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In the context of the study of plants in the Bible, some translation problems are related to the identification of the plant species referred to in the biblical text. One of the unresolved problems concerns the plant living in the desert of Jer 17:6, because the botanists’ proposals have not been understood in the same way by the exegetes: it is not clear whether it is a tree, a bush or a shrub and to which plant species it refers. After presenting the general characteristics of the study of plants in the Bible, the research presents proposals for identification by botanists and how these have been received by exegetes. The study of the biblical context integrated with the dynamics of plant growth allows a better understanding of the two opposing metaphorical images of Jeremiah: the plant living in the desert and the tree that grows along streams. The analysis indicates a generic tree which, due to the difficult environmental conditions, cannot develop as such and remains smaller in size. The best translation is therefore a generic shrub, which also allows the different interpretations to be reconciled.

Flood, drought, and frost may be disruptive events for agriculture. The subsidised crop insurance schemes are coping strategies that increase farms resilience to weather shocks and in fact the occurrence of extreme weather events and the level of subsidised crop insurance are correlated. Stronger evidence is found in Southern geographical areas, where drought (a major risking risk) is more frequent, and for spring-summer crops, that are less resilient to weather shocks. The article points at the need to reform extant policies to move toward a holistic approach for risk management.

In the context of the internet of things, and particularly within distributed measurement systems that are subject to high privacy risks, it is essential to emphasize the need for increasingly effective privacy protections. The idea presented in this work involves managing critical traffic through an architectural proposal aimed at solving the problem of communications between nodes by optimizing both the confidentiality to be guaranteed to the payload and the transmission speed. Specifically, data such as a typical sensor on/off signal could be sent via a standard encrypted channel, while a sensitive aggregate could be transmitted through a dedicated private channel. Additionally, this work emphasizes the critical importance of optimizing message sizes to 5 k-bytes (small payload messages) for transmission over the reserve channel, enhancing both privacy and system responsiveness, a mandatory requirement in distributed measurement systems. By focusing on small, encrypted payloads, the study facilitates secure, timely updates and summaries of network conditions, maintaining the integrity and privacy of communications in even the most challenging and privacy-sensitive environments. This study provides a comprehensive performance analysis of IoT networks using Dark Net technologies and MQTT protocols, with a focus on privacy and anonymity. It highlights the trade-offs between enhanced security and performance, noting increased latency, reduced bandwidth, and network instability when using TOR, particularly with cipher suites like AES256-GCM-SHA384 and DHE-RSA-CHACHA20-POLY1305. The research emphasizes the need for further exploration of alternative protocols like LWM2M in secure IoT environments and calls for optimization to balance privacy with performance in Dark-Net-based IoT deployments.

Abstract Introduction Stigma has undermined the scale‐up of evidence‐based HIV prevention and treatment. Negative beliefs influence clinicians’ discriminatory behaviour and ultimately have wide‐ranging effects across the HIV prevention and treatment continuum. Stigma among clinicians can be mitigated in several ways, including through interpersonal contact. In this study, we test whether interactions with people who inject drugs (PWID) influence attitudes of both direct and indirect providers of opioid agonist therapies (OATs) within the same primary care clinics (PCCs) where OAT is newly introduced. Methods In a cluster randomized controlled trial integrating OAT and HIV care into PCCs in Ukraine, clinicians at 24 integrated care sites (two sites in 12 regions) from January 2018 to August 2022 completed a structured survey at baseline, 12 and 24 months. The survey included feeling thermometers and standardized scales related to clinician attitudes towards patients and evidence‐based care. Nested linear mixed‐effects models were used to examine changes in mean scores over three timepoints for both direct and indirect clinicians. Results There were fewer significant changes in any of the scales for direct providers (n = 87) than for indirect providers (n = 155). Direct providers became less tough‐minded about substance use disorders (p = 0.002), had less negative opinions about PWID (p = 0.006) and improved their beliefs regarding OAT maintenance (p

