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Establishing a coherent meaning in life has long been considered to be a protective factor of well-being, but this construct has been understudied in early adolescent development. The current study investigated the relationships between family allocentrism and depressive symptoms as well as the mediation effect of meaning in life in 214 Chinese and 201 Italian early adolescents. Although family allocentrism was higher in Chinese than Italian participants, it was significantly associated to lower depressive symptoms in both countries. Moderated mediational analyses showed that in both countries: (a) family allocentrism was positively related with presence of meaning; (b) family allocentrism and presence of meaning were negatively related to depressive symptoms; and (c) presence of meaning mediated the relationship between family allocentrism and depressive symptoms. In conclusion, family allocentrism and presence of meaning in life are important preventive factors of early adolescents' depressive symptoms in both collectivistic and in individualistic countries.

This paper investigates the effect of legal deterrence (sticks) and economic conditions (carrots) on environmental crime in Italy. We have a unique dataset of environmental crime related to illegal wastewater and waste activities across regions for the decade 2006–2016. Considering that, albeit scant, a first recent literature on environmental crimes in Italy has already begun to study the relationship between economic growth, socio-economic variables, and environmental crime, our analysis is committed to explore the extent to which enforcement and deterrence variables can have an impact on the phenomenon under observation. Consistent with the law and economics literature, our empirical findings show evidence that both economic conditions and enforcement efforts may be effective tools for the fight against environmental crime and, thus, support policy makers to better target environmental crime-control policies in Italy. [ABSTRACT FROM AUTHOR]

Bacterial infections are a common complication in patients with decompensated liver cirrhosis. The complex landscape of cirrhosis, characterized by immune paralysis and an exhausted response to exogenous triggers, explains the higher prevalence of such infections, particularly in advanced disease stages. In clinical practice, the onset of a bacterial infection can lead to further deterioration of hepatic and extra-hepatic function, potentially resulting in acute decompensation or acute-on-chronic liver failure. This has significant clinical implications, particularly for patients awaiting a transplant. In this review, we will discuss the latest evidence on the diagnosis and therapy of bacterial infections in patients with decompensated cirrhosis. Additionally, we will analyze the impact of bacterial infections in the context of liver transplantation, discussing debated topics such as the timing of transplantation in patients with infections, potential implications for prioritization, effects on post-operative recovery, grafts, and patient survival. [ABSTRACT FROM AUTHOR]

This article investigates the role of education on environmental crime in Italy using a panel of 110 Italian provinces over the period 2010–2015. We employ a system-GMM (Generalized Method of Moments) dynamic panel data approach to tackle the endogeneity that might arise in the estimations from the environmental crime dynamic path and to consider time-invariant effects on provinces. Our empirical results, even after controlling for socioeconomic and judicial efficiency characteristics, support the existence of a U-inverted relationship between education and environmental crime, which depicts an unconventional finding: At the margin, a higher level of education endowment offsets the propensity to commit environmental crimes, which are confirmed to be white-collar type of crimes. The results are robust to model specifications and endogeneity. Furthermore, to check the robustness of nonmonotonicity in the relationship between environmental crime and education and to control for unobserved provincial heterogeneity, we also exploit a semiparametric fixed effects model. There is wide room for efficiency gains that could arise from policy interventions aiming to put environmental crimes into perspective. [ABSTRACT FROM AUTHOR]

• We find evidence that air pollution influences internal migration acting as a push factor to move to less polluted provinces. • Our results highlight that education, unemployment, demographic and geographic factors are also relevant matters. • Central and Northern regions appear to attract people more than the Southern regions, other factors being equal. • Policymakers may find these insights useful for the creation of policies designed to cope with environmental degradation. • The development of more uniform territorial strategies of quality-of-life standards are likely desirable in Italy. This research analyzes the role that air pollution plays, controlling for other socio-economic factors, in the movement of the population among Italian provinces. In spite of the increased prominence of environmental degradation in the public policy debate, empirical evidence on the effects of air quality on the attraction or retention of people is still limited in Italy. This study aims at partly filling this gap. Specific attention is paid to the environmental risks presented in provinces contaminated by air pollution. We investigate whether population moves away from provinces with higher levels of air pollution emissions toward those characterized by lower levels, net of the other contextual factors associated with migration streams. While many factors can come into play on mobility decisions, it is suggested that the increased concerns with environmental risks may be influential in shaping internal migration choices. We discuss the implications of our findings for future policy options. [ABSTRACT FROM AUTHOR]

