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Septic non-union (SNU) represents an insidious complication of open fractures. SNU is defined as a clinical and radiological evidence of cessation of fracture healing after 6-8 months of treatment, associated with persistence of clinical, laboratoristic and radiological signs of infection. The infection is mostly caused by bacteria and when it occurs at the bone fracture site, the healing process slows down and generally the treatment takes place in multiple phases. First a surgical debridement, often with the use of polymethylmethacrylate and local antibiotics, associated with specific systemic antibiotic therapy and a temporary stabilization of the septic non-union. Once the infection is cleared up, the final definitive synthesis is performed. Recently the use of implantable antibiotic medical devices in one step surgery has been introduced with encouraging results and have shown numerous advantages both in terms of management and morbidity for the patient. There are several "pre-formed" devices on the market, which however must be approved by the institution and often have the limit of a high cost in addition to the impossibility of using specific antibiotics. We want to report our experience with a clinical case of a tibial SNU successfully treated by one-step surgery procedure using a custom-made intramedullary antibiotic cement-coated