimeter, acoustic doppler current profilers, portable mobile radar profiler and salt dilution method equipment, respectively. Power functions are fitted to the stage–discharge field data. Furthermore, extrapolation is performed to cover the full range of flow measurements; in general, extrapolation is not an easy task because of sharp changes in the stream cross-section geometry for very high or very low stages. In the present work, we also focused attention on the application problems that occur in practice and the need for frequent updating. [ABSTRACT FROM AUTHOR]

Preterm and small-for-gestational-age (SGA) infants are more susceptible to vaccine-preventable diseases. To evaluate routine vaccination timeliness in these high-risk groups, a full birth cohort of infants (n = 41,502) born in 2017 and 2018 in Tuscany was retrospectively followed up until 24 months of age. Infants were classified by gestational age (GA) and SGA status. The vaccinations included: hexavalent (HEXA), measles-mumps-rubella, varicella, pneumococcal conjugate (PCV), and meningococcal C conjugate. Time-to-event (Kaplan–Meier) analyses were conducted to evaluate the timing of vaccination according to GA; logistic models were performed to evaluate the associations between GA and SGA with vaccination timeliness. Time-to-event analyses show that the rate of delayed vaccine receipt increased with decreasing GA for all the vaccinations, with a less marked gradient in later vaccine doses. Compared to full-term infants, very preterm infants significantly showed an increased odds ratio (OR) for delayed vaccination in all the vaccinations, while moderate/late preterm infants only showed an increased OR for HEXA-1, HEXA-3, PCV-1, and PCV-3. SGA infants had a significantly higher risk of delayed vaccination only for HEXA-1 and PCV-1 compared to non-SGA infants. In conclusion, vaccinations among preterm and SGA infants showed considerable delay. Tailored public health programs to improve vaccination timeliness are required in these high-risk groups. [ABSTRACT FROM AUTHOR]

This study described a SARS-CoV-2 infection in minks on an Italian farm. Surveillance was performed based on clinical examination and a collection of 1879 swabs and 74 sera from dead and live animals. The farm was placed under surveillance for 4.5 months, from the end of July 2020, when a man working on the farm tested positive by RT-PCR, till mid-December 2020 when all the animals were sacrificed. Clinical examination revealed no clinical signs or increased mortality rates attributable to SARS-CoV-2, while diagnostic tests detected only four weak PCR-positive samples, but 100% of sera were positive for SARS-CoV-2 anti-S antibodies. The phylogenetic analysis of two SARS-CoV-2 sequences from two minks and the sequence of the worker showed that they belonged to different clades. It could be therefore assumed that two distinct introductions of the virus occurred on the farm, and that the first introduction probably occurred before the start of the surveillance period. From the data collected, and especially from the detection of specific antibodies through the combination of different tests, it can be postulated that syndromic surveillance combined with genome detection by PCR may not be sufficient to achieve a diagnosis in asymptomatic animals. In particular, the serological approach, especially when using tests directed towards the S protein, may be useful for improving the traceability of virus circulation in similar environments. [ABSTRACT FROM AUTHOR]

Background: To date, no paper reports cases of lymphangitis after COVID 19 vaccination. We present a case of lymphangitis after vaccination from COVID 19, in a patient with colorectal liver metastases. Methods: We described the case of a 56-year-old woman with history of a surgical resection of colorectal cancer and liver metastases, without any kind of drug therapy for about a month. In addition, a recent administration (2 days ago) of Spikevax (mRNA-1273, Moderna vaccine), as a booster dose, on the right arm was reported. Results: The magnetic resonance (MR) examination showed the effects of the previous surgical resection and five new hepatic metastases, located in the VIII, VI, V, IV and II hepatic segments. As an accessory finding the presence of lymphadenopathy in the axillary area and lymphangitis of the right breast and chest were identified. The computed tomography scan performed a week earlier, and re-evaluated in light of the MR data, did not identify the presence of lymphadenopathy in the axillary area and lymphangitis signs. Conclusions: Lymphangitis could occur after COVID 19 vaccine and it is important to know this data to avoid alarmism in patients and clinicians and economic waste linked to the execution of various radiological investigations for the search for a tumour that probably does not exist. Trial registration: Not applicable. [ABSTRACT FROM AUTHOR]

Ink disease of sweet chestnut (Castanea sativa) caused by the oomycetes Phytophthora cinnamomi and P. x cambivora is the limiting factor for chestnut cultivation in several European regions. The objective of this study was to explore how the spatial landscape heterogeneity affects the distribution pattern of ink disease over a large chestnut area in Central Italy using an approach that combined remote sensing, ground truthing activities and GIS. A multivariate model was developed that explained a large proportion of the variance of the impact of the disease using the density of roads and drainage networks as predictor variables. The association of these landscape elements, specifically with ink disease foci, also provides practical tool to improve the accuracy of monitoring of this disease and the preparation of risk maps. [ABSTRACT FROM AUTHOR]

Background: Increased expertise with minimally invasive liver surgery (MILS) could cause an unjustified extension of indications to resect liver benign disease (BD). The aim of this study was to evaluate the operative risk of MILS for BD and if implementation and diffusion of MILS have widened indications for BD resection.Methods: A prospective study including centers with > 6 MILS for BD, enrolled in the I Go MILS registry from January 2015 to October 2016. Cysts fenestrations were excluded.Results: Eight hundred eighteen MILS were performed in 15 centers. One hundred seventy-three of these (21.1%) were for BD: conversion rate was 6.9%, postoperative mortality and morbidity rates were 0 and 13.9%. During the same period, 3713 liver resections (open + MILS) were performed and 407 (11.0%) were for BD. A time-trend analysis showed that the total number of MILS and the number of MILS for malignant disease significantly increased, but this increasing trend was not documented for the number of MILS for BD, which remained stable during the study period of time. This trend was confirmed for the overall rate of resected BD (open + MILS) that remained stable.Discussion: BD represents a valid indication for MILS. For BD, 21.1% of MILS was performed, rate significantly lower than that previously reported in Italy. Although an evident growth of the use of MILS was observed during the time period analysis in Italy, this trend did not correspond to an increased number of MILS for BD, and the overall rate of resected BD was comparable to that reported in previous large open series. [ABSTRACT FROM AUTHOR]

