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Background: Botulism is a rare and life-threatening disease caused by the potent botulinum neurotoxin (BoNT), which can be produced by Clostridium botulinum (C. botulinum) and related bacteria. Clinical manifestations, which include a symmetrical, descending muscular paralysis, generalized hypotonia, and potentially respiratory failure, are non-specific and diagnosis is challenging, especially when anamnesis does not reveal any typical risk factor, like honey consumption., Case Presentation: We present what is, to the best of our knowledge, the first documented case of infant botulism (IB) in Sicily and discuss its peculiarities and the challenges faced in the diagnostic-therapeutic process. The infant was exclusively breastfed and no history of consumption of possibly contaminated foods, like honey, was found. The signs observed at presentation included poor suction, hypotonia, and hyporeactivity. A detailed anamnesis motivated the suspicion of botulism, due to the occurrence of constipation and exposure to dust from home renovation works during the days before the onset of symptoms. The botulinum antitoxin was administered and the diagnosis was confirmed through fecal examination, detecting toxin-producing C. botulinum., Conclusion: IB should be considered in every infant with rapidly progressing hypotonia and a history of constipation. However rarely, transmission could occur through inhalation of dust particles containing the toxin, therefore it is important to explore all possible sources of exposure. In the case described, timely diagnosis and treatment determined the successful outcome, which highlights the importance of early intervention in managing IB., (© 2024. The Author(s).)

After disruption in the influenza circulation due to the emergence of SARS-CoV-2, the intensity of seasonal outbreaks has returned to the pre-pandemic levels. This study aimed to evaluate the evolution and variability of whole-genome sequences of A(H1N1)pdm09, the predominant influenza virus in Sicily (Italy) during the season 2023-2024. The potential vaccine efficacy was calculated using the p epitope model based on amino acid changes in the dominant epitope of hemagglutinin. The HA gene sequences showed several amino acid substitutions, some of which were within the major antigenic sites. The phylogenetic analysis showed that Sicilian strains grouped into two main genetic clades (6B.1A.5a.2a.1 and 6B.1A.5a.2a) and several subclades. Notably, about 40% of sequences partially drifted from the WHO-recommended vaccine strain A/Victoria/4897/2022 for the Northern Hemisphere. These sequences mostly belonged to the subclades C.1.8 and C.1.9 and harboured the amino acid mutations responsible for the modest predicted vaccine efficacy (E = 38.12% of 53%, p epitope = 0) against these viruses. Amino acid substitutions in other gene segments were also found. Since influenza viruses are constantly evolving, genomic surveillance is crucial in monitoring their molecular evolution and the occurrence of genetic and antigenic changes, and, thus, their potential impact on vaccine efficacy.

Background: Refugees and migrants may represent the most vulnerable communities in many societies. Health systems should be sensitive to needs of refugees and migrants. The document "The Refugee and Migrant Health: Global Competency Standards for Health Workers (the Standards )" identifies the competencies and areas of practice of health workers working with refugees and migrants. The aim of this study is to provide an analysis of these competences and training needs, identifying the educational priorities for the implementation of the Standards in Sicily, Italy., Methods: A cross-sectional analytical pilot study was conducted by administering a questionnaire, in electronic format "Google Form ®," to doctors attending the Medical Training Course for General Practitioners in Sicily (Italy). Data obtained were collected in a Microsoft Excel database and analyzed with IBM SPSS Software 24 version. Absolute and relative frequencies were calculated for relevant categorical variables. Univariate analysis of the selected variables was subsequently carried out. The significance level chosen was a p value <0.05 (two-tailed)., Results: A total of 192 General Practitioner (GP) trainees responded to the questionnaire. They were asked if their training course comprised a Global Health Course that included the topic of health protection and social and health care for migrant populations and the 65.4% of them answered "No" or "Do not Know." GP trainees were also asked if they considered useful to include a Global Health Course dedicated to the management of patients with a migratory background within the training course in general medicine. Of the total 192 participants, 81.9% answered "Yes." Overall, in a simple regression model, the perception of having addressed migrants' health needs is positively correlated with having attended a Global Health Course (OR = 3.34 95%CI 1.2-9.1; p  = 0.018)., Conclusion: This study identified educational priorities for the implementation of the Standards in Sicily for doctors attending the Medical Training Course for General Practitioners. We hope that the results of this study will guide and inform possible future projects to implement the Standards at a national level., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Cimino, Pirrello, Casuccio, Costantino, Graci, Piazza and Immordino.)

The loss of one of the two copies of the 9 bp tandem repeat sequence (CCCCCTCTA) located in the small non-coding region between the cytochrome oxidase II (COII) and the lysine tRNA genes in human mtDNA has been reported to be polymorphic in Asian, Oceanian and Sub-Saharan African populations, but it has rarely been observed in Europe. In this study, we will evaluate the possible association between the MIC9D polymorphism and cognitive disorders. A genetic analysis of unrelated Sicilian patients with cognitive deficits was performed to identify the 9 bp deletion MIC9D polymorphism. The MIC9D polymorphism was found in six patients, whereas this variant was absent in control individuals without cognitive deficits. The patients with the MIC9D polymorphism exhibited more complex clinical presentations; in particular, all had neuromuscular disorders and five also presented with behavioral disorders. The present study suggests a potential association between the MIC9D polymorphism and cognitive impairment with concurrent neuromuscular and behavioral involvement.

The island of Sicily is considered to be among the first occupied by humans in the European Upper Paleolithic. Studies to understand early occupation of the island are mostly concentrated on the northern shores. Our project, Early Occupation of Sicily (EOS), focuses on southeastern Sicily so to address questions regarding dispersal to Mediterranean islands and Late Pleistocene landscapes and environments. Here, we present the initial results of our terrestrial and underwater surveys in combination with archival work and analyses of museum collections. In SE Sicily very few Upper Paleolithic sites have been excavated and analyzed using scientific methods. We have relocated and assessed ~20 caves and rock shelters identified between the 1870s and 1990s, studied museum collections, and collected raw material to reconstruct procurement patterns. To identify new sites, we conducted land and underwater surveys to reconstruct paleo-shorelines and past environments. We have identified three sites, two on land and one partially submerged, that still contain unexplored archaeological sediments, demonstrated in one instance through seismic tomography. This work shows the potential of re-examining minimally studied sites and materials to reconstruct mobility patterns and environmental impact of the first inhabitants of the island., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Patania et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Nuclear magnetic resonance (NMR) metabolomic analysis was applied to investigate the differences within nineteen Sicilian Nocellara del Belice monovarietal extra virgin olive oils (EVOOs), grown in two zones that are different in altitude and soil composition. Several classes of endogenous olive oil metabolites were quantified through a nuclear magnetic resonance (NMR) three-experiment protocol coupled with a yet-developed data-processing called MARA-NMR (Multiple Assignment Recovered Analysis by Nuclear Magnetic Resonance). This method, taking around one-hour of experimental time per sample, faces the possible quantification of different class of compounds at different concentration ranges, which would require at least three alternative traditional methods. NMR results were compared with the data of traditional analytical methods to quantify free fatty acidity (FFA), fatty acid methyl esters (FAMEs), and total phenol content. The presented NMR methodology is compared with traditional analytical practices, and its consistency is also tested through slightly different data treatment. Despite the rich literature about the NMR of EVOOs, the paper points out that there are still several advances potentially improving this general analysis and overcoming the other cumbersome and multi-device analytical strategies. Monovarietal EVOO's composition is mainly affected by pedoclimatic conditions, in turn relying upon the nutritional properties, quality, and authenticity. Data collection, analysis, and statistical processing are discussed, touching on the important issues related to the climate changes in Sicily and to the specific influence of pedoclimatic conditions.

