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Simple Summary: Third-line or further treatments are rarely given to patients with refractory mCRC. In this regard, two noteworthy innovative therapy options, with varying toxicity profiles and statistically significant improvements in overall survival (OS), progression-free survival (PFS), and disease control, are regorafenib (R) and trifluridine/tipiracil (T). This study is a subset analysis of a larger retrospective study that we have already published, with the aim of evaluating patient outcomes when R and T were administered in that order. The purpose of this analysis was to evaluate the relationship between survival outcomes and the first drug treatment duration (<3 months, 3 to <6 months, and ≥6 months) in patients who had received the regorafenib-to-trifluridine/tipiracil sequence or vice versa. Our substudy found that administering R three to six months prior to T can prolong both OS and PFS in comparison to the opposite sequence. Background: Patients with refractory metastatic colorectal cancer (mCRC) rarely receive third-line or further treatment. In this context, regorafenib (R) and trifluridine/tipiracil (T) are two important novel therapeutic choices with statistically significant increases in overall survival (OS), progression-free survival (PFS), and disease control, with different toxicity profiles. This study is a subgroup analysis of our larger retrospective study, already published, whose objective was to assess the outcomes of patients when R and T were given sequentially. Patients and Methods: The study involved thirteen Italian cancer centers on a 10-year retrospective observation (2012–2022). In this subgroup analysis, we focused our attention on the correlation between the first drug treatment duration (<3 months, 3 to <6 months and ≥6 months) and survival outcomes in patients who had received the sequence regorafenib-to-trifluridine/tipiracil, or vice versa. Results: The initial study included 866 patients with mCRC who received sequential T/R, or R/T, or T or R alone. This analysis is focused on evaluating the impact of the duration of the first treatment in the sequence on clinical outcomes (OS, PFS) and includes 146 and 116 patients of the T/R and R/T sequences, respectively. Based on the duration of the first drug treatment, subgroups for the T/R sequence included 27 patients (18.4%) who received T for <3 months, 86 (58.9%) treated for 3 to <6 months, and 33 (22.6%) treated for ≥6 months; in the reverse sequence (R as the first drug), subgroups included 18 patients (15.5%) who received their first treatment for <3 months, 62 (53.4%) treated for 3 to <6 months, and 35 (31.0%) treated for ≥6 months. In patients who received their first drug treatment for a period of 3 to <6 months, the R/T sequence had a significantly longer median OS (13.7 vs. 10.8 months, p = 0.0069) and a longer median PFS (10.8 vs. 8.5 months, p = 0.0003) than the T/R group. There were no statistically significant differences between groups with first drug treatment durations of <3 months and ≥6 months. Conclusions: Our analysis seems to suggest that the administration of R for a period of 3 to <6 months before that of T can prolong both OS and PFS, as compared to the opposite sequence. [ABSTRACT FROM AUTHOR]

Background: Human respiratory syncytial virus (hRSV) is a key contributor to lower respiratory tract infections (LRTIs), affecting children aged 0–5 years and often leading to outpatient visits, emergency department utilization, and hospitalization. With the development of hRSV vaccines for mitigation, understanding the epidemiological impact of hRSV infections among 0–5-year-old pediatric outpatients in Italy is crucial. Methods: This systematic review conducted searches on PubMed, Embase, Scopus, and the International HTA Database, yielding 20,845 English and Italian records from January 2000 to July 2022. Results: Six eligible articles were identified following inclusion and exclusion criteria. These studies demonstrated hRSV-positivity proportions ranging from 18% to 41% in pediatric outpatients with respiratory infections. However, data comparability was hindered by diverse diagnostic approaches, data sources, sample populations, and study designs. Notably, hRSV-positivity showed temporal variability, rising from 23.8% (2001–2002) to 40.6% (2019–2020). This trend could stem from evolving epidemiological factors, heightened clinician awareness in hRSV diagnosis, or more sensitive molecular techniques. Conclusion: As the first review of its kind, this study underscores the need for more comprehensive data to inform effective preventive strategies against hRSV-related burdens in pediatric outpatients. [ABSTRACT FROM AUTHOR]