Purpose: To define based on expert opinion and practical experience using a systematic and scientific approach, (1) the perceived most effective exercise-based strategies to prevent muscle injury in elite footballers; and, (2) when and how these exercise programs are prescribed based on the number of days between games i.e. implementation strategy. Methods: A Delphi survey obtained opinions and assessed for agreement. Delphi respondents consisted of 21 experienced sports practitioners (12 ± 5.3 years in elite football and with an academic background) belonging to 18 teams from the Big-5 European football leagues; England, France, Germany, Italy, Spain. Three teams were represented collaboratively by two experts. The Delphi process involves sequential rounds each evolving based on the responses from the previous. The number of rounds is not pre-defined and continues until an agreement is either achieved or it is clear that no agreement will be reached. Frequency of responses was recorded where the agreement was sought (i.e. in closed questions) and an agreement was achieved if ≥ 13/18 (70%) respondents agreed. For open-ended questions, a qualitative content analysis was performed to identify recurring themes and when themes were specified by ≥ 13 (70%), these were also considered as reaching an agreement. Practitioners had the opportunity to raise concerns if they disagreed with the 'agreement from recurrent themes'. Results: There were four Delphi rounds (100% response for each round). Sprinting and High-Speed Running (HSR) focused exercises were agreed as most effective (perceived) to prevent muscle injuries. Eccentric exercise was perceived as the next most effective. It was agreed that sprinting and HSR be integrated into coaches training, and target 100% of players worst-case match scenario (e.g. volume, intensity) based on individual maximum speeds. Eccentric exercise was recommended to be implemented according to the context of the main football session and planned/actual sprinting and HSR content. It was agreed that eccentrics can be performed before or after training, context dependent. The day to perform specific sprinting and HSR or eccentric exercises depended on the proximity of previous and upcoming matches. Other exercises reaching agreement as 'somewhat effective' included concentric and isometric, horizontal and vertical plyometrics, coordination, core and dynamic flexibility in addition to core stability. No agreement was reached for multi-joint, resisted sprinting, kicking or agility exercises nor simultaneous single-leg strength and stability. Finally, no agreement was reached regarding programming variables e.g. sets, repetitions as deemed too contextual. Conclusion: Regarding exercise-based strategies, particular importance agreed by the Delphi expert group was to focus on sprinting, HSR and eccentric exercises, integrated with a variety of other exercise modes which also carry some level of effectiveness in a multidimensional programme. Context was agreed to be key and decision-making about when to undertake/ how to prescribe exercise strategies to be made according to the content of normal football training and the proximity of matches. [ABSTRACT FROM AUTHOR]

Soccer involves multiple high-intensity physical, technical and tactical actions; as result of this, soccer training must include high-intensity exercises, which can act as a stimulus to the hypothalamus pituitary-adrenal axis, resulting in a significant increase in circulating cortisol levels. This study examined the effect of 4 weeks of Speed Endurance Maintenance (SEM) and Speed Endurance Production (SEP) on the serum cortisol concentration in response to a 5-meter multiple shuttle run test (5-m MST) in young elite soccer players. Fifteen soccer players were divided to SEM (n = 7) or SEP (n = 8) training group. Blood drawings were performed four times: before and after the 5-m MST at baseline (T1a, T1b) and at follow-up (T2a, T2b). Both training regimes determined a cortisol secretion following the 5-m MST at both baseline and follow-up. Data on delta values highlighted that SEP had greater values than SEM at baseline and registered a significant decrease at the follow-up. This difference is probably due to the lack of specific speed endurance training for players of SEP group prior to the beginning of the protocol. The physiological mechanisms behind the observed biological differences should be deeply investigated. [ABSTRACT FROM AUTHOR]

Sustainable agricultural and food processing practices are often proposed as attractive strategies enabling food systems to respond to the challenges posed by climate change in terms of adaptation and mitigation. However, information on the actual contribution to climate change provided by sustainable food production systems is lacking in literature. With the intention to contribute to a more informed debate, this study aims at quantify the actual impact on climate of sustainable practices applied to a grape-to-wine system in Italy. The overall budget of greenhouse gas (GHG) fluxes is assessed at wine farm level, from the vineyard to the final bottle of wine, through an integration of methods, including the eddy covariance technique, the life cycle assessment (LCA) and the IPCC guidelines. All the components of the GHG budget have been considered: the (a) biogenic GHG fluxes and the (b) anthropogenic GHG emissions generated for the grape production as well as the (c) carbon stock change due to the vineyard management and the (d) anthropogenic GHG emissions generated by the transformation of grape into wine. At the vineyard level, the overall GHG budget resulted to be close to zero, showing a potential carbon neutrality of sustainable viticulture: the sum of biogenic GHG fluxes (a) and the carbon stock change (c) resulted in a net carbon sink with a potential contribution to climate change mitigation of −0,27 ± 1,11 Mg CO 2 eq year−1 per hectare; while the anthropogenic GHG emissions (b) for the sustainable vineyard management accounted for 0,24 ± 0,05 Mg CO 2 eq ha−1 year−1. The total carbon footprint (b + d) of sustainable wine is 0,79 ± 0,14 kg CO 2 eq per bottle, with 15% attributable to the agricultural phase and 85% to the transformation of grape into wine. These findings indicate that sustainable wine production has in general a lower contribution to climate change. In particular, sustainable practices applied to viticulture can turn the system into a net carbon sink able to totally compensate the anthropogenic emissions for the vineyard management. Therefore, sustainable viticulture allows food production with a potential carbon neutrality without exacerbating climate change. • Sustainable viticulture allows food production with a potential carbon neutrality without exacerbating climate change. • Sustainable viticulture generates biogenic GHG fluxes that turn the agrosystem into a net carbon sink. • Anthropogenic GHG emissions in sustainable vineyard are low and can be totally compensate by the net carbon sink. • The carbon footprint (CF) of sustainable wine is 0,79 ± 0,14 kg CO 2 eq per bottle. • Sustainable wine production has in general a lower contribution to climate change. [ABSTRACT FROM AUTHOR]