This study aimed to determine 16 mineral elements (Cd, Pb, As, Na, Mg, Al, Ca, K, Cr, Mn, Fe, Ni, Cu, Zn and Se) using inductively coupled plasma mass spectrometry (ICP-MS) and a direct mercury analyzer (DMA-80) for Hg evaluation. Aflatoxin M1 was determined by high-performance liquid chromatography with fluorescence detection (HPLC-FLD) in cow milk samples. This research considered 180 milk samples, 20 by province (Palermo, Catania, Messina), collected for a period of three years (2020-2022) to assess the potential risks for consumer, the safety status and nutritional quality related to mineral intake by consuming of milk. All samples showed a Pb concentration below the limit reported by European Regulation 915/2023. Cadmium and Hg concentrations were below the Limit Of Quantification (LOQ) in all samples analyzed. The milk samples analyzed proved to be a good source of Ca (up to 44.5 % of the dietary reference values), with well percentages also for Na (up to 7.6 %), K (up to 23.1 %) and Mg (up to 11.1 %). Regarding trace elements, the results reported that chromium requires attention; its value was always higher than 168.8 % in all samples analyzed. Levels of arsenic and lead were up to 20.2 % and up 7.1 % respectively. Aflatoxin M1 concentrations were below the limit of detection (< 0,009 mcg/kg) in all milk analyzed. Therefore, further studies are needed to safeguard consumer health, the quality of the product and to assess the state of animal health., Competing Interests: Declaration of Competing Interest All authors declare that there are no conflicts of interest in the development, drafting and publication of the following manuscript., (Copyright © 2024. Published by Elsevier GmbH.)

Jacobaea is a small genus of plants belonging to Asteraceae family, formerly joint to Senecio genus, that includes more than 60 species and sub-species. Several taxa of this genus have been extensively studied both for their non-volatile and volatile metabolites. In the present study the chemical composition of the essential oil (EO) from aerial parts of Jacobaea delphiniifolia (Vahl) Pelser & Veldkamp, collected in Sicily, was analyzed by GC-MS. No one report has been previously published on the EO of this species. The result showed the presence of a large quantity of two metabolites, namely 1-undecene (63.57%) and thymol methyl ether (13.65%). Chemotaxonomic considerations were carried out by comparing the other oils of Jacobaea taxa studied so far.

In this work the mucilage obtained from the cladodes of a not previously investigated accession of Opuntia stricta (Haw.) Haw. (syn. Opuntia dillenii (Ker-Gawl) Haw), collected in Sicily, was analysed by 13 C-NMR. The yield of mucilage extracted from cladodes in aqueous medium was 2.55%. The monosaccharides identified, after acidic hydrolyses of the mucilage, were arabinose (36.48%), galactose (32.31%), xylose (15.33%), glucose (10.45%) and rhamnose (5.40%). The mucilage showed a sufficient antimicrobial activity and excellent antioxidant property.

A geometric morphometric analysis was performed on the right wing of adult Calliphora vicina (Robineau-Desvoidy) collected across 4 altitudinal levels in Sicily. The objective of this study was to assess differences in shape and centroid size (CS) between females and males and across elevations. The wings analyzed in this study were removed from adults of C. vicina collected with baited traps at 20, 700, 1,153, and 1,552; for this study, 19 landmarks were identified in each wing. The coordinates of the landmarks were aligned and superimposed to prevent variations due to position, orientation, and scale; they were then scaled to the same CS and recentered. CS and Procrustes differences were, respectively, used to assess variations in size and shape. Significant differences were observed in wing shape between males and females but not between all altitudinal levels. Female wings were found to be significantly larger than males (P < 0.01). Wings of flies collected at the highest altitudinal level resulted in significantly larger wings than those collected at lower altitudes (P < 0.001), with CS values ranging from 12.1 to 14.1. Variation in wing shape can impact thermal regulation, and therefore, oxygen content, temperature, atmospheric pressure, and solar radiation can have an effect on an insect's body and activity levels. At high elevations and lower temperatures, larger wings could mean less energy expenditure when flying to increase body temperature., (© The Author(s) 2024. Published by Oxford University Press on behalf of Entomological Society of America.)

A retrospective study was carried out on selected feline viral pathogens detected in domestic cat in Sicily, southern Italy. Samples from 64 cats, collected from 2020 to 2022, were analysed for the presence of feline panleukopenia virus, canine parvovirus type 2 (CPV-2), feline coronavirus (FCoV), feline calicivirus (FCV), feline herpesvirus type 1, norovirus (NoV), and rotavirus (RoV). Single (45 %) or mixed (38 %) viral infections were detected. FPV, related with other Italian FPV strains, remains the main viral cause of infection (66 %). CPV-2c Asian lineage strains (3 %) were detected for the first time in domestic cats in Europe. FCoV (29.6 %), either enteric or systemic, and systemic FCV (18.7 %) infections were detected in positive cats. Less commonly reported viruses (GIV.2/GVI.2 NoVs, RoV), potentially related to the animal/human interface, were detected at lower rates as well (5 %). The present epidemiological data suggest the need to improve disease prevention, immunization, and biosecurity strategies., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Lampedusa, a picturesque Italian island in the Mediterranean, serves as a gateway for migrants from Africa and Asia to Europe. Despite populist rhetoric portraying migrants as carriers of disease, epidemiological data reveal very low levels of communicable diseases among migrants, challenging false narratives and xenophobic sentiments propagated by populist governments., Competing Interests: Declaration of interests I declare that I have no conflicts of interest. Although the content of this article closely relates to European politics and the work of Pietro Bartolo, MD, a Member of the European Parliament from the Italian centre-left Democratic Party [Partito Democratico (PD)], I maintain no personal, professional, or financial ties to Dr. Bartolo or any individuals associated with the PD or its supporters., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

Animal welfare has become an increasingly important concern regarding equids working as carriage animals. In the present study, the changes in the markers of stress and inflammatory responses as a result of the work performed by tourism carriage horses under real working conditions in Sicily (Italy) were investigated. Twenty-two Standardbreds performed a normal working day in the carriage tourism business during the months of May, June and July 2022, consisting of one day of work for each month. Blood samples were collected in the stables at rest before the tour route (Pre; 07.00 AM) and within 10 min after the end of the workday (Post; 05.00 PM). Haematological parameters, serum concentration of cortisol, total proteins together with the globulin fractions were investigated before and after the carriage work. Environmental temperature, relative humidity and temperature humidity index (THI) were also assessed. The direct erythrocyte indices increased after work compared to rest condition (P < 0.05). The values of cortisol, total proteins and globulins were not affected by carriage work (P > 0.05), while, higher cortisol, total proteins, α1- and α2-globulins values were observed in July compared to May and June (P < 0.05). These changes are probably due to the increase in THI values which showed mild stress in June and high stress in July. This study suggests that the tourism carriage horses herein investigated have adapted to their work activity, however, avoiding working horses during the hottest hours of the day in the summer months is advocated., Competing Interests: Declaration of competing interest The authors declare no competing interests. None of the authors has any financial or personal relationships that could inappropriately influence or bias the content of the paper., (Copyright © 2024. Published by Elsevier Inc.)