Summary: Background: Pre-exposure vaccination with MVA-BN has been widely used against mpox to contain the 2022 outbreak. Many countries have defined prioritized strategies, administering a single dose to those historically vaccinated for smallpox, to achieve quickly adequate coverage in front of low supplies. Using epidemiological models, real-life effectiveness was estimated at approximately 36%–86%, but no clinical trials were performed. Few data on MVA-BN immunogenicity are currently available, and there are no established correlates of protection. Immunological response in PLWH in the context of the 2022 outbreak was also poorly described. Methods: Blood samples were collected from participants eligible for pre-exposure MVA-BN vaccination before (T1) receiving a full course of vaccine (single-dose for vaccine-experienced or smallpox-primed and two-dose for smallpox vaccine-naïve or smallpox non-primed) and one month after the last dose (T2 and T3, respectively). MPXV-specific IgGs were measured by in-house immunofluorescence assay, using 1:20 as screening dilution, MPXV-specific nAbs by 50% plaque reduction neutralization test (PRNT50, starting dilution 1:10), and IFN-γ-producing specific T cells to MVA-BN vaccine, by ELISpot assay. Paired or unpaired t-test and Wilcoxon or Mann–Whitney test were used to analyse IgG and nAbs, and T-cell response, as appropriate. The probability of IgG and nAb response in vaccine-experienced vs. vaccine-naïve was estimated in participants not reactive at T1. The McNemar test was used to evaluate vaccination's effect on humoral response both overall and by smallpox vaccination history. In participants who were not reactive at T1, the proportion of becoming responders one month after full-cycle completion by exposure groups was compared by logistic regression and then analysed by HIV status strata (interaction test). The response was also examined in continuous, and the Average Treatment Effect (ATE) of the difference from baseline to schedule completion according to previous smallpox vaccination was estimated after weighting for HIV using a linear regression model. Self-reports of adverse effects following immunization (AEFIs) were prospectively collected after the first MVA-BN dose (T1). Systemic (S-AEFIs: fatigue, myalgia, headache, GI effects, chills) and local (L-AEFIs: redness, swelling, pain) AEFIs were graded as absent (grade 0), mild (1), moderate (2), or severe (3). The maximum level of severity for S-AEFIs and L-AEFIs ever experienced over the 30 days post-dose by vaccination exposure groups were analysed using a univariable multinomial logistic regression model and after adjusting for HIV status; for each of the symptoms, we also compared the mean duration by exposure group using an unpaired t-test. Findings: Among the 164 participants included, 90 (54.8%) were smallpox vaccine-experienced. Median age was 49 years (IQR 41–55). Among the 76 (46%) PLWH, 76% had a CD4 count >500 cells/μL. There was evidence that both the IgG and nAbs titers increased after administration of the MVA-BN vaccine. However, there was no evidence for a difference in the potential mean change in humoral response from baseline to the completion of a full cycle when comparing primed vs. non-primed participants. Similarly, there was no evidence for a difference in the seroconversion rate after full cycle vaccination in the subset of participants not reactive for nAbs at T1 (p = 1.00 by Fisher's exact test). In this same analysis and for the nAbs outcome, there was some evidence of negative effect modification by HIV (interaction p-value = 0.17) as primed people living with HIV (PLWH) showed a lower probability of seroconversion vs. non-primed, and the opposite was seen in PLWoH. When evaluating the response in continuous, we observed an increase in T-cell response after MVA-BN vaccination in both primed and non-primed. There was evidence for a larger increase when using the 2-dose vs. one-dose strategy with a mean difference of −2.01 log2 (p ≤ 0.0001), after controlling for HIV. No evidence for a difference in the risk of developing any AEFIs of any grade were observed by exposure group, except for the lower risk of grade 2 (moderate) fatigue, induration and local pain which was lower in primed vs. non-primed [OR 0.26 (0.08–0.92), p = 0.037; OR 0.30 (0.10–0.88), p = 0.029 and OR 0.19 (0.05–0.73), p = 0.015, respectively]. No evidence for a difference in symptom duration was also detected between the groups. Interpretation: The evaluation of the humoral and cellular response one month after the completion of the vaccination cycle suggested that MVA-BN is immunogenic and that the administration of a two-dose schedule is preferable regardless of the previous smallpox vaccination history, especially in PLWH, to maximize nAbs response. MVA-BN was safe as well tolerated, with grade 2 reactogenicity higher after the first administration in vaccine-naïve than in vaccine-experienced individuals, but with no evidence for a difference in the duration of these adverse effects. Further studies are needed to evaluate the long-term duration of immunity and to establish specific correlates of protection. Funding: The study was supported by the National Institute for Infectious Disease Lazzaro Spallanzani IRCCS “Advanced grant 5 × 1000, 2021” and by the Italian Ministry of Health “Ricerca Corrente Linea 2”.

The widespread adoption of Internet of Things (IoT) devices in home, industrial, and business environments has made available the deployment of innovative distributed measurement systems (DMS). This paper takes into account constrained hardware and a security-oriented virtual local area network (VLAN) approach that utilizes local message queuing telemetry transport (MQTT) brokers, transport layer security (TLS) tunnels for local sensor data, and secure socket layer (SSL) tunnels to transmit TLS-encrypted data to a cloud-based central broker. On the other hand, the recent literature has shown a correlated exponential increase in cyber attacks, mainly devoted to destroying critical infrastructure and creating hazards or retrieving sensitive data about individuals, industrial or business companies, and many other entities. Much progress has been made to develop security protocols and guarantee quality of service (QoS), but they are prone to reducing the network throughput. From a measurement science perspective, lower throughput can lead to a reduced frequency with which the phenomena can be observed, generating, again, misevaluation. This paper does not give a new approach to protect measurement data but tests the network performance of the typically used ones that can run on constrained hardware. This is a more general scenario typical for IoT-based DMS. The proposal takes into account a security-oriented VLAN approach for hardware-constrained solutions. Since it is a worst-case scenario, this permits the generalization of the achieved results. In particular, in the paper, all OpenSSL cipher suites are considered for compatibility with the Mosquitto server. The most used key metrics are evaluated for each cipher suite and QoS level, such as the total ratio, total runtime, average runtime, message time, average bandwidth, and total bandwidth. Numerical and experimental results confirm the proposal’s effectiveness in foreseeing the minimum network throughput concerning the selected QoS and security. Operating systems yield diverse performance metric values based on various configurations. The primary objective is identifying algorithms to ensure suitable data transmission and encryption ratios. Another aim is to explore algorithms that ensure wider compatibility with existing infrastructures supporting MQTT technology, facilitating secure connections for geographically dispersed DMS IoT networks, particularly in challenging environments like suburban or rural areas. Additionally, leveraging open firmware on constrained devices compatible with various MQTT protocols enables the customization of the software components, a crucial necessity for DMS.

The new power generation systems, the increasing number of equipment connected to the power grid, and the introduction of technologies such as the smart grid, underline the importance and complexity of the Power Quality (PQ) evaluation. In this scenario, an Automatic PQ Events Classifier (APQEC) that detects, segments, and classifies the anomaly in the power signal is needed for the timely intervention and maintenance of the grid. Due to the extension and complexity of the network, the number of points to be monitored is large, making the cost of the infrastructure unreasonable. To reduce the cost, a new architecture for an APQEC is proposed. This architecture is composed of several Locally Distributed Nodes (LDNs) and a Central Classification Unit (CCU). The LDNs are in charge of the acquisition, the detection of PQ events, and the segmentation of the power signal. Instead, the CCU receives the information from the nodes to classify the PQ events. A low-computational capability characterizes low-cost LDNs. For this reason, a suitable PQ event detection and segmentation method with low resource requirements is proposed. It is based on the use of a sliding observation window that establishes a reasonable time interval, which is also useful for signal classification and the multi-sine fitting algorithm to decompose the input signal in harmonic components. These components can be compared with established threshold values to detect if a PQ event occurs. Only in this case, the signal is sent to the CCU for the classification; otherwise, it is discarded. Numerical tests are performed to set the sliding window size and observe the behavior of the proposed method with the main PQ events presented in the literature, even when the SNR varies. Experimental results confirm the effectiveness of the proposal, highlighting the correspondence with numerical results and the reduced execution time when compared to FFT-based methods.