Study Question: Does the oxygen concentration in the culture medium [either physiologic (5%) or atmospheric (20%)] affect mitochondrial ultrastructure and function in preimplantation mouse embryos generated by IVF?Summary Answer: Embryos cultured in 20% oxygen show increased mitochondrial abnormalities compared to embryos cultured in 5% oxygen.What Is Known Already: ART are widely used and have resulted in the birth of more than 8 million children. A variety of media and oxygen concentrations are used to culture embryos. Embryos cultured under physiological O2 tension (5%) reach the blastocyst stage faster and have fewer alterations in gene expression when compared with embryos cultured under atmospheric oxygen conditions (20%). The mechanisms by which oxygen tension affects preimplantation development remain unclear, but mitochondria are believed to play an important role. The aim of this study was to evaluate how mitochondrial ultrastructure and function in IVF embryos were affected by culture under physiologic (5%) or atmospheric (20%) oxygen concentrations.Study Design, Size, Duration: Zygotes, 2-cell, 4-cell, morula and blastocyst were flushed out of the uterus after natural fertilization and used as controls. IVF was performed in CF1 x B6D2F1 mice and embryos were cultured in Potassium simplex optimized medium (KSOM) with amino acids (KAA) under 5% and 20% O2 until the blastocyst stage. Embryo development with the addition of antioxidants was also tested.Participants/materials, Setting, Methods: Mitochondrial function was assessed by measuring mitochondrial membrane potential, reactive oxygen species (ROS) production, ATP levels, and the expression of selected genes involved in mitochondrial function. Mitochondria ultrastructure was evaluated by transmission electron microscopy (TEM).Main Results and the Role Of Chance: Embryos cultured under 20% O2 had fewer mitochondria and more vacuoles and hooded (abnormal) mitochondria compared to the other groups (P < 0.05). At the blastocyst stage the mitochondria of IVF embryos cultured in 20% O2 had lower mtDNA copy number, a denser matrix and more lamellar cristae than controls. Overall IVF-generated blastocysts had lower mitochondrial membrane potential, higher ROS levels, together with changes in the expression of selected mitochondrial genes (P < 0.05). ATP levels were significantly lower than controls only under 5% O2, with the 20% O2 IVF group having intermediate levels. Unexpectedly, adding antioxidant to the culture medium did not improve development.Large Scale Data: N/A.Limitations, Reasons For Caution: Findings in mice embryos might be different from human embryos.Wider Implications Of the Findings: This study suggests that changes in the mitochondria may be part of the mechanism by which lower oxygen concentration leads to better embryo development and further emphasize the importance of mitochondria as a locus of reprogramming.Study Funding/competing Interest(s): This study was funded by R01 HD 082039 to PFR, the Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy (RIA 2016-2018) and the Department of Anatomy, Histology, Forensic Medicine and Orthopaedics, La Sapienza University of Rome, Italy (University grants 2016-2017). The authors declare no competing interests. [ABSTRACT FROM AUTHOR]

Practicing on the human body was considered extremely relevant for health professionals' education, but a drastic reduction was observed due to an increase in alternative virtual and multimedia means, and, in Italy, also due to a lack of regulation. Italian Law 10/2020 regulates body donation for research and training through an advanced directive for post - mortem body donation. A cross-sectional study was carried out to investigate the law knowledge and body donation perception of health students of any degree courses enrolled at the University of Pavia, Italy, in 2021, through ad hoc web questionnaire. 485 students participated to this survey; median age was of 21 years (25th-75th percentiles, 20–23), 73.2% were females, and 62.5% were medical students. Among them 14.9% knew the Italian law 10/2020. Age was the only variable associated with students' knowledge of the law. Further, 8.3% reported the current availability of cadaveric practice, 85.6% of health students acknowledged usefulness of cadaveric practice, with a significant difference between medical and non-medical students (71.4% vs 28.6%, p < 0.001). Overall, 59.7% would donate their body, rising to 62.7% with reference to specific law regulation, with 30.5% and 28.7% undecided, respectively. 51.3% of participants answered not practicing religious faith, 82.9% with Catholic families, without significance on the knowledge of the law. Poor knowledge of the law compared with great interest and acknowledged cadaveric practice usefulness highlighted the need for better information, especially among health students, where critical discussion could be more valuable. Then, there arises the urgent need to fill the gaps within university studies and syllabuses, to relaunch the central role that cadaveric practice and research had in the education of health professionals. Consequences on basic and specific health students' skills, on health education quality in general, and further on health professionals' expertise must be carefully considered. • Poor knowledge of the new law was found. • Poor current availability of dissection practices was also found. • Faith was not found to be associated with student support to body donation. • Health students need to be better informed about body donation and donor programs. • Medical students are more likely to perceive usefulness of dissection practices. [ABSTRACT FROM AUTHOR]

On February 22nd, 2021, a landslide on the Italian coast caused the collapse of an old cemetery. About 370 coffins tumbled and more than 200 fell into the sea. 333 groups of unidentified human remains were found: 140 decomposed bodies and 193 bags of commingled skeletal remains. The Medical Staff of Legal and Forensic Medicine was involved for analyzing the remains in order to identify and bury them. The remains involved belonged to people who died between the end of the XIX century and 2017; all were interesting by advanced transformative phenomena. For the identifications, new forms, based on the Interpol DVI ones, were created. Information was collected by relatives through a specific antemortem form. Relatives' information and post-mortem data were compared: 19 body were identified thanks to secondary methods (like object in the bury, dresses, medical devices). 147 bone samples (long bones and teeth) were collected for the genetic analysis. Among the 77 relatives eligible for a genetic comparison, 66 gave consent to DNA swab for collection and genetic typing. Currently, after 48 samples DNA analysis (STRs and Y-polymorphism) 12 remains were identified, 21 presented a profile suitable for comparison but without attribution, and 7 did not return a comparable profile caused by stochastic effects. 31 subjects have been identified and the genetics analysis are still in progress. The Cemetery collapse shows that every disaster requires a tailored approach. [ABSTRACT FROM AUTHOR]