The current investigation tested life satisfaction (LS), a cognitive component of subjective well‐being, among emerging adults, in the context of individualism (I) and collectivism (C), by distinguishing both cultural and individual levels of analysis, considering their horizontal (H) and vertical (V) dimensions, and controlling age and gender effects. Emerging adults (N = 1760 university students, aged 18–25, Mage = 19.46, SDag = 1.50) located across four countries, namely China, Italy, Russia, and the USA, known to differ in the individualism index value (IDV), completed measures on the Horizontal and Vertical Individualism and Collectivism and Life Satisfaction. At the cultural level, an ANCOVA showed a significant country effects on LS. The post hoc comparisons indicated that the higher the country IDV score, the higher the average LS score, in the following order: Americans, Italians, Russians, and Chinese. At the individual level, LS was unrelated to HI and VI. Instead, it was associated with HC and VC. The positive link between LS and VC suggested an important role of family connectedness on LS across different cultures during emerging adulthood. However, contrary to previous studies, LS was unrelated to HI and VI. [ABSTRACT FROM AUTHOR]

Objective: The main aim of this study was to assess the psychometric proprieties of the Child Feeding Questionnaire (CFQ) in Italian mothers.Design: Mothers completed the Italian version of the CFQ, and children's anthropometric data were collected. Construct validity of the CFQ was assessed by comparing three different models: (a) a seven correlated factors model in which all items were analysed; (b) a seven correlated factors model with composite items based on the Restriction factor and (c) an eight correlated factors model with a separate Reward factor. Measurement invariance using BMI categories and gender was evaluated. Furthermore, discriminant validity with group comparison was performed between BMI categories and gender.Setting: Italy.Participants: A total of 1253 6-year-old Italian children (53·9 % male) attending elementary school (1st grade) and their mothers (mean age = 38·22 years; sd = 4·89) participated in this study.Results: The eight-factor model with a separate reward factor provided the best fit for the data. The strict invariance of the CFQ across child BMI categories and gender was confirmed. The CFQ internal consistency was acceptable for most subscales. However, two subscales showed no adequate values. As expected, the CFQ scales showed significant differences between BMI categories, while no gender-related differences were found.Conclusions: The study indicated the Italian version of the CFQ to be factorially valid for assessing parental feeding practices of 6-year-old children across BMI categories. Future research should address low internal consistency in some of the CFQ subscales. [ABSTRACT FROM AUTHOR]

This article describes the authors' experience with Public Private Partnerships (PPPs) being dealt with by the Italian Autonomous Province of Bolzano/South Tyrol. All PPPs considered by the Province and other local authorities must be compulsorily envisaging the enforcement of an effective performance control system during operations, in order to provide a timely assessment of key performance indicators (KPIs) and, in case of non-compliance, to levy relevant penalties to the private partner. Measuring a concessionaire's performance during operation stage in PPP arrangements is an essential requirement set forth by European standards, in order for PPPs to be accounted off public balance. In the Guide to Statistical Treatment of PPPs, Eurostat sets out that PPP contracts must contain provisions that allow for the Operational Payments to be adjusted for unavailability of the asset and poor service performance by the private partner. Unlike concessions, where the private party bears most of the risks and the majority of revenues come directly from user charges, in PPPs the public party is the major purchaser of the services provided by the operator. The investment repayment is assured for the greatest part by regular availability-based payments granted by the acquiring administration throughout contract duration. In the latter case, it is essential to ensure that a substantial risk portion is transferred to the private party, by contractually defining a clear set of performance levels to be matched during Operations, and making sure that an efficient and sound performance control system is in place to check if requirements are met. [ABSTRACT FROM AUTHOR]

Italian (n = 129) and American (n = 86) samples were evaluated with the Five Factor Inventory of personality and a measure of individualism/collectivism. Greater individualism was seen in the American group than the Italian group, as in the Hofstede (2019) data. For the Italian sample only, greater individualism was associated with greater neuroticism and greater collectivism was associated with lower neuroticism. This may reflect poor culture fit for Italians with a very individualistic orientation given that Italy falls between the United States and Asian countries in terms of the individualism/collectivism dimension. Other studies have shown better personal adjustment being associated with having a personality that fits with the culture in which one is embedded. For both Italian and American groups, higher collectivism was associated with higher extraversion, agreeableness, and conscientiousness consistent with other reports. Additional findings included higher openness in the Italian group and higher conscientiousness in the American group. [ABSTRACT FROM AUTHOR]

Background: Italian laws allow the protection of a child who is suspected to be a victim of abuse through a procedure that can be put in motion by the attending physician in any Emergency Department (article nr. 403 Civil Code) with a temporarily suspension of parental authority. This study aims at evaluating both the appropriateness of the activation of the protection procedure by ED doctors in cases of suspected child abuse in terms of judicial confirmation and how it impacts children in the long-term. Methods: We selected cases in which the procedure was activated due to suspected child abuse. The children were admitted to the ED of a tertiary children hospital from 2006 to 2018. We then reviewed the medical charts and collected data from the social services through a questionnaire concerning the long-term outcomes. Results: Twenty-eight patients were included (75% females, mean age 13.8 years). In 90% of cases the activation of the procedure in the ED was followed by a Court confirmation. Evaluation of long term outcome was possible in 22 cases. Among them, a positive social outcome was achieved in 15 cases (68.2%). The remaining abandoned the program or had critical reintegration in the family. Eighteen percent of patients developed major issues such as aberrant behaviours, substance abuse or psychiatric disorders. Conclusions: This report identifies a good ability of ED doctors in the activation of an emergency procedure to protect the child. Overall, the social outcome was good for nearly 70% of the patients, highlighting the importance of activation of social support programs for child abuse. [ABSTRACT FROM AUTHOR]

