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Background Cognitive dysfunctions are very frequent in people living with multiple sclerosis (MS). Several studies have previously indicated grey matter (GM) atrophy as useful predictor of patients’ cognitive impairment. However, considerable uncertainty exists about the possible impact of deep grey matter volumes on cognition. This study aimed to evaluate the relationship of the subcortical (sc) GM volumes with the presence and severity of global and selective cognitive impairment in MS. Methods A group of MS patients with relapsing remitting course were enrolled. Patients underwent a neuropsychological evaluation by using the Brief Repeatable Battery of Neuropsychological Tests (BRBN) and the Delis–Kaplan Executive Function System Sorting Test (D-KEFST); z scores were estimated and items with z score below 2 standard deviation were considered failed. Thus, brain MRIs images were acquired and measurements of whole brain (WB), white matter (WM), and cortical grey matter (GM) were obtained by SIENAX. After FIRST tool segmentation, volumes of subcortical GM structures were also estimated. Results The sample included 50 MS patients, of which 16/50 (32%) subjects were cognitively impaired. Multiple regression analyses found a significant association of severity of cognitive impairment, defined as number of failed neuropsychological tests, with lower volumes of cortex (p=0.003), thalamus (p=0.009), caudate (p=0.011), putamen (p=0.020), pallidus (p=0.012) and hippocampus (p=0.045), independently from other MS features. In addition, an association between accumbens volume and D-KEFS ST FSC and D-KEFS ST FSD z scores was observed (p Conclusions Our results indicated that volumes of several scGM structures, and in particular of thalamus, contribute to determine cognitive dysfunctions in MS, mainly influencing the executive functioning. Further investigations in larger MS cohorts with cognitive impairment are necessary to better understand the structural brain damage underlying this “invisible disability”.

Regional assessments could be more reliable than global ones, especially for species in peripheral parts of their range. In this sense, distribution criteria proposed by the IUCN, expressed by the Extent of Occurrence (EOO) and the Area of Occupancy (AOO), are of critical importance to evaluate the risk category at any scale. Our study was focused on the yellow gentian ( Gentiana lutea L. subsp. lutea ), a rhizomatous mountain plant of central and southern Europe, included in the Annex V of the Directive 92/43/EEC. The exhaustive and updated regional distribution and the recently published extinct localities, allowed for review of option to increase the number of criteria used for its regional conservation status assessment. In particular, the current restricted EOO and AOO extents and reductions occurred during the last three generations led this plant being considered as Endangered (EN), according to the IUCN sub-criteria A2, B1 and B2. Additionally, Species Distribution Models based on the extant localities and the respective current and future climate scenarios (2050 and 2070) predicted a decrease of its environmental niche reducing its altitudinal range towards higher elevations. This reduction was greater than 50% and confirmed the regional conservation status of EN, also according to the sub-criterion A3. This paper shows the reliability of regional risk assessment of peripheral and/or narrow populations, which is an effective tool for helping the development of the necessary conservation management, underling a diversified set of solutions for each specific past, present and future threat that could occur in each locality.

In Mediterranean coastal dune habitats, the facilitative mechanisms among plants could be crucial for the persistence of several plants for which survival is linked to a fragile equilibrium with the surrounding microenvironment. The aim of this study was to verify whether there exists a facilitative effect on Dianthus morisianus Vals., a narrow endemic plant of Sardinia, and to analyze the potential importance of facilitative effects via the analysis of the interaction outcome with the nurse plants. Forty-five plots of 1 × 1 m were randomly placed within the habitat where D . morisianus grows preferentially, composed of sclerophyllous shrubs (Cisto-Lavanduletalia sensu Habitats Directive). All D . morisianus plants recorded within the plots were assigned to one of the three microhabitats identified: (i) open areas in the inter-shrub discontinuities, (ii) under shrubs canopy influence and (iii) inside the shrubs. For each D . morisianus plant, the reproductive or vegetative status and both morphological and reproductive traits, as well as the possible physical damage (grazing and trampling), were measured. Inside the Cisto-Lavanduletalia habitat there was a greater number of reproductive plants, whereas in the open patches the vegetative plants prevailed. Morphological and reproductive parameters varied significantly among microhabitats and showed higher values inside the shrubs. As expected, grazing and trampling negatively affected mainly plants growing in the open and below microhabitats. A strong facilitative interaction between D . morisianus and the coastal Cisto - Lavanduletalia habitat was found: this habitat had a crucial positive effect on the persistence of D . morisianus and preserved this threatened plant; therefore, it is essential to primarily conserve the Cisto-Lavanduletalia habitat.

In this contribution, the conservation status assessment of six plant species according to IUCN categories and criteria are presented. It includes the assessment at global level of Linaria tonzigii Lona, Allium garganicum Brullo, Pavone, Salmeri & Terrasi, Ferula arrigonii Bocchieri, Orchis patens Desf. subsp. patens and Armeria saviana Selvi and the assessment at regional level (Italy) of Viola jordanii Hanry.

The TRACER multicenter retrospective study aimed to collect data on treatment adherence in a real-life setting, in order to identify predictors of adherence at baseline.We recruited 384 relapsing-remitting (RR) multiple sclerosis patients with at least 12 months of use of RebiSmart®. This electronic device records the performed injections and assesses adherence as the percentage of 'not missing doses', through the connection to the iMed database. Subjects with at least 80% of completed doses at the 12 month of therapy were defined 'treatment adherents'.After 12 months, 89.3% of patients were adherent; 93.2% of patients aged 26-40 years at baseline were adherent (vs 79% of the ≤25 and 87.5% of the ≥41 year olds; p = 0.006). Furthermore, 90.5% of patients with a baseline Expanded Disability Status Scale (EDSS) score4 showed ≥80% adherence (vs 71.4% in those with EDSS score ≥4; p = 0.016). Fifty-four percent of the patients who were not adherent after 3 months were also not adherent after 12 months (OR 16.8; CI 95%:7.1-39.8).Patients aged 26-40 years and with an EDSS score4 at baseline were the most adherent. The status of 'treatment adherent' in the first 3 months was predictive of higher adherence in the long term.

Mediterranean coastal dunes have been highly modified by human impacts and understanding their conservation status is crucial to preserve these extremely vulnerable habitats. In the present study three different diversity indices elaborated by Grunewald and Schubert (H dune , a modified version of the Shannon diversity index, E dune , a modified Evenness index, and N, the Naturalness index) were applied in order to assess the conservation status and anthropogenic impacts on Is Arenas dune system (CW Sardinia), one of the widest and most important in the Western Mediterranean Basin. Within the system, two sites with different anthropic disturbance conditions were selected; 25 permanent plots were seasonally monitored and the cover of each vascular plant present was visually estimated. The H dune values were similar between sites and differences were not significant; E dune showed higher value in the North than in the South site with relevant statistical differences. Moreover a seasonal variation in the indices values was recorded, which could be linked to presence of annual plants rather than the touristic pressure. Instead, the small variability of N index suggests that the application of this index may be an important tool to assess human impact on coastal dunes, but better discriminates between sites with different disturbance degrees. Our results highlight the usefulness of H dune and E dune indices to assess the conservation status of a Mediterranean coastal dune system, while these indices are less influenced by the human trampling at finer scale (sites within the beach). Spring and summer are the best seasons when the main plant diversity of Mediterranean coastal dune can be captured. The diversity indices applied, although need to be developed through further researches, could be a quickly tool allowing to assess the integrity of the coastal dunes in order to plan management actions of these complex and threatened ecosystems.