Aim: The aim of this study was to measure the prevalence of inadequate health literacy (HL) in a sample of family caregivers of older adults with dementia, and to assess the relationship of HL with characteristics of caregiver and persons with dementia. Methods: The study followed a cross-sectional design. Persons with dementia and their family caregivers were enrolled in an outpatients' geriatric memory clinic. For the caregivers, the following information was collected: socio-demographic data, level of HL, cognitive impairment (using the Mini-Cog). For persons with dementia, the following data were collected: socio-demographic data, functional status (using the Basic and Instrumental Activities of Daily Living), cognitive impairment (using the Mini Mental State Evaluation, and the Global Deterioration Scale) behavioral and psychological symptoms associated with dementia (assessed using the Neuropsychiatric Inventory). Results: A total of 174 person with dementia/caregiver dyads were enrolled. About 45% of the caregivers presented a possibility or a high likelihood of inadequate HL. The percentage of caregivers with inadequate HL was higher among spousal caregivers than in offspring. Female gender, higher age and lower education were independent predictors of low HL. On multiple logistic regression analysis, persons with dementia assisted by caregivers with a high likelihood of limited HL presented higher risk of a more severe disease. Conclusion: The results of this study suggest that the HL of dementia caregivers has to be included in the comprehensive geriatric assessment, to develop an appropriate individualized care plan. Moreover, public health interventions are needed to increase the HL of dementia caregivers. [ABSTRACT FROM AUTHOR]

Using the Programme for International Student Assessment (PISA) 2015 data for Italy, this paper offers a complete overview of the relationship between test anxiety and school performance by studying how anxiety affects the performance of students along the overall conditional distribution of mathematics, literature and science scores. We aim to indirectly measure whether higher goals increase test anxiety, starting from the hypothesis that high-skilled students generally set themselves high goals. We use an M-quantile regression approach that allows us to take into account the hierarchical structure and sampling weights of the PISA data. There is evidence of a negative and statistically significant relationship between test anxiety and school performance. The size of the estimated association is greater at the upper tail of the distribution of each score than at the lower tail. Therefore, our results suggest that high-performing students are more affected than low-performing students by emotional reactions to tests and school-work anxiety. [ABSTRACT FROM AUTHOR]

Measuring differences in the economic standard of living of between natives and other ethnic groups can inform us about the relative disadvantages and inequalities within Italian society. Despite the importance of this question, the measurement of this gap is not an easy task because, when using the usual design-based approach to survey sampling inference, the available micro-data lack sufficient sample size for the majority of immigrant communities needed to obtain reliable estimates. In this paper, we show that small area estimation (SAE) techniques can be applied in a fruitful way to avoid this issue. In particular, we use an approach based on M-quantile regression for estimating the economic standard of living in each community in Italy. Our findings highlight economic disparities between natives and other ethnic groups and suggest the need to adopt specific policies that target the most vulnerable immigrant communities and are designed to improve their economic standard of living. [ABSTRACT FROM AUTHOR]

