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We will present cultural transposition as a particular perspective to frame the use of foreign mathematics education practices as an opportunity for questioning the didactic practices of one's own cultural context. This requires a process activated by researchers, who deconstruct the cultural layers underpinning the foreign education practice before proposing it to teachers. We discuss the theoretical premises of this approach and, in accordance with them, we propose a transposition process of the El'konin-Davydov curriculum. In particular, we will show how our deconstruction process has affected the design and implementations of particular Professional Development courses (PDs) in Italy. Finally, we will present a case study of a teacher involved in one of these PDs to observe her new educational awareness.

In this work, we examined mathematical knowledge mobilised by mathematics teachers while interpreting students' answers, which we denote as Interpretative Knowledge (IK). In particular, we analysed the IK of prospective mathematics teachers (PTs), who were students of a Mathematics Education course for the Master's Degree in Mathematics. In order to study the possible development of the IK of these students, we explored their interpretations of secondary students' productions and compared those given before, during, and after a collective discussion about these productions. Our findings reveal considerable differences in PTs' knowledge and interpretations provided during the three activities, confirming that these and similar activities can be useful in training mathematics teachers in order to develop their IK.

Two low-cost (LC) monitoring networks, PurpleAir (instrumented by Plantower PMS5003 sensors) and AirQino (Novasense SDS011), were assessed in monitoring PM2.5 and PM10 daily concentrations in the Padana Plain (Northern Italy). A total of 19 LC stations for PM2.5 and 20 for PM10 concentrations were compared vs. regulatory-grade stations during a full "heating season" (15 October 2022–15 April 2023). Both LC sensor networks showed higher accuracy in fitting the magnitude of PM10 than PM2.5 reference observations, while lower accuracy was shown in terms of RMSE, MAE and R2. AirQino stations under-estimated both PM2.5 and PM10 reference concentrations (MB = −4.8 and −2.9 μg/m3, respectively), while PurpleAir stations over-estimated PM2.5 concentrations (MB = +5.4 μg/m3) and slightly under-estimated PM10 concentrations (MB = −0.4 μg/m3). PurpleAir stations were finer than AirQino at capturing the time variation of both PM2.5 and PM10 daily concentrations (R2 = 0.68–0.75 vs. 0.59–0.61). LC sensors from both monitoring networks failed to capture the magnitude and dynamics of the PM2.5/PM10 ratio, confirming their well-known issues in correctly discriminating the size of individual particles. These findings suggest the need for further efforts in the implementation of mass conversion algorithms within LC units to improve the tuning of PM2.5 vs. PM10 outputs. [ABSTRACT FROM AUTHOR]

Benzodiazepines, psychotropic drugs, are ubiquitous in the aquatic environment due to over-consumption and inefficient removal by sewage treatment plants. Bioaccumulation with consequent behavioral and physiological effects has been reported in many aquatic species. However, the responses are species-specific and still poorly understood. To improve the knowledge, we exposed the freshwater snail Planorbarius corneus to 1, 5, or 10 µg/L of delorazepam, the most widely consumed benzodiazepine in Italy. Conventional behavioral tests were used to assess the effects on locomotor and feeding behavior. Histological and biochemical analyses were also performed to detect possible changes in the structure and composition of the foot mucus and glands. The results show a paradoxical response with reduced feeding activity and locomotor hyperactivity. Pedal mucus was altered in texture but not in composition, becoming particularly rich in fibrous collagen-like material, and a significant change in the protein composition was highlighted in the foot. In conclusion, exposure to delorazepam induces disinhibited behavior in Planorbarius corneus, potentially increasing the risk of predation, and an increase in mucus protein production, which, together with reduced feeding activity, would severely compromise energy resources. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies show that neuropsychiatric disorders are the most frequent sequelae of COVID-19 in children. Purpose: Our work aimed to evaluate the impact of SARS-CoV-2 infection on behavior and sleep in children and adolescents. Materials and Methods: We enrolled 107 patients aged 1.5–18 years who contracted COVID-19 between one year and one month prior to data collection, referred to the University of Campania Luigi Vanvitelli in Italy. We asked their parents to complete two standardized questionnaires for the assessment of behavior (Child Behavior CheckList (CBCL)) and sleep (Sleep Disturbance Scale for Children (SLDS)). We analysed and compared the results with a control group (pre-COVID-19 pandemic). Results: In the COVID-19 group, the major results were found for sleep breathing disorders, sleep–wake transition disorders and disorders of initiating and maintaining sleep for the SDSC questionnaire, and internalizing scale, total scale and anxiety/depression for the CBCL questionnaire. The comparison of the CBCL results of the cases with the controls revealed statistically significant differences for the following items: internalizing scale, externalizing scale, somatic complaints, total score, thought problems [(p < 0.01)], anxious/depressed problems and withdrawn [(p < 0.001)]. Conclusions: COVID-19 has impacted children's and adolescents' mental health. Adolescents were the most affected patient group for internalizing problems, including anxiety and depression. [ABSTRACT FROM AUTHOR]

Aims: We aim to provide real-world evidence on the use of ocrelizumab for treating multiple sclerosis (MS), with specific regard to prescription pattern, adherence, persistence, healthcare resource utilization and related costs, also in relation to other disease-modifying treatments (DMTs). Methods: We included 2495 people with MS from the Campania Region (South Italy) who received first or switch DMT prescription from Jan 2018 to Dec 2020, and with at least 6-month follow-up. We collected hospital discharge records, drug prescriptions, and related costs, and calculated persistence (time from first prescription to discontinuation or switch to other DMT), adherence (proportion of days covered (PDC)), annualized hospitalization rate (AHR) for MS-related hospital admissions, and DMT costs. Results: Ocrelizumab was the most commonly prescribed DMT (n = 399; age = 45.74 ± 10.98 years; females = 224), after dimethyl fumarate (n = 588) and fingolimod (n = 401); 26% patients treated with ocrelizumab were naïve. When compared with ocrelizumab, the risk of discontinuation was higher for other highly active DMTs (HR = 3.78; p = 0.01), and low/medium efficacy DMTs (HR = 7.59; p < 0.01). When compared with ocrelizumab, PDC was similar to other highly active DMTs (Coeff = 0.01; p = 0.31), but higher for low/medium efficacy DMTs (Coeff = 0.09; p < 0.01). When compared with ocrelizumab, AHR was similar to other highly active DMTs (Coeff = 0.01; p = 0.51), and low/medium efficacy DMTs (Coeff = 0.01; p = 0.55). When compared with ocrelizumab, DMT monthly costs were higher for other highly active DMTs (Coeff = 92.30; p < 0.01), but lower for low/medium efficacy DMTs (Coeff = − 1043.61; p < 0.01). Discussion: Ocrelizumab was among the most frequently prescribed DMTs, with 26% prescriptions to treatment-naïve patients, suggesting its relevance in addressing unmet clinical needs (e.g., first approved treatment for primary progressive MS). Ocrelizumab was associated with the highest persistence, confirming its favorable benefit-risk profile. Costs for ocrelizumab were lower than those associated to similarly effective DMTs, in absence of changes in healthcare resource utilization. [ABSTRACT FROM AUTHOR]