Climate change and trade are closely related. Climate may alter the comparative advantages across countries, which may in turn trigger changes in trade patterns. Trade itself may constitute an adaptation strategy, moving excesses of agri-food supply to regions with shortages, and this in turn may explain changes in land-use. We investigate these linkages, showing that the changes in climate affect counties’ trade value and contribute to reshaping trade patterns. First, we quantify the long-term impacts of climate on the value of agri-food exports, implicitly considering the ability of countries to adapt, and show that higher marginal temperatures and rainfall levels tend to be beneficial for countries’ exports. Following a gravity model approach, we then link the evolving trade patterns to climate change adaptation strategies. We find that the larger the difference in temperatures and rainfall levels between trading partners, the higher the value of bilateral exports. Furthermore, while developed and developing exporters are both sensitive to climate change and to cross-countries heterogeneity in climate, we found their responses to changes in climate to be quite diverse.

Abstract Background The impacts of climate change on crop and livestock sectors are well-documented. Climate change and its related events (e.g., high temperatures, extreme events, disease outbreaks) affect livestock production in various ways (e.g., nutrition, housing, health, welfare), and tend to compromise the physical productivity and the economic performances. Understanding animal responses to climate change may help planning strategies to cope with the adverse climatic conditions and also to reduce polluting emissions. Through an interdisciplinary approach, we develop a conceptual framework to assess and develop new organisational models for Mediterranean small-scale farming systems so as to mitigate the impacts of climate change, to improve farm management and farming technologies, and to achieve an effective adaptation to the climate changes. The conceptual framework consists of four phases: (i) community engagement, (ii) strategies development, (iii) data collection and analysis, (iv) business model generation and sustainability assessment. We assess strengths, weaknesses, opportunities, and threats of the eco-solutions by mean of a SWOT (Strengths, Weaknesses, Opportunities, Threats) analysis technique. Results The proposed eco-solutions are expected to increase the sustainability of agriculture and food production systems by introducing new and efficient uses of natural resources. The proposed models are expected to have an impact not only on the environment (in terms of mitigation), but also on the economic and social performances, as they are expected to foster the responses of small-scale farms to the increasingly frequent effects of climate change (adaptation solutions). Among the positive impacts, we emphasise the importance of more stable revenues, a tendency that would help farmers to raise their revenues. Last but not least, we found that the proposed models are likely to increase the social resilience of the farming systems to the challenges imposed by the climate change. Conclusions The eco-solutions can support stakeholders involved in Mediterranean small-scale farming systems by suggesting novel land, crop, and livestock management approaches to optimise revenue flows, business models and climate change mitigation strategies thanks to the adoption of a systemic approach, that is not only focused on specific components of the system but instead based on the linkages between environmental, social, and economic aspects.

Climate change includes different dramatic events, and among them, heat stress exposition is the strongest phenomenon affecting the livestock sector. The effects of heat stress events on animal welfare are complex and the economic impacts for the livestock sector are relevant. Management measures may contribute to improve the resilience to heat stress, but the extent to which they impact on livestock performances and management strategies depend on the magnitude of the stress conditions. Through a pioneering synthesis of existing knowledge from experiments conducted in controlled conditions, we show that management strategies, both adaptation and mitigation measures, halved the negative impacts on the ruminants' performances and welfare induced by heat stress, but the efficacy is low in extreme conditions, which in turn are more and more frequent. These novel findings emphasize the need to deepen research on more effective adaptation and mitigation measures.

The climate changes and the weather events affect agricultural production and farmers’ income. Several strategies may help improving the resilience of farms to climate change, and particular mention should be done to the weather index-based crop insurance schemes, as they rely on the yield-weather relationship. A vast majority of studies investigate the limitation of the weather index insurance, due to the complex relationships linking weather events and yields and the difficulty to capture them with an index (i.e., the basis risk). The literature has not devoted sufficient attention to compare different specifications within the same statistical model in yield-weather estimation. Our study, conducted on durum wheat in Italy, shows how the identification (and design) of the phenological stages (i.e., temporal specifications) may help capturing or depicting the yield-weather relationships. The negative effects of the low temperatures, especially during the early stages of durum wheat, is remarkable. Our findings contribute to the debate on the design of triggers in weather indexes (e.g., for minimum temperatures), stimulating new research directions to assist stakeholders interested in planning agricultural risk management interventions.

Measurement of Morphological Blood Cell Parameter (MBCP) plays a key role in hematological examination and diagnosis of various diseases. Recently, Cellular Image Analysis (CIA) techniques have been widely used in clinical diagnosis. Nowadays, these CIA techniques are mainly based on image acquisition followed by digital processing for image segmentation and measurement of MBCP. This paper presents an overview of segmentation methods currently used for measurement of MBCP. Furthermore, main challenges and limitations related to metrological aspects that can affect the performances of these methods are also highlighted.

Since 2013, the olive landscapes have gradually degenerated due to the spread and establishment of Xylella fastidiosa subsp. pauca (hereafter Xf) in Apulia, southern Italy. From 2013 to 2019, a total of approximately 54,000 hectares of olive orchards in the south of this region have been seriously damaged, and their restoration will progressively regenerate the economic, social, cultural and environmental nonmarket benefits. Since there is a willingness to restore the affected landscape in the best interest of the local citizens, this research aims to predict their preference heterogeneity and willingness to pay (WTP) to improve this landscape and continue research and experimentation in relation to Olive Quick Decline Syndrome Disease by the bacterium. For this purpose, a choice experiment method is used. The social field survey includes a representative sample of 683 respondents in three major cities (Foggia, Bari and Lecce) of Apulia region. The results reveal that for the local citizens interviewed, the most appreciated olive landscape services are cultural heritage and aesthetic values. In addition, the findings revealed citizens’ positive appreciation of improving the damaged olive landscape, while respondents are not willing to pay a premium for research. The results show that the average value that Apulians are willing to pay for landscape restoration is about 5.7 million of € per year. Further, this research has implications for land use planners in the study area, which faces issues of harmful pathogen management and land revival.