Val d'Agri is a seismically active intermontane basin in southern Italy known for hosting the largest on-shore hydrocarbon reservoir in western Europe. Despite extensive study of the basin, important questions remain regarding fluid circulation and the possible link between deep hydrocarbon reservoirs, faults, natural and induced seismicity, and gas migration towards the surface. To address some of these issues we performed near-surface gas geochemistry and structural geology surveys throughout the basin at both the regional and local scale. While carbon dioxide data are due to shallow, biological processes in the soil, anomalous results for other gas species are interpreted as being linked to structural discontinuities. Coincident methane and ethane anomalies, which imply a deep thermogenic origin, occur primarily in the northern part of the Val d'Agri basin. The most dominant alignment of these gases starts from a surface hydrocarbon seep and extends above a buried, NE-SW-striking fault that transects the valley. In contrast, radon anomalies are localized in the southern part of the basin along the western border, in correspondence with the Monti della Maddalena Fault System (MMFS) and a cluster of background natural seismicity. The origin and implications of the observed anomalies are discussed. • Gas geochemistry / structural surveys were performed at Val d'Agri, host of Europe's largest onshore hydrocarbon reservoir. • Coincident methane and ethane anomalies along known / inferred faults imply upward migration of reservoir hydrocarbons. • hydrocarbon gas alignment above buried fault shows possible link between exploited reservoirs on either side of the valley. • The correlation between radon anomalies and recent low-level seismicity implies fracture enhanced emanation. [ABSTRACT FROM AUTHOR]

Complex suicide is performed using more harmful methods, simultaneously or consecutively. In these cases, the distinction between suicide and homicide represents a challenge for forensic pathologists. In literature, complex suicide is divided in two subgroups: “planned complex suicide” or “unplanned complex suicide” depending from forensic features and often related to psychiatric variables. Aim of this study was to show the casuistry of complex suicide in Parma’s Forensic service analyzing, for each case, the forensic medical problems (type and site of lesions on the body), and the supplementary data [Police’s inspection report, toxicological analysis and psychiatric anamnesis (when available)], trying, through a multidisciplinary approach, to determine a possible correlation between the victim’s mood and suicide’s method chosen, whether planned or unplanned. Our results showed the importance of all the elements collected on the crime scene to distinguish suicide from homicide, and the correlation between bipolar disorder, borderline personality disorder and schizophrenia with unplanned complex suicide (because of the impulsiveness), and major depression disorder and anxiety disorder with planned complex suicide. Being able to understand the causes behind this extreme gesture may become important not only for forensic pathologists and judicial authority, but also, and above all, for the family as well. [ABSTRACT FROM AUTHOR]

Respiratory syncytial virus (RSV) is a frequent cause of acute lower respiratory infection in children, imposing a substantial economic burden on healthcare systems. This systematic review aimed to assess the economic burden and healthcare utilisation of RSV in children aged 0–59 months in Italy. Systematic review. A systematic search of PubMed, Embase, Scopus, and the International HTA Database, including studies published in English or Italian, was conducted between January 2000 and July 2022. Inclusion criteria required studies to be conducted in Italy and provide data on the economic costs and healthcare resource utilisation related to RSV infections. Out of 20,845 records screened, 18 articles met the inclusion criteria. Only one study provided comprehensive data on RSV disease costs, including hospitalisation, diagnostic tests, and medical procedures for infants with RSV-bronchiolitis. The mean cost per inpatient was higher for RSV-positive children (€5753.43 ± €2041.62) than that for RSV-negative children. Additionally, five studies reported a median length of hospital stay of 5 days for RSV-infected children, and four studies indicated a higher frequency of intensive care unit admissions for RSV-infected children than for those with other viral infections. This is the first systematic review to examine the economic burden and healthcare utilisation of RSV in children aged 0–59 months in Italy. While limited data were available, the findings underscore the urgency to conduct further research and gather additional evidence on the costs and healthcare resource utilisation associated with RSV infections. Such efforts are essential for informing the development of effective prevention strategies for paediatric RSV infections in Italy. [ABSTRACT FROM AUTHOR]

An overview of a lecture presentation on the use of sunscreens to prevent skin damage from ultraviolet (UV) radiation in older people at de Senectute: Age and Health Forum in Catanzaro, Italy from December 5 to 7, 2009 is presented. It tackles the different levels of skin damage caused by ultraviolet B (UVB) and ultraviolet A (UVA) rays. It is said that excellent protection from UV rays can be achieved by using physical sunscreens made of metals such as zinc oxide but they have a bleaching effect.