(1) Introduction: The aim of our research was to explore emotional/behavioral changes in adolescents with neuropsychiatric conditions during the COVID-19 pandemic, and parental stress levels through a standardized assessment, comparing the data collected before and during the first months of lockdown. Moreover, an additional goal was to detect a possible relationship between emotional/behavioural symptoms of adolescents and the stress levels of their parents. (2) Methods: We enrolled 178 Italian adolescents aged between 12–18 that were referred to the Child Neuropsychiatry Unit of the University Hospital of Salerno with different neuropsychiatric diagnoses. Two standardized questionnaires were provided to all parents for the assessment of parental stress (PSI-Parenting Stress Index-Short Form) and the emotional/behavioral problems of their children (Child Behaviour Check List). The data collected from questionnaires administered during the six months preceding the pandemic, as is our usual clinical practice, were compared to those recorded during the pandemic. (3) Results: The statistical comparison of PSI and CBCL scores before/during the pandemic showed a statistically significant increase in all subscales in the total sample. The correlation analysis highlighted a significant positive relationship between Parental Stress and Internalizing/Externalizing symptoms of adolescent patients. Age and gender did not significantly affect CBCL and PSI scores, while the type of diagnosis could affect behavioral symptoms and parental stress. (4) Conclusions: our study suggests that the lockdown and the containment measures adopted during the COVID-19 pandemic could have aggravated the emotional/behavioral symptoms of adolescents with neuropsychiatric disorders and the stress of their parents. Further studies should be conducted in order to monitor the evolution of these aspects over time. [ABSTRACT FROM AUTHOR]

A year-round air quality analysis was addressed over four Italian cities (Milan, Turin, Bologna, and Florence) following the outbreak of the Coronavirus 2019 (COVID-19) pandemic. NO2, O3, PM2.5, and PM10 daily observations were compared with estimations of meteorological variables and observations of anthropogenic emission drivers as road traffic and heating systems. Three periods in 2020 were analysed: (i) the first (winter/spring) lockdown, (ii) the (spring/summer) partial relaxation period, and (iii) the second (autumn/winter) lockdown. During the first lockdown, only NO2 concentrations decreased systematically (and significantly, between −41.9 and −53.9%), mainly due to the drastic traffic reduction (−70 to −74%); PM2.5 varied between −21 and +18%, PM10 varied between −23 and +9%, and O3 increased (up to +17%). During the partly relaxation period, no air quality issues were observed. The second lockdown was particularly critical as, although road traffic significantly reduced (−30 to −44%), PM2.5 and PM10 concentrations dramatically increased (up to +87 and +123%, respectively), mostly due to remarkably unfavourable weather conditions. The latter was confirmed as the main driver of PM's most critical concentrations, while strong limitations to anthropogenic activity—including traffic bans—have little effect when taken alone, even when applied for more than two months and involving a whole country. [ABSTRACT FROM AUTHOR]

Pivotal trials showed the effectiveness of the monoclonal antibody ocrelizumab in relapsing and progressive multiple sclerosis (MS). However, data on everyday practice in MS patients and markers of treatment effectiveness are scarce. We aimed to collect real-world data from ocrelizumab-treated MS patients, relapsing-remitting (RR) and progressive MS patients (PMS), including active secondary progressive MS (aSPMS) and primary progressive MS (PPMS) patients, and to explore potential prognostic factors of clinical outcome. Patients were enrolled at MS centres in the Campania region, Italy. We collected clinic-demographic features retrospectively one year before ocrelizumab start (T−1), at ocrelizumab start (T0), and after one year from ocrelizumab start (T1). We explored possible clinical markers of treatment effectiveness in those patients receiving ocrelizumab treatment for at least one year using multilevel-mixed models. We included a total of 383 MS patients (89 RRMS and 294 PMS; 205 females, mean age: 45.8 ± 11.2, disease duration: 12.7 ± 11.6 years). Patients had a mean follow-up of 12.4 ± 8.2 months, and 217 patients completed one-year ocrelizumab treatment. Overall, EDSS increased from T−1 to T0 (coeff. = 0.30, 95% coefficient interval [CI] = 0.19–0.41, p < 0.001) without a further change between T0 and T1 (p = 0.61). RRMS patients did not show an EDSS change between T−1 and T0 nor between T0 and T1. Conversely, PMS patients showed EDSS increase from T−1 to T0 (coeff. = 0.34, 95% CI = 0.22–0.45, p < 0.001) without a further change between T0 and T1 (p = 0.21). PMS patients with a time from conversion shorter than 2 years showed increased EDSS from T−1 to T0 (coeff. = 0.63, 95% CI = 0.18–1.08, p = 0.006) without a further change between T0 and T1 (p = 0.94), whereas PMS patients with a time from conversion longer than 2 years showed increased EDSS from T0 to T1 (coeff. = 0.30, 95% CI = 0.11–0.49, p = 0.002). Naïve patients showed an EDSS decrease between T0 and T1 (coeff. = −0.30, 95% CI = −0.50–−0.09, p = 0.004). In conclusion, our study highlighted that early ocrelizumab treatment is effective in modifying the disability accrual in MS patients. [ABSTRACT FROM AUTHOR]

Background: Emergency hospital admissions are common in multiple sclerosis (MS), and can highlight unmet medical needs. Objectives: To evaluate burden, predictors and outcomes of MS emergency admissions. Methods: This is a population-based study, conducted in the Campania Region (South Italy) from 2015 to 2019, using hospital discharge records, drug prescriptions and outpatients. The risk of emergency hospital admissions and the likelihood of worse outcomes were evaluated using the Cox regression and multinomial logistic regression models, respectively, in relation to age, sex, disease-modifying treatments (DMTs), comorbidities and adherence. Results: We recorded 1225 emergency admissions for 1001 patients (out of 5765 prevalent MS patients), overall costing 4,143,764.67 EUR. The risk of emergency admissions increased with age (hazard ratio (HR) = 1.02; 95% confidence interval (CI) = 1.01, 1.03; p < 0.01) and comorbidities (HR = 1.62; p < 0.01), and decreased in patients using DMTs (interferon beta/peg-interferon beta/glatiramer acetate HR = 0.19; p < 0.01; teriflunomide/dimethyl-fumarate/fingolimod HR = 0.18; p < 0.01, and alemtuzumab/cladribine/natalizumab/ocrelizumab HR = 0.21; p < 0.01), and with higher adherence (HR = 0.18; 95% CI = 0.13, 0.26; p < 0.01). Following emergency admission, older age was associated with probability of death (n = 63) (odds ratio (OR) = 1.06; p < 0.01) and discharge to long-term facility (n = 65) (OR = 1.03; p = 0.01). Conclusion: With 17% people with MS requiring emergency medical care over 5 years, improved management of DMTs and comorbidities could potentially reduce their medical, social and financial burden. [ABSTRACT FROM AUTHOR]