Emerging adulthood is characterized by pervasive changes in identity and relationships. These challenges can entail problems for subjective well‐being, leading to depressive symptoms. The development of an autonomous‐related self is considered crucial for emerging adults' personal growth and psychological well‐being. Autonomous‐related self is linked to self‐esteem and secure attachment style, which are also protective factors for depression. The current research sought to investigate the relation between autonomous‐related self and depressive symptoms, as well as the role of secure attachment style and self‐esteem, in a sample of 356 Italian emerging adults. Gender differences were taken into account in preliminary analyses. Gender differences emerged for autonomous‐related self and self‐esteem, while secure attachment and depression levels were similar across gender. Our results suggest that autonomous‐related self, mediated by self‐esteem and secure attachment style, is a protective factor for emotional states of depression, controlling for social desirability. These findings emphasize the importance of taking autonomy and relatedness into account in emerging adulthood and represent a starting point for future studies. [ABSTRACT FROM AUTHOR]

The paper aims to analyse and compare the environmental performances of the most widely used cooking appliances (the induction hob vs. the gas hob) considering a typical Italian scenario in terms of food, family and social habits. Cooking appliances are subject to energy labelling, and they represent the most impacting system inside households. This study was performed in accordance with the international standard, ISO 14040/14044, by using an attributional Life Cycle Assessment (aLCA). The functional unit is defined as the “preparation of a complete homemade meal (lunch) for 20 years consumed by a four-member family in Italy”. This study shows the dominance, in terms of environmental impact, of the induction hob with respect to the gas hob for most of the selected midpoint indicators. In particular, the induction hob accounts for more than 60% of the climate change and ozone depletion impact categories and more than 70% of the metal depletion category. The same trend is also noticed in the end-point categories (human health, ecosystem qualities and resources) and for the Cumulative Energy Demand indicator. Based on the experimental evidence of this work, the use phase is the most important due to the different energy carriers (natural gas vs. electrical energy). This finding is the result of the nature of the energy carrier (the electricity grid mix) in the Italian scenario, which is mainly based on non-renewable sources. In addition, concerning the production phase of the two appliances, the induction hob shows a relevant dominance in terms of the human toxicity and metal depletion impact categories due to the use of rare metals and coppers in the cooktop part manufacturing. The outcomes obtained from this study may be used by household manufacturers to improve the performance and design solutions of their appliances as well as by end users in their selection of cooking technologies. [ABSTRACT FROM AUTHOR]

The presence of organized crime strongly affects sustainable waste management in Italy. In particular, illegal trafficking of waste has become one of the fastest growing areas of crime and one of the most lucrative industries among organized criminal activities, which has now infiltrated both the Italian urban and hazardous waste management cycle. In this study, we aim to investigate the determinants of the illegal trafficking of waste using waste, economic, and enforcement data in a panel analysis over the period 2002-2013. The topic is particularly relevant, given the high heterogeneity across Italian regions which also relates, and eventually leads, to different environmental performances. Our main findings reveal that, in most Italian regions, enforcement activities do not exert a significant deterrence on criminal behaviors; a negative relationship between enforcement and illegal trafficking of waste can be identified only for very high levels of enforcement efforts. Moreover, we find that the major determinants influencing the rate of illegal trafficking of waste differ between northern-central and southern regions, confirming the existence of a regional dualism. In particular, while in the northern-central area the crime rate is positively related to the level of education and negatively to the adoption of environmentally sound policies, in southern regions the organized activities for illegal trafficking are negatively related to the degree of education attainment and positively to the endowment of waste management plants. [ABSTRACT FROM AUTHOR]

This paper provides an empirical analysis on the relationship between income, demographic characteristics and concentrations of air industrial pollutants within the Italian provinces. Two general conclusions can be drawn from the empirical results. First, the estimates obtained are consistent with an inverse U-shaped environmental Kuznets curve: air pollution releases increase with income up to a turning point where the relation reverts. Second, there is evidence that air releases tend to be higher in provinces with high concentration of females as households' head and with high concentration of children. Since our findings do not point to environmental discrimination on the basis of ethnicity, this suggests that environmental justice issues in Italy are not likely to manifest themselves along racial and ethnic terms but instead in terms of social categories and gender composition. We also find that the proxy variables employed to measure the efficiency or inefficiency of law enforcement are associated with higher levels of pollution. In terms of policy implications, this result suggests the need to strengthen, all through the country, the local enforcement of environmental laws in order to possibly reduce the negative effects on ambient air pollution. [ABSTRACT FROM AUTHOR]