The 4th Italian Zebrafish Meeting took place in Palermo from February 7 to 9, 2024. The primary aim of this meeting was to bring together a diverse group of principal investigators, young researchers, facility managers, commercial vendors, and others to provide an important forum for presentation and discussion of the most innovative and exciting scientific research currently ongoing in Italy using the zebrafish model. Nonetheless, the meeting program has been conceived to allow the dissemination of cutting-edge scientific research across a wide range of topics and to shed light on its future directions, without geographical boundaries. Indeed, people from various parts of the world joined the meeting, and 210 participants presented their latest work in talks and posters. Importantly, the meeting had designated time to foster open scientific exchange and informal networking opportunities among participants of all career stages, thus allowing initiation of new collaborations and strengthening of existing partnerships. The meeting was a tremendous success as testified by the highest participation ever since the first meeting of the series in 2017, coupled with the highly positive satisfaction rating expressed by the attendants. The full program and detailed information about the meeting can be found on the dedicated website at https://itazebrafishmeeting.wixsite.com/izm2024.

In this study, 327 presumptive lactic acid bacteria (LAB) were isolated from goats' milk acid curds produced at a Sicilian dairy farm with the aim to identify potential starter cultures for traditional cheeses. All isolates were first processed by randomly amplified polymorphic DNA (RAPD)-PCR analysis. This approach identified 63 distinct strains which were evaluated for their acidifying capacity. Only 15 strains specifically stood out for their acidification capacity and were identified through 16S rRNA gene sequencing as Lactococcus lactis (11 strains) Enterococcus faecalis (three strains), and Ligilactobacillus animalis (one strain). Notably, all 15 LAB isolates produced bacteriocin-like inhibitory substances and anti-biofilm compounds, against both planktonic and biofilm forms of Listeria monocytogenes, Salmonella Enteritidis, Escherichia coli, and Staphylococcus aureus, albeit at varying levels. Among these 15 LAB, En. faecalis RGM25 and Lc. lactis RGM55, susceptible to five antibiotics tested, were put in contact with wooden vat prototypes, because all equipment used in traditional cheese production in Sicily are made of wood. Scanning electron microscopy and bacterial plate counts of the wooden vat prototypes showed the development of biofilms at levels of approximately 6.0 log CFU/cm 2 . Overall, this study contributes to establishing a custom-made LAB starter cultures with bio-preservatives properties for Sicilian cheese productions., Competing Interests: Declaration of competing interest The authors declare that there is no conflict of interest for this research., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Influenza represents a serious public health threat, especially for the management of severe cases and complications of the disease, requiring the implementation of control measures. We aimed to assess the acceptance and impact of qLAIV vaccination among a representative sample of family paediatricians (FPs) operating in Palermo Local Health Authority (LHA). To this end we evaluated vaccination coverage rates, comparing it with that observed in Sicilian context, while actively monitoring possible adverse reactions and their severity., Methods: An observational descriptive non-controlled study was conducted in two phases, from September 2022 to June 2023. The first phase involved a formative and educational intervention with a pre-intervention questionnaire to assess the knowledge and attitudes of FPs on paediatric influenza vaccination. The second phase consisted of an active surveillance on qLAIV safety and acceptance among the paediatric population assisted by the participating FPs, from October 2022 to April 2023. Frequencies, chi-squared tests, and comparisons statistics were performed using Stata/MP 14.1., Results: The overall coverage rate among the paediatric population involved in the intervention was 13.2%, with an I.M./qLAIV ratio of vaccine administered of 1/4.25. This coverage rate was significantly higher (p-value <0.001) when compared to the average values reported in the population under the Palermo Local Health Authority (LHA) (6.7%) and in the entire Sicily (5.9%). Adverse events in the qLAIV group were mild, with only 3.3% experiencing them, primarily presenting as a feverish rise (3.2%). No severe adverse reaction was reported., Conclusions: The educational intervention significantly raised paediatric influenza vaccination rates among the participating FPs, and in general improved influenza vaccination coverage rates in the Palermo's LHU. Minimal, non-serious adverse events underscored the vaccine's safety. Training sessions ensured paediatricians stayed informed, enabling them to provide comprehensive information to parents for secure and informed vaccination decisions in their practices., (© 2024. The Author(s).)

This paper describes the experience carried out in a general hospital, implemented in collaboration with a city network of associations involved in the care of migrant populations. Considering the vulnerability of these populations, the difficulty of access to healthcare facilities, and the linguistic and cultural barriers, an organisational model was designed characterised by the concentration of highly complex care (hub centre) supported by a network of peripheral reception centres (spoke centres) responsible for selecting patients and sending them to the centre of reference with the aim of offering screening for sexually transmitted infections, tuberculosis, taking charge of pathologies, including non-infectious ones, treatment, and follow-up. The effectiveness of the model was measured in relation to the continuum of care and its effectiveness with reference to the Joint Commission International guidelines.

The health of humans, animals and the environment is interconnected. Adopting a One Health approach means intervening promptly to prevent the main diseases that affect animal health to guarantee the safety of livestock production. Exposure to toxic trace elements in sheep can lead to increased accumulation in different biological substrate, developing both acute and chronic diseases in humans and livestock. The aim of this study was to evaluate the bioaccumulation of arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg) in Sicilian Barbaresca sheep using the following biological substrates: milk, blood and fleece. An inductively coupled plasma mass spectrometer (ICP-MS) was used for As, Cd and Pb, and a direct mercury analyser (DMA-80) was used for Hg determination. In addition, the role of the haematological parameters as possible indicators of different biodistribution was evaluated. A statistically significant value was observed from our analysed metals in the substrates: arsenic (p < 0.001), cadmium (p < 0.01), lead (p < 0.001) and mercury (p < 0.0001). The correlation analysis showed a relationship between milk and blood for arsenic (p < 0.0001) and lead (p < 0.0001), and no correlation for the metals was observed between milk/blood and the haematological parameters analysed for the low concentration observed in the present study comforting the final consumer., (© 2024. The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature.)

Background: In the hospital environment, any liability for organizational inadequacy and/or inefficiency, or again for defects in the facilities, or inadequacy of health equipment may be found in the work of the apex professional figures: Medical Director, the General Manager, and/or others. The responsibility for the internal organization of the department falls on the figure of the Director of the Complex Structure where the deficiencies have not been promptly and adequately reported to the top figures., Case Report: A woman 61-year-old, was admitted on a voluntary basis to the Department of Psychiatry. On the third day, in the early morning hours, the patient was found on the ground floor, lying on the floor near the entrance door of the ward with a lacerated contusion wound to the head. The woman underwent total body CT examination with findings of fractured polytrauma as well as subarachnoid hemorrhage and complete fracture of the spleen, which was surgically removed. Three days later, despite the care given, death occurred. The injuries ascertained were consistent with voluntary precipitation from the second-floor stairwell window. The investigations conducted by the police and the checks carried out by the head of the Internal Prevention and Protection Service and the company's Risk Manager, highlighted multiple critical issues., Conclusion: The case allows for numerous considerations relating to liability profiles in the determinism of the patient's death, the hospital's company failure to implement measures to prevent the patient's suicide in the hospital was influential.