Background: We aim to overcome limitations of previous clinical and population-based studies by merging a clinical registry to routinely-collected healthcare data, and to specifically describe differences in clinical outcomes, healthcare resource utilization and costs between interferon beta formulations for multiple sclerosis (MS). Methods: We included 850 patients with MS treated with interferon beta formulations, from 2015 to 2019, seen at the MS Clinical Care and Research Centre (Federico II University of Naples, Italy) and with linkage to routinely-collected healthcare data (prescription data, hospital admissions, outpatient services). We extracted and computed clinical outcomes (relapses, 6-month EDSS progression using a roving EDSS as reference), persistence (time spent on a specific interferon beta formulation), adherence (medication possession ratio (MPR)), healthcare resource utilization and costs (annualized hospitalization rate (AHR), costs for hospital admissions and DMTs). To evaluate differences between interferon beta formulations, we used linear regression (adherence), Poisson regression (AHR), mixed-effect regression (costs), and Cox-regression models (time varying variables); covariates were age, sex, treatment duration, baseline EDSS and adherence. Results: Looking at clinical outcomes, rates of relapses and EDSS progression were lower than studies run on previous cohorts; there was no differences in relapse risk between interferon beta formulations. Risk of discontinuation was higher for Betaferon®/Extavia® (HR = 3.28; 95%CI = 2.11, 5.12; p<0.01). Adherence was lower for Betaferon®/Extavia® (Coeff = -0.05; 95%CI = -0.10, -0.01; p = 0.02), and Avonex® (Coeff = -0.06; 95%CI = -0.11, -0.02; p<0.01), when compared with Rebif® and Plegridy® (Coeff = 0.08; 95%CI = 0.01, 0.16; p = 0.02). AHR and costs for MS hospital admissions were higher for Betaferon®/Extavia® (IRR = 2.38; 95%CI = 1.01, 5.55; p = 0.04; Coeff = 14.95; 95%CI = 1.39, 28.51; p = 0.03). Conclusions: We have showed the feasibility of merging routinely-collected healthcare data to a clinical registry for future MS research, and have confirmed interferon beta formulations play an important role in the management of MS, with positive clinical outcomes. Differences between interferon beta formulations are mostly driven by adherence and healthcare resource utilization. [ABSTRACT FROM AUTHOR]

Background: Botulinum toxin (BT) is an effective and safe treatment for spasticity, with limited evidence in multiple sclerosis (MS). We aim to describe the use of BT for the management of MS spasticity in the clinical practice, its combination with other anti-spastic treatments in MS and possible MS clinical correlates.Methods: This is a multicentre cross-sectional observational study including 386 MS patients, receiving BT for spasticity in 19 Italian centres (age 53.6 ± 10.9 years; female 228 (59.1%); disease duration 18.7 ± 9.2 years; baseline Expanded Disability Status Scale (EDSS) 6.5 (2.0-9.0)).Results: BT was used for improving mobility (n = 170), functioning in activities of daily living (n = 56), pain (n = 56), posturing-hygiene (n = 63) and daily assistance (n = 41). BT formulations were AbobotulinumtoxinA (n = 138), OnabotulinumtoxinA (n = 133) and IncobotulinumtoxinA (n = 115). After conversion to unified dose units, higher BT dose was associated with higher EDSS (Coeff = 0.591; p < 0.001), higher modified Ashworth scale (Coeff = 0.796; p < 0.001) and non-ambulatory patients (Coeff = 209.382; p = 0.006). Lower BT dose was used in younger patients (Coeff = - 1.746; p = 0.009), with relapsing-remitting MS (Coeff = - 60.371; p = 0.012). BT dose was higher in patients with previous BT injections (Coeff = 5.167; p = 0.001), and with concomitant treatments (Coeff = 43.576; p = 0.022). Three patients (0.7%) reported on post-injection temporary asthenia/weakness (n = 2) and hypophonia (n = 1).Conclusion: BT was used for spasticity and its consequences from the early stages of MS, without significant adverse effects. MS-specific goals and injection characteristics can be used to refer MS patients to BT treatment, to decide for the strategy of BT injections and to guide the design of future clinical trials and observational studies. [ABSTRACT FROM AUTHOR]

The performances of limited area weather models are affected by the choice of core solvers, domain resolutions, and initial and boundary conditions. To understand the extent of such differences on simulated wind fields, weather research and forecast (WRF) simulations initialized by different forcings were extensively compared with an aircraft-derived high-resolution data set. The two used forcings were the European Centre for Medium-Range Weather Forecasts (ECMWF) ERA-Interim reanalysis and the National Centers for Environmental Predictions (NCEP) Climate Forecast System Reanalysis (CFSR). The model domain covered a large portion of central western Italy (including part of the Tyrrhenian coast) encompassing the aircraft track and allowed the characterization of their performance across the simulation domain rather than a small set of point-based observations. The WRF results show good agreement with the aircraft data across the whole flight track with both forcings (root mean square errors (RMSEs) < 2.3 m·s-1 and an average r² = 0.7). Orography and coasts show an effect on simulated wind fields. The presence of a strong orography (which is smoothed by the model internal terrain elevation model) is associated with increased errors. Distance from the coast is also associated with a variation in RMSE (even if in a non-straightforward manner) because of potential breeze effects. No forcing data set clearly outperforms the other, while the ECMWF has higher correlation co-efficients when considering wind direction. [ABSTRACT FROM AUTHOR]

Background: To differentiate five formulations of Interferon Beta for the treatment of multiple sclerosis (MS) in clinical practice, by analysing persistence, adherence, healthcare resource utilisation and costs at population level.Methods: In this population-based study, we included individuals with MS living in the Campania Region of Italy from 2015 to 2017, on treatment with intramuscular Interferon Beta-1a (Avonex® = 618), subcutaneous pegylated Interferon Beta-1a (Plegridy® = 259), subcutaneous Interferon Beta-1a (Rebif® = 1220), and subcutaneous Interferon Beta-1b (Betaferon® = 348; and Extavia® = 69). We recorded healthcare resource utilisation from administrative databases (hospital discharges, drug prescriptions, MS-related outpatients), and derived costs from the Regional formulary. We classified hospital admissions into MS-related and non-MS-related. Persistence (time to switch to other disease modifying treatments (DMTs)), and adherence (medication possession ratio (MPR) = medication supply obtained/medication supply expected during follow-up period) were calculated.Results: Patients treated with Rebif® were younger, when compared with other Interferon Beta formulations (p < 0.01). The probability of switching to other DMTs was 60% higher for Betaferon®, 90% higher for Extavia®, and 110% higher for Plegridy®, when compared with Rebif® (p < 0.01). Plegridy® presented with 7% higher adherence (p < 0.01), and Betaferon® with 3% lower adherence (p = 0.03), when compared with Rebif®. The probability of MS-related hospital admissions was 40% higher in Avonex® (p = 0.03), 400% higher in Betaferon® (p < 0.01), and 60% higher in Plegridy® (p = 0.04), resulting into higher non-DMT-related costs, when compared with Rebif®.Discussion: Interferon Beta formulations presented with different prescription patterns, persistence, adherence, healthcare resource utilisation and costs, with Rebif® being used in younger patients and with less MS-related hospital admissions. [ABSTRACT FROM AUTHOR]