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) represents the gold standard for jaundice palliation in malignant biliary obstruction (MBO) patients. Biliary drainage using electrocautery lumen apposing metal stent (EC-LAMS) is currently a well-established procedure when ERCP fails. We aimed to assess the technical and clinical success of a new EC-LAMS as the first approach to the palliation of malignant jaundice due to MBO in patients unfit for surgery. Patients and methods Twenty-five consecutive patients undergoing endoscopic-guided biliary drainage with the new EC-LAMS were prospectively enrolled. Clinical success was defined as bilirubin level decrease > 15 % 24 hours after EC-LAMS placement. Results Mean age was 76.6 ± 11.56 years, and male patients were 10 (40 %). EC-LAMS placement was technically feasible in 24 patients (96 %) and clinical success rate was 100 %. Only one patient (4 %) experienced a misplacement rescued by an immediate second EC-LAMS placement. The mean duration of hospital stay was 4.66 ± 4.22 days. The median overall survival was 7 months (95 % CI 1–7). Conclusions In this preliminary study, the new EC-LAMS seems to allow a single-step palliative endoscopic therapy in patients affected by jaundice due to MBO, with high technical and clinical success and low adverse events. Further large prospective studies are warranted to validate these results.

Background and study aims Chronic radiation proctitis (CRP) occurs in 5 % to 20 % of patients undergoing pelvic radiation therapy and frequently manifests with rectal bleeding. Endoscopic management of more severe and refractory cases can be challenging. Rectal band ligation (RBL) has been shown to be a feasible alternative to current available techniques, especially in extensive CRP. Our aim is to evaluate clinical and technical success of RBL. Patients and methods We enrolled all consecutive patients treated with RBL for severe or recurrent hemorrhagic CRP. Success was defined as endoscopic evidence of complete rectal healing and/or cessation of bleeding not requiring further treatment or blood transfusion. Results We enrolled 10 patients (7 males, mean age 75.6 years). Median length of the CRP from the anal verge was 4.5 cm and mean surface area involved was 89 %. Eight patients (80 %) were naïve to endoscopic treatment, while two had undergone argon plasma coagulation (APC). Median follow-up was 136.5 days. Success was achieved in 100 % of patients after a mean number of 1.8 RBL sessions. A mean number of 4.7 bands were released in the first session while a mean of 3.1 and 2 bands were placed in the second and third sessions, respectively. As for adverse events, only one patient reported mild tenesmus and pelvic pain after the procedure. Conclusions RBL is a safe and effective therapeutic modality for the treatment of hemorrhagic CRP. It could be considered a valid first-line option in case of extensive rectal involvement as well as a viable rescue treatment after failed APC.

Abstract Climate change is a phenomenon that includes different dramatic events that deeply affect the physiology of animal species both directly and indirectly with qualitative–quantitative impacts on livestock performances and health. The implications of climate change on animal welfare and on production demand are complex and call for a multidisciplinary approach which involved both animal science and economic sciences. The current technical report will describe the activities performed by the fellow while placed at the University of Foggia, Department of Agriculture, Natural Resources and Engineering, in Italy. Furthermore, the work programme offered by the hosting site consisted in performing a systematic literature review, following the Preferred Reporting Items for Systematic Reviews and Meta‐analyses (PRISMA) Statement, and a quantitative synthesis of the literature on the impact of climate change events (e.g. heat stress) on livestock welfare and productivity and the effect of heat relieving strategies on the animals’ performance.

Abstract Cerebrospinal fluid (CSF) kappa free light chain (KFLC) index has been described as a reliable marker of intrathecal IgG synthesis to diagnose multiple sclerosis (MS). Our aims were: (1) to compare the efficiency of KFLC through different interpretation approaches in diagnosing MS. (2) to evaluate the prognostic value of KFLC in radiologically and clinically isolated syndromes (RIS-CIS). We enrolled 133 MS patients and 240 with other neurological diseases (93 inflammatory including 18 RIS-CIS, 147 non-inflammatory). Albumin, lambda free light chain (LFLC) and KFLC were measured in the CSF and serum by nephelometry. We included two groups of markers: (a) corrected for blood-CSF barrier permeability: immunoglobulin G (IgG), KFLC and LFLC indexes. (b) CSF ratios (not including albumin and serum-correction): CSF KFLC/LFLC, CSF KFLC/IgG, CSF LFLC/IgG. KFLC were significantly higher in MS patients compared to those with other diseases (both inflammatory or not). KFLC index and CSF KFLC/IgG ratio showed high sensitivity (93% and 86.5%) and moderate specificity (85% and 88%) in diagnosing MS. RIS-CIS patients who converted to MS showed greater KFLC index and CSF KFLC/IgG. Despite OB are confirmed to be the gold-standard to detect intrathecal IgG synthesis, the KFLC confirmed their accuracy in MS diagnosis. A “kappa-oriented” response characterizes MS and has a prognostic impact in the RIS-CIS population.