Horses are excellent bioindicators for the assessment of environmental pollution. The aim of this study was to evaluate the levels and potential bioaccumulation of 28 mineral elements in 75 horse whole blood samples collected from five pollution-prone areas of Sicily, Italy. A direct mercury analyzer (DMA-80) was used for Hg determination, and an inductively coupled plasma mass spectrometer (ICP-MS) for all other elements. A one-way ANOVA test, followed by Bonferroni's multiple comparison for post hoc comparison, was applied to assess statistically significant differences between mineral elements and the five experimental groups. The levels of mineral elements in hay and concentrate were below the limits set by Regulation No. 744/2012. The mineral content of whole blood samples was slightly influenced by the region of origin of the horse. p values < 0.05 were statistically meaningful. However, the concentrations of mineral elements in horses' whole blood remained within reference ranges. In conclusion, the present study shows that the mineral content does not represent a toxicological risk for the analyzed horses. In addition, the study areas did not appear to show a high mineral element contamination., (© 2023. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

This study presents the first data on REY (Rare Earth Elements plus Yttrium) in the aquifer of Mount Etna (Sicily, Italy). Patterns normalized to chondrites indicate strong water-rock interaction, facilitated by a slightly acidic pH resulting from the dissolution of magma-derived CO 2 . REY patterns provide insights into the processes of both mineral dissolution and the formation of secondary phases. The relative abundance of light to heavy rare earth elements is compatible with the prevailing dissolution of ferromagnesian minerals (e.g., olivine or clinopyroxenes), reinforced by its strong correlation with other proxies of mineral dissolution (e.g., Mg contents). Pronounced negative Ce anomalies and positive Y anomalies demonstrate an oxidizing environment with continuous formation of secondary iron and/or manganese oxides and hydroxides. The Y/Ho fractionation is strongly influenced by metal complexation with bicarbonate complexes, a common process in C-rich waters. In the studied system, the measured REY contents are always below the limits proposed by Sneller et al. (2000, RIVM report, Issue 601,501, p. 66) for surface water and ensure a very low daily intake from drinking water., (© 2024. The Author(s).)

July 2023 has been confirmed as Earth's hottest month on record, and it was characterized by extraordinary heatwaves across southern Europe. Field data collected under real heatwave periods could add important evidence to understand human adaptability to extreme heat. However, field studies on human physiological responses to heatwave periods remain limited. We performed field thermo-physiological measurements in a healthy 37-years male undergoing resting and physical activity in an outdoor environment in the capital of Sicily, Palermo, during (July 21; highest level of local heat-health alert) and following (August 10; lowest level of local heat-health alert) the peak of Sicily's July 2023 heatwave. Results indicated that ~40 min of outdoor walking and light running in 33.8°C Wet Bulb Globe Temperature (WBGT) conditions (July 21) resulted in significant physiological stress (i.e., peak heart rate: 209 bpm; core temperature: 39.13°C; mean skin temperature: 37.2°C; whole-body sweat losses: 1.7 kg). Importantly, significant physiological stress was also observed during less severe heat conditions (August 10; WBGT: 29.1°C; peak heart rate: 190 bpm; core temperature: 38.48°C; whole-body sweat losses: 2 kg). These observations highlight the physiological strain that current heatwave conditions pose on healthy young individuals. This ecologically-valid empirical evidence could inform more accurate heat-health planning., (© 2024 The Author(s). Physiological Reports published by Wiley Periodicals LLC on behalf of The Physiological Society and the American Physiological Society.)

Citrus fruits are a diverse and economically important group of fruit crops known for their distinctive flavors and high nutritional value. Their cultivation and consumption contribute significantly to the global agricultural economy and offer a wide range of health benefits. Among the genetic diversity of citrus species, Citrus x limon (L.) Osbeck is particularly relevant due to its chemical composition and potential health benefits. Two cultivars from the Sicily region (southern Italy) were compared for their phenolic content and preliminary antioxidant activity to select the distinctive extract with potential biological activity. A detailed characterization revealed the occurrence of phenolics, coumarins, and flavonoids. The quantification of metabolites contained in the selected extract was performed by an ultrahigh-performance liquid chromatographic method coupled with an ultraviolet detector. Different concentrations were tested in vivo through the fish embryo acute toxicity test, and the 50% lethal dose of 107,833 µg mL -1 was calculated. Finally, the effect of the extract on hatching was evaluated, and a dose-dependent relationship with the accelerated hatching rate was reported, suggesting a Femminello Zagara Bianca green peel upregulating effect on the hatching enzymes. PRACTICAL APPLICATION: Citrus fruits and their products continue to be one of the natural food sources with the highest waste output. In this study, we demonstrate how food industry waste, particularly lemon peel, is rich in bioactive compounds with anti-inflammatory and antioxidant properties that may be used in the nutraceuticals industry., (© 2024 Institute of Food Technologists.)

The genus Tordylium L. (Apiaceae) is distributed in almost all the countries bordering the Mediterranean. They are plants widely used in ethnomedicine in various countries, especially in the Eastern part of Mediterranean, and, furthermore largely used as food. Consequently, in order to evaluate not only the chemical aspects but also the biological properties, the essential oil (EO), obtained from the Sicilian accession of Tordilym apulum L., not previously studied, were investigated. The chemical composition of the essential oil, obtained by classical hydrodistillation and GC-MS analysis, showed the occurrence of large amount of monoterpene hydrocarbons (68.8%) containing huge quantity of β - cis -ocimene (65.0%). The second most abundant metabolite was octyl hexanoate (14.4%), that can be considered a marker of genus Tordylium . ROS levels and the activity of antioxidant enzymes SOD and CAT on normal and OZ-stressed PMNs were measured in order to study the effects of EO of T. apulum .

Previous to this study, there is no data relating to the reproductive physiology of the Cirneco dell'Etna breed. The birth date of 141 bitches and 104 sires registered at the National Agency of the Italian Kennel Club (ENCI) from all Sicilian breeders, and data related their fertile matings, which produced 266 whelps over a 14-year period, (2009-2022) were collected. Total whelping produced 1069 pups. The mean bitch age at first whelping was 39.13 ± 21.7 months and the mean litter size was 3.84 ± 2.08. The birth period of the bitches and sires was significantly influenced by the month of the year ( p  < 0.01), as was the distribution of the first ( p  < 0.05) and subsequent whelping periods ( p  < 0.01). Whelping distributions show a significant difference between the highest peak in April (which roughly corresponds to a period of heat in February) and in July (which roughly corresponds to a period of heat in May) and the lowest peak in March. No influence of month on litter size and sex ratio was found. Available data suggests that some ancient breeds such as the Cirneco dell'Etna may show seasonal patterns as a vestige of the stricter seasonality of its closest relative the wolf.

The genus Brassica is an important source of food in the Mediterranean diet with documented nutritional and medicinal properties. However, few studies have investigated the phytochemical composition and the biological activity of wild Sicilian taxa. Thus, we aimed to study the chemical profile and the antioxidant potential, in vitro and in LPS-stimulated RAW 264.7 cells, of a methanolic extract of leaves of wild Brassica macrocarpa Guss ( B. macrocarpa ) (Egadi Islands; Sicily-Italy). B. macrocarpa methanolic extract showed a large amount of glucosinolates and different phenolic compounds. It exhibited antioxidant activity in the DPPH assay and in LPS-stimulated RAW 264.7 cells, being able to reduce NO and ROS levels and NOS2 mRNA expression. Our study demonstrated that Sicilian B. macrocarpa methanolic extract, in LPS-stimulated macrophages, efficiently counteracts oxidative stress and displays radical scavenging activity. Future studies are required to identify the contribution of the single phytocomponents, to characterize the action mechanism, and to reveal possible applications in human health.