A fundamental feature of any earthquake early warning system is the ability of rapidly broadcast earthquake information to reach a wide audience of potential end users and stakeholders, in an intuitive, customizable way. Smartphones and other mobile devices are nowadays continuously connected to the Internet and represent the ideal tools for earthquake alerts dissemination to inform a large number of users about the potential damaging shaking of an impending earthquake. Here we present a mobile app (named ISNet EWApp or simply EWApp) for Android devices which can receive the alerts generated by a network-based Early Warning system. Specifically, the app receives the earthquake alerts generated by the PRESTo EEWS, which is currently running on the accelerometric stations of the Irpinia Seismic Network (ISNet) in southern Italy. In the absence of alerts, EWApp displays the standard bulletin of seismic events that have occurred within the network. In the event of a relevant earthquake, the app has a dedicated module to predict the expected ground-shaking intensity and the available lead time at the user's position and to provide customized messages to inform the user about the proper reaction to adopt during the alert. We first present the architecture of both the network-based system and EWApp and then describe its essential operational modes. The app is designed in a way that is easily exportable to any other network-based early warning system. [ABSTRACT FROM AUTHOR]

A fundamental feature of any Earthquake Early Warning System is the ability of rapidly broadcast earthquake information to a wide audience of potential end users and stakeholders, in an intuitive, customizable way. Smartphones and other mobile devices are nowadays continuously connected to the internet and represent the ideal tools for earthquake alerts dissemination, to inform a large number of users about the potential damaging shaking of an impending earthquake. Here we present a mobile App (named ISNet EWApp) for Android devices which can receive the alerts generated by a network-based Early Warning system. Specifically, the app receives the earthquake alerts generated by the PRESTo EWS, which is currently running on the accelerometric stations of the Irpinia Seismic Network (ISNet) in Southern Italy. In the absence of alerts, the EWApp displays the standard bulletin of seismic events occurred within the network. In the event of a relevant earthquake, instead, the app has a dedicated module to predict the expected ground shaking intensity and the available lead-time at the user position and to provide customized messages to inform the user about the proper reaction during the alert. We first present the architecture of both network-based system and EWApp, and then and describe its essential operational modes. The app is designed in a way that is easily exportable to any other network-based early warning system. [ABSTRACT FROM AUTHOR]

Aim: The Brief Repeatable Battery of Neuropsychological Tests (BRB) is frequently used to estimate cognitive function in adults with multiple sclerosis (MS), while it has been included in few studies on young MS, also because of the absence of normative values. We aim to evaluate the impact of age, gender, and education on BRB scores in a young adolescent population.Methods: We administered the BRB to 76, 14-to-17-year-old, healthy subjects. Linear regression models were used to assess the impact of age, gender, and education on sub-test scores. When statistically significant (p < 0.05), we used the regression coefficient to correct the raw scores.Results: Younger age was associated with better performance on SPART (β = - 2.54; p < 0.05) and SPART-D (β = - 1.06; p < 0.05). Male gender was associated with better performance on SPART (β = 3.40; p < 0.05), SPART-D (β = 1.41; p < 0.05), PASAT-3 (β = 5.58; p < 0.05), and PASAT-2 (β = 5.07; p < 0.05). Educational attainments were associated with better performance on SPART (β = 3.23; p < 0.05) and SPART-D (β = 1.28; p < 0.05). Cut-off points were suggested at the 5th lowest percentile.Interpretation: Age, gender, and education must be accounted for when applying the BRB to young population. Present results can prove useful for future clinical and research applications in adolescent MS patients. [ABSTRACT FROM AUTHOR]

Background and objective Weight loss can determine significant improvement of migraine in obese patients. Herein, we evaluated a clinical sample of adolescent migraineurs with obesity who participated in an interdisciplinary programme for weight loss, in order to identify possible metabolic parameters associated with good migraine control. Subjects and methods Using a cross-sectional design, we evaluated 112 out of 135 adolescents who previously underwent our intervention programme. Based on persistence of headache, subjects for comparison were 40 migraine-free and 72 not migraine-free adolescents. Participants underwent anthropometric evaluations and biochemical tests. Results Patients with persistence of migraine had significantly higher weight ( P < 0.01), body mass index ( P < 0.01), waist circumference ( P < 0.01), homeostasis model assessment of insulin resistance ( P < 0.001), triglyceride ( P < 0.05), total cholesterol ( P < 0.05) and low-density lipoprotein cholesterol ( P < 0.05) values when compared with those who became migraine-free. Between potential predictors, only insulin resistance (odds ratio = 3.5, 95% confidence interval = 1.4-6.1; P < 0.001) was significantly associated with persistence of migraine after intervention programme. Conclusions Among obese adolescents with migraine who underwent an intervention programme for weight loss, patients who did not become migraine-free showed higher adiposity values than those who became migraine-free. Patients with insulin resistance had 3.5 times the odds of having persistence of migraine compared with those without. [ABSTRACT FROM AUTHOR]

Aim The purpose of this study was to evaluate both the effects of ibuprofen and/or acetaminophen for the acute treatment of primary migraine in children in or out prophylactic treatment with magnesium. Methods Children ranging from the ages of 5 to 16 years with at least 4 attack/month of primary migraine were eligible for participation the study. A visual analog scale was used to evaluate pain intensity at the moment of admission to the study (start of the study) and every month up to 18 months later (end of the study). Results One hundred sixty children of both sexes aged 5-16 years were enrolled and assigned in 4 groups to receive a treatment with acetaminophen or ibuprofen without or with magnesium. Migraine pain endurance and monthly frequency were similar in the 4 groups. Both acetaminophen and ibuprofen induced a significant decrease in pain intensity ( P < .01), without a time-dependent correlation, but did not modify its frequency. Magnesium pretreatment induced a significant decrease in pain intensity ( P < .01) without a time-dependent correlation in both acetaminophen- and ibuprofen-treated children and also significantly reduced ( P < .01) the pain relief timing during acetaminophen but not during ibuprofen treatment ( P < .01). In both acetaminophen and ibuprofen groups, magnesium pretreatment significantly reduced the pain frequency ( P < .01). Conclusions Magnesium increased the efficacy of ibuprofen and acetaminophen with not age-related effects. [ABSTRACT FROM AUTHOR]

Abstract: This paper extends a former analysis on the thermal behavior of a new kind of scraped surface heat exchanger operated in laminar regime to treat hazelnut paste, a high viscous non-Newtonian fluid largely adopted in the Italian confectionary industry. This unit, named A-SSHE, presents an alternate arrangement of the scraping blades that allows doubling the exchanger thermal efficiency respect to conventional SSHE with continuous blades, mainly thanks to backmixing phenomena. Three-dimensional CFD simulations of the A-SSHE are used to estimate the overall heat transfer coefficient as a function of the main process parameters: blades rotational speed, flow rate and wall temperature. The heat transfer coefficient results slightly higher during cooling than during heating and increases much more with blades rotational speed than with mass flow rate. Dimensional analysis provides a correlation among heat transfer coefficient, fluid properties and easily measurable flow parameters. This correlation is useful to design and operate an A-SSHE treating high viscous food pastes. [Copyright &y& Elsevier]