Gaia Pellegatta,1 Marco Spadaccini,1 Laura Lamonaca,1 Vincenzo Craviotto,1 Ferdinando D’Amico,1 Laura Ceriotti,2 Marisa Meloni,2 Alessandro Repici1 1Humanitas Clinical and Research Center and Humanitas University, Digestive Endoscopy Unit, Division of Gastroenterology, Rozzano, MI, Italy; 2VitroScreen, Milano, ItalyCorrespondence: Gaia PellegattaDigestive Endoscopy Unit, Division of Gastroenterology, Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI 20089, ItalyTel +390282247091Email gaia.pellegatta@humanitas.itPurpose: New medical devices that contain hyaluronic acid (HA) and chondroitin sulphate (CS), with or without antacid components, have been developed for the treatment of gastroesophageal reflux disease (GERD) with the aim of improving oesophageal mucosal defences by creating a film on the oesophageal mucosa and acting as a mechanical barrier against the noxious components of refluxate, both acidic and basic.Methods: The film-forming and protective efficacy of medical device A based on HA and CS plus aluminium hydroxide, device B combining HA and CS with magnesium trisilicate and device C with only the combination of HA and CS was tested on a reconstructed human oesophageal epithelium (HO2E/S/5) as a biological model in 2 different pH environments, neutral and acidic, to mimic realistic conditions. Caffeine penetration kinetics and Lucifer yellow (LY) permeability modifications induced by these products were compared to those induced by a negative control series (saline solution, code NC) and positive control series (white Vaseline, code V) under neutral and acidic pH conditions.Results: Under neutral and acidic pH conditions, compared to the negative control, all the products tested reduced (> 80% and 85– 90%, respectively) the caffeine passage, and no significant difference was observed among the products tested. Under neutral and acidic conditions, the LY permeabilities registered with device A and device C were not different from that registered with the negative control, while an LY flux% increase was calculated after 2 hrs of treatment (21.1%) with device B under acidic conditions.Conclusion: These results confirm the ability of the products tested to interact with the oesophageal epithelium in order to adhere and create a stable protective film for at least 2 hours after their homogeneous distribution on the epithelium surface. Further clinical studies are needed to test these devices in the topical treatment of gastroesophageal reflux symptoms.Keywords: hyaluronic acid, chondroitin sulphate, gastroesophageal reflux disease, antacid, caffeine, Lucifer yellow

Trademarks are useful territorial marketing policies contributing to the economic growth of a certain region. However, the complexity of these strategies from a marketing and legal perspective requires a deeper understanding of the functioning of trademarks. We investigate these dynamics for the trademark “Prodotti di Qualità” (PQ), a territorial marketing initiative of Apulia Region (Italy) aiming at enhancing agri-food products with regulated high-quality standards, raising awareness among consumers and promoting marketing and sales of such products. We adopt a multidisciplinary approach to conduct a prospective analysis of marketing issues and a perspective analysis on legal issues. We conclude that, in face of some benefits for users in terms of reduced asymmetric information between consumers and producers, a stronger communication and promotion campaign would increase consumers’ awareness and producers’ confidence, also contributing to avoid the overlap of the PQ trademarks with other legal forms of labelling, such as geographical indications and certification trademarks. Policy interventions in this direction would be beneficial for the future development of the Apulian territorial marketing.

Organic food, consumers and their buying behaviour are well examined fields of research, although there is a lack of consistent findings on consumers' perception about organic food's quality, in terms of healthiness, safety, and environmental sustainability, and on determinants of perceived quality. This study investigates how consumers perceive the quality of organic food, in terms of environmental sustainability, safety, and healthiness. The study also analyses how and to what extent perceived quality of organic food is influenced by the presence of information related to quality on food products' labels and consumers' socio-demographic profile. A survey has been conducted on a convenience sample of Italian consumers, recruited through a snowball sampling technique. An approach based on a Combination of Uniform and shifted Binomial random variables, named CUB model, is adopted to analyse consumers' perceptions in terms of two latent components, feeling and uncertainty. The CUB model approach is suitable for analyses that involve consumers perception. The results suggest that consumers perceive safety of organic food better than healthiness and environmentally sustainable attributes. Findings also highlight that the presence of specific information on food's label contributes to perceive organic food as healthier, safe, and environmentally sustainable: the more the details on food labels, the higher the consumers' perception. Furthermore, consumers' socio-demographic profile plays a significant role: males and females have a different perception of organic food and younger consumers tend to be more prone to buy and consume organic product.

International agencies recommend integrating addiction treatment into primary care for people who inject drugs (PWID) with opioid use disorder (OUD). Empirical data supporting integration that incorporates comprehensive health outcomes, however, are not known. For this randomized controlled trial in Ukraine, adult PWID with OUD were randomized to receive opioid agonist therapy (OAT) in specialty addiction treatment clinics (SATC) or to primary care clinics (PCCs). For those randomized to PCC, they were subsequently allocated to PCCs where clinicians received pay-for-performance (P4P) incentives (PCC with P4P) or not (PCC without P4P). Participating cities had one of each of the three intervention sites to control for geographic variation. Ongoing tele-education specialty training (OAT, HIV, tuberculosis) was provided to all PCCs. While the primary outcome for the parent trial focuses on patient medical record data, this preliminary analysis focuses on assessment of self-reported achievement of nationally recommended quality health indicators (QHIs) which is summed as a composite QHI score. Secondary outcomes included specialty and primary care QHI subscores. This study occurred from 01/20/2018-11/1/2020 with 818 of 990 randomized participants having complete self-reported data for analysis. Relative to SATC (treatment as usual), the mean composite QHI score was 12.7 (95% CI: 10.1-15.3; p3 months) experience with OAT compared to participants newly initiating OAT. In summary, PWID with OUD receive greater primary care and specialty healthcare services when receiving OAT at PCCs supported by tele-education relative to treatment as usual provided in SATCs. Clinical trial registration: This trial was registered at clinicaltrials.gov and can be found using the following registration number: NCT04927091.

New production and trade patterns due to climate change and policy interventions are increasingly affecting the wine sector. This paper investigates how patterns of production and trade in main wine producing regions respond to changes in climate and policy interventions. An approach based on a combination of Ricardian trade and climate models suggests that higher temperatures in the main producing regions of wine benefit both production and trade of wine. A gravity-based analysis shows that the effects of policy interventions on the global trade of wine are heterogeneous and dependent on the specific objective of the intervention.