Monitoring the genetic variability of human respiratory syncytial virus (hRSV) is of paramount importance, especially for the potential implication of key antigenic mutations on the emergence of immune escape variants. Thus, to describe the genetic diversity and evolutionary dynamics of hRSV circulating in Sicily (Italy), a total of 153 hRSV whole-genome sequences collected from 770 hRSV-positive subjects between 2017 and 2023, before the introduction of expanded immunization programs into the population, were investigated. The phylogenetic analyses indicated that the genotypes GA.2.3.5 (ON1) for hRSV-A and GB.5.0.5a (BA9) for hRSV-B co-circulated in our region. Amino acid (AA) substitutions in the surface and internal proteins were evaluated, including the F protein antigenic sites, as the major targets of immunoprophylactic monoclonal antibodies and vaccines. Overall, the proportion of AA changes ranged between 1.5% and 22.6% among hRSV-A, whereas hRSV-B varied in the range 0.8-16.9%; the latter was more polymorphic than hRSV-A within the key antigenic sites. No AA substitutions were found at site III of both subgroups. Although several non-synonymous mutations were found, none of the polymorphisms known to potentially affect the efficacy of current preventive measures were documented. These findings provide new insights into the global hRSV molecular epidemiology and highlight the importance of defining a baseline genomic picture to monitor for future changes that might be induced by the selective pressures of immunological preventive measures, which will soon become widely available.

This study was aimed at investigating the phytochemical profile and bioactivity of Diplotaxis harra subsp. crassifolia (Brassicaceae), a species from central-southern Sicily (Italy), where it is consumed as a salad. For this purpose, LC-ESI/HRMS n analysis of the ethanolic extract was performed, highlighting the occurrence, along with flavonoids, hydroxycinnamic acid derivatives, and oxylipins, of sulfated secondary metabolites, including glucosinolates and various sulfooxy derivatives (e.g., C13 nor-isoprenoids, hydroxyphenyl, and hydroxybenzoic acid derivatives), most of which were never reported before in the Brassicaeae family or in the Diplotaxis genus. Following ethnomedicinal information regarding this species used for the treatment of various pathologies such as diabetes and hypercholesterolemia, D. harra ethanolic extract was evaluated for its antioxidant potential using different in vitro tests such as 2,2-diphenyl-1-picrylhydrazyl, 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid), Ferric Reducing Ability Power, and β -carotene bleaching tests. The inhibitory activity of carbohydrate-hydrolyzing enzymes (α-amylase and α-glucosidase) and pancreatic lipase was also assessed. In the 2,2'-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid assay, an IC 50 value comparable to the positive control ascorbic acid (2.87 vs. 1.70 μg/mL, respectively) was obtained. The wild-wall rocket salad extract showed a significant α-amylase inhibitory effect. Obtained results indicate that Sicilian wild-wall rocket contains phytochemicals that can prevent hyperglycemia, hyperlipidemia, and obesity.

The genus Phagnalon Cass., included in the Asteraceae family, has a wide distribution, expanding from Macaronesia in the West to the Himalayas in the East, from South France and Nord Italy to Ethiopia and Arabian Peninsula. Various species of Phagnalon have been used in the popular medicine of several countries as medicinal herbs and food. The extracts and the secondary metabolites, have a varied application spectrum at several biological levels, with antimicrobial, antioxidant, antidiabetic, antitumor, etc. properties having been reported. The essential oils of four taxa, Phagnalon rupestre , Phagnalon saxatile var. viride , and Phagnalon rupestre subsp. illyricum var. metlesicsii collected in Sicily (Italy), never previously investigated, and of Phagnalon graecum collected in Greece, were analysed by gas chromatography-mass spectrometry (GC-MS). All the oils were very rich in monoterpene hydrocarbons, with β -pinene as main constituent. Chemotaxonomic considerations with respect to all the other oils of Phagnalon taxa were carried out.

Background: Carnitine palmitoyltransferase II (CPT II) deficiency is a rare inborn error of mitochondrial fatty acid metabolism with autosomal recessive pattern of inheritance. Its phenotype is highly variable (neonatal, infantile, and adult onset) on the base of mutations of the CPT II gene. In affected subjects, long-chain acylcarnitines cannot be subdivided into carnitine and acyl-CoA, leading to their toxic accumulation in different organs. Neonatal form is the most severe, and all the reported patients died within a few days to 6 months after birth. Hereby, we report on a male late-preterm newborn who presented refractory cardiac arrhythmias and acute multiorgan (hepatic, renal, muscular) injury, leading to cerebral hemorrhage, hydrocephalus, cardiovascular failure and early (day 5 of life) to death. Subsequently, extended metabolic screening and target next generation sequencing (NGS) analysis allowed the CPT II deficiency diagnosis., Case Presentation: The male proband was born at 36 + 4 weeks of gestation by spontaneous vaginal delivery. Parents were healthy and nonconsanguineous, although both coming from Nigeria. Family history was unremarkable. Apgar score was 9/9. At birth, anthropometric measures were as follows: weight 2850 g (47th centile, -0.07 standard deviations, SD), length 50 cm (81st centile, + 0.89 SD) and occipitofrontal circumference (OFC) 35 cm (87th centile, + 1.14 SD). On day 2 of life our newborn showed bradycardia (heart rate around 80 bpm) and hypotonia, and was then transferred to the Neonatal Intensive Care Unit (NICU). There, he subsequently manifested many episodes of ventricular tachycardia, which were treated with pharmacological (magnesium sulfate) and electrical cardioversion. Due to the critical conditions of the baby (hepatic, renal and cardiac dysfunctions) and to guarantee optimal management of the arrythmias, he was transferred to the Pediatric Cardiology Reference Center of our region (Sicily, Italy), where he died 2 days later. Thereafter, the carnitines profile evidenced by the extended metabolic screening resulted compatible with a fatty acid oxidation defect (increased levels of acylcarnitines C 16 and C 18 , and low of C 2 ); afterwards, the targeted next generation sequencing (NGS) analysis revealed the known c.680 C > T p. (Pro227Leu) homozygous missense mutation of the CPTII gene, for diagnosis of CPT II deficiency. Genetic investigations have been, then, extended to the baby's parents, who were identified as heterozygous carriers of the same variant. When we meet again the parents for genetic counseling, the mother was within the first trimester of her second pregnancy. Therefore, we offered to the couple and performed the prenatal target NGS analysis on chorionic villi sample, which did not detect any alterations, excluding thus the CPT II deficiency in their second child., Conclusions: CPTII deficiency may be suspected in newborns showing cardiac arrhythmias, associated or not with hypertrophic cardiomyopathy, polycystic kidneys, brain malformations, hepatomegaly. Its diagnosis should be even more suspected and investigated in cases of increased plasmatic levels of creatine phosphokinase and acylcarnitines in addition to kidney, heart and liver dysfunctions, as occurred in the present patient. Accurate family history, extended metabolic screening, and multidisciplinary approach are necessary for diagnosis and adequate management of affected subjects. Next generation sequencing (NGS) techniques allow the identification of the CPTII gene mutation, essential to confirm the diagnosis before or after birth, as well as to calculate the recurrence risk for family members. Our report broads the knowledge of the genetic and molecular bases of such rare disease, improving its clinical characterization, and provides useful indications for the treatment of patients., (© 2024. The Author(s).)