Introduction: In the last decades, dietary supplements consumption has increased in the Western world for all age groups. The long-term potentially dangerous effects related to an indiscriminate consumption of dietary supplements are still unknown and are becoming a matter of public health concern. Therefore, the aims of the present study were: to explore the contribution of dietary supplements to micronutrient daily intake, and to evaluate awareness and knowledge about dietary supplements. Methods: Participants (age ranging from 14 to 18 years) were recruited among students attending 8 high schools in the province of Frosinone (Italy). An anonymous questionnaire, composed of 12 multiple-choice items, was administered to all the participants. T-test and the analysis of variance (ANOVA) were performed to describe differences between means of the groups, while the chi-square test was used to compare observed and expected frequencies. The logistic regression model, aimed at identifying the characteristics of potential consumers of dietary supplements, Results: A total of 686 teenagers (288 males and 398 females, average age: 17,89±0,91 years) participated in the study. The 83,6% of participants affirmed to be aware of dietary supplements. 239 participants consumed dietary supplements: 118 males and 121 females. 49,1% of females consumed dietary supplements less than twice a week, whereas 43,6% of males consumed dietary supplements from 2 to 5 times per week. Statistically significant differences emerged between the genders with respect to the source of information regarding dietary supplements, the perceived indications for their use, and the choice of the store/place to purchase them. Discussion: Findings in the present study provide insight into the consumption of dietary supplements among young Italians, highlighting the need to foster further awareness among adolescents about the correct use of dietary supplements, especially in terms of indications and contraindications. [ABSTRACT FROM AUTHOR]

OBJECTIVES: From an Italian Registry of patients with upper gastrointestinal hemorrhage (UGIH), we assessed the clinical outcomes and explored the roles of clinical, endoscopic, and therapeutic factors on 30-day mortality in a real life setting. METHODS: Prospective analysis of consecutive patients endoscoped for UGIH at 23 community and tertiary care institutions from 2003 to 2004. Covariates and outcomes were defined a priori and 30-day follow-up obtained. Logistic regression analysis identified predictors of mortality. RESULTS: One thousand and twenty patients were included. A total of 46 patients died for an overall 4.5% mortality rate. In all, 85% of deaths were associated with one or more major comorbidity. Sixteen of 46 patients (35%) died within the first 24 h of the onset of bleeding. Of these, eight had been categorized as ASA class 1 or 2 and none of them was operated upon, despite a failure of endoscopic intention to treatment in four. Regression analysis showed advanced age, presence of severe comorbidity, low hemoglobin levels at presentation, and worsening health status as the only independent predictors of 30-day mortality ( P < 0.001). The acute use of a PPI exerted a protective effect (OR 0.23, 95% CI 0.09–0.73). Recurrent bleeding was low (3.2%). Rebleeders accounted for only 11% of the total patients deceased (OR 3.27, 95% CI 1.5–11.2). CONCLUSIONS: These results indicate that 30-day mortality for nonvariceal bleeding is low. Deaths occurred predominantly in elderly patients with severe comorbidities or those with failure of endoscopic intention to treatment. [ABSTRACT FROM AUTHOR]

The article focuses on the behavior and the rules governing the behavior of Napoleon's army in Italy in 1796-1797. The author uses military court records of the Army of Italy to consider how soldiers interacted among themselves as well as with Italy's civilians while serving as an army of occupation. The author considers how councils of war determined guilt or innocence of defendants and whether they applied criminal sentences based on legislated military justice codes enacted by France's government of the Directory. Several anecdotes taken from military court records are presented.

Background: The recent introduction of COVID-19 certificates in several countries, including the introduction of the European green pass, has been met with protests and concerns by a fraction of the population. In Italy, the green pass has been used as a nudging measure to incentivize vaccinations because a valid green pass is needed to enter restaurants, bars, museums, or stadiums. As of December 2021, a valid green pass can be obtained by being fully vaccinated with an approved vaccine, recovered from COVID-19, or tested. However, a green pass obtained with a test has a short validity (48 hours for the rapid test, 72 hours for the polymerase chain reaction test) and does not allow access to several indoor public places.Objective: This study aims to understand and describe the concerns of individuals opposed to the green pass in Italy, the main arguments of their discussions, and their characterization.Methods: We collected data from Telegram chats and analyzed the arguments and concerns that were raised by the users by using a mixed methods approach.Results: Most individuals opposing the green pass share antivaccine views, but doubts and concerns about vaccines are generally not among the arguments raised to oppose the green pass. Instead, the discussion revolves around the legal aspects and the definition of personal freedom. We explain the differences and similarities between antivaccine and anti-green pass discourses, and we discuss the ethical ramifications of our research, focusing on the use of Telegram chats as a social listening tool for public health.Conclusions: A large portion of individuals opposed to the green pass share antivaccine views. We suggest public health and political institutions to provide a legal explanation and a context for the use of the green pass, as well as to continue focusing on vaccine communication to inform vaccine-hesitant individuals. Further work is needed to define a consensual ethical framework for social listening for public health. [ABSTRACT FROM AUTHOR]