Background: Outdoor air pollution and particulate matter (PM) have recently been classified in Group 1 by IARC. In Italy there is no epidemiological study on the association between female lung cancer and PM as measured by the official monitoring stations. Methods: We estimated the dose-response relationship between female lung cancer mortality and available long-term outdoor PM10 and/or PM2.5 concentrations for all the Italian province capital city municipalities (respectively, 64 and 32 municipalities). Multiple regression analysis of standardized mortality rates (SMRates) for the period 2000-11, as a function of PM concentrations, considering percentage of smokers and deprivation index as additional explanatory variables, was performed for PM10 only. Results: The number of province capital cities with available PM2.5 data was not sufficient to detect a significant increment of SMRates as a function of concentrations. An SMRate increase of 0.325 for 1 µg m-3 increment of PM10 concentration was calculated. Moreover, the attributable risk of the overall SMRates for the two subgroups of municipalities under/equal and above 20 µg m-3 value was evaluated. Attributable deaths were computed by both the unitary SMRate increase and the attributable risk. A rough estimate of the impact of PM10 exposure at level above the WHO guideline value of 20 µg m-3 in these 64 municipalities is between 2920 and 3449 lung cancer deaths out of 22 162 (13-16%). Conclusion: Maintaining the PM10 concentrations below such WHO recommendation, an overall saving of nearly 300 lung cancer deaths per year in a population of 8 146 520 women living in the municipalities at study has been evaluated. [ABSTRACT FROM AUTHOR]

Background Patients with atrial fibrillation (AF) have an increased thromboembolic risk that can be estimated with risk scores and sometimes require oral anticoagulation therapy (OAT). Despite correct anticoagulation, some patients still develop left atrial spontaneous echo contrast (SEC) or thrombosis. The value of traditional risk scores (R2CHADS2, CHADS2, and CHA2DS2-VASc) in predicting such events remains controversial. Methods and Results The aim of our study was to explore variables linked to severe SEC or atrial thrombosis and evaluate the performance of traditional risk scores in identifying these patients. In order to do this, we retrospectively analyzed 568 patients with nonvalvular nonparoxysmal AF who underwent electrical cardioversion from January 2011 to December 2016 after OAT for a minimum of 4 weeks. A transesophageal echocardiogram was performed in 265 patients for various indications, and 24 exhibited left atrial SEC or thrombosis. Female gender, history of heart failure or left ventricular ejection fraction <40%, and high levels (>1 mg/dL) of C-reactive protein (CRP) were independently associated with left atrial SEC/thrombosis. A score composed by these factors (denominated HIS [ Heart Failure, Inflammation, and female Sex]) showed a sensitivity of 79% and a specificity of 60% (area under receiver operating characteristic curve 0.695, P = 0.002) in identifying patients with a positive transesophageal echo; traditional risk scores did not perform as well. Conclusions In patients with persistent AF and suboptimal anticoagulation, a risk score composed by history of heart failure, high CRP, and female gender identifies patients at high risk of left atrial SEC/thrombosis when its value is >1. [ABSTRACT FROM AUTHOR]

Purpose: To propose a magnetic resonance imaging (MRI) quality assurance procedure that can be used for multicenter comparison of different MR scanners for quantitative diffusion-weighted imaging (DWI).Materials and Methods: Twenty-six centers (35 MR scanners with field strengths: 1T, 1.5T, and 3T) were enrolled in the study. Two different DWI acquisition series (b-value ranges 0-1000 and 0-3000 s/mm(2) , respectively) were performed for each MR scanner. All DWI acquisitions were performed by using a cylindrical doped water phantom. Mean apparent diffusion coefficient (ADC) values as well as ADC values along each of the three main orthogonal directions of the diffusion gradients (x, y, and z) were calculated. Short-term repeatability of ADC measurement was evaluated for 26 MR scanners.Results: A good agreement was found between the nominal and measured mean ADC over all the centers. More than 80% of mean ADC measurements were within 5% from the nominal value, and the highest deviation and overall standard deviation were 9.3% and 3.5%, respectively. Short-term repeatability of ADC measurement was found <2.5% for all MR scanners.Conclusion: A specific and widely accepted protocol for quality controls in DWI is still lacking. The DWI quality assurance protocol proposed in this study can be applied in order to assess the reliability of DWI-derived indices before tackling single- as well as multicenter studies. [ABSTRACT FROM AUTHOR]

The study explores twitter use by Italian central governments through a content analysis carried out on 5330 tweets of 9 official accounts of government departments at the state level. The aim is to give a picture of what governmental organizations are doing on twitter by investigating their models of communications and asking whether or not twitter is used in a participatory way. To do this, the study looks at the nature of content published on twitter and the network of relationships built through mentioning. On the basis of these dimensions, a positional map synthesising the models of communication and use of twitter for each account is built. Findings indicate that twitter use in Italian context is somewhat limited and that twitter is rarely used in a participatory way. Contrary to literature claims of interactivity, participation and collaboration on twitter, in the context of Italian central governments twitter seems tofunction as a promotional and informative channel of communication rather than as a catalyst for generating shared governance. In the Italian context, twitter cannot be considered a new venue for participation and collaboration but continues to be primarily a broadcast technology used to promote political and institutional values and to distribute information in a traditional top-down model. [ABSTRACT FROM AUTHOR]