Background: The purpose of this study was to assess the cognitive functioning of children affected by headache, pinpointing the differences in intelligence style between subjects affected by migraine without aura and subjects with tension-type headache. Methods: The study population consisted of 147 children (mean age 10.82 ± 2.17 years) with headache, recruited from the Headache Center for Developmental Age, Child and Adolescent Neuropsychiatry Clinic, Second University of Naples. Cognitive profiling was performed using Weschler Intelligence Scale for Children Third Edition throughout the sample. According to the International Classification of Headache Disorders II criteria for pediatric age, subjects were divided into a migraine without aura group (n = 75; 43 boys, 32 girls) and a tension-type headache group (n = 72; 49 boys, 23 girls). The results were compared with the findings obtained from a sample of 137 healthy control subjects recruited from schools in the Campania region, matched for age and gender. Results: No difference in full intelligence quotient was found between the groups, but the children with tension-type headache had a lower verbal intelligence quotient and a higher performance intelligence quotient than the healthy controls and children with migraine. Factor analysis data showed that the children with migraine seemed to have lower perceptual organization than the children affected by tension-type headache. Conclusion: To our knowledge, studies on cognitive functioning in children affected by headache in the interictal phase are scarce, and our results suggest a new perspective in understanding of the neuropsychological aspects of young patients affected by headaches. [ABSTRACT FROM AUTHOR]

Abstract: In the Mediterranean mountains and hills spontaneous reforestation occurred in the last fifty years at the expenses of open habitats. This process was triggered by depopulation and cessation of traditional farming. In this paper we investigate landscape changes in one such area in central Apennines (Italy), which is currently almost uninhabited after centuries of human presence; we give a quantitative description of the changes that occurred between 1955 and 2006, and we discuss their management implications in a multidisciplinary context. To do this, we used aerial photos and field surveys to map land-use/land-cover classes in 1955, 1978 and 2006; we then employed a transition matrix model based on Markov chains, together with landscape and class metrics, to analyze gains and losses of each class over time. Our results show that almost all classes were replaced directly by woodlands: no “shrub stage” was observed and a surprisingly brief interval of about 25years was sufficient for canopy closure on abandoned open lands; furthermore, some classes increased their transformation rate from period 1 (1955–1978) to period 2 (1978–2006), while others did not. Metrics show that reforestation is accompanied by simplification and homogenization of the original mosaic, with no intermediate fragmentation process. We discuss current management plans and propose strategies that take into account the presence of endangered species: management should exploit the spontaneous reforestation and promote the creation and preservation of mature forests; concurrently, it should plan to maintain the last “islands” of grasslands, even if small. [Copyright &y& Elsevier]

Background: The relationship between sleep and mood regulation is well known, and some reports suggest a key role of sleep-related breathing disorders (SRBD) in the development of the symptomatology of depression, even if no conclusive data are actually found in the clinical literature. The aim of this study was to assess the relationship between SRBD and depressive symptoms in a population of school-aged children. Methods: The study population comprised 94 children affected by SRBD and 107 healthy children. To identify the severity of SRBD, an overnight respiratory evaluation was performed. All subjects filled out the Italian version of the Children Depression Inventory (CDI) to screen for the presence of depressive symptoms. Results: The group with SRBD showed higher CDI scores than the group without SRBD, with a positive correlation found between CDI scores, apnea-hypopnea index, and oxygen desaturation index values. Logistic regression showed that an apnea-hypopnea index ≥ 3 and an oxygen desaturation index ≥ 1 could be risk factors for development of depressive symptoms. According to receiver-operating characteristic curve analysis, the cutoff point for the apnea-hypopnea index that could cause a pathological CDI score (≥19) was >5.66, and the cutoff point for the oxygen desaturation index was >4.2. The limitations of this study are that our data are derived from one single psychometric test and not from a complete psychiatric evaluation, and our subjects came from a small group in southern Italy. Conclusion: Our results suggest the importance of mood assessment in children affected by SRBD. [ABSTRACT FROM AUTHOR]

The highest economic costs of a geothermal plant are basically related to well drilling and heat exchanger maintenance cost due to the chemical aggressiveness of geothermal fluid. The possibility to reduce these costs represents an opportunity to push toward geothermal plants development. Such challenges are even more important in the sites with a low-medium temperature geothermal fluids (90–120 °C) availability, where the use of these fluids for direct thermal uses can be very advantageous. For this reason, in this study, a direct geothermal heating system for a building will be investigated by considering a plastic plate heat exchanger. The choice of a polymeric heat exchanger for this application is upheld by its lower purchase cost and its higher fouling resistance than the common metal heat exchangers, overcoming the economic issues related to conventional geothermal plant. Thus, the plastic plate heat exchanger was, firstly, geometrical and thermodynamical modeled and, after, exergoeconomic optimized. In particular, an exergoeconomic analysis was assessed on the heat exchanger system by using a MATLAB and REFPROP environment, that allows for determination of the exergoeconomic costs of the geothermal fluid extraction, the heat exchanger, and the heating production. A sensitivity analysis was performed to evaluate the effect of main design variable (number of plates/channels) and thermodynamic variable (inlet temperature of geothermal fluid) on yearly exergoeconomic product cost. Then, the proposed methodology was applied to a case study in South of Italy, where a low-medium enthalpy geothermal potential exists. The plate-heat exchanger was used to meet the space heating requests of a single building by the exploitation of low-medium temperature geothermal fluids availability in the selected area. The results show that the inlet temperature of geothermal fluid influences the exergoeconomic cost more than the geometrical parameter. The variation of the exergoeconomic cost of heat exchanger with the inlet geothermal fluid temperature is higher than the change of the exergoeconomic costs associated to wells drilling and pumping with respect to the same variable. This is due the fact that, in the selected zone of South of Italy, it is possible to find geothermal fluid in the temperature range of 90–120 °C, at shallow depth. The product exergoeconomic cost is the lowest when the temperature is higher than 105 °C; thus, the smallest heat exchange area is required. The exergoeconomic optimization determines an optimum solution with a total product cost of 922 €/y for a temperature of geothermal fluid equal to 117 °C and with a number of plates equal to 15. [ABSTRACT FROM AUTHOR]

Starting from the observation that human longevity patterns show regional variations, we applied Spatial Analysis (using the Geographic Information System) and Surname Analysis to highlight the effect of the population genetic structure on such patterns. The study was carried out in Calabria, a southern Italian region which is characterized by a wide variability of geographic features (high mountains and deep valleys which created geographic isolates in the past). We identified three zones of high longevity: a male and a female longevity zone were located near the town of Cosenza (northern Calabria), while a male longevity zone was located in a mountainous and quite isolated part of the province of Reggio Calabria (southern Calabria). The latter zone was characterized by the lowest Female/Male ratio in nonagenarians observed to date. By applying surname analysis (Fisher's alpha) we found a significant negative correlation between surname abundance and index of longevity, showing that this isolated zone of male longevity presents a high level of inbreeding. On the whole, the results showed the effectiveness of spatial analysis in revealing geographical longevity patterns, and highlighted the importance of the population genetic structure in shaping such patterns. [ABSTRACT FROM AUTHOR]