Groundwater from karst circulation systems of Central Italy were sampled and analyzed, in 2018, for delineating a preliminary, general geochemical framework of their relationship with neotectonics, in an area characterized by a frequent and often destructive seismicity. We determined field physical-chemical parameters, concentrations of main dissolved ions and gases and isotopic composition of water (δ18O, δD) and total dissolved inorganic carbon (δ13C TDIC). We discriminated between "normal" hydro-karst systems and multi-component aquifers, composed of meteoric groundwater that have also interacted with rocks of different lithological nature and/or deep fluids. These multicomponent aquifers are of potential interest in the monitoring of neotectonics activity, because changes in the stress field associated with the preparatory phase of an earthquake may affect the permeability of rocks, in turn causing variation of their chemical-isotopic character. The geographical distribution of these aquifers seems to be controlled by tectonics. In fact, the Olevano–Antrodoco–Sibillini thrust separates the more anomalous sites, located westwards of it, from the groundwater bodies at its eastern side, showing a more typical karst character. [ABSTRACT FROM AUTHOR]

• We find evidence of an inverted U-shaped environmental crimes Kuznets curve. • The apex of environmental crimes with respect to per capita GDP is 24,181€. • Results are robust to functional form and income measures. The shape of the Environmental Kuznets Curve, which relates the trade-offs between environmental goods and production changes to income, has been the focus of much study in the literature. A similar kind of relationship may or may not exist between environmental crime and income, but this has not yet been empirically investigated. Using a unique panel dataset spanning 110 Italian provinces from 2010 to 2015, we empirically investigate the shape of an Environmental Crime Kuznets Curve while controlling for demographic, judicial, and socio-economic heterogeneity. We find evidence of an inverted U-shaped relationship. Moreover, these results are robust to different functional forms and income measures. We discuss the implications of our findings for future policy options. [ABSTRACT FROM AUTHOR]

Immune checkpoint inhibitors (ICIs) are the standard treatment in patients with mismatch repair deficient (dMMR)/microsatellite instability-high (MSI-H) metastatic colorectal cancer (mCRC). Tumour mutational burden (TMB) is a promising biomarker for the prediction of treatment outcomes. We screened 203 patients with dMMR/MSI-H mCRC treated with an anti-PD-(L)1 (anti-Programmed-Death-(Ligand)1) plus or minus an anti-Cytotoxic T-Lymphocyte Antigen 4 (anti-CTLA-4) agent at three Italian Academic Centers. TMB was tested by Foundation One Next Generation Sequencing assay and correlated with clinical outcomes, in the overall population and according to ICI regimen. We included 110 patients with dMMR/MSI-H mCRC. Eighty patients received anti-PD-(L)1 monotherapy and 30 received anti-CTLA-4 combinations. Median TMB was 49 mut/Mb (range: 8–251 mut/Mb). The optimal prognostic cut-off for progression-free survival (PFS) stratification was 23 mut/Mb. Patients with TMB ≤23 mut/Mb had significantly worse PFS (adjusted Hazard Ratio [aHR] = 4.26, 95% confidence interval [CI]:1.85–9.82, p = 0.001) and overall survival (OS) (aHR = 5.14, 95% CI: 1.76–14.98, p = 0.003). Using a cut-off optimised for predicting treatment outcome, anti-CTLA-4 combination was associated with a significant PFS/OS benefit versus anti-PD-(L)1 monotherapy in patients with TMB>40 mut/Mb (2-year PFS: 100.0% versus 70.7%, p = 0.002; 2-year OS: 100.0% versus 76.0%, p = 0.025), but not in those with TMB ≤40 mut/Mb (2-year PFS: 59.7% versus 68.6%, p = 0.888; 2-year OS: 80.0% versus 81.0%, p = 0.949). Patients with dMMR/MSI-H mCRC and relatively lower TMB value displayed early disease progression when receiving ICIs, whereas patients with the highest TMB values may obtain the maximal benefit from intensified anti-CTLA-4/PD-1 combination. [Display omitted] • The TMB stratifies the outcomes of dMMR/MSI-H mCRC receiving ICIs. • Patients with a low TMB has poor outcomes regardless of the ICI type. • Patients with the highest TMB have greater benefit from anti-CTLA-4 combos. • TMB could be used to drive future research projects and trials' design. [ABSTRACT FROM AUTHOR]