Several studies have established the sortilin-related receptor gene (SORL1) as a susceptibility locus for Alzheimer's disease (AD). Single nucleotide polymorphisms of SORL1 reported in literature as being associated with AD were investigated in an Italian case-control data set, and their role as a risk factor of conversion to AD was studied in an independent sample of subjects diagnosed with mild cognitive impairment (MCI) at baseline. rs641120, rs2070045, and rs1010159 were genotyped in 734 subjects diagnosed with AD (n = 338) and MCI (n = 181) and in healthy controls (n = 215). Our results confirmed the association between rs641120 and AD (p = 0.01). In the MCI cohort, rs1010159 was associated with conversion to AD (HR = 1.56, p = 0.002). Taken together, these findings confirm that SORL1 is associated with AD and might be a potential tool for identifying MCI subjects at high risk of conversion to AD. [ABSTRACT FROM AUTHOR]

Background Colchicine is effective for the treatment of acute pericarditis and first recurrences. However, conclusive data are lacking for the efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis. Methods We did this multicentre, double-blind trial at four general hospitals in northern Italy. Adult patients with multiple recurrences of pericarditis (≥two) were randomly assigned (1:1) to placebo or colchicine (0·5 mg twice daily for 6 months for patients weighing more than 70 kg or 0·5 mg once daily for patients weighing 70 kg or less) in addition to conventional anti-inflammatory treatment with aspirin, ibuprofen, or indometacin. Permuted block randomisation (size four) was done with a central computer-based automated sequence. Patients and all investigators were masked to treatment allocation. The primary outcome was recurrent pericarditis in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, number NCT00235079. Findings 240 patients were enrolled and 120 were assigned to each group. The proportion of patients who had recurrent pericarditis was 26 (21·6%) of 120 in the colchicine group and 51 (42·5%) of 120 in the placebo group (relative risk 0·49; 95% CI 0·24—0·65; p=0·0009; number needed to treat 5). Adverse effects and discontinuation of study drug occurred in much the same proportions in each group. The most common adverse events were gastrointestinal intolerance (nine patients in the colchicine group vs nine in the placebo group) and hepatotoxicity (three vs one). No serious adverse events were reported. Interpretation Colchicine added to conventional anti-inflammatory treatment significantly reduced the rate of subsequent recurrences of pericarditis in patients with multiple recurrences. Taken together with results from other randomised controlled trials, these findings suggest that colchicine should be probably regarded as a first-line treatment for either acute or recurrent pericarditis in the absence of contraindications or specific indications. Funding Azienda Sanitaria 3 of Torino (now ASLTO2). [ABSTRACT FROM AUTHOR]

Background The choice of the imaging modality (transthoracic [TTE] vs. transesophageal echocardiography [ TEE]) for the diagnosis of infective endocarditis ( IE) depends on different variables. Aim of the present study is to provide updated data on the diagnostic sensitivity and the clinical usefulness of TTE vs. TEE from the Italian Registry on IE ( RIEI). Methods The RIEI has enrolled consecutive cases of IE in every participating centre, evaluating diagnostic and therapeutic data from a real world practice perspective. Results From July 2007 to October 2010, 658 consecutive cases with definite IE according to Duke criteria have been enrolled in the RIEI (483 males). The following diagnostic echocardiographic exams were performed: 616 TTE (94%) and 476 TEE (72%). A positive TTE was recorded in 399 cases (65%), an uncertain TTE in 108 cases (17%), and a negative TTE in 109 cases (18%). For TEE, a positive study was reported in 451 cases (95%), uncertain in 13 cases (2.7%), and negative in 12 cases (2.5%) (P < 0.001). This difference is not evident in patients with tricuspid valve IE or i.v. drug addiction, and in Streptococcus bovis or Streptococcus viridans IE. TTE was significantly more performed before the admission and earlier than TEE during admission (P = 0.000). TTE was mainly responsible for the initial diagnosis in 59%. TEE contributed to changing the therapeutic approach in 42%. Conclusions In the real world, TTE is performed earlier and more commonly, and it is the major echocardiographic tool for the initial diagnosis. TEE confirms its superior diagnostic sensitivity in most cases, although it is relatively underused. [ABSTRACT FROM AUTHOR]

This paper gathers arguments and reasons why muons surviving the Gran Sasso mountain cannot mimic the Dark Matter annual modulation signature exploited by the DAMA/NaI and DAMA/LIBRA experiments. A number of these items have already been presented in individual papers. Further arguments have been addressed here in order to present a comprehensive collection and to enable a wider community to correctly approach this point. [ABSTRACT FROM AUTHOR]

Background Most familial pancreatic cancer (FPC) remains unexplained. The identification of individuals with a high genetic risk of developing pancreatic adenocarcinoma (PC) is important to elucidate its biological basis and is critical to better define emerging strategies for the detection of early pancreatic neoplasms. Patients and methods A series of 225 consecutively enrolled patients with PC were tested for CDKN2A mutations. After personal and family cancer histories of all the patients had been reviewed, a subset of the patients were classified as FPC and were also tested for mutations in PALLD, PALB2, BRCA1 and BRCA2 as FPC candidate genes. Results The CDKN2A mutation rate in the 225 PC cases was 5.7%. The CDKN2A founder mutations, p.E27X and p.G101W, were predominant, but the mutation spectrum also included p.L65P, p.G67R and two novel, potentially pathogenic variants, promoter variant c.-201ACTC>CTTT and p.R144C. None of the patients with FPC harboured germline mutations in PALLD, PALB2 or BRCA2. One family was positive for the BRCA1 UV variant p.P727L. Strikingly, five of 16 patients with FPC (31%) carried CDKN2A mutations Conclusion These findings suggest that a sizeable subset of Italian FPC families may carry CDKN2A mutations. This result may be of value for identifying the best candidates for future PC screening trials in Italy [ABSTRACT FROM AUTHOR]