Measurement of morphometric parameters of blood cells play a key role in hematological examination representing one of the main tools for the diagnosis and evaluation of blood disorders. Different techniques are currently used to measure blood cell parameters to provide important clinical information, to consolidate pertinent second opinions, and to minimize the human intervention in the diagnosis process. This paper presents a brief overview of the research work that can be found in the literature dealing with the measurement methods for morphometry of blood cells. The main challenges and limitations of the presented methods from the metrological point of view are discussed too.

Mutations in leucine-rich repeat kinase 2 (LRRK2) are associated with Parkinson's disease. LRRK2 modulates the autophagy-lysosome pathway (ALP), a clearance process subserving the quality control of cellular proteins and organelles. Since dysfunctional ALP might lead to α-synuclein accumulation and, hence, Parkinson's disease, LRRK2 kinase modulation of ALP, its age-dependence and relation with pSer129 α-synuclein inclusions were investigated in vivo. Striatal ALP markers were analyzed by Western blotting in 3, 12 and 20-month-old LRRK2 G2019S knock-in mice (bearing enhanced kinase activity), LRRK2 knock-out mice, LRRK2 D1994S knock-in (kinase-dead) mice and wild-type controls. The lysosomotropic agent chloroquine was used to investigate the autophagic flux in vivo. Quantitative Real-time PCR was used to quantify the transcript levels of key ALP genes. The activity of the lysosomal enzyme glucocerebrosidase was measured using enzymatic assay. Immunohistochemistry was used to co-localize LC3B puncta with pSer129 α-synuclein inclusion in striatal and nigral neurons. No genotype differences in ALP markers were observed at 3 months. Conversely, increase of LC3-I, p62, LAMP2 and GAPDH levels, decrease of p-mTOR levels and downregulation of mTOR and TFEB expression was observed in 12-month-old kinase-dead mice. The LC3-II/I ratio was reduced following administration of chloroquine, suggesting a defective autophagic flux. G2019S knock-in mice showed LAMP2 accumulation and downregulation of ALP key genes MAP1LC3B, LAMP2, mTOR, TFEB and GBA1. Subacute administration of the LRRK2 kinase inhibitor MLi-2 in wild-type and G2019S knock-in mice did not replicate the pattern of kinase-dead mice. Lysosomal glucocerebrosidase activity was increased in 3 and 12-month-old knock-out and kinase-dead mice. LC3B puncta accumulation and pSer129 α-synuclein inclusions were dissociated in striatal neurons of kinase-dead and G2019S knock-in mice. We conclude that constitutive LRRK2 kinase silencing results in early deregulation of GCase activity followed by late impairment of macroautophagy and chaperone-mediated autophagy.

Climate change has the potential to impact the agricultural sector and the wine sector in particular. The impacts of climate change are likely to differ across producing regions of wine. Future climate scenarios may push some regions into climatic regimes favourable to grape growing and wine production, with potential changes in areas planted with vines. We examine which is the linkage between climate change and productivity levels in the global wine sector. Within the framework of agricultural supply response, we assume that grapevines acreage and yield are a function of climate change. We find that grapevines yield suffers from higher temperatures during summer, whereas precipitations have a varying impact on grapevines depending on the cycle of grapevines. Differently, acreage share of grapevines tends to be favoured by higher annual temperatures, whereas greater annual precipitations tend to be detrimental. The impacts vary between Old World Producers and New World Producers, also due to heterogeneity in climate between them.

What should doctoral training in the humanities and humanistic social sciences look like in the 21st century? This question has prompted a steady stream of foundation inquiries over the past two decades, including "The Graduate Education Initiative" (Mellon Foundation), "The Responsive Ph.D." (Woodrow Wilson National Fellowship Foundation), and "The Carnegie Initiative on the Doctorate." Most of the resulting analyses critique academic hyper-specialization as crimping the salience of research projects, hampering effectiveness in the classroom, and hindering intellectual engagement beyond narrow subfields. The reports highlight instead the advantages of wider perspectives and expanded intellectual toolkits, while calling for more diverse graduate cohorts, strategies for leveraging technology, and the adoption of collaborative approaches to research. At a university where approximately half of humanities PhDs move on to tenure-track positions within a few years of graduating, the authors set out to create a program that would support all of their PhD students and their diverse goals. As they re-envisage the content and structure of doctoral training, they remain committed to thinking holistically about what it means to be a humanist scholar in the 21st century and how a more capacious preparation and versatile skill set might better prepare PhDs to make significant professional contributions within and beyond the academy.

The recovery of industrial by-products is part of the zero-waste circular economy. Lentil seed coats are generally considered to be a waste by-product. However, this low-value by-product is rich in bioactive compounds and may be considered an eco-friendly source of health-promoting phytochemicals. For the first time, a sustainable microwave-assisted extraction technique was applied, and a solvent screening was carried out to enhance the bioactive compound content and the antioxidant activity of green and red lentil hull extracts. With respect to green lentil hull extracts that were obtained with different solvents, the aqueous extract of the red lentil seed coats showed the highest total phenolic and total flavonoid content (TPC = 28.3 ± 0.1 mg GAE/g dry weight, TFC = 1.89 ± 0.01 mg CE/100 mg dry weight, respectively), as well as the highest antioxidant activity, both in terms of the free radical scavenging activity (ABTS, 39.06 ± 0.73 mg TE/g dry weight; DPPH, IC50 = 0.39 μg/mL) and the protection of the neuroblastoma cell line (SH-SY5Y, IC50 = 10.1 ± 0.6 μg/mL), the latter of which has never been investigated so far. Furthermore, a metabolite discovery analysis was for the first time performed on the aqueous extracts of both cultivars using an HPLC separation which was coupled with an Orbitrap-based high-Resolution Mass Spectrometry technique.