Municipal waste management, especially in developed countries, has a significant impact on the environment and humans that need to be quantified and mitigated. This study aims to investigate and compare the environmental impact and occupational risks of the following three municipal waste collection methods in Italy: street bins, door-to-door collection, and a smart bins system. Six waste categories (paper, plastics, glass, metal, organic materials, and residual waste) are analysed. Environmental performances are calculated by the life cycle assessment (LCA) and material and flow analysis (MFA) methodologies. The ergonomic analysis is based on direct observation of municipal waste collectors and the application of standard assessment methods as RULA, NIOSH, and Snook Ciriello. show that the smart bins collection method is environmentally more effective in all the impact categories considered, thanks to the better quality of collected waste. The residual waste flow directed to landfills has a lower value in the case of smart bins (36.63%) in comparison with door-to-door (52.90%) and street bins (89.56%). The use of smart bins allows higher environmental benefits, passing for the Climate Change impact category from −2.80E+01 kg of CO2eq. of the door-to-door system and −2.74E+01 kg of CO2eq. of street bins to −7.13E+01 kg of CO2eq. of smart bins. Regarding the transport phase, the smart bins system determines a reduction of the impact of about 60% if compared with the door-to-door system for all the impact categories considered. On the other hand, acceptable occupational risks result in street and smart waste collection methods, while poor ergonomics conditions are observed during the door-to-door collection. Containers lifting and emptying are the most critical tasks. [Display omitted] • Smart technologies in urban waste management determines benefits in environmental terms. • Smart technologies in urban waste management preserves the operators' health condition. • Analysis of environmental impact and occupational risk of municipal waste systems. [ABSTRACT FROM AUTHOR]

Abstract: The scientific approach to the restoration and monitoring of mural paintings, at S. Girolamo Chapel – SS. Annunziata Church in Florence, is reported as a fruitful example of the synergic collaboration between restorers and scientists in the planning and development of conservative interventions. Before restoration, the painting technique and the state of preservation of the pictorial cycle have been investigated firstly by close examination of the painted surfaces and then by optical and/or SEM-EDS microscopy and μFT-IR spectroscopy on appropriately selected samples. In particular, the original constituent materials and those belonging to subsequent restorations were characterized together with those originating from decay processes. In this mural painting cycle, a peculiar “fresco” technique has been used although an auxiliary binder for pigment distemper has been also employed. The use of this technique, sometimes in an improper way together with uncorrected restoration interventions, are the main responsible of the unsatisfactory state of conservation of many painted areas. Preliminary conservation trials and scientific studies were carried out to design the most convenient restoration intervention and to verify the correctness and non-invasive of the necessary operations. Special attention was devoted to cleaning procedures, continuously monitored by a physico-chemical methodology, mainly based on microinvasive, microscopic and spectroscopic investigations, to evaluate the efficiency, advantages and drawbacks of the proposed cleaning procedures and define the most appropriate ones. Finally, specific decay markers have been recognized, by a comparison of the results obtained from the detached samples with those deriving from artificially aged models, to be used for a correct future monitoring and maintenance of the wall paintings. [Copyright &y& Elsevier]

Hypertrophic cardiomyopathy (HCM) is a genetic cardiac muscle disease characterized by clinical and genetic heterogeneity. Genetic testing can reveal the presence of disease-causing variants in genes encoding sarcomere proteins. However, it yields inconclusive or negative results in 40-60% of HCM cases, owing to, among other causes, technical limitations such as the inability to detect pathogenic intronic variants. Therefore, we aimed to increase the diagnostic yield of molecular analysis for HCM by improving the in-silico detection of intronic variants in MYBPC3 that may escape detection by algorithms normally used with tagged diagnostic panels. We included 142 HCM probands with negative results in Illumina TruSight Cardio panel analysis, including exonic regions of 174 cardiomyopathy genes. Raw data were re-analyzed using existing bioinformatics tools. The spliceogenic variant c.1224-80G>A was detected in three patients (2.1%), leading us to reconsider their molecular diagnosis. These patients showed late onset and mild symptoms, although no peculiar phenotypic characteristics were shared. Collectively, rare spliceogenic MYBPC3 variants may play a role in causing HCM, and their systematic detection should be performed to provide more comprehensive solutions in genetic testing using multigenic panels.

Internet Gaming Disorder, Internet Addiction, Problematic Internet Use and Compulsive Internet Use cause distress and significant impairment in important areas of a person's functioning, in particular among young people. The literature has indicated that males show higher levels of problematic internet use than females. People can use the internet to avoid or alleviate negative affects; in fact, problematic internet use is associated with alexithymia and dissociation. Few studies have focused on the different stages of adolescence, gender differences, and the relationships between the aforementioned variables. This research aims to fill this gap. Five hundred and ninety-four adolescents aged between 13 and 19 filled in the Compulsive Internet Use Scale, the Toronto Alexithymia Scale, the Adolescents Dissociative Experiences Scale, and other ad hoc measures. Surprisingly, females reported higher compulsive internet use compared with males. Moreover, they referred more difficulties/symptoms and greater levels of alexithymia than males. No differences across the stages of adolescence were found. Different strengths in the relationships between variables were found according to gender. Moderated mediation analyses indicated that dissociation is an important mediator in the relation between alexithymia and Compulsive Internet Use only among females. This study shed new light on gender differences around problematic internet use and some related risk factors, in order to identify and develop prevention and treatment programs to face this topical and relevant issue.