A national audit focused on laparoscopic appendectomy was promoted by the Italian Association of Hospital Surgeons (ACOI). Four-hundred and sixty surgical practices received an e-mail questionnaire. Data concerning epidemiology, timetable, surgeon's age, selection of patients, laparotomic conversion, behaviour in the case of a normal appendix, and technical aspects were investigated. The response rate was 51.7%. The median number of appendectomies performed is 50-100 each year in a surgery ward. Laparoscopic operations are very common (93%), but mostly performed in less than 50% of the observed cases. There is no significant difference between the number of operations during the day vs. at night, and they are performed by a limited (<30%) group of surgeons, equally composed of physicians aged above and below 40. The majority of surgeons adopt an 'all comers' policy regarding laparoscopic appendectomy, including selected older patients (>70 years old). There are no standard indications for conversion, while the behaviour in the presence of a normal appendix is generally removal. Even if laparoscopic appendectomy is not yet considered a gold standard, it is widely diffused in Italy, and the audit's data show different behaviours between subgroups. [ABSTRACT FROM AUTHOR]

Background: Recurrence is the most common complication of pericarditis, affecting 10% to 50% of patients. Objective: To evaluate the efficacy and safety of colchicine for the secondary prevention of recurrent pericarditis. Design: Prospective, randomized, double-blind, placebocontrolled multicenter trial. (ClinicalTrials.gov registration number: NCT00128414) Setting: 4 general hospitals in urban areas of Italy. Patients: 120 patients with a first recurrence of pericarditis. Intervention: In addition to conventional treatment, patients were randomly assigned to receive either placebo or colchicine, 1.0 to 2.0 mg on the first day followed by a maintenance dose of 0.5 to 1.0 mg/d, for 6 months. Measurements: The primary study end point was the recurrence rate at 18 months. Secondary end points were symptom persistence at 72 hours, remission rate at 1 week, number of recurrences, time to first recurrence, disease-related hospitalization, cardiac tamponade, and rate of constrictive pericarditis. Results: At 18 months, the recurrence rate was 24% in the colchicine group and 55% in the placebo group (absolute risk reduction, 0.31 [95% CI, 0.13 to 0.46]; relative risk reduction, 0.56 [CI, 0.27 to 0.73]; number needed to treat, 3 [CI, 2 to 7]). Colchicine reduced the persistence of symptoms at 72 hours (absolute risk reduction, 0.30 [CI, 0.13 to 0.45]; relative risk reduction, 0.56 [CI, 0.27 to 0.74]) and mean number of recurrences, increased the remission rate at 1 week, and prolonged the time to subsequent recurrence. The study groups had similar rates of side effects and drug withdrawal. Limitation: Multiple recurrences and neoplastic or bacterial causes were excluded. Conclusion: Colchicine is safe and effective for secondary prevention of recurrent pericarditis. Primary Funding Source: Maria Vittoria Hospital, Torino, Italy. [ABSTRACT FROM AUTHOR]

This study concerns those crystallographic and microstructural features that can provide indications on the actual origin of red pigments based on hematite (Fe2O3). The main features of natural and artificial hematite are recalled and used to discuss the results obtained from the characterization of red-ochre samples coming from the Palaeolithic site of Riparo Dalmeri, a rock-shelter located in northeastern Italy, dated to 13 000 cal. bp, and notorious for the presence, among the other finds, of red-painted calcareous stones. Painting and the treatment of leather and hides obtained from the intensive hunting activity were the main uses of the hematite-based red-ochres at Riparo Dalmeri. It turns out that hematite was mostly obtained from the thermal treatment of goethite, which, unlike hematite, was and still is widely available in the neighbourhood of the site. [ABSTRACT FROM AUTHOR]

The α decays of naturally occurring platinum isotopes, which are accompanied by the emission of γ quanta, have been searched for deep underground (3600 m water equivalent) at the Gran Sasso National Laboratories of the INFN (Italy). A sample of Pt with a mass of 42.5 g and a natural isotopic composition has been measured with a low background HP Ge detector (468 cm3) during 1815 h. The α decay of 190Pt to the first excited level of 186Os (Jπ=2+, Eexc=137.2 keV) has been observed for the first time, with the half-life determined as T1/2=2.6-0.3+0.4(stat.)±0.6(syst.)×1014 yr. The T1/2 limits for the α decays of other Pt isotopes have been determined at the level of T1/2≂1016-1020 yr. These limits have been set for the first time or they are better than those known from earlier experiments. [ABSTRACT FROM AUTHOR]

The DAMA/LIBRA experiment has a sensitive mass of about 250 kg highly radiopure NaI(Tl). It is running at the Gran Sasso National Laboratory of the INFN in Italy and is mainly devoted to the investigation of dark matter (DM) particles in the galactic halo by exploiting the model-independent DM annual modulation signature. The present DAMA/LIBRA and the former DAMA/NaI experiments (the first generation experiment having an exposed mass of about 100 kg) have thus far cumulatively released the results of data collected over 13 annual cycles (total exposure: 1.17 t year). They give model-independent evidence of the presence of DM particles in the galactic halo on the basis of the investigated DM signature at 8.9 σ C.L. for the cumulative exposure. The main aspects of the obtained results are summarized and some comments are addressed. L'expérience DAMA/LIBRA utilise un détecteur de 250 kg de NaI(Tl) de haute pureté radioactive. Les mesures sont prises au Laboratoire National du Gran Sasso de l'I.N.F.N. en Italie et l'expérience se concentre sur la recherche de particules de matière noire (DM) dans le halo galactique en exploitant la signature indépendante des modèles de la modulation annuelle de ces particules (DM). L'actuelle expérience DAMA/LIBRA et sa prédécesseur DAMA/NaI un (la première génération avec un détecteur de 100 kg) ont produit les résultats cumulatifs de données colligées sur 13 cycles annuels (capture totale: 1.17 tonne années). Ces résultats suggèrent, de façon indépendante des modèles, la présence de particules de matière noire dans le halo galactique sur la base de leur signature, avec un intervalle de confiance de 8.9 σ pour le cumulatif des données. Nous résumons les aspects principaux des données et y ajoutons quelques commentaires. [ABSTRACT FROM AUTHOR]