In this study, we explore the influence of environmental and anthropogenic factors on the floristic variability of the “coastal dunes with Juniperus spp.” European habitat (code 2250*) in Sardinia. Two datasets were created: the first by inputting phytosociological releves available in literature plus our own samplings; the second by including, for each releve, environmental, floristic, and human-related factors. Differences in Juniperus habitat composition and the influence of the explanatory variables were analyzed by multivariate analysis, while GLM were used to test the effect of human disturbance and sampling period on several habitat parameters (plant richness, cover of endemic and alien taxa). The floristic composition differed among sites, being significantly influenced by all the variables analyzed except coastal type. Composition was governed mainly by a latitudinal gradient, linked to a climatic gradient, which varied from North to South. In addition, the floristic richness was positively influenced by low and medium levels of human disturbance. Similarly, the plant richness and cover of endemic taxa was positively related to medium level of human disturbance, while the cover of alien taxa was positively related to recent sampling. The analysis of our own floristic data together with those recorded from 1976 is useful to monitor floristic changes over decades and gives a better understanding of the “coastal dunes with Juniperus spp.” habitat to contribute to its conservation; therefore, management actions, such as eradication of alien taxa, should be implemented.

Biogeographical studies are considered effective for investigations on macroecology and evolution, as well as for delineating patterns of endemism and identifying the key drivers influencing the historical distribution of species. Clustering techniques, based on environmental datasets and distribution of endemic species, have been largely used in biogeography and for the definition of endemic-rich regions where conservation actions should be implemented. Despite several earlier studies have dealt with the biogeographical territories in Egypt, none of them have provided a replicable method to support such regionalisation. We proposed a two-step procedure for the biogeographical regionalisation of Egypt consisting in (1) the definition of environmental clusters (based on 24 climatic, three topographic, two soil organic carbon content and pH, and four habitat heterogeneity variables) by using the k-nearest neighbours algorithm and (2) the spatial clustering of such clusters according to the distribution of 140 endemic vascular plants. The hierarchical clustering and indicator values analyses, based on the presence-absence matrix of endemic taxa in each cluster were performed to define two cut-off levels of biogeographical sectors and subsectors. A total of six sectors and nine subsectors were identified. Climatic-related variables, elevation and soil organic carbon were the most important determinants for environmental clustering of Egypt. The highest endemic richness was recorded in the Marioutico-Arishian (71 species), Sinaico-Arabian (62 species) and Nilotic (16 species) sectors, and in Sinaic (54 species), Arishian (45 species) and Marioutic (40 species) subsectors. Nonetheless, the most protected sectors were Elbanian and Suezian (62.73 and 29.05%, respectively) while the lowest sectors were Nilotic and Marioutico-Arishian (9.86 and 13.26%, respectively). The already established protected areas in Egypt are not sufficient for conserving the representation of the identified endemic rich plant sectors. This two-step procedure confirms the usefulness of environmental attributes together with the spatial distribution of endemic vascular plants to define the biogeographical units in Egypt. Our regionalisation method could be replicated for other species’ groups, with the ultimate goal of integration all species of interest in a single biogeographical system. Furthermore, the presented regionalisation will help to identify weaknesses in current protection actions and to understand biogeographical processes.

Some studies have indicated the importance of considering smoking, vitamin D deficiency and obesity as negative prognostic factors for clinical and MRI outcomes in multiple sclerosis (MS). This study aimed to evaluate the possible effects of these modifiable risk factors on brain MRI lesion burden of patients with early MS, also exploring the influence on initial clinical features.MS patients were enrolled at diagnosis time and examined for smoking, body mass index (BMI), serum level of lipids and 25(OH) vitamin D. Brain MRIs' were acquired and lesion volume assessed by Jim software. Clinical data (disease course, disease duration, and EDSS score) were also collected.64 patients were enrolled, of these 4 (6.2%) had a primary progressive course. Mean age was 39.8 ± 11.1 years and mean EDSS 1.5 ± 1.1. Forty (62.5%) patients were smokers and 40 (62.5%) were overweight (BMI25). Insufficient levels of vitamin D (20 ng/mL) were reported in 36 (56.2%) patients, while 24 (37.5%) patients had an altered lipid profile with total cholesterol200 mg/dl and LDL100 mg/dl. No association between early clinical features and modifiable risk factors were reported. Multiple regression analysis showed an association between lesion burden and smoking status (p 0.003), while no association was reported with BMI, altered lipid profile and vitamin D insufficiency.Several risk factors may play a role in evolution of MS. Our results show that smoking status, probably due to chronic vascular and neurotoxic effects of the cigarette components, can affect the brain damage from the early stages of MS. No association was observed with the other explored modifiable risk factors, although an effect due to the small sample size cannot be excluded.

Know the breeding system of endemic plants is important to design conservation strategies. Translocations are actions to improve the survival prospects of the species, but nowadays there are only a few studies that analyse their success and make a comparison between translocation and the natural populations. Dianthus morisianus is a threatened narrow endemic plant species growing on sand dunes in SW Sardinia (Italy). The objective of this study was to assess the breeding system, the presence of inbreeding depression and pollen limitation, as well as the success of the plant translocation. All these results were compared with those from the single natural population. The breeding system was tested through five pollination treatments and the reproductive success was analysed by the fruit set, seed set, seed weight, germination and mortality rate. The translocated population behaved like the natural one on fruit and seed formation. Autonomous self-pollination was lower than the other treatments regarding fruit set and seed/ovule ratio in the two studied populations. The species is self-compatible and presents partial self-fertility. The selfing rate was higher in the translocated population and the inbreeding depression presented low values for the natural population, while the translocated population presented negative values. Neither of the populations suffered pollen limitation. The species did not present reproductive problems and it is pollinator dependent. Moreover, the translocated population demonstrated high success after five years, as an increase of the population area and new recruited plants was observed; the offspring were able to flower, fruiting and reproduce. This translocation success increases the survival prospects of the species.

Some studies have indicated the importance of considering the presence of vascular comorbidities as negative prognostic factors for MRI outcomes in multiple sclerosis (MS). This study aimed to evaluate the possible influence of the most frequent vascular risk factors on brain volume in MS, also exploring the burden of their combined effects.MS patients with at least one vascular risk factor and a control group of MS patients were enrolled. Patients underwent brain MRI and the volumes of the whole brain (WB), white matter (WM), grey matter (GM), and cortical GM were estimated by SIENAX. Longitudinal atrophy was assessed by SIENA.The sample included 326 MS patients, of these 49 (15%) had diabetes mellitus, 44 (13.4%) hypertension and 50 (15.3%) were active smokers. Multiple regression analyses revealed that diabetes mellitus was associated with significant reductions in WB (p = 0.03), GM and cortical GM (p = 0.01) volumes. Similarly, reduced cortical GM volume was associated with hypertension (p 0.05). A strong relationship between the co-occurrence of multiple vascular risk factors and lower cortical GM volume (p = 0.007) was also identified. Ninety patients were included in the longitudinal study and a greater annualized brain volume loss was found in those with at least one vascular risk factor than in the control group (-1.05% vs. -0.58%, p = 0.005).Our results show that the vascular comorbidities affect brain atrophy, indicating that these conditions should be carefully monitored in patients with MS with a focus on limiting brain damage.