Background: Equine piroplasmosis is caused by two tick-borne protozoan parasites, Theileria equi and Babesia caballi,, which are clinically relevant in susceptible horses, donkeys, and mules. Moreover, equine piroplasmosis significantly constrains international trading and equestrian events. Rapidly diagnosing both parasites in carrier animals is essential for implementing effective control measures. Here, a rapid immunochromatographic test for the simultaneous detection of antibodies to T. equi and B. caballi was evaluated using samples from horses and donkeys collected in Greece, Israel, and Italy. The results were compared with an improved competitive enzyme-linked immunosorbent assay (cELISA) for detecting antibodies to both parasites using the same panel of samples., Methods: Blood samples were collected from 255 horses and donkeys. The panel consisted of 129 horses sampled at four locations in northern Greece, 105 donkeys sampled at four locations in Sicily, and 21 horses sampled at two locations in Israel. The rapid test and the cELISA were performed according to the manufacturer's instructions, and the results were subjected to a statistical analysis to determine the sensitivity and specificity of both tests and their association., Results: The immunochromatographic test provided a result within 15 min and can be performed in the field, detecting both pathogens simultaneously. The overall coincidence rate between the rapid test and the cELISA for detecting antibodies against T. equi was 93% and 92.9% for B. caballi. The rapid test's sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) for T. equi were above 91.5%. Sixteen samples were positive for both parasites in the rapid test and eight in the cELISA. Either test had no significant association between T. equi and B. caballi detection. The detection rates of both parasites were significantly higher in Italy than in Greece or Israel and in donkeys than in horses. The agreement for T. equi between the results of both tests was high in Greece (93.8%) and Italy (95.2%) and moderate in Israel (76.2%). For B. caballi, the specificity and NPV of the rapid test were high (94.2% and 98.3%, respectively), although the sensitivity and PPV were moderate (69.2% and 39.1%, respectively) due to the small sample size. However, for B. caballi, the sensitivity was higher with the rapid test., Conclusions: The rapid test detected T. equi and B. caballi simultaneously in the field, potentially replacing laborious cELISA testing and is recommended for import/export purposes. The test can also be helpful for the differential diagnosis of clinical cases, since seropositivity may rule out equine piroplasmosis since it does not indicate current or active infection., (© 2024. The Author(s).)

We report the presence of Echovirus 11 (E11) in wastewater in Sicily (Southern Italy), since August 2022. Overall, the 5.4 % of sewage samples (7/130) collected in 2022 were positives for E11 and then the percentage of E11-positive sewage samples reached the value of 27.27(18/66) in the first semester of 2023. Phylogenetic analysis of VP1 sequences showed for most E11-positive samples (16/25: 64 %) close genetic correlation (98.4-99.4 % nucleotide identity) to E11 lineage 1 strains involved in recently reported severe neonatal infections., Competing Interests: Declaration of competing interest Giovanni Maurizio Giammanco reports financial support was provided by AOUP Paolo Giaccone University Hospital Palermo. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Background and Purpose: Biological monitoring of trace element horses is a well-known tool for investigating potential bioaccumulation in urbanized and industrialized geographical areas. Some biomaterials such as hoof are considered as an important indicator of environmental pollution. Hooves can store trace elements for a long time compared to blood and this represents a scientific key to long-term monitoring of exposure to environmental pollutants. In the present study, samples of equine hoof and blood were taken from an experimental group of horses living in an industrialized area of Sicily (Italy) and from a control group of horses housed in a non-industrialized area of Sicily to evaluate the bioaccumulation of different trace elements in different substrates., Methods: Hoof and blood mineral concentration of Li- Lithium, Cu- Copper, Zn- Zinc, Sr- Strontium and, Pb- Lead was processed by means of Thermo Scientific iCAP-Q ICP-MS spectrometer. Student T-test was applied to evaluate the differences between groups and substrates. Correlation analysis between substrates and hematological parameters was performed., Results: Statistical analysis showed a significant statistical difference for Li (p < 0.0001) and Pb (p < 0.0001) between blood and hoof in both groups. A statistically significant difference was observed for Li (p < 0.0001), Cu(p < 0.01), Zn (p < 0.0001) and Pb (p < 0.0001) between substrates in the experimental group. The statistical analysis showed a significant difference of blood Zn (p < 0.01) and hoof Pb (p < 0.01) concentration between groups. Our results revealed a statistically higher concentration of minerals in the blood substrate than in the hoof in both groups. Li (p < 0.0001) and Zn (p < 0.001) were positively correlated between control and experimental group in blood substrate. No correlations were found (P > .05) in hoof between groups for other elements. A positive correlation with WBC was observed in Cu concentration for hoof substrate (p < 0.02) in control group and for Zn in experimental group (p < 0.02). A positive correlation with HGB and HCT was observed for Cu hoof concentration (p < 0.02) in experimental group and PLT resulted positively correlated (p < 0.02) with Pb blood substrate in control group., Conclusions: Horses were not overexposed to these elements in the analyzed groups. The study highlights the role of a new bioaccumulation substrate such as the horse hoof identified as an analytical matrix for the monitoring of heavy metal concentrations in domestic animals., Competing Interests: Declaration of Competing Interest The authors declare that they have no conflict of interest., (Copyright © 2023 Elsevier GmbH. All rights reserved.)

Objective: This paper explores dental diseases and wear as a proxy for dietary patterns in Hellenistic-early Roman Menainon., Materials: This study includes 166 individuals (4th-1st c. BCE)., Methods: Carious lesions, dental calculus, antemortem tooth loss, and dental wear were recorded to explore male-female and adult-juvenile differences, and to position Menainon in the broader Hellenistic/early Roman world through comparisons with published data from other sites., Results: Males and females showed similar rates of dental diseases. Dental wear, in contrast, was systematically greater in males. Caries rates were high in both adults and juveniles, but adults showed more calculus. The population from Menainon had higher frequencies for calculus and carious lesions compared to contemporary Italian and Greek assemblages, and a similar frequency for antemortem tooth loss., Conclusion: Some sex-related differences in the dietary patterns of the Menainon population were visible but small. The diet of adults and juveniles must have been similar in terms of carbohydrate consumption but different with regard to protein consumption. The high frequency of carious lesions and calculus compared to other Greco-Roman sites suggests that this population must have had good access to dietary resources (protein and carbohydrates)., Significance: This paper provides insights on gender (sex-related) and age divisions in the Hellenistic/early Roman society through the exploration of food consumption in a Sicilian assemblage., Limitations: Dividing the assemblage by sex and age group reduced considerably the sample size., Suggestions for Further Research: Stable isotopes and dental microwear analyses should be used to investigate dietary patterns further., (Copyright © 2023 Elsevier Inc. All rights reserved.)