Abstract: A sample of 100MoO3 powder with molybdenum enriched in 100Mo to 99.5% and mass of 1199 g was measured for 18120 h in a low-background set-up with 4 HP Ge detectors ( volume each one) deep underground (3600 m w.e.) at the Laboratori Nazionali del Gran Sasso of the INFN (Italy). The two γ quanta of 540 keV and of 591 keV emitted in the deexcitation process after a decay of 100Mo to the excited level of 100Ru () are observed in the accumulated data both in coincidence and in the 1-dimensional sum spectrum. The measured half life is: , well in agreement with positive results obtained in previous experiments. Moreover, the limit on charge non-conserving β decay of 100Mo is also set: at 90% C.L.; it corresponds to the limit on CNC admixture in weak currents: . [ABSTRACT FROM AUTHOR]

The DAMA/LIBRA set-up (about 250 kg highly radiopure NaI(Tl) sensitive mass) is running at the Gran Sasso National Laboratory of the INFN. The first DAMA/LIBRA results point out the presence of a dark matter particle component in the galactic halo, as well as the former DAMA/NaI set-up; cumulatively the data support such evidence at 8.2 σ CL and satisfy all the peculiarities of the dark matter annual modulation signature. [ABSTRACT FROM AUTHOR]

A search for double- $ \beta$ processes in 96Ru and 104Ru was realized in the underground Gran Sasso National Laboratories of the INFN (Italy) with the help of ultra-low background HPGe $ \gamma$ spectrometry. After 158h of data taking with 473g ruthenium sample, new improved limits on double-beta processes in 96Ru have been established on the level of 1018-1019yr. For the first time the double-beta decay of 104Ru to the 2+ 1 excited level of 104Pd has been restricted as T1/2 > 3.5×1019 yr. [ABSTRACT FROM AUTHOR]

Several environmental and life-style factors reported as possibly associated with ALS have been analysed in the present study, focusing on the two clinical onsets of ALS. A case-control study (77 cases and 185 controls) has been performed in the province of Rome in the period 2005–2006. Increased risks were observed in bulbar cases for former smokers (OR: 4.55, 90% CI 1.72–12.08) and more than 24 pack-years, compared with spinal cases for employment in the construction sector and professional exposure to building materials (OR: 5.27, 90% CI 1.15–24.12) and metals (OR: 2.94, 90% CI 1.20–7.21). Overall and bulbar cases showed an increased risk for consumption of cold cuts and a decreased risk for vegetables intake. Regarding head injuries, differences were observed if the last injury occurred in the age range of 30–40 years, among all (OR: 14.2, 90% CI 1.04–194.42) and bulbar (OR: 17.4, 90% CI 1.70–178.5) cases, and less than 30 years among spinal cases (OR: 7.13, 90% CI 1.34–37.94). Moreover, a risk for a time period of 11–30 years since the last head injury suffered was found in bulbar cases (OR: 3.51, 90% CI 1.03–11.95). Some of the hypothesized risk factors for ALS have been found positively associated in this study, with different patterns between bulbar and spinal ALS. [ABSTRACT FROM AUTHOR]

Abstract: Double beta processes in 64Zn, 70Zn, 180W, and 186W have been searched for with the help of large volume (0.1–0.7 kg) low background ZnWO4 crystal scintillators at the Gran Sasso National Laboratories of the INFN (Italy). The total measurement time exceeds ten thousand hours. New improved half-life limits on double electron capture and electron capture with positron emission in 64Zn have been set, in particular (all the limits are at 90% C.L.): , , and . In addition, new bounds were set for different modes of 2β processes in 70Zn, 180W, and 186W at the level of 1017–1020 yr. [Copyright &y& Elsevier]

Abstract: A small CeCl3 crystal (6.9 g) was measured deep underground (3600 m w.e.) at the Gran Sasso National Laboratories of the INFN (Italy) with a low background HP Ge detector (244 cm3) during 1280 h. The crystal is not polluted by 232Th, 40K, 60Co, 137Cs (limits were set on the activity at a level of 0.05–1 Bq/kg), but contains radioactive 138La (0.68 Bq/kg) and, probably, is polluted by 235U and 238U (0.3–0.7 Bq/kg). The half life limits for different double β processes in 136Ce and in 138Ce were set in the range of . In particular, the 2ε captures in 136Ce to various excited levels of 136Ba were considered for the first time. The limits for the resonant neutrinoless transitions to the 2392.1 keV and 2399.9 keV levels of 136Ba are: and at 90% C.L., respectively. [Copyright &y& Elsevier]

In the present paper the contribution to the external gamma dose rate due to 137Cs in soil as a function of time is presented. Sampling sites were selected along the Calabria and Basilicata Regions coastal beaches (southern part of Italy) to assess the external gamma dose rate in air, 1 m above the ground level. A convection-dispersion model, with constant parameters was used to approximate the radiocesium soil vertical migration. The model was calibrated using the initial 137Cs activity deposition in this region (Chernobyl fallout) and 137Cs activity concentration down the soil profile, measured 10 years later. The dispersion coefficient and the advection velocity values, were respectively: 2.17 cm2 y−1 and 0.32 cm y−1. The Radionuclide Software Package (RSP), which uses a Monte Carlo simulation code, was used to determine the primary 137Cs gamma dose contribution in air 1 m above the ground surface. The resulting 137Cs external dose rate ranged from 0.42 nGy h−1 in 1986, to 0.05 nGy h−1 in 2007. [ABSTRACT FROM AUTHOR]