Abstract Background Alternating induction and maintenance phases is a common strategy in metastatic colorectal cancer (mCRC). Metronomic chemotherapy (metroCT) may represent a well-tolerated chemotherapy backbone for maximising bevacizumab effect during maintenance. The MOMA trial was designed to compare metroCT plus bevacizumab versus bevacizumab alone as maintenance following 4 months of induction with FOLFOXIRI plus bevacizumab. Patients and methods In this phase II study, patients with unresectable mCRC were randomised to receive up to 8 cycles of FOLFOXIRI plus bevacizumab, followed by bevacizumab (arm A) or the same regimen followed by bevacizumab plus metroCT (capecitabine 500 mg/three times per day and cyclophosphamide 50 mg/die, arm B) until disease progression. The primary end-point was progression-free survival (PFS). According to the Rubinstein and Korn's design, to detect a hazard ratio[HR] of 0.75 favouring arm B, with 1 sided-alpha and beta errors of 15% and 80%, 173 events and 222 patients were required. Results Between May 2012 and March 2015, 232 patients, mostly with RAS (65%) or BRAF (9%) mutant tumours, were randomised in 16 Italian centres. At a median follow-up of 47.8 months, 210 and 164 progression and death events were registered. The primary end-point was not met. Median PFS was 10.3 and 9.4 months in arm B and A, respectively (HR: 0.94 [70% confidence interval {CI}: 0.82–1.09], p = 0.680). No significant differences were reported in terms of overall survival (OS) (median OS arm B/A: 22.5/28 months; HR: 1.16 [95%CI: 0.99–1.37], p = 0.336). Response rate with FOLFOXIRI plus bevacizumab was 63% (arm B/A: 58%/68%). In the liver-limited subgroup, the secondary resection rate was 49% (arm B/A: 45%/55%). Conclusions The addition of metroCT to maintenance with bevacizumab does not significantly improve PFS of mCRC patients. The activity of FOLFOXIRI plus bevacizumab is confirmed in a population with high prevalence of RAS/BRAF mutations treated with a 4-months induction. Trial registration www.clinicaltrials.gov NCT02271464. Highlights • The addition of metronomic chemotherapy to bevacizumab (bev) during maintenance does not significantly improve PFS. • 5FU/bev is the standard maintenance following upfront FOLFOXIRI/bev. • The activity of FOLFOXIRI/bev is confirmed with 4 instead of 6 months duration. • Results among BRAF mutants are consistent with previous findings with FOLFOXIRI/bev. [ABSTRACT FROM AUTHOR]

• A mephedrone-related acute toxicity case. • Chemsex: misuse of mephedrone in a sexual context. • Effects of mephedrone similar to those of cocaine, amphetamines, and metamphetamines. • Mephedrone cross-reacts with methamphetamine screening tests. The chemsex or slamsex phenomenon has attracted attention worldwide, with concerns also expressed by health professionals for the spread of sexually transmitted diseases. Mephedrone or 4-methylmethcathinone, a substituted cathinone homolog of ephedrine, is one of the most popular substances used as a cheaper alternative to other traditional drugs. Fatal cases of chemsex are still rare. We present here the first case-report to the best of our knowledge of a mephedrone-related acute toxicity case in Parma (Italy) detected and quantitated in biological specimens (2.0 mg/L in urine sample, 1.1 mg/L in bile and 1.0 mg/L in central blood while 0.8 mg/L in peripheral blood). None of the other most common drugs of abuse could be detected. Autopsy findings such as facies edematosa, oedema and polyvisceral congestion, interstitial petechiae are compatible elements with a death from acute cardio-respiratory failure, with peri-mortem agony of few minutes in which the cardiac hypertrophy, the moderate aortocoronary sclerosis and mephedrone injection have played a substantial role in the evaluation of the final cause due to an accidental acute intoxication with mephedrone. [ABSTRACT FROM AUTHOR]