In this contribution, the conservation status of four vascular plants according to IUCN categories and criteria are presented. It includes the assessment ofArceuthobiumoxycedri(DC.) M.Bieb.,IonopsidiumalbiflorumDurieu,TrifoliumlatinumSebast., andViciaincisaM.Bieb. at a Regional level (Italy).

Cognitive impairment concerns a significant percentage of patients with multiple sclerosis (MS). A transient impairment of cognition with a simultaneous presence of non-symptomatic gadolinium (Gd)-enhancing lesions in patients with MS was previously described. Our study aimed to evaluate modifications in cognitive function before and after the occurrence of asymptomatic MRI gadolinium (Gd)-enhancing lesions in relapsing MS patients.All patients underwent a neuropsychological evaluation before (30-60 days) and after (30-60 days) brain MRI with Gd administration. Patients were classified as Gd positive (presence of enhancing-lesions) and Gd negative (absence of enhancing-lesions). We also recruited a healthy controls group underwent to the same neuropsychological assessment for two times with the same timing of MS patients.We included 84 relapsing-remitting patients and 40 healthy controls. Brain MRI results showed that 14/84 (16.7%) patients had asymptomatic Gd-enhancing-lesion. No significant variation in cognitive performance between baseline and follow-up was observed in patients with or without MRI-enhancing lesions. However, an increase between baseline and follow-up was observed in the mean scores of the Symbol Digit Modality Test (41.9 at baseline versus 46.7 at follow-up, p : 0.001). This increase was significantly lower in Gd positive patients compared to Gd negative patients (mean increase 1.1 in Gd positive versus 4.9 in Gd negative, p: 0.001) and to healthy controls groups (mean increase 7.2; p 0.001) CONCLUSIONS: In our study, the absence of a practice effect in Gd positive compared to Gd negative patients and to healthy controls suggests a possible role of focal inflammation on cognitive function of MS patients.

Background The principal biomarker of neurodegeneration in multiple sclerosis (MS) is believed to be brain volume, which is associated with cognitive functions and retinal nerve fibre layer (RNFL). A cross-sectional and longitudinal assessment of the relationship between RNFL, cognitive functions and brain volume. Methods At baseline, relapsing patients and healthy controls underwent 1.5 T MRI to estimate the normalized volume of brain (NBV), grey (NGV), white (NWV) and peripheral grey (pNGV) matter. Cognitive functions were evaluated by BICAMS, RNFL by Spectral-Domain OCT. Patients were re-evaluated after 12 months. Results Cognitive functions, brain volume, and RNFL differed between the group of 66 patients and that of 16 healthy controls. In the MS group, at baseline, an association was found between: p-NGV and symbol-digit (SDMT) (p = 0.022); temporal-RNFL and NBV (p = 0.007), NWV (p = 0.012), NGV (p = 0.048), and p-NGV (p = 0.021); papillo-macular bundle-RNFL and NBV (p = 0.013), NWV (p = 0.02), NGV (p = 0.049), and p-NGV (p = 0.032). Over the observational period, we found a reduction of brain volume (p

BACKGROUND AND PURPOSE Patients with multiple sclerosis (MS) have many pregnancy-related doubts and fears. Careful counselling is thus important. Mitoxantrone (MITO) is used in patients with aggressive MS and may affect reproductive capacity. The aim of this study was to investigate pregnancy planning and outcomes in patients with MS treated with MITO, both before and after the treatment. METHODS Patients with MS previously treated with MITO were recruited. Clinical, demographic and treatment data were recorded. A questionnaire regarding the planning and outcomes of all pregnancies was administered. Parametric and non-parametric tests were performed using SPSS 22 software. RESULTS A total of 238 patients (female/male, 158/80) were included; 106 subjects planned a pregnancy before MITO and 40 after MITO. Of these, respectively, 102 (97%) and 35 (85%) resulted in conception, 19 (19%) and 7 (18%) in miscarriage, 6 (6%) and 1 (3%) in abortion and 98 (96%) and 32 (91%) were full-term pregnancies. A total of 96 patients (40%) planned a pregnancy only before MITO (and not after), whereas 30 (13%) planned a pregnancy only after MITO (and not before) (P < 0.01). A total of 103 patients did not plan a pregnancy before MITO and 198 did not plan a pregnancy after MITO. The reasons included lack of interest or a partner, fear of MS and infertility. All of the babies born were healthy until the end of follow-up. CONCLUSIONS Mitoxantrone does not affect the ability to conceive or pregnancy outcomes. We found no differences in pregnancies, abortions or miscarriages before and after MITO. The tendency to plan pregnancies decreased significantly after MITO. Our findings may be useful for improving the quality of life of patients and the approach taken by neurologists.

Background: Few data are available on very long-term follow-up of pediatric multiple sclerosis (MS) patients treated with disease modifying treatments (DMTs). Objectives: To present a long-term follow-up of a cohort of Pediatric-MS patients starting injectable first-line agents. Methods: Data regarding treatments, annualized relapse rate (ARR), Expanded Disability Status Scale (EDSS) score, and serious adverse event were collected. Baseline characteristics were tested in multivariate analysis to identify predictors of disease evolution. Results: In total, 97 patients were followed for 12.5 ± 3.3 years. They started therapy at 13.9 ± 2.1 years, 88 with interferons and 9 with copaxone. During the whole follow-up, 82 patients changed therapy, switching to immunosuppressors/second-line treatment in 58% of cases. Compared to pre-treatment phase, the ARR was significantly reduced during the first treatment (from 3.2 ± 2.6 to 0.7 ± 1.5, p Conclusion: Pediatric-MS patients benefited from interferons/copaxone, but the majority had to switch to more powerful drugs. Starting therapy before 12 years of age could lead to a more favorable outcome.

Several studies indicated that multiple sclerosis (MS) is frequently associated with other autoimmune diseases. However, it is little known if the coexistence of these conditions may influence the radiologic features of MS, and in particular the brain volumes. To evaluate the effect of autoimmune comorbidities on brain atrophy in a large case–control MS population. A group of MS patients affected by a second autoimmune disorder, and a control MS group without any comorbidity, were recruited. Patients underwent a brain MRI and volumes of whole brain (WB), white matter (WM), and gray matter (GM) with cortical GM were estimated by SIENAX. The sample included 286 MS patients, of which 30 (10.5%) subjects with type 1 diabetes (T1D), 53 (18.5%) with autoimmune thyroiditis (AT) and 4 (0.1%) with celiac disease. Multiple regression analysis found an association between T1D and lower GM (p = 0.038) and cortical GM (p = 0.036) volumes, independent from MS clinical features and related to T1D duration (p

In this paper, we present a spatially explicit procedure for mapping and assessing coastal plant diversity value in the context of biodiversity monitoring and conservation planning. Our objective was to devise a replicable and easy to understand methodology framework, which can represent an expedient tool for coastal management and decision making at spatial scales between 1:25,000 and 1:50,000. For this purpose, we adopted a small number of key descriptors that refer to easily quantifiable information on species and habitats: plant species richness, species of conservation value, floristic consistency, habitat diversity, and habitats of conservation interest under the Council Directive 92/43/EEC. We built an expedient sampling strategy that combines systematic sampling by grid cells of fixed size with stratification per habitat type, and apply a plain equal weighting scoring system for assessing overall plant diversity. All floristic and habitat data were entered into a spatial database built within a GIS environment and referred to a 1 × 1 square km spatial grid overlaid on two selected test sites in southern Sardinia (Italy). The descriptors we chose were successful surrogates of plant diversity, as they were able to represent the known conservation importance of both test sites and of specific areas within them, both individually and in combination. In particular, our results show that integrating indicators at different levels of biodiversity enabled to represent aspects with marked differences in distribution as well as to compensate possible biases in data collection, as habitat data are more easily available than floristic information and spatially continuous even in less accessible areas. Being based on well-known criteria and policies, and on data that are most widely and consistently available, our assessment procedure proved effective and easily transferable, and provides a spatial reference framework for systematically evaluating and monitoring coastal plant diversity at national level and across the Mediterranean Basin.