Samples of a prehistoric consolidated vegetable basketry, coming from an important pile building in the North-East of Italy (Fiavé Carrera, Trento), had been irradiated with excimer laser pulses to remove the consolidant layer and restore the artifact. Some problems, related to the nature of the consolidant resin, were found in the preliminary laser cleaning process. The two main obstacles were related to the unknown composition of the polymeric resin and to the irregular surface morphology of the archaeological find. We observed that large numbers of laser pulses, for selected laser parameters, strongly modify the resin surface morphology with formation of a large number of cones. After cone formation, the surface was so irregular that it was almost impossible to complete the laser cleaning procedure. To find a solution to the problem, we here try to understand the mechanisms of cone formation in the present polymeric material. Scanning electron microscopy (SEM) and Fourier transformation infrared spectroscopy (FTIR) have been used to study surface morphology and chemical modification after selected irradiation processes. To understand the influence of laser irradiation on surface modifications and to establish a cleaning procedure for this specific application, investigations have been carried out separately on models of resin consolidants and wood (both dried and buried wood sample). The consolidants were commercial resins, typically used in archaeological conservation (Plexisol and Paraloid), deposited on a silicon substrate. Silicon was used because it is an appropriate substrate in FT-IR analysis. Finally, we chose wood because of its wide use in prehistoric artefact (Viburnum lantana). [ABSTRACT FROM AUTHOR]

Abstract   222Rn was used to assess river–groundwater interactions within Castel di Sangro alluvial aquifer (Italy). The effectiveness of results obtained through this indicator was verified by also analyzing δ18O, major ions and temperature in both surface and groundwater, and carrying out piezometric head monitoring and discharge measurements. Hydrogeological investigations suggested that the river infiltrates into the aquifer in the south-eastern aquifer portion, while groundwater discharges into the river in the north-eastern portion. The latter phenomenon is supported by 222Rn data. Nevertheless, flow-through conditions cause the modelled discharge along this river reach, estimated by 222Rn data in a degassing-corrected two-component mixing model, to be greater than the measured discharge. Concerning river infiltration into the aquifer, δ18O, major ions and temperature data show that the river contribution is negligible in terms of aquifer recharge. Thus, the observed increase in 222Rn concentration in that portion of the aquifer is due to the enrichment process caused by infiltration of rainwater (222Rn free) which flows from the local divide area. Hence, in the study site, the use of only 222Rn to predict river–groundwater interactions causes some estimation inaccuracies and it must be coupled with other hydrochemical and hydrogeological parameters to gain a thorough understanding of such interactions. [ABSTRACT FROM AUTHOR]

Past intensive use of asbestos has implied severe public health consequences. Spatial distribution of deaths from malignant mesothelioma and of compensated cases for asbestos related diseases in Italy were compared to identify unexpected sources of asbestos exposure. Mortality for malignant mesothelioma at municipal level and geographical clusters of compensated cases for asbestos related diseases, as proxy of industrial asbestos exposure, were identified in the period 1988–2001. Municipalities with at least four mesothelioma deaths and a statistically significant mortality excess were 148; and 53 out of them had no compensated case for asbestos-related diseases. Finally 22 of these lay outside of any aforementioned cluster, thus suggestive of a possible unrecognized exposure. Availability long-term national figures and the different etiology of asbestos related diseases are the key features of this exercise that was applied to Italy, but can be replicated wherever registration systems of diseases related to long term exposure to asbestos are available. [ABSTRACT FROM AUTHOR]

Sampling sites, located along the Calabria and Basilicata Regions coastal beaches (south of Italy), were selected to assess the external gamma dose rate in air, 1 m above ground, and to estimate the fraction attributable to the radiocesium and radiopotassium contents along the vertical sand profile. Mean values for the gamma dose rate were: 76±30 nGy·h−1. 137Cs and 40K deposition densities in sand samples were determined for each sampling site (mean values 0.24±0.22 kBq·m−2 and 178±88 kBq·m−2, respectively). The 137Cs external dose rate contribution was assessed using a Monte Carlo simulation code. The method gives an estimation of the contribution to the external gamma dose rate of each sand layer along the vertical profile. The dose rate associated with the 137Cs content in sand was 0.16±0.14 nGy·h−1. The cosmic radiation and 40K contributions to the external gamma dose rate were estimated using the UNSCEAR methodologies. The values obtained were 34±3 nGy·h−1 and 18±9 nGy·h−1, respectively. [ABSTRACT FROM AUTHOR]

How to guarantee liver transplantation in the north of Italy during the COVID-19 pandemic: A sound transplant protection strategy In compliance with our transplant protection strategy, every transplant patient was admitted to an ICU not serving COVID-19 patients. We have demonstrated that a transplant protection strategy is valid and feasible in a really COVID-19 stressed hospital and that transplant activity can continue, with none of the transplant programs selectively stopped a priori, but each case discussed taking into account resources at that precise moment. [Extracted from the article]

Background. Many sources of health advice are consulted by travelers, but in Europe, only 35% go to a travel clinic. Travel to countries outside Europe increases daily, and from 2001 to 2004, there was a marked increase in the number of travelers from the Florentine area crossing the borders (+18.0%), taking a plane (+81.4% of international travelers in Pisa airport), and applying to the Centre of Travel and Migration Medicine (CTMM) (+96%). Methods. An anonymous survey was carried out at CTMM among those travelers returning to complete vaccinations for which the first dose had been given before going abroad. The survey included questions on vaccination status, adherence to recommended antimalaria prophylaxis, occurrence of other health problems, and food and drink consumption. Results. The study population (which represents a “best case scenario”) was composed of 1,237 subjects and had a very high compliance to the proposed questionnaire (95%). Approximately 55% of travelers took malaria chemoprophylactic measures, and 88% of them followed the indications given. Approximately 28% reported one or more secondary effects following antimalarial medication, and approximately 69% reported constant attention regarding safe consumption of food and drinks. Notwithstanding these measures, 236 cases of travelers’ diarrhea were reported. Conclusions. Our results are conditioned by the self-selection of the study population (those who seek advice are likely to follow it through). However, since no certainty exists about other sources of health advice for the remainder of the traveler population in our region, both the importance of counseling offered by travel clinics as well as the recommendation to the ever-increasing number of travelers to consult these clinics are stressed. [ABSTRACT FROM AUTHOR]