There is evidence that promoting physical activity programs and decreasing sedentary behavior is a potential strategy for improving health-outcomes, peer relationships and social/emotional well-being in at-risk youth. The World Health Organization recommends enhancing physical education and school-based programs with multi-component and evidence-based assessment methodology. In Umbria (Italy) an uncontrolled pilot study project referred to as "Improving Umbrian kids' healthy lifestyle" was implemented as a systemic school-based intervention directed at 6-year-old primary school children. The intervention applied a consolidated assessment methodology developed by the C.U.R.I.A.Mo. and Eurobis projects that inserted two hours per week of physical education activity into the school curriculum, structured and supervised by specialists with Exercise and Sport Science degrees, for eight months (from October to June) of the school year. We measured anthropometric values (BMI, waist circumference, waist-to-height ratio index) with objective tools. Moreover, we evaluated physical performance variables (speed, strength, and flexibility) using standard tests. Additionally, self-report measures (measured physical activity during the week, sedentary habits, and psychological well-being) were assessed using validated questionnaires. We observed a significant decrease in waist to height ratio, and improvements in physical performance values and self-report questionnaire measures. Our study suggests that the promotion of physical activity in the school setting is likely to result in physically, mentally, and psycho-socially healthier primary-school-age children., Competing Interests: The authors declare no conflict of interest.

The outbreak of the coronavirus disease 2019 (COVID-19) has dramatically changed our habits and routines. Uncertainty, insecurity, instability for the present and future, and reduced autonomy and self-directedness, are common feelings at the time of COVID-19. These aspects are very important during emerging adulthood. In spite of the fact that medical reports suggest that youth are less prone to experience COVID-19 infections, emerging adults might be at higher risk for their psychological adjustment. Emerging adults showed higher concerns about their role as a possible asymptomatic carrier than being positive with COVID-19 themselves. Both worries and concerns about COVID-19 and psychological maladjustment may be related to cultural factors. Individualism, collectivism, equality, and hierarchy seem to be meaningful perspectives to take into account. A total of 1183 Italian emerging adults were asked to fill out an online survey during the second week of the national lockdown in Italy. Results showed they reported an accurate perceived knowledge about COVID-19. At the same time, they showed higher worries and concerns about COVID-19 for their relatives, followed by more general/social worries. The lowest score included worries about COVID-19 related to themselves. State anxiety and stress levels were above the normal cutoff, confirming the challenges that emerging adults are facing during the pandemic. On one hand, emerging adults' collectivistic orientation was related to higher perceived risks of infection; on the other hand, it predicted lower psychological maladjustment, controlling for socio-demographic variables. The study suggests that to fight the COVID-19 pandemic and decrease levels of psychological maladjustment in emerging adulthood, individuals' cultural orientation such as the wish of sharing common goals with others, interdependence, and sociability, have to be emphasized and promoted as protective factors., Competing Interests: The authors declare no conflicts of interest.

Introduction: Postpartum haemorrhage (PPH) is the main cause of morbidity and mortality for pregnant women. Administrative databases are useful sources of information for the assessment of PPH and related outcomes, once the corresponding ICD-9-CM code is validated. The objective of the present study is to evaluate the accuracy of the ICD-9-CM code related to PPH., Material and Methods: Source of the data was the Regional Healthcare Database of the Umbria Region. The population of interest were women with at least 20 weeks of gestation that delivered in any hospital in the Umbria Region during 2012-2016. Cases of interest were identified using the ICD-9-CM 666.x code. For validation purposes, both cases (women who delivered and developed PPH) and non-cases (women who delivered without occurrence of PPH) were considered and algorithms proposed. The basic criterion used for the validity of ICD-9-CM codes was the presence of bleeding ≥500 ml. Additional criteria based on values of haemoglobin or transfusion of red blood cells were considered. Sensitivity, specificity and predictive values were calculated., Results: Medical charts of 422 cases and 200 non-cases were examined. Accuracy results for code 666.x related to the presence of bleeding ≥500 ml were: sensitivity 97% (95% CI, 96-99%), specificity 70% (65-76%), positive predictive value (PPV) 79% (76-82%) and negative predictive value (NPV) 95% (91-97%). The best algorithm was the one that, in addition to the basic criterion, considered both the haemoglobin values and red blood cell transfusion: sensitivity 93% (90-95%), specificity 85% (80-90%), PPV 92% (89-94%) and NPV 86% (81-90%). ICD-9 subcodes showed a higher specificity and PPV for immediate bleeding (666.0, 666.1) than delayed or secondary haemorrhage (666.2)., Conclusions: The accuracy data from the present study confirm that the Regional Healthcare Database of the Umbria Region can be used as a reliable source for the evaluation of epidemiological studies relating to PPHs, in order to improve the quality of maternity care.