Background: Autism Spectrum Disorder (ASD) is characterized by impairments in social interaction and reciprocal communication. ASD affects about 1% of the general population and is associated with substantial disability and economic loss. A variety of approaches to improve the core deficits and lives of people with ASD have been developed, including behavioral, developmental, educational, and medical interventions. The main objective of this study was to evaluate the efficacy of a neuro-psychomotor approach in children affected by ASD. Methods: The sample consisted of 84 children (66 males, mean age 56.9 ± 15.8 months) affected by ASD assessed between September 2020 to March 2021. The trained therapist was asked to complete the ASD behavior inventory (ASDBI) test at baseline (T0) (September 2020) and after six months (T1) (March 2021) to assess the child's evolution over the observational period. The study was carried out in southern Italy (Campania Region). Results: ASD children showed a significant improvement for AUTISM composite after 6 months of neuro-psychomotor treatment (T1) compared to baseline (65.4 ± 12.2 vs. 75.8 ± 11.5, p < 0.0001). In particular, significant changes were observed for such domains as the problems of excitability (ECCIT), aggression (AGG), behaviors in social relations (RELSOC), expressive (all p < 0.001), sense/perceptual contact modes (SENS) (p = 0.0007), ritualisms/resistance to changes (RIT) (p = 0.0002), pragmatic/social problems (PPSOC) (p = 0.0009), specific fears (FEARS) (p = 0.01), and learning and memory (AMLR) (p = 0.0007). No differences for the domains Semantic/pragmatic problems (PPSEM) and language (LESP) were found. Conclusions: Our preliminary results suggest the usefulness of the neuro-psychomotor treatment in children with ASD. Although promising, these findings need to be tested further to better understand the long-term effects of this specific type of approach. [ABSTRACT FROM AUTHOR]

Gluten-free diets are often characterized by an inadequate intake of nutrients and are generally monotonous for the limited number of products celiac patients can use. As rice is the most used cereal by celiac consumers, studying rice varieties nutritional characteristics is of interest to manage diet quality and variety. Proteins, total carbohydrates and amylose content of six rice varieties (Ribe, Vialone Nano, Carnaroli, Arborio, Basmati, and Fragrance) were analyzed. Analyses were performed in raw products and after boiling, stewing, and microwaving. A decrease of proteins and total carbohydrates amount was observed in cooked rice. The same was reported for amylose content with boiling showing the highest loss (average retained amylose 53%). Considering amylose percentage with respect to total carbohydrates, each variety showed either an increase or a decrease depending on cooking method. The highest values were obtained with stewing above all for Basmati rice and Arborio rice. However, exceptions can be underlined as Carnaroli rice, showing the highest percentage when boiled. In this context, nutritional characteristics of cooked rice varieties appear to be of great importance to increase specific nutritional knowledge to better manage gluten-free diets. [ABSTRACT FROM AUTHOR]

Seismic sequences are a powerful tool to locally infer geometrical and mechanical properties of faults and fault systems. In this study, we provided detailed location and characterization of events of the 3–7 July 2020 Irpinia sequence (southern Italy) that occurred at the northern tip of the main segment that ruptured during the 1980 Irpinia earthquake. Using an autocorrelation technique, we detected more than 340 events within the sequence, with local magnitude ranging between −0.5 and 3.0. We thus provided double difference locations, source parameter estimation, and focal mechanisms determination for the largest quality events. We found that the sequence ruptured an asperity with a size of about 800 m, along a fault structure having a strike compatible with the one of the main segments of the 1980 Irpinia earthquake, and a dip of 50–55° at depth of 10.5–12 km and 60–65° at shallower depths (7.5–9 km). Low stress drop release (average of 0.64 MPa) indicates a fluid-driven initiation mechanism of the sequence. We also evaluated the performance of the earthquake early warning systems running in real-time during the sequence, retrieving a minimum size for the blind zone in the area of about 15 km. [ABSTRACT FROM AUTHOR]

Covid19-induced lockdown measures caused modifications in atmospheric pollutant and greenhouse gas emissions. Urban road traffic was the most impacted, with 48–60% average reduction in Italy. This offered an unprecedented opportunity to assess how a prolonged (∼2 months) and remarkable abatement of traffic emissions impacted on urban air quality. Six out of the eight most populated cities in Italy with different climatic conditions were analysed: Milan, Bologna, Florence, Rome, Naples, and Palermo. The selected scenario (24/02/2020–30/04/2020) was compared to a meteorologically comparable scenario in 2019 (25/02/2019–02/05/2019). NO 2 , O 3 , PM 2.5 and PM 10 observations from 58 air quality and meteorological stations were used, while traffic mobility was derived from municipality-scale big data. NO 2 levels remarkably dropped over all urban areas (from −24.9% in Milan to −59.1% in Naples), to an extent roughly proportional but lower than traffic reduction. Conversely, O 3 concentrations remained unchanged or even increased (up to 13.7% in Palermo and 14.7% in Rome), likely because of the reduced O 3 titration triggered by lower NO emissions from vehicles, and lower NO x emissions over typical VOCs-limited environments such as urban areas, not compensated by comparable VOCs emissions reductions. PM 10 exhibited reductions up to 31.5% (Palermo) and increases up to 7.3% (Naples), while PM 2.5 showed reductions of ∼13–17% counterbalanced by increases up to ∼9%. Higher household heating usage (+16–19% in March), also driven by colder weather conditions than 2019 (−0.2 to −0.8 °C) may partly explain primary PM emissions increase, while an increase in agriculture activities may account for the NH 3 emissions increase leading to secondary aerosol formation. This study confirmed the complex nature of atmospheric pollution even when a major emission source is clearly isolated and controlled, and the need for consistent decarbonisation efforts across all emission sectors to really improve air quality and public health. Image 1 • Air quality impacts of Covid19 lockdown over 6 major Italian cities were assessed. • Daily observations of air quality, meteorological parameters and mobility were used. • Against a dramatic road traffic reduction (48–60%), NO 2 levels reduced by 24.9–59.1%. • O 3 levels remained basically unchanged or slightly increased (up to 11.4–14.7%). • PM daily concentrations slightly decreased, at most by 17% (PM 2.5) and 32.1% (PM 10). Main finding A 2-month urban traffic ban extended to the whole Italy only significantly reduced NO 2 levels, while O 3 , PM 2.5 and PM 10 concentrations were affected to a minor extent. [ABSTRACT FROM AUTHOR]

The valorization of residual biomass plays today a decisive role in the concept of "circular economy", according to which each waste material must be reused to its maximum extent. The collection and energy valorization at the local level of biomass from forest management practices and wildfire prevention cutting can be settled in protected areas to contribute to local decarbonization, by removing power generation from fossil fuels. Despite the evident advantages of bioenergy systems, several problems still hinder their diffusion, such as the need to assure their reliability by extending the operating range with materials of different origin. The Italian project "INNOVARE—Innovative plants for distributed poly-generation by residual biomass", funded by the Italian Ministry of Economic Development (MISE), has the main scope of improving micro-cogeneration technologies fueled by biomass. A micro-combined heat and power (mCHP) unit was chosen as a case study to discuss pros and cons of biomass-powered cogeneration within a national park, especially due to its flexibility of use. The availability of local biomasses (woodchips, olive milling residuals) was established by studying the agro-industrial production and by identifying forest areas to be properly managed through an approach using a satellite location system based on the microwave technology. A detailed synergic numerical and experimental characterization of the selected cogeneration system was performed in order to identify its main inefficiencies. Improvements of its operation were optimized by acting on the engine control strategy and by also adding a post-treatment system on the engine exhaust gas line. Overall, the electrical output was increased by up to 6% using the correct spark timing, and pollutant emissions were reduced well below the limits allowed by legislation by working with a lean mixture and by adopting an oxidizing catalyst. Finally, the global efficiency of the system increased from 45.8% to 63.2%. The right blending of different biomasses led to an important improvement of the reliability of the entire plant despite using an agrifood residual, such as olive pomace. It was demonstrated that the use of this biomass is feasible if its maximum mass percentage in a wood matrix mixture does not exceed 25%. The project was concluded with a real operation demonstration within a national park in Southern Italy by replacing a diesel genset with the analyzed and improved biomass-powered plant and by proving a decisive improvement of air quality in the real environment during exercise. [ABSTRACT FROM AUTHOR]