Objectives: Rotaviruses G1P[8] are epidemiologically relevant and are targeted by vaccines. The introduction of vaccines has altered rotavirus epidemiology. Hospital-based surveillance conducted in Sicily, Italy, showed a progressive decline in rotavirus prevalence since 2014, along with an increasing vaccine coverage (63.8% in 2020), and a marked decrease in circulation of G1P[8] strains. Surprisingly in 2021, G1P[8] viruses accounted for 90.5% (19/21) of rotavirus infections. This study aimed to understand if the increased activity of G1P[8]'s was related to virus-related peculiarities., Design: In 2021, 266 patients <15 years of age were hospitalized with acute gastroenteritis (AGE) and included in rotavirus surveillance. Viral proteins (VP7 and VP4) genotyping and sequence data were generated from all rotavirus-positive samples. The genetic makeup of G1P[8] rotaviruses was investigated by full-genome sequencing., Results: Peculiar G1P[8] rotaviruses, with VP7 and VP4 belonging to novel sub-lineages, circulated in 2021, accounting for 76.2% (16/21) of all rotavirus infections. On full-genome analysis, the novel G1P[8] variant displayed an intra-genotype (Wa-like) reassortant constellation, involving G12 and G1 strains, into a unique arrangement never observed before. The novel G1P[8] variant showed peculiar amino acid substitutions in 8-1 and 8-3 epitopes of the VP4 with respect to the Rotarix strain., Conclusions: Prompt identification of virus variants circulating in the human population is pivotal to understanding epidemiological trends and assessing vaccine efficacy., Competing Interests: Declaration of competing interest The authors declare no conflict of interest., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Embia minapalumboi n. sp., a new species of the genus Embia Latreille, 1925, was collected during an excursion in the Madonie Regional Natural Park that took place at the conclusion of the XXVII Italian National Congress of Entomology celebrated in Palermo from 12 to 16 June 2023. In the location of discovery, at an elevation of just under 1400 m and therefore unusual for European Embioptera, the new species was found to be very rare and for this reason most of the few juvenile specimens found were kept in breeding by the author. The new species was compared with all 36 species known to date for the genus and in particular with the 21 species from the Mediterranean area and the 8 known from Europe. The author also presents the general distribution of all species of the genus. Embia tyrrhenica, Stefani, 1953 is also reported for the Madonie and reconfirmed for Sicily.

A previously undocumented shallow water hydrothermal field from Sicily (Southern Tyrrhenian Sea, Italy) is here described, based on a multidisciplinary investigation. The field, covering an area of nearly 8000 m2 and a depth from the surface to -5 m, was explored in June 2021 to characterise the main physico-chemical features of the water column, describe the bottom topography and features, and identify the main megabenthic and nektonic species. Twenty sites were investigated to characterise the carbonate system. Values of pH ranged between 7.84 and 8.04, ΩCa between 3.68 and 5.24 and ΩAr from 2.41 to 3.44. Geochemical analyses of hydrothermal gases revealed a dominance of CO2 (98.1%) together with small amounts of oxygen and reactive gases. Helium isotope ratios (R/Ra = 2.51) and δ13CCO2 suggest an inorganic origin of hydrothermal degassing of CO2 and the ascent of heat and deep-seated magmatic fluids to the surface. Visual census of fishes and megabenthos (mainly sessile organisms) allowed the identification of 64 species, four of which are protected by the SPA/BIO Protocol and two by the International Union for Conservation of Nature. The macroalgae Halopteris scoparia and Jania rubens and the sponge Sarcotragus sp. were the dominant taxa in the area, while among fishes Coris julis and Chromis chromis were the most abundant species. This preliminary investigation of San Giorgio vent field suggests that the site could be of interest and suitable for future experimental studies of ocean acidification., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 D’Alessandro et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Ammi L. is a small genus of economically important plants belonging to Apiaceae family that includes only six taxa. In the present study the chemical composition of the essential oil from aerial parts of Ammi crinitum Guss., a very rare plant, endemic of Sicily, was analyzed by GC-MS. No previously paper has been published on this species. The results showed the presence of large quantity of monoterpene hydrocarbons with sabinene (63.9%), as the most abundant component. Other metabolites present in good quantity were γ -terpinene (8.0%), and 4-terpineol (3.7%). Based on the composition of the essential oil of all the other Ammi taxa, several considerations have been carried out.

Background: Cladribine tablets are a highly effective option for the treatment of relapsingremitting multiple sclerosis (RRMS)., Objective: The study aims to evaluate the effectiveness of cladribine in a real-world setting., Methods: This prospective real-world study consecutively screened all RRMS patients from seven different MS centers in Sicily (Italy) who completed the 2-year treatment course of cladribine tablets in the period between 11 th March 2019 and 31 st October 2021. Data about Expanded Disability Status Scale (EDSS), relapses, previous treatments, adverse events (AEs) and magnetic resonance imaging (MRI) were collected. Patients who were previously treated with other DMTs were further stratified into moderately active treatment (MAT) and highly active treatment (HAT) patients., Results: A total of 217 patients (70% women, with a mean age of 38.4 ± 11.3 years) were enrolled. Fifty patients (23.0%) were naïve to treatment and 167 (77%) switched from other disease modifying therapies. After the second year of treatment, about 80% were EDSS progression free, 88% remained relapse-free at T24, and 48% of patients were MRI activity-free. Kaplan Meier analyses showed significant differences between MT and HAT in terms of time to first clinical relapse (HR: 2.43, IC 1.02- 5.76; p = 0.04), time to the first new T1-gadolinium enhancing lesion (HR: 3.43, IC 1.35-8.70; p = 0.009) and time to MRI worsening (HR: 2.42, IC 1.15-5.09; p = 0.02)., Conclusion: This study confirmed that cladribine is an effective treatment for MS, particularly in naïve patients and those who have switched from MATs., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Lonas annua (L.) Vines & Druce (Asteraceae), commonly known as African Daisy or Yellow Ageratum is a rare therophyte native to northwestern Africa (Algeria, Morocco, and Tunisia) and Italy (Sicily and Sardinia). In the present study, the chemical composition of the essential oil from aerial parts of Lonas annua was analyzed by GC-MS. No one report has been previously published on the essential oil of this species. The results showed the presence of large quantity of two unusual metabolites 2,3-dihydrofarnesol (41.64%), and acenaphthene (36.18%). Chemotaxonomic considerations were carried out in order to confirm the phylogenetic reconstructions of Anthemideae.

Background and Purpose: Hereditary transthyretin amyloidosis with polyneuropathy (ATTRv-PN) is caused by mutations in the TTR gene, leading to misfolded monomers that aggregate generating amyloid fibrils., Methods: A prospective systematic genetic screening for ATTRv-PN was proposed in patients presenting with a sensory-motor idiopathic polyneuropathy and two or more "red flags" among the following: family history of polyneuropathy or cardiopathy, bilateral carpal tunnel syndrome, cardiac insufficiency, renal amyloidosis, lumbar tract stenosis, autonomic dysfunction, idiopathic gastrointestinal disease, amyloid deposits on biopsy, and vitreous opacities. The detection rate was calculated, and nonparametric analyses were carried out to underline differences among screened positive versus negative patients., Results: In the first step, 145 suspected patients underwent genetic testing, revealing a diagnosis of ATTRv-PN in 14 patients (10%). Then, cascade screening allowed early recognition of 33 additional individuals (seven symptomatic ATTRv-PN patients and 26 presymptomatic carriers) among 84 first-degree relatives. Patients with a positive genetic test presented a higher frequency of unexplained weight loss, gastrointestinal symptoms, and family history of cardiopathy., Conclusions: A systematic screening for ATTRv-PN yielded an increased recognition of the disease in our neurological clinic. Unexplained weight loss associated with axonal polyneuropathy had the highest predictive value in the guidance of clinical suspicion. A focused approach for the screening of ATTRv-PN could lead to an earlier diagnosis and identification of asymptomatic carriers, who will be promptly treated after a strict follow-up at the clinical onset., (© 2023 The Authors. European Journal of Neurology published by John Wiley & Sons Ltd on behalf of European Academy of Neurology.)