Introduction: Postpartum haemorrhage (PPH) is one of the main causes of mortality and severe maternal morbidity and its incidence is increasing also in Western countries. Aim of this study is to estimate the incidence and the trend of PPH in the Umbrian population using the validated Umbrian health database and to identify possible determinants for the development of PPH., Methods: The source of the data was the regional Healthcare Database of the Umbria Region. The population of interest was represented by women who gave birth in Umbria between 2006 and 2017. The PPH was identified from the hospital data using the ICD-9-CM 666.x codes. Demographic data, principal and secondary diagnoses and data on maternal morbidity and blood component transfusion were collected. The incidence of PPH was calculated taking into account cases of PPH over the total number of births. The determinants of PPH, the associated morbidity and the variation in the severity of the PPH over time have been identified by logistic regression models., Results: In Umbria, between 2006 and 2017, 93,403 births were registered (69% by vaginal delivery and 31% by caesarean section) and the rate of caesarean sections decreased by about 4%. The incidence of PPH increased three-fold during this period with an increase (p<0.001) of women with PPH who received transfusions. Regarding the caesarean sections, the PPH trend increased by 53% (p=0.3), while in the vaginal deliveries the PPHs increased by 233% (p<0.001). Logistic regression analysis showed that possible risk factors for the occurrence of PPH are maternal morbidity (OR 22.8, 95% CI 18.5-30.0), twin birth (OR 2.0, 95% CI 1.3-3.2) and antepartum haemorrhage (OR 5.7, 95% CI 3.1-10.4)., Conclusions: The incidence of PPH has increased in recent years, while the morbidity associated with PPH has remained substantially unchanged. The study identified several risk factors responsible for PPH that can be used in the monitoring of pregnant women and for planning prevention strategies such as Patient Blood Management.

Background: Epidemiological studies have established the health benefits associated with the adherence to the MD (Mediterranean Diet), mainly in relation to reducing the risk of developing the non communicable diseases. The MD is a sustainable diet model that respects the environment, promotes the bio-diversity, the local cultural heritages, the social interaction and economic aspects., Methods: The pyramid is a graphical representation designed to represent the frequencies of consumption and portion sizes of each food according to the Mediterranean model and tradition. The pyramid was developed taking into account the LARN (Reference Intake of nutrients and energy for Italian Population) and the Italian Guidelines for a healthy diet., Results: The frequency of consumption and the portion size recommended are located at the different level of the pyramid. At the base of the pyramid there are the foods that should be consumed every meal and some concepts typical of the Mediterranean culture. In the middle there are foods that should be consumed daily and at the top of the pyramid the foods consumed on a weekly basis., Conclusions: The new modern MD Italian Pyramid is an important tool to promote the MD and improve the adherence to the MD dietary pattern.

Background: Fresh-frozen plasma (FFP) is unanimously recognised by international guidelines as the blood component of choice for the management of acute haemorrhage when accompanied by disorders of haemostasis, for disseminated intravascular coagulation in the presence of haemorrhage, for rare bleeding disorders when specific clotting factor concentrates are not available and for thrombotic thrombocytopenic purpura. The literature, however, reports a high percentage of inappropriate requests for FFP. This article presents the results of a pilot study of clinical auditing of the use of FFP in the Region of Umbria (Italy)., Methods: This study was based on the examination of the requests for FFP made in April 2006 to four Immunotransfusion Services (ITS) in Umbria and of the clinical records of the patients receiving transfusions. The following indicators were identified and evaluated: completeness of the request, appropriateness of the indication and the dose, completeness of the records in the clinical charts, adverse events, in-hospital morbidity and mortality, efficacy of the treatment (evaluated by analysing the changes between pre- and post-transfusion coagulation test results) and, as an indicator of the process, the correspondence between data in the paper request form and in the computerised database. The data were extracted from the ITS databases, from the paper request forms and from the patients' clinical records., Results: Two hundred and twenty-one requests (615 units of FFP) for 109 patients and 92.8% of the related clinical records were examined. The patients were admitted in medical (22.9%), surgical (51.4%) and critical care units (25.7%). In 50.7% of the cases, the completeness of the data in the individual requests was good (65-80% of the fields filled in). The indication was appropriate in 31.5% of the requests evaluated (56.1% of the total), with no difference related to different requesters. The dosage was appropriate in 62.7% of the requests evaluated (62% of the total). A comparison of pre- and posttransfusion laboratory data showed a significant correction of pathological values (p=0.02) only for the International Normalised Ratio (INR)., Conclusions: Critical areas that should be targeted by interventions to improve plasma usage are those related to the appropriateness of the indication, the completeness of the data entered in the request forms and the data recorded in the clinical charts.