In this study, the sustainability of low-temperature geothermal field exploitation in a carbonate reservoir near Mondragone (CE), Southern Italy, is analyzed. The Mondragone geothermal field has been extensively studied through the research project VIGOR (Valutazione del potenzIale Geotermico delle RegiOni della convergenza). From seismic, geo-electric, hydro-chemical and groundwater data, obtained through the experimental campaigns carried out, physiochemical features of the aquifers and characteristics of the reservoir have been determined. Within this project, a well-doublet open-loop district heating plant has been designed to feed two public schools in Mondragone town. The sustainability of this geothermal application is analyzed in this study. A new exploration well (about 300 m deep) is considered to obtain further stratigraphic and structural information about the reservoir. Using the derived hydrogeological model of the area, a numerical analysis of geothermal exploitation was carried out to assess the thermal perturbation of the reservoir and the sustainability of its exploitation. The effect of extraction and reinjection of fluids on the reservoir was evaluated for 60 years of the plant activity. The results are fundamental to develop a sustainable geothermal heat plant and represent a real case study for the exploitation of similar carbonate reservoir geothermal resources. [ABSTRACT FROM AUTHOR]

An abstract of the article "Developmental coordination disorder and migraine in childhood" by M. Esposito, M. A. Faraldo, L. Antinolfi and M. Carotenuto is presented.

Greenhouse gas emissions, climate change and the rising energy demand are currently seen as most crucial environmental concerns. With the exploration of renewable energy sources to meet the challenges of energy security and climate change, geothermal energy is expected to play an important role. In this study a LCA (Life Cycle Assessment) and an EMA (Emergy Assessment) of a 20 MW dry steam geothermal power plant located in the Tuscany Region (Italy) are performed and discussed. The plant is able to produce electricity by utilizing locally available renewable resources together with a moderate support by non-renewable resources. This makes the geothermal source eligible to produce renewable electricity. However, the direct utilization of the geothermal fluid generates the release into the atmosphere of carbon dioxide, hydrogen sulfide, mercury, arsenic and other chemicals that highly contribute to climate change, acidification potential, eutrophication potential, human toxicity and photochemical oxidation. The study aims to understand to what extent the geothermal power plant is environmentally sound, in spite of claims by local populations, and if there are steps and/or components that require further attention. The application of the Emergy Synthesis method provides a complementary perspective to LCA, by highlighting the direct and indirect contribution in terms of natural capital and ecosystem services to the power plant construction and operation. The environmental impacts of the geothermal power plant are also compared to those of renewable and fossil-based power plants. The release of CO 2 -eq calculated for the investigated geothermal plant (248 g kWh −1 ) is lower than fossil fuel based power plants but still higher than renewable technologies like solar photovoltaic and hydropower plant. Moreover, the SO 2- eq release associated to the geothermal power plant (3.37 g kWh −1 ) is comparable with fossil fuel based power plants. Results suggest the need for further investigation of other geothermal options (e.g. binary systems) in order to reduce the environmental impacts while taking the maximum advantage of the geothermal resource. [ABSTRACT FROM AUTHOR]

Abstract: The Plio-Pleistocene large mammal fauna of peninsular Italy has been considered in order to explore diversity and turnover patterns through time. Several diversity metrics and turnover rates were quantified both for the whole mammal community and for large mammalian orders, taken separately. Temporal units of reference were the previously-defined paleocommunities (PCOMs). Rarefaction analysis has been applied to correct for possible sampling biases. The results show that large mammal richness in the Italian fossil record was highly influenced by the number of sites per PCOM. After this bias has been controlled for, no significant variation in species richness was apparent. In spite of the overwhelming climatic changes, species richness remained constant in the mammalian orders and in the whole community as well. In sharp contrast, turnover rates appear guided by major climatic changes (especially at the Villafranchian–Galerian transition) and are highly inconstant. This correlation with climatic change is particularly evident in even-toed ungulates. We argue that diversity dynamics should respond to a larger temporal scale, while ecosystem functioning and structure were sensitive to the strongest climatic oscillations of the Plio-Pleistocene. Our findings agree with previous claims that ecosystem functioning switches to alternative stable states instead of changing continuously. [Copyright &y& Elsevier]

Objective: The present Italian multicenter study aimed at investigating whether the course of primary headache disorders in children and adolescents was changed during the lockdown necessary to contain the COVID-19 emergency in Italy.Methods: During the lockdown, we submitted an online questionnaire to patients already diagnosed with primary headache disorders. Questions explored the course of headache, daily habits, psychological factors related to COVID-19, general mood and school stress. Answers were transformed into data for statistical analysis. Through a bivariate analysis, the main variables affecting the subjective trend of headache, and intensity and frequency of the attacks were selected. The significant variables were then used for the multivariate analysis.Results: We collected the answers of 707 patients. In the multivariate analysis, we found that reduction of school effort and anxiety was the main factor explaining the improvement in the subjective trend of headache and the intensity and frequency of the attacks (p < 0.001). The greater the severity of headache, the larger was the clinical improvement (p < 0.001). Disease duration was negatively associated with the improvement (p < 0.001). It is noteworthy that clinical improvement was independent of prophylaxis (p > 0.05), presence of chronic headache disorders (p > 0.05) and geographical area (p > 0.05).Conclusions: Our study showed that lifestyle modification represents the main factor impacting the course of primary headache disorders in children and adolescents. In particular, reduction in school-related stress during the lockdown was the main factor explaining the general headache improvement in our population. [ABSTRACT FROM AUTHOR]

With the increasing use of sustainable energy sources, the electric scooter has become a widely used vehicle. The aim of the study is to analyse the types of facial fracture related to road traffic accidents to outline the need for dedicated road rules. An observational, retrospective, multicentre study was carried out at the Maxillofacial Surgery Units of six Italian hospitals. Fifty patients (mean age was 34.76 years) from January 2020 to January 2024 were enrolled. The severity of trauma was evaluated by the Facial Injury Severity Scale (FISS) by Bagheri et al. Most of the accidents occurred during the day and the weekend in spring or summer; 24 drivers collided with infrastructures or pedestrians, while 26 involved other vehicles. A total of 33 vehicles were rented, and 17 were privately owned. A total of 43 subjects were not wearing helmets, five patients were drunk, and three patients took drugs. In order of frequency, the facial fractures involved: zygomatico-maxillary-orbital complex (ZMOC) (n = 16), mandibular condyle (n = 13), nasal bone (n = 11), orbit floor (n = 8), and mandibular body (n = 7). Fractures such as Le Fort I (n = 4), naso-orbito-ethmoidal NOE (n = 4) and mandibular ramus (n = 4) were less common. Other types of facial fracture were rare. Thirty patients reported multiple facial fractures. The vast majority of the cases showed a low severity grade FISS score. Fifteen patients suffered polytrauma. The mean hospitalisation time was 8.3 days. As accidents with electric scooters are increasing, it is important to characterise the most frequent facial fractures to improve patient management and encourage the introduction of new road rules., (Copyright © 2024 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.)