During the last decades, significant changes in trade regulations are modifying the global trade of wine. The number of non-tariff measures (NTMs) implemented in the wine sector is relevant: a large number of country-specific NTMs, set in the occasion of trade agreements, have been adopted. The impact of these policy instruments on trade is not always clear, nor quantified at global scale. We investigate the effects that country-specific NTMs are showing on global imports of wine. In particular, we estimate a gravity model to explain how and to what extent country-specific NTMs influence wine trade, and we disentangle these effects for different segments of the international market of wine.Our results suggest that country-specific NTMs tend to favour imports of wine. Differences emerge across market segments and types of regulations. In particular, the Technical Barriers to Trade favour (friction) bottled (bulk) wine; pre-shipment inspections enhance imports of bottled wine; the Sanitary and Phytosanitary Standards and the export-related measures are the most trade-enhancing NTMs, regardless of the market segment. JEL Classification codes: Q17, Q18, F13, Keywords: Global trade, NTM, Policy, SPS, TBT

Several drivers may generate market instability, but the partial contribution of different factors is still debated. We investigate how market-based drivers influence the global price volatility of three major grains: wheat, corn, barley. We adopt a Seemingly Unrelated Regression Equations model, in order to investigate potential common patterns. We compare inter-annual, intra-annual, and global volatility, to conclude on short-run and long-run dynamics of markets instability. We quantify the negative relationship linking (temporal) arbitrage and grain price volatility and conclude on the effects of supply movements on price volatility.

Background and study aims The standard method for obtaining samples during endoscopic ultrasonography (EUS) is fine-needle aspiration (FNA), the accuracy of which can be affected by the presence of a cytopathologist in endoscopy room (rapid on-site evaluation [ROSE]). With the introduction of fine-needle biopsy (FNB), macroscopic on-site evaluation (MOSE) of a acquired specimen has been proposed. Only a few studies have evaluated the role of MOSE and in all except one, a 19G needle was used. Our primary aim was to evaluate the diagnostic yield and accuracy of MOSE with different needle sizes and the secondary aim was to identify factors influencing the yield of MOSE. Patients and methods Data from patients who underwent EUS-FNB for solid lesions, with MOSE evaluation of the specimen, were collected in six endoscopic referral centers. Results A total of 378 patients (145 F and 233 M) were enrolled. Needles sizes used during the procedures were 20G (42 %), 22G (45 %), and 25G (13 %). The median number of needle passes was two (IQR 2–3). The overall diagnostic yield of MOSE was of 90 % (confidence interval [CI] 86 %–92 %). On multivariable logistic regression analysis, variables independently associated with the diagnostic yield of MOSE were a larger needle diameter (20G vs. 25G, OR 11.64, 95 %CI 3.5–38.71; 22G vs. 25G, OR 6.20, 95 %CI 2.41–15.90) and three of more needle passes (OR 3.39, 95 %CI 1.38–8.31). Conclusions MOSE showed high diagnostic yield and accuracy. Its yield was further increased if performed with a large size FNB needles and more than two passes.

The kappa index (K-Index), calculated by dividing the cerebrospinal fluid (CSF)/serum kappa free light chain (KFLC) ratio by the CSF/serum albumin ratio, is gaining increasing interest as a marker of intrathecal immunoglobulin synthesis. However, data on inter-laboratory agreement of these measures is lacking. The aim was to assess the concordance of CSF and serum KFLC measurements, and of K-index values, across different laboratories. KFLC and albumin of 15 paired CSF and serum samples were analyzed by eight participating laboratories. Four centers used Binding Site instruments and assays (B), three used Siemens instruments and assays (S), and one center used a Siemens instrument with a Binding Site assay (mixed). Absolute individual agreement was calculated using a two-way mixed effects intraclass correlation coefficient (ICC). Cohen’s kappa coefficient (k) was used to measure agreement on positive (≥5.8) K-index values. There was an excellent agreement in CSF KFLC measurements across all laboratories (ICC (95% confidence interval): 0.93 (0.87–0.97)) and of serum KFLC across B and S laboratories (ICC: 0.91 (0.73–0.97)), while ICC decreased (to 0.81 (0.53–0.93)) when including the mixed laboratory in the analysis. Concordance for a positive K-Index was substantial across all laboratories (k = 0.77) and within S laboratories (k = 0.71), and very good (k = 0.89) within B laboratories, meaning that patients rarely get discordant results on K-index positivity notwithstanding the testing in different laboratories and the use of different platforms/assays.

The analysis of immunosuppressive drugs allows the physician to monitor, and eventually correct, immunosuppressive therapy. The panel of molecules under evaluation includes cyclosporine A (CsA), tacrolimus, sirolimus, and everolimus. Initially, assays were performed by immunometric methods, but in the past few years this methodology has been largely superseded by a more accurate and specific technique, liquid chromatography coupled to tandem mass spectrometry (LC-MS/MS), which is now considered the “gold standard” for immunosuppressant analysis. Both LC-MS/MS and often also immunoassays require a preanalytical manual sample preparation, which involves time-consuming sequential operations whose traceability is often hampered and adds up to the probability of gross errors. The aim of this work was to compare an “open” LC-MS/MS with a fully automated system, consisting of LC instrumentation combined with a triple quadrupole MS, named Thermo ScientificTM CascadionTM SM Clinical Analyzer (Cascadion). Such automated systems suit the requirements of the reference method and are designed to completely eliminate all of the manual procedures. More than 2000 immunosuppressant samples were analyzed both with the open LC-MS/MS and with Cascadion. Statistics allowed the evaluation of linearity, intra- and inter-assay CV%, bias %, limit of detection and of quantitation, and Passing–Bablok and Bland–Altman plots. Results indicated a good correlation between the two methods. In both cases, methods confirmed their suitability for diagnostic settings. Cascadion could provide support when the presence of specialized personnel is lacking, and/or when great productivity and continuous workflow are required.