Background: International and national registries consistently report substantial differences in kidney transplant (KT) activity despite demonstrable clinical and financial benefits. The study aims to estimate the financial resources gained by KT and produce a benchmark analysis that would inform adequate strategies for the growth of the service., Methods: We analyzed the KT activity in our region between 2017 and 2019. The benchmark analysis was conducted with programs identified from national and international registries. The estimate of financial resources was obtained by applying the kidney transplant coefficient of value; subsequently, we compared the different activity levels and savings generated by the three KT programs., Findings: The KT activity in the region progressively declined in the study years, producing a parallel reduction of the estimated savings. Such savings were substantially inferior when compared to those generated by benchmark programs (range €18-22 million less)., Interpretation: The factors influencing the reduced KT activity in the study period with the related "foregone savings" are multiple, as well as interdependent. Organ donation, access to the transplant waiting list, and KT from living donors appear to be the most prominent determinants of the observed different levels of activities. International experience suggests that a comprehensive strategy in the form of a "task force" may successfully address the critical areas of the service reversing the observed trend. The financial impact of a progressively reduced KT activity may be as critical as its clinical implications, jeopardizing the actual sustainability of services for patients with end-stage kidney disease., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Cacciola, Leonardis, Gitto, Favi, Gruttadauria, Clancy, Veroux, Angelico, Pagano, Mazzeo, Cacciola, Santoro, Toti, Tisone and Cucinotta.)

The soundscape is an intrinsic property of an ecosystem and influences the species that live in it. Here, we examined for the first time the soundscape of a beach, one of the most dynamic ecosystems on Earth, where every year the loggerhead sea turtle Caretta caretta lays eggs. The aim of this work was to analyze the acoustic components (biophony, anthropophony and geophony) to which turtles embryos were exposed throughout the development and the post-hatching period. The acoustic monitoring was carried out on the volcanic island of Linosa (central Mediterranean Sea, Strait of Sicily), during the months of July and August 2022, close to two turtle nests. Results revealed that all the acoustic levels (octave bands from 4 Hz to 16 kHz, and total 1-24,000 Hz band) showed lower values in July, and during the night. Furthermore, above 1 kHz the levels decreased and had very little variability. Anthropogenic noise was the main component of the soundscape and consisted of marine and land traffic, that affected sound levels directly or via seismic tremors. When the beach was exposed to the breaking waves, the latters were the first contributor to the noise up to 1 kHz. The only recognized biophony was represented by the shearwater choruses in July (at the frequency band 700-1500 Hz), but they had a negligible weight on the soundscape. Finally, human speech contributed to the soundscape at higher frequencies (1-8 kHz). These outcomes show that the embryos and the post-hatching turtles are exposed to a high anthropogenic noise level, which the effects of are still unknown., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Sicily (Italy) is the second producer of Opuntia ficus-indica (OFI) fruits after Mexico. To date, huge quantities of fruit are discarded during the selection for the fresh market, generating a large amount of by-product to be valorized. This study aimed to investigate on the composition of OFI discarded fruits from the main Sicilian productive areas, over two harvesting periods. Peel, seeds and whole fruit samples were characterized in terms of minerals and phenolic compounds through ICP-OES and HPLC-DAD-MS. Potassium, calcium and magnesium were the most abundant elements and peel samples showed the highest values. Seventeen phenolic compounds were detected in peel and whole fruit, including flavonoids, phenylpyruvic and hydroxycinnamic acids, while only phenolic acids were found in the seeds. A multivariate chemometric approach highlighted a correlation between the mineral and phenolic content and the different parts of the fruit as well as a significant influence of productive area., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

The present study aims to characterize the artisanal saffron ricotta cheese produced from the whey of Piacentinu Ennese protected designation of origin (PDO) cheesemaking, including via technological parameters detected during the production process and by assessment of the main physicochemical, microbial, sensory, and antioxidant characteristics. A survey on the manufacture process of saffron and control ricotta cheese was conducted on 3 farms, located in the production area of the Piacentinu Ennese PDO cheese. pH and temperature followed a specific behavior, characterized by an inverse trend where pH decreased and temperature increased, playing an important role in the production process. All the analytical parameters were affected by the presence of saffron, also showing high between-farm variability, with significantly higher total solids and fat contents in saffron ricotta cheese compared with the control cheese (28.68% vs. 23.86%, and 19.83% vs. 14.22%, respectively). Microbial analysis showed significantly lower values in saffron compared with control ricotta cheese, for coliforms (1.51 vs. 1.91 log 10 cfu/g, respectively), yeasts (1.55 vs. 2.06 log 10 cfu/g, respectively), and molds (1.03 vs. 1.30 log 10 cfu/g, respectively), denoting potential reduction of microbial growth asserted by saffron. Escherichia coli concentration (1.26 log 10 cfu/g) in saffron ricotta cheese was in accordance with EU Regulation 2073/2005 and then safe for consumption. The presence of saffron influenced all sensory attributes, particularly color and aroma. Interestingly, high total antioxidant activity was found in saffron ricotta cheese (372 µC) compared with the control cheese. Thus, this artisanal dairy production could be considered a suitable option for functional foods with antimicrobial properties, due to the presence of saffron, which may contribute to extend the shelf life of the product. Further studies need to focus on the bioactive compounds that affect the antioxidant proprieties, characterization of the microbiota of saffron ricotta cheese, and evaluation of consumers' acceptance and perception as well as market demand., (© 2023, The Authors. Published by Elsevier Inc. and Fass Inc. on behalf of the American Dairy Science Association®. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).)

Background: Mesothelioma is strongly associated with exposure to asbestos fibers, however, recent studies have also linked exposure to "naturally occurring asbestos" fibers with this disease. Fluoro-edenite, a silicate mineral found in the southeast of Biancavilla (Sicily, Italy), has been identified as a potential risk factor for mesothelioma. Unfortunately, this cancer often has a poor prognosis, and current diagnostic and prognostic biomarkers are inadequate. Histological subtype, gender, and age at diagnosis are the most significant parameters for mesothelioma. Stathmin, a cytosolic protein that regulates cell growth and migration and is overexpressed in many human malignancies, has not yet been linked to mesothelioma survival or clinical-pathological variables., Aim: The aim of this study was to investigate the immunohistochemical expression of stathmin in ten mesothelioma tissue samples with available clinical and follow-up data., Material and Methods: Paraffin-embedded tissue samples from ten mesothelioma patients were processed for immunohistochemical analyses to evaluate stathmin expression., Results: Our findings suggest that stathmin overexpression is associated with shorter overall survival in patients with mesothelioma. Furthermore, stathmin expression was significantly correlated with the survival time of mesothelioma patients., Conclusion: Our results suggest that stathmin expression may serve as a potential prognostic biomarker for mesothelioma. This biomarker could be used to promptly identify patients with poor prognosis and to guide clinicians in the selection of treatment options., (©The Author(s) 2023. Open Access. This article is licensed under a Creative Commons CC-BY International License.)

This article documents, through a quantitative approach, the negative effect of the highly invasive species Amphistegina lobifera Larsen, 1976 on native benthic foraminiferal assemblages of coastal areas in the Sicily Channel (Central Mediterranean). A nested sampling design was applied through the comparison of benthic foraminiferal community structure across three areas that are known to be at different stages of invasion (i.e. Maltese Islands - advanced, southern Sicily - medium, and eastern Sicily - early). Results suggested that both diversity and richness of benthic foraminiferal community from the Maltese Islands were strongly modified by increased abundances of A. lobifera. In contrast, this phenomenon is less evident in southern and eastern Sicily, where the invader displayed lower abundances and the community structure was more diversified. Collected data also allowed for predicting what could happen in the near future in the whole Sicily Channel, as well as in the rest of the Mediterranean Sea., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)