Background: Active relapsing-remitting (RR) and secondary progressive (SP) multiple sclerosis (MS) are currently defined as "relapsing MS" (RMS). The aim of this cross-sectional study was to assess drivers of treatment switches due to clinical relapses in a population of RMS patients collected in the Italian MS and Related Disorders Register (I-MS&RD)., Methods: RRMS and SPMS patients with at least one relapse in a time window of 2 years before of data extraction were defined as RMS. Factors associated with disease-modifying therapy (DMT) switching due to clinical activity were assessed through multivariable logistic regression models in which treatment exposure was included as the last recorded DMT and the last DMT's class [moderate-efficacy (ME), high-efficacy (HE) DMTs and anti-CD20 drugs]., Results: A cohort of 4739 RMS patients (4161 RRMS, 578 SPMS) was extracted from the I-MS&RD. A total of 2694 patients switching DMTs due to relapses were identified. Switchers were significantly (p < 0.0001) younger, less disabled, more frequently affected by an RR disease course in comparison to non-switcher patients. The multivariable logistic regression models showed that Alemtuzumab (OR 0.08, 95% CI 0.02-0.37), Natalizumab (0.48, 0.30-0.76), Ocrelizumab (0.1, 0.02-0.45) and Rituximab (0.23, 0.06-0.82) exposure was a protective factor against treatment switch due to relapses. Moreover, the use of HE DMTs (0.43, 0.31-0.59), especially anti-CD20 drugs (0.14, 0.05-0.37), resulted to be a protective factor against treatment switch due to relapses in comparison with ME DMTs., Conclusions: More than 50% of RMS switched therapy due to disease activity. HE DMTs, especially anti-CD20 drugs, significantly reduce the risk of treatment switch., (© 2023. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany.)

Objective: We aim to validate an algorithm based on routinely-collected healthcare data to detect incidence of multiple sclerosis (MS) in the Campania Region (South Italy) and to explore its spatial and temporal variations., Methods: We included individuals resident in the Campania Region who had at least one MS record in administrative datasets (drug prescriptions, hospital discharge, outpatients), from 2015 to 2020. We merged administrative to the clinical datasets to ascertain the actual date of diagnosis, and validated the minimum interval from our study baseline (Jan 1, 2015) to first MS records in administrative datasets to detect incident cases. We used Bayesian approach to explore geographical distribution, also including deprivation index as a covariate in the estimation model. We used the capture-recapture method to estimate the proportion of undetected cases., Results: The best performance was achieved by the 12-month interval algorithm, detecting 2,150 incident MS cases, with 74.4% sensitivity (95%CI = 64.1%, 85.9%) and 95.3% specificity (95%CI = 90.7%, 99.8%). The cumulative incidence was 36.68 (95%CI = 35.15, 38.26) per 100,000 from 2016 to 2020. The mean annual incidence was 7.34 (95%CI = 7.03, 7.65) per 100,000 people-year. The geographical distribution of MS relative risk shows a decreasing east-west incidence gradient. The number of expected MS cases was 11% higher than the detected cases., Conclusions: We validated a case-finding algorithm based on administrative data to estimate MS incidence, and its spatial/temporal variations. This algorithm provides up-to-date estimates of MS incidence, and will be used in future studies to evaluate changes in MS incidence in relation to different risk factors., Competing Interests: Declaration of Competing Interest Marcello Moccia has received research grants from the ECTRIMS-MAGNIMS, the UK MS Society, and Merck; honoraria from Biogen, Ipsen, Merck, Roche, and Sanofi-Genzyme. Vincenzo Brescia Morra has received research grants from the Italian MS Society, and Roche, and honoraria from Bayer, Biogen, Merck, Mylan, Novartis, Roche, Sanofi-Genzyme, and Teva. Raffaele Palladino has received research grants from Sanofi-Genzyme. Other authors have nothing to disclose., (Copyright © 2023 Elsevier B.V. All rights reserved.)

Background: People with multiple sclerosis (MS) may experience sexual dysfunction throughout the disease course. Validated scales to assess sexual dysfunction in MS for Italian patients are lacking. Hence, we aimed at validating Multiple Sclerosis Intimacy and Sexuality Questionnaire (MSISQ-19) for Italian MS patients., Methods: We included both male and female MS patients. Each patient completed the Italian translation of the MSISQ-19. Construct validity was explored by the exploratory factor analysis and the Cronbach's alpha coefficient. Test-retest stability and concurrent internal and external validity were examined by Pearson' correlation coefficients., Results: We enrolled 369 MS patients (323 female and 46 male). Italian MSISQ-19 showed a Cronbach's alpha of 0.92. MSISQ-19 test and retest total scores correlated between each other (r = 0.48, p = 0.01). MSISQ-19 total score also correlated with primary, secondary and tertiary subscales (p < 0.001)., Conclusion: The Italian Version of the MSISQ-19 showed satisfactory internal consistency and reliability with moderately adequate test-retest reproducibility, suggesting that it may be used as a valuable measure of sexual dysfunction in the Italian population.

Background: Fingolimod is the first oral agent approved for treatment of relapsing-remitting multiple sclerosis (RRMS). We aimed to evaluate fingolimod effectiveness in a real-world sample of RRMS patients., Methods: A retrospective, multicentre study in patients treated with fingolimod, whom clinical and radiological data were collected in the 2 years preceding and following the initiation of fingolimod., Results: Out of 414 patients, 56.8% received prior first-line injectable disease-modifying therapies, 25.4% were previously treated with natalizumab, 1.2% with immunosuppressant agents, and 16.7% were treatment naive. The annualized relapse rate decreased by 65% in the first year and by 70% after two years of treatment. Age ≤ 40 years, ≥ 1 relapse in the 24 months before fingolimod initiation and previous treatment with natalizumab were risk factors for relapses. Overall, 67.9% patients had no evidence of disease activity (NEDA-3) after 1 year and 54.6% after 2 years of treatment. A higher proportion of naïve (81.2% in 1 year and 66.7% after 2 years) or first-line injected patients (70.2% and 56.6%) achieved NEDA-3 than those previously treated with natalizumab (54.3% and 42.9%)., Conclusions: Fingolimod appeared to be effective in naive patients and after first-line treatment failure in reducing risk of relapse and disease activity throughout the 2-year follow-up.

An investigation of the extracts from Allium neapolitanum has led to the isolation of 13 flavonoid glycosides, based on kaempferol, quercetin and isorhamnetin. Four of them are new compounds and have been identified as: kaempferol 3-O-[[2-O-alpha-L-rhamnopyranosyl-4-O-beta-D-glucopyranosyl]-beta-D- glucopyranoside]], isorhamnetin 3-O-[[2-O-alpha-L-rhamnopyranosyl-6-O-beta- D-glucopyranosyl]-beta-D-glucopyranoside], isorhamnetin 3-O-[[2-O-alpha-L-rhamnopyranosyl-6-O-beta-D-glycopyranosyl] beta-D-glucopyranoside]-7-O-beta-D-glucopyranoside and isorhamnetin 3-O-[[2-O-alpha-L-rhamnopyranosyl-6-O-beta-D-gentiobiosyl]- beta-D-glucopyranoside]]. The isolated compounds were evaluated for their anti-aggregation human platelet activity.