The existing literature on the consumers’ attitude toward region-of-origin (RoO) provides numerous and varying evidence on the relative importance of this extrinsic attribute as compared to other product characteristics. The article aims at characterising the heterogeneity in the relative importance of RoO. We systematically review the literature on RoO and build an ad hoc indicator to measure the relative importance of RoO as compared to other attributes of agri-food products under investigation. We then explain, through a meta-analytical approach, how the relative importance of RoO varies according to factors related to publication process, methodological issues, and characteristics of articles. Findings reveal the limited influence of publication process and methodological issues on the relative importance of RoO. In contrast, we find a strong effect of characteristics of articles, with the relative importance of RoO being highly dependent on products and origins under investigation. The results also highlight that RoO is an effective differentiation instrument in the agri-food markets only if supported by geographical indication labels. Managerial implications are also provided.

Background and study aims Little is known about outcomes of biliopancreatic endosonography (EUS) in patients with surgically altered upper gastrointestinal (gastrointestinal) anatomy. We aimed to assess the rate of procedural success and EUS-related adverse events (AEs), according to post-surgical anatomies. Patients and methods Retrospective study including patients with post-surgical altered upper gastrointestinal anatomy who underwent EUS for evaluation of the biliopancreatic region between January 2008 and June 2018 at eight European centers. Results Of 242 patients (162 males, mean age 66.4 ± 12.5), 86 had (35.5 %) Billroth II, 77 (31.8 %) pancreaticoduodenectomy, 23 (9.5 %) Billroth I, 19 (7.9 %) distal esophagectomy, 15 (6.2 %) total gastrectomy, 14 (5.8 %) sleeve gastrectomy, and eight (3.3 %) Roux-en-Y. Sleeve gastrectomy, Billroth I, and pancreaticoduodenectomy were associated with high rates of success (100 %, 95.7 %, and 92.2 %, respectively). Visualization of the head of the pancreas was significantly impacted by total gastrectomy, Billroth II, and Roux-en-Y (success rates 6.7 %, 53.7 %, and 57.1 %, respectively). Examination of the pancreatic body and tail was impaired in esophagectomy and total gastrectomy (82.4 % and 71.4 %, respectively). Technical success and diagnostic accuracy of EUS-guided tissue acquisition (EUS-TA) was 78.2 % and 71.3 % (95 % CI, 60.6–80.5), respectively. Four (1.6 %) AEs were observed: one mucosal tearing in a Billroth II patient, one cardiac arrest in a distal esophagectomy patient, one bleed after EUS-TA in a Billroth I patient, and one acute pancreatitis after EUS-TA in a sleeve gastrectomy patient. Conclusions The yield of bilio-pancreatic EUS is dependent on lesion location and surgery type. Before considering EUS in these patients, one must carefully consider whether the lesion may be approachable by EUS.

BackgroundThe achievement of recovery is related to the notion of developing personal potential and restoring a legitimate social role, even against the backdrop of mental illness limitations. It is still difficult to fully understand this highly subjective and dynamic process. Therefore, in order to test the recovery process, specific tools, still only marginally used in our country, are needed.AimsThe Italian Study on Recovery is the first study aimed at confirming the validity of the Italian version of the Recovery Assessment Scale (RAS), an instrument developed with the goal of detecting recovery among patients.MethodThis multicentric research involved several Mental Health Services from various parts of Italy. The first phase of the study consisted in the administration of the Italian translation of RAS, previously used in a pilot study conducted in 2009. RAS was administered to 219 patients diagnosed with psychosis, whose mental disorder lasted for at least 5 years.ResultsFindings supported the good psychometric properties of the Italian version of RAS, demonstrating its capability of identifying patients matching the “in recovery” operational criteria.ConclusionsIn consideration of the results highlighting the good psychometric properties of RAS, the present study may contribute to the diffusion of instruments to be included in Mental Health Service planning in the Italian context, in order to start a recovery-oriented transformation.

Understanding the determinants of price volatility is a key step to prevent the potential negative consequences of the uncertainty faced by farmers. The presented critical review provides a novel categorization of grain price volatility drivers. The authors distinguish the endogenous and exogenous causes and conclude on the potential effects that each of the identified factors may generate on the price dynamics. In particular, there is deepened the contribution of endogenous factors, such as the spatial and temporal arbitrage, as well as the drivers of shocks of demand and supply.

Abstract Background Numerous health benefits have been attributed to the Ginkgo biloba leaf extract (GBLE), one of the most extensively used phytopharmaceutical drugs worldwide. Recently, concerns of the safety of the extract have been raised after a report from US National Toxicology Program (NTP) claimed high doses of GBLE increased liver and thyroid cancer incidence in mice and rats. A safety study has been designed to assess, in a population of elderly residents in nursing homes, clinical and genomic risks associated to GBLE treatment. Methods GiBiEx is a multicentre randomized clinical trial, placebo controlled, double blinded, which compared subjects randomized to twice-daily doses of either 120-mg of IDN 5933 (also known as Ginkgoselect®Plus) or to placebo for a 6-months period. IDN 5933 is extracted from dried leaves and contains 24.3% flavone glycosides and 6.1% of terpene lactones (2.9% bilobalide, 1.38% ginkgolide A, 0.66% ginkgolide B, 1.12% ginkgolide C) as determined by HPLC. The study was completed by 47 subjects, 20 in the placebo group and 27 in the treatment group. Clinical (adverse clinical effect and liver injury) and genomic (micronucleus frequency, comet assay, c-myc, p53, and ctnnb1 expression profile in lymphocytes) endpoints were assessed at the start and at the end of the study. Results No adverse clinical effects or increase of liver injury markers were reported in the treatment group. The frequency of micronuclei [Mean Ratio (MR) = 1.01, 95% Confidence Intervals (95% CI) 0.86–1.18), and DNA breaks (comet assay) (MR = 0.91; 95% CI 0.58–1.43), did not differ in the two study groups. No significant difference was found in the expression profile of the three genes investigated. Conclusions None of the markers investigated revealed a higher risk in the treatment group, supporting the safety of IDN 5933 at doses prescribed and for duration of six months. Trial registration ClinicalTrials.gov Identifier: NCT03004508 , December 20, 2016. Trial retrospectively registered.