Taxa endemic to a country are key elements for setting national conservation priorities and for driving conservation strategies, since their persistence is entirely dependent on national policy. We applied the IUCN Red List categories to all Italian endemic vascular plants (1340 taxa) to assess their current risk of extinction and to highlight their major threats. Our results revealed that six taxa are already extinct and that 22.4% (300 taxa) are threatened with extinction, while 18.4% (247; especially belonging to apomictic groups) have been categorized as Data Deficient. Italian endemic vascular plants are primarily threatened by natural habitat modification due to agriculture, residential and tourism development. Taxa occurring in coastal areas and lowlands, where anthropogenic impacts and habitat destruction are concentrated, display the greatest population decline and extinction. The national network of protected areas could be considered effective in protecting endemic-rich areas (ERAs) and endemic taxa, but ineffective in protecting narrow endemic-rich areas (NERAs), accordingly changes to the existing network may increase the effectiveness of protection. For the first time in the Mediterranean Basin biodiversity hotspot, we present a comprehensive extinction assessment for endemic plants under the full responsibility of a single country. This would provide an important step towards the prioritization and conservation of threatened endemic flora at Italian, European, and Mediterranean level. A successful conservation strategy of the Italian endemic vascular flora should implement the protected area system, solve some taxonomical criticism in poorly known genera, and should rely on monitoring threatened species, and on developing species-specific action plans.

Plant population dynamics is fundamental to identify which parts of the life cycle are important when designing management actions. In this study, the short-term population dynamics of Helianthemum caput-felis (Cistaceae), a perennial plant distributed throughout the western Mediterranean Basin, was investigated by monitoring 98 permanent plots randomly placed along the overall distribution range for three years (2013–2015). Demographic surveys were analysed by Integral Projection Models (IPMs), and the analysis of population growth rates, elasticities, and life table response experiment (LTRE) analyses were performed. Under deterministic conditions, the H. caput-felis population showed a slight increase in the first censuses, but a general population decline followed. This trend was probably due to the shrinkage of plants in the last year, which correlated negatively with reproductive traits. Despite this decline, the population was at equilibrium under the simulated environmental stochasticity. The population dynamics of H. caput-felis followed the general pattern typical for long-lived Mediterranean plants: populations with growth rates closer to the equilibrium in the long term, determinant role of the survival-growth transitions for the population growth rate, slow growth and stasis, longevity of established individuals, shrinkage of medium-large plants, low recruitment rate, high generation times and mean long lifespans. The results of this study, which highlight how conservation measures can be focused on protecting and increasing the number of plants of medium-large size, provide important information for the planning management conservation actions for H. caput-felis and for several Mediterranean plants that show a similar life-history strategy.

Oligoclonal IgM (OCMB) and IgG (OCGB) bands were found to be associated with poor multiple sclerosis (MS) prognosis. We aimed to evaluate the prognostic value of OCMB/OCGB in a cohort of Sardinian MS patients. We recruited patients from the University of Cagliari. They underwent lumbar puncture for diagnostic purposes. Demographic and the following clinical data were recorded: clinical course; time to reach EDSS 3 and 6; EDSS at last follow-up; and MS treatments. The influence of gender, clinical course, age at onset, treatments, and OCGB/OCMB on reaching EDSS 3 was analysed using Cox regression. Kaplan–Meier curves were used to study the time to reach EDSS 3 considering OCMB/OCGB and therapies. The enrolled number of subjects was 503. The variables influencing the achievement of EDSS 3.0 were: male gender (p = 0.005); progressive course (p = 0.001); age at onset (p

Climate change can have significant impacts on the survival of plant species. However, it is seldom included in the assessment of the extinction risk according to IUCN Red List criteria. Lack of data and uncertainties of predictions make difficult such inclusion. In our paper we present an approach, in which the effect of climate change on plant species spatial distribution is used to prioritize conservation within IUCN categories. We used, as a case study, 37 Italian policy species, relevant for conservation, and listed in the Habitat Directive and Bern Convention, and for which a Red List (RL) assessment was available. A stochastic SDM incorporating data on plant dispersal, generation length, and habitat fragmentation was used to predict a range shift due to climate change according to two climatic scenarios (RCP 2.6 and 8.5). No species was predicted to become extinct in the considered timespans (2050 and 2070) due to climate change, and only two were characterized by critical decline probabilities. However, all taxa were potentially affected by climate change through a reduction of their range. In all RL categories, species with the highest predicted reduction of range were those from lowlands, where fragmentation of natural habitats has occurred in the last decades. In these cases, despite some limitations, assisted migration can be considered a suitable conservation option.

Background and purpose There is debate as to whether the apparent rebound after fingolimod discontinuation is related to the discontinuation itself or whether it is due to the natural course of highly active multiple sclerosis (MS). Our aim was to survey the prevalence of severe reactivation and rebound after discontinuation of fingolimod in a cohort of Italian patients with MS. Methods Patients with relapsing-remitting MS who were treated with fingolimod for at least 6 months and who stopped treatment for reasons that were unrelated to inefficacy were included in the analysis. Results A total of 100 patients who had discontinued fingolimod were included in the study. Fourteen patients (14%) had a relapse within 3 months after fingolimod discontinuation, and an additional 12 (12%) had a relapse within 6 months. According to this study's criteria, 10 patients (10%) had a severe reactivation. Amongst these patients, five (5%) had a reactivation that was considered to be a rebound. Conclusions The present study showed that more than 26% of patients are at risk of having a relapse within 6 months after fingolimod discontinuation. Nevertheless, the risk of severe reactivations and rebound is lower than has been previously described.

An updated inventory of the vascular flora alien to Italy, providing details on the occurrence at regional level, is presented. The checklist includes 1597 species, subspecies, and hybrids, distributed in 725 genera and 152 families; 2 taxa are lycophytes, 11 ferns and fern allies, 33 gymnosperms, and 1551 angiosperms. 157 taxa are archaeophytes and 1440 neophytes. The alien taxa currently established in Italy are 791 (570 naturalized and 221 invasive), while 705 taxa are casual aliens, 4 are not assessed, 7 are of unknown regional distribution, 47 have not been confirmed in recent times, 3 are considered extinct or possibly extinct in the country, and 40 are doubtfully occurring in Italy. This checklist allows to establish an up-to-date number (9792) of taxa constituting the whole (native and alien) Italian flora.

Background Several reports suggest a higher risk of psychiatric disorders after high-dose corticosteroids (HDC), routinely used to treat clinical relapses in multiple sclerosis (MS). The present study aimed to examine the possible effect of HDC on mood in patients with MS and to determine the specific factors that influence mood changes. Methods The study included MS patients prior to receive HDC. The presence of depressive and bipolar symptoms was determined with the Beck Depression Inventory-Second Edition (BDI-II) and the Mood Disorder Questionnaire (MDQ). These assessments were made at three time points: prior to HDC initiation, after HDC completion, and 1 month after HDC. Results The study included 101 MS patients. At baseline, 32 (31.7%) patients had depressive symptoms (BDI-II scores ≥ 14) and 20 (19.8%) patients had bipolar symptoms (MDQ scores ≥ 7). While it was observed a reduction of BDI-II scores after HDC, an increase in MDQ score was found in patients with MDQ positivity at baseline, resulting associated with a higher number of HDC infusions (p 0.018). Conclusions Our results emphasize the importance of accurate screening for mood disorders in patients with MS prior to HDC initiation, and indicate that HDC should be used with caution in patients with MDQ positivity.

Introduction Cognitive motor interference (CMI) is performance impairment due to simultaneuous task execution and is measured using the dual task cost (DTC). No pathological feature of MS has to date been associated with CMI. Aim To assess the relationship between brain volumes and CMI, as measured using the DTC, in a cross-sectional study. Methods A group of persons with MS (pwMS) and an age- and sex-matched healthy control (HC) group underwent 3D gait analysis during using the dual task paradigm. Brain volumes were measured on T1-weighted gradient echo scans using SIENAX software. The relationships between brain volumes and the DTCs of spatial temporal parameters were evaluated using Pearson correlation. A multiple regression model was used to evaluate the ability to predict the DTC of cadence based on brain volume and grey matter (GM) volume. Results Forty-four patients and 16 HCs underwent MRI and gait analysis. The mean expanded disability status scale (EDSS) was 2.4 ± 1.5. Significant relationships between brain volumes and DTC were found only in the pwMS group, with higher rho scores for the DTC of mean velocity, DTC of cadence, and DTC of stride time. A statistically significant regression equation with an R 2 value of 0.684 was found using GM and Z-score on the Stroop test as predictors of the DTC of cadence ( p Conclusion Brain atrophy, especially than in the GM, is a major determinant of DTC, although other pathological markers also contribute to CMI in patients with MS.

Background: The strongest genetic determinant for multiple sclerosis (MS) is located at the human leukocyte antigen (HLA) class II DRB1 and DQB1 loci. Objectives: To investigate the possible role of predisposing HLA genotypes in determining brain atrophy. Methods: HLA genotypes were categorized as high risk (two predisposing haplotypes) or medium/low risk (one or no predisposing haplotypes). Patients underwent a brain magnetic resonance imaging (MRI) study and volumes of white matter (WM), gray matter (GM), and whole brain (WB) were estimated with SIENAX. Longitudinal atrophy was also assessed with SIENA. Results: The study included 240 MS patients. In 51/240 (21%) subjects, a high-risk HLA genotype was observed, while medium- and low-risk HLA genotypes were 109/240 (45%) and 80/240 (34%), respectively. Multiple regression analysis found that the high-risk HLA genotype was associated with significant reduction in WB ( p = 0.02) and GM ( p = 0.03) volumes compared with the medium-/low-risk HLA genotypes, independently from MS clinical features. The longitudinal study included 60 patients and showed a brain volume loss of −0.79% in high-risk HLA genotype group versus −0.56% in low-risk HLA genotype. Conclusion: Our results suggest an influence of HLA genotype on WB and GM atrophy. Further investigations are necessary to confirm these findings.

Increases in temperature have been predicted and reported for the Mediterranean mountain ranges due to global warming and this phenomenon is expected to have profound consequences on biodiversity and ecosystem functioning. We hereby present the case of Gentiana lutea L. subsp. lutea, a rhizomatous long-lived plant living in Central-Southern Europe, which is at the edge of its ecological and distributional range in Sardinia. Concretely, we analysed the reproductive success experienced during three phenological cycles (2013/2014, 2014/2015 and 2015/2016) in four representative populations, with particular attention to the phenological cycle of 2014/2015, which has been recorded as one of the warmest periods of the last decades. The Smirnov-Grubbs test was used to evaluate differences in temperature and precipitation regimes among historical data and the analysed years, while the Kruskal-Wallis followed by the Wilcoxon test was used to measure differences between anthesis and reproductive performances among cycles and populations. In addition, generalised linear models were carried out to check relationships between climate variables and reproductive performance. Significant differences among climate variables and analysed cycles were highlighted, especially for maximum and mean temperatures. Such variations determined a non-flowering stage in two of the four analysed populations in 2014/2015 and significant differences of further five reproductive traits among cycles. These results confirmed that in current unstable climatic conditions, which are particularly evident in seasonal climates, reproductive success can be a sensitive and easily observable indicator of climatic anomalies. Considering the importance of this issue and the ease and cost-effectiveness of reproductive success monitoring, we argue that research in this sense can be a supporting tool for the enhancement of future crucial targets such as biodiversity conservation and the mitigation of global warming effects.

Plant translocation has become a widely used tool to improve the conservation status of threatened plants. Dianthus morisianus (Caryophyllaceae) is a narrow endemic plant which only grows on the Portixeddu coastal dune (South-West Sardinia). Its natural habitat has been strongly modified, and it is currently considered one of the most threatened plants of Sardinia. In a conservation effort, a translocation of reproductive plants was planned. Plants were obtained from seeds collected in the natural population and cultivated at the Botanic Gardens of Cagliari University. The following two suitable areas near the natural population were identified: the first is located in a fenced site which is managed by public administration, and the second is located in an unprotected site. In November 2010, 113 plants were reintroduced in site one, and in February 2011, 25 plants were reintroduced in site two; all plants were regularly monitored. The aim was to analyse the effect of different management activities (i.e. the herbivore and human exclusion) on transplanted plants. The following consistent differences between sites with different management types were found: the survival and growth of D. morisianus were enhanced by reducing herbivory and human disturbance; in particular, fences positively enhanced the plant’s long-term survival, reproductive success and seedling recruitment. This study highlights that management activities (i.e. erection of fences) should be incorporated into translocation design since they contribute to translocation success. Our experience can serve as a model for further translocations of the threatened plants of Sardinia and, more widely, of the Mediterranean islands.

Recently, nabiximols was approved as a treatment in MS spasticity. Data leading to approval and clinical use of nabiximols, although widely recognised, are based on subjective scales. Movement analysis procedures would obtain more detailed data about the impact on mobility. The aim of the study was to quantitatively assess the functional modification of gait patterns induced by nabiximols in MS. We evaluated three-dimensional gait analysis (spatial–temporal and kinematic) variation by means of one-way ANOVA. Twenty patients were enrolled—9 male and 11 female—with mean EDSS of 5.3 (SD ± 0.81) and mean reduction of numerical rating scale during nabiximols treatment of 1.88. The spatial–temporal parameters of gait revealed an increased speed (+15 %, p

Multiple sclerosis (MS) is a complex autoimmune disease originated from the interplay between genetic and environmental factors. An overlap of clinical and neuroradiological parameters has been described between MS and an adult-onset neurodegenerative disorder, the fragile-X-associated tremor/ataxia syndrome (FXTAS). This syndrome is caused by a trinucleotide premutation expansion of a CGG sequence in the 55–200 repeat range, which is located in the fragile-X mental retardation 1 (FMR1) gene. Female premutation carriers have an increased propensity for immune-mediated disorders. Recently, a case of co-occurrence of MS and FXTAS was reported. Assuming that the premutation expansion may play a role in the MS susceptibility, we evaluated its frequency in a cohort of MS patients from Sardinia, an island characterized by a very high frequency of MS. Nuclear DNA was extracted by standard methods, purified with bisulfite treatment and then amplified twice by PCR with specific primers. Microsatellite analysis was performed and emizogotic subjects were sequenced. Clinical data of patients were also collected. Only 1/755 MS patients exhibited the premutation expansion with a heterozygosis pattern (30/58). No pathogenic repeat expansions (>200 repeats) were found in the entire cohort. Repeats labeled as the gray zone (45–60 repeats) were observed in 15/755 patients. No specific clinical features concerning disease course, disease activity, and disability were reported for these patients. Our results do not support a possible role for premutation or gray zone alleles in MS Sardinian patients. Further studies are needed to better understand the relationship between FXTAS and MS.

Border and isolated plant populations represent an interesting target for ecological and conservation issues. We analysed the ecological constraints and the conservation status of the eastern population of Helianthemum caput-felis Boiss. (Cistaceae), located in Sardinia. The distribution of H. caput-felis was verified via field surveys; ecological data, morphological and reproductive traits, were recorded in 40 permanent plots randomly established; the human trampling effects on plant density, plant size and plant performance were analysed. Plant density was higher in bedrock and lowland areas, in garrigue and maquis habitats; however, the differences among plants growing in different ecological conditions were not statistically significant; only human trampling intensity significantly affected plant density and lowest values were observed in areas with intense trampling pressure. All ecological variables analysed had a statistically significant effect on plant size and on the number of fruits per...

The Aichi Biodiversity Target 12 aims to prevent the extinction risk of known threatened species and to improve their conservation status by 2020. We present the integrated strategy implemented in the last 10 years for the keystone plant species of Sardinia (Italy, W. Mediterranean Basin), which includes the following activities: conservation status assessment (following the IUCN protocol), ex situ conservation, in situ monitoring and active protection measures. To date, an average of 51.8% of keystone plant species have been subjected to the latter first three activities while, due to the higher costs, only few active conservation measures have been carried out. Considering the activities realised since 2004, we have also predicted the conservation effectiveness towards 2020 and have elaborated an index to evaluate it. Halfway through the strategic plan, we argue that more efforts are needed to guarantee the effective conservation of all threatened plants in Sardinia.

Multiple sclerosis (MS) is a long-lasting neurological disease with onset in young adult age. Patients with MS are less active than healthy people, and their sedentary lifestyle might lead to secondary diseases or worsening of symptoms, disability and quality of life. In the study, we evaluated the attitude of physical activity (PA) of a group of MS patients and the differences in practice PA before and after the diagnosis. A randomly recruited group of patients with MS fulfilled a questionnaire about their attitudes towards PA before the onset and after the diagnosis of the disease. Clinical and demographic data were recorded. Out of 118 patients, 37 % practiced PA only before the diagnosis, 9 % only after and 52 % during both periods. After the diagnosis, 64 % of participants noted some negative differences in PA, in particular less physical resistance and worsening of symptoms, and 38 % stopped PA. However, patients referred benefits from PA after diagnosis. Individual exercises rather than group activities were preferred after diagnosis. Only 26 % of patients knew that adapted PA existed and the differences between adapted PA and classic physiotherapy. We observed a reduction in the practice of PA in patients after the diagnosis of MS, in particular for disease-related reasons. Nevertheless, active patients referred benefits from PA. It is important to know the point of view of patients towards developing individualized training programs. In this way, it could be possible to achieve more benefits from PA and reduce the negative effects.

The in situ conservation activities carried out in the last 10 years on endemic and threatened Sardinian vascular flora were analysed. Monitored species were selected following the policy species (listed in the Habitat Directive) and following the regional responsibility criterion. A monitoring scheme, with three levels of intensity, was applied and economic costs of the monitoring activities were analysed. In the 10-year long field work, 49 taxa corresponding to 50% of policy species and to 22.5% of the Sardinian endemics were monitored. The Sulcitano-Iglesiente sector showed the highest number of monitored taxa (20), whereas the Gennargenteo sector showed the highest number of populations monitored (32). A variation of the relative importance of the three levels of monitoring has been detected and most of the protocols showed a high level of intensity and complexity (90%). Plant-monitoring programmes have been considerably intensified over time with an increase in the total costs; the most important cos...

Background: The purpose is to measure the worsening of the Quality of Life (QoL) in people with Multiple Sclerosis (MS) and the concomitant role of co-morbid Major Depressive Disorder (MDD) and Bipolar Disorder (BD), the latter not yet studied even though it was found strictly associated with MS. Methods: Cases: 201 consecutive-MS-patients. Controls: 804 sex-and-age-matched subjects without MS, randomly selected from an epidemiological database study. Psychiatric diagnoses according to DSM-IV were determined by physicians using structured interview tools (ANTAS-SCID). Bipolar Spectrum Disorders were identified by Mood Disorders Questionnaire (MDQ). QoL was measured by SF-12. Results: MS was the strongest determinant in worsening the QoL in the overall sample. Both MDD and BD type-II lifetime diagnoses were significantly associated with a poorer quality of life in the total sample as in cases of MS. In MS the impairment of the QoL attributable to BD type-II was even greater than that in MDD. Limitations: The MS diagnosis was made differently in cases and controls. Although this may have produced false negatives in controls, it would have reinforced the null hypothesis (no role of MS in worsening the QoL); therefore, it does not invalidate the study. Conclusions: MDD as well BD type-II are co-determinants in worsening QoL in MS. Clinicians should consider depressive symptoms as well as the hypomanic and mixed components in MS. Additional research is required to confirm our results and further clarify the manner in which BD and the mixed symptoms of BD type-II may affect awareness of both the underlying disease and psychiatric component and finally to what extent they impact treatment adherence with the available therapies for MS. & 2014 Elsevier B.V. All rights reserved. 1. Background

Background Oligoclonal bands of IgG (OB) are proposed as an early prognostic factor of the disease. Growing attention is directed towards brain volume evaluation as a possible marker of the severity of MS. Previous studies found that MS patients lacking OB have less brain atrophy. Aim to evaluate a possible relationship between OB and cerebral volume in a cohort of early MS patients. Methods Inclusion criteria were: diagnosis of relapsing-remitting MS; CSF analysis and MRI acquired simultaneously and within 12 months from clinical onset. A total of 15 healthy controls underwent MRI. Results In 20 MS patients, CSF analysis did not show OB synthesis (OB negative group). A control group of 25 MS patients in whom OB was detected was also randomly recruited (OB positive group). T test showed a significant difference in NWV between the OB positive and OB negative groups (P value = 0.01), and between the OB positive group and the healthy controls (P value = 0.001). No differences were detected between OB negative group and healthy controls. Multivariable linear regression showed a relationship between NWV and OB synthesis (P value = 0.02) controlling for age, gender, and EDSS. Conclusions Our preliminary results suggest that OB positive patients show more atrophy of white matter since early phases of the disease, supporting the role of CSF analysis as a prognostic factor in MS.

Habitat variations influence the richness and composition of insect guilds. This affects plant reproduction, which depends upon functional relationships with insects, responsible for both pollination and predation. Major consequences can occur in composite landscapes, where forest fragmentation produces transition habitats showing a great heterogeneity over short-spatial scales. We studied herbivory and pollination in an edge-specialist carnation over a forest-open habitat gradient. Visiting insects varied over the gradient, affecting herbivory and pollination rates, and offspring quality and quantity. Our findings emphasize the role of plant-insect interactions in tuning plant fitness in edge habitats, and provide guidelines for managing such ecological contexts., Spatial shifts in insect fauna due to ecological heterogeneity can severely constrain plant reproduction. Nonetheless, data showing effects of insect visit patterns and intensity of mutualistic and/or antagonistic plant–insect interactions on plant reproduction over structured ecological gradients remain scarce. We investigated how changes in flower-visitor abundance, identity and behaviour over a forest-open habitat gradient affect plant biotic interactions, and quantitative and qualitative fitness in the edge-specialist Dianthus balbisii. Composition and behaviour of the insects visiting flowers of D. balbisii strongly varied over the study gradient, influencing strength and patterns of plant biotic interactions (i.e. herbivory and pollination likelihood). Seed set comparison in free- and manually pollinated flowers suggested spatial variations in the extent of quantitative pollen limitation, which appeared more pronounced at the gradient extremes. Such variations were congruent to patterns of flower visit and plant biotic interactions. The analyses on seed and seedling viability evidenced that spatial variation in amount and type of pollinators, and frequency of herbivory affected qualitative fitness of D. balbisii by influencing selfing and outcrossing rates. Our work emphasizes the role of plant biotic interactions as a fine-scale mediator of plant fitness in ecotones, highlighting that optimal plant reproduction can take place into a restricted interval of the ecological gradients occurring at forest edges. Reducing the habitat complexity typical of such transition contexts can threat edge-adapted plants.

Charcot–Marie–Tooth disease (CMT) is characterised by great variability of genetic subtypes. This study aimed to assess the genetic subtypes of CMT disease in the Sardinian population. Genetic screening was performed for CMT cases (CMT1, CMT2, and hereditary neuropathy with susceptibility to pressure palsies [HNPP]). A total of 1,043 subjects (119 index cases) were evaluated. In CMT1 index cases (69/119; 58%), PMP22 duplication at 17p11.2 was the most frequent genetic diagnosis (60/69; 87%), followed by mutations in the GJB1 gene (5/69; 7.2%), in the SH3TC2 gene (3/69; 4.4%) and PMP22 Gly107Val point mutation (1/69; 1.4%). The CMT2 group (24/119; 20.1%) comprised 10/24 (41.6%) patients carrying MPZ gene Ser44Phe mutation, 6/24 (25%) with mutations in MFN2 and HSPB1, and 1/24 (4.2%) in GJB1 and LRSAM1. In the HNPP group (26/119; 21.9%), the majority of patients reported the PMP22 deletion (25/26; 96.2%). Further studies are needed to comprehend the overall picture of the disease in Mediterranean area.

Supported by grants (2011/R/13 and 2015/R/09, to Dr. Cucca) from the Italian Foundation for Multiple Sclerosis; contracts (N01-AG-1-2109 and HHSN271201100005C, to Dr. Cucca) from the Intramural Research Program of the National Institute on Aging, National Institutes of Health (NIH); a grant (FaReBio2011 “Farmaci e Reti Biotecnologiche di Qualità,” to Dr. Cucca) from the Italian Ministry of Economy and Finance; a grant (633964, to Dr. Cucca) from the Horizon 2020 Research and Innovation Program of the European Union (...), Steri, M.; Orru, V.; Idda, M. L.; Pitzalis, M.; Pala, M.; Zara, I.; Sidore, C.; Faa, V.; Floris, M.; Deiana, M.; Asunis, I.; Porcu, E.; Mulas, A.; Piras, M. G.; Lobina, M.; Lai, S.; Marongiu, M.; Serra, V.; Marongiu, M.; Sole, G.; Busonero, F.; Maschio, A.; Cusano, R.; Cuccuru, G.; Deidda, F.; Poddie, F.; Farina, G.; Dei, M.; Virdis, F.; Olla, S.; Satta, M. A.; Pani, M.; Delitala, A.; Cocco, E.; Frau, J.; Coghe, G.; Lorefice, L.; Fenu, G.; Ferrigno, P.; Ban, M.; Barizzone, N.; Leone, M.; Guerini, F. R.; Piga, M.; Firinu, D.; Kockum, I.; Bomfim, I. Lima; Olsson, T.; Alfredsson, L.; Suarez, A.; Carreira, P. E.; Castillo-Palma, M. J.; Marcus, J. H.; Congia, M.; Angius, A.; Melis, M.; Gonzalez, A.; Riquelme, M. E. A.; da Silva, B. M.; Marchini, M.; Danieli, M. G.; Del Giacco, S.; Mathieu, A.; Pani, A.; Montgomery, S. B.; Rosati, G.; Hillert, J.; Sawcer, S.; D'Alfonso, S.; Todd, J. A.; Novembre, J.; Abecasis, G. R.; Whalen, M. B.; Marrosu, M. G.; Meloni, A.; Sanna, S.; Gorospe, M.; Schlessinger, D.; Fiorillo, E.; Zoledziewska, M.; Cucca, F.

The Egyptian Mediterranean sand dunes are being lost due to recent excessive unplanned anthropogenic interventions that caused a modification in floristic composition. The present study provides a description of the floristic inventory and plant clusters in coastal dunes in relation to natural and human factors. Floristic sampling was carried out in nine transects along Nile Delta coast, a total of 55 plots were randomly placed and data on natural and anthropogenic factors were measured for each plot. Agglomerative Hierarchical Cluster allowed to identify four plant clusters: (A) Elymus farctus-Silene succulenta, (B) Echinops spinosus-Moltkiopsis ciliata, (C): Stipagrostis lanata-Echium angustifolium and (D): Lycium schweinfurthii-Asparagus stipularis. Fish farming, ceramic industry, trampling, agriculture, urbanization, magnesium, total nitrogen, potassium, calcium and organic matter were identified as the most significant key factors for the definition of plant clusters by Canonical Correspondence Analysis. Variance partitioning confirmed that 40% of the variance was explained by both natural and anthropogenic factors. In particular, anthropogenic factors explained only 9% while natural variables 2% of the total variance, whereas the combined shared effect was 29%. The information in this study enables us to establish an effective conservation strategy to prevent further declines in plant diversity along coastal dunes.

Habitat Directive is the core strategy of nature conservation in Europe aiming at halting biodiversity loss. In this study the results of the third Italian assessment regarding the conservation status (CS) of plants listed in the Habitat Directive (Flora of community interest—FCI) was presented. Data was collected from several sources related to plant distribution, population data, habitats and pressures. Following the official European procedure, all parameters were evaluated and combined to give the CS of each taxon in each biogeographical region of presence. A comparison between the recent Italian IUCN and Reporting assessments was performed in order to evaluate the consistency between these two assessments. The official EU checklist comprises 113 Italian plant taxa, 107 of which were examined in this study. Our results showed a critical situation with only 34% of favourable CS, while 50% were unfavourable (40% inadequate plus 10% bad) and 16% unknown, in particular in the Mediterranean bioregion, where the unfavourable assessments reach the 65%. The results of the Report were consistent with those of the IUCN assessment, in which 41.9% of plants were threatened with extinction. This report highlighted some benefits and criticisms at national level, but it may have a wider significance. Although a general advance of knowledge, a great effort is needed to reach the Habitats Directive goals. Despite the limited resources, monitoring activities needs to be improved in order to close information gaps for several plants. A positive outcome was the development of a specific national project funded by the Italian Ministry of Environment, with the ambitious target to set future monitoring activities for FCI and optimize monitoring efforts.

In this contribution, the conservation status assessment of four vascular plants are presented according to IUCN categories and criteria. It includes the assessment at global level of CrepislaceraTensubsp.titani (Pamp.) Roma-Marzio, G.Astuti & Peruzzi and AnthyllishermanniaeL.subsp.sicula Brullo & Giusso and the regional assessment of Commicarpusplumbagineus (Cav.) Standl. (Spain and Europe) and Ambrosiamaritima L. (Italy).

Sardinia hosts 186 endemic plant species and represents an important centre for Mediterranean biodiversity. In view of the threats facing its flora, 27 terrestrial vascular plants have been listed in international regulations and 124 sites designated for species and habitat conservation. This study analyses gaps in the Natura 2000 network and the current and future distribution of four representative plants. Each plant population was georeferenced and the effectiveness of the Natura 2000 network was compared according to conservation status and distribution. Future species distributions were modelled by considering current climatic conditions and future scenarios. In apparent discordance with other results, we found that the Natura 2000 network represents most plant species well. This research shows a forward-looking survey on the regional effectiveness of protection measures which led us to confirm the need to enhance the current state of the Natura 2000 network by implementing local legislation and regulations.

Due to the impelling urgency of plant conservation and the increasing availability of high resolution spatially interpolated (e.g. climate variables) and categorical data (e.g. land cover and vegetation type), many recent studies have examined relationships among plant species distributions and a diversified set of explanatory factors; nevertheless, global and regional patterns of endemic plant richness remain in many cases unexplained. One such pattern is the 294 endemic vascular plant taxa recorded on a 1 km resolution grid on the environmentally heterogeneous island of Sardinia. Sixteen predictors, including topographic, geological, climatic and anthropogenic factors, were used to model local (number of taxa inside each 1 km grid cell) Endemic Vascular Plant Richness (EVPR). Generalized Linear Models were used to evaluate how each factor affected the distribution of local EVPR. Significant relationships with local EVPR and topographic, geological, climatic and anthropogenic factors were found. In particular, elevation explained the larger fraction of variation in endemic richness but other environmental factors (e.g. precipitation seasonality and slope) and human-related factors (e.g. the Human Influence Index (HII) and the proportion of anthropogenic land uses) were, respectively, positively and negatively correlated with local EVPR. Regional EVPR (number of endemic taxa inside each 100 m elevation interval) was also measured to compare local and regional EVPR patterns along the elevation gradient. In contrast to local, regional EVPR tended to decrease with altitude partly due to the decreasing area covered along altitude. The contrasting results between local and regional patterns suggest that local richness increases as a result of increased interspecific aggregation along altitude, whereas regional richness may depend on the interaction between area and altitude. This suggests that the shape and magnitude of the species-area relationship might vary with elevation. This work provides—for the first time in Sardinia—a comprehensive analysis of the influence of environmental factors on the pattern of EVPR in the entire territory, from sea level to the highest peaks. Elevation, as well as other environmental and human-related variables, were confirmed to be influencing factors. In addition, variations of EVPR patterns at regional-to-local spatial scales inspire next investigations on the possible interaction between elevation and area in explaining patterns of plant species richness.

In this contribution, the conservation status assessments of three vascular plants are presented following to IUCN categories and criteria. It includes the assessment at global level of Saxifragacaprariae Mannocci, Ferretti, Mazzoncini & Viciani and S.montis-christi Mannocci, Ferretti, Mazzoncini & Viciani and the regional assessment of Halocnemumcruciatum (Forssk.) Tod. (Spain).

The Italian vascular flora is one of the richest in the European Union and the Italian peninsula is located at the centre of the Mediterranean Basin, one of the 25 world biodiversity hotspots with an exceptional loss of habitats and species (1). Preliminary to any conservation initiative concerning plant diversity, a prioritization of the most endangered species is needed. IUCN Red List protocol is widely recognized and used to evaluate the conservation status of a species, according to its estimated extinction risk (2). Assessing the conservation status of plants endemic to an entire nation is a key challenge, because of the huge amount of data, knowledge and information required. Such a result can be achieved only through the collaboration of many specialists and an adequate financial base. “The Red List of the Italian Flora” project, promoted by the Ministry for Environment and Protection of Land and Sea General, Directorate for Protection of Nature and Sea, in collaboration with the Italian Botanical Society, started in 2013 with the aim to update the conservation status of Italian plants. In 2016 the assessment of all the vascular plants strictly endemics to Italy was completed. Considering all the Italian endemics, with the exclusion of taxonomically critical genera (i.e. Alchemilla, Hieracium, Ophrys, Pilosella, Ranunculus, Rubus and Taraxacum), a total of 1088 taxa was assessed. Three taxa are considered extinct (EX), one extinct in the wild (EW) and six are possibly extinct (CR[PE]). Around 27% of the Italian endemics are included in one of the major threat categories (CR, EN and VU), while c. 20% may become threatened with extinction in the near future (NT). Around half of the Italian endemic taxa (506) are widespread and abundant taxa (LC). Finally, 80 species (7%) were categorized as Data Deficient since the available data did not allow a robust assessment, indicating that further taxonomic and field studies should be undertaken in the next future.

Neuroactive steroid family includes molecules synthesized in peripheral glands (i.e., hormonal steroids) and directly in the nervous system (i.e., neurosteroids) which are key regulators of the nervous function. As already reported in clinical and experimental studies, neurodegenerative diseases affect the levels of neuroactive steroids. However, a careful analysis comparing the levels of these molecules in cerebrospinal fluid (CSF) and in plasma of multiple sclerosis (MS) patients is still missing. To this aim, the levels of neuroactive steroids were evaluated by liquid chromatography-tandem mass spectrometry in CSF and plasma of male adults affected by Relapsing-Remitting MS and compared with those collected in control patients. An increase in pregnenolone and isopregnanolone levels associated with a decrease in progesterone metabolites, dihydroprogesterone, and tetrahydroprogesterone was observed in CSF of MS patients. Moreover, an increase of 5α-androstane-3α,17β-diol and of 17β-estradiol levels associated with a decrease of dihydrotestosterone also occurred. In plasma, an increase in pregnenolone, progesterone, and dihydrotestosterone and a decrease in dihydroprogesterone and tetrahydroprogesterone levels were reported. This study shows for the first time that the levels of several neuroactive steroids, and particularly those of progesterone and testosterone metabolites, are deeply affected in CSF of relapsing-remitting MS male patients. We here demonstrated that, the cerebrospinal fluid and plasma levels of several neuroactive steroids are modified in relapsing remitting multiple sclerosis male patients. Interestingly, we reported for the first time that, the levels of progesterone and testosterone metabolites are deeply affected in cerebrospinal fluid. These findings may have an important relevance in therapeutic and/or diagnostic field of multiple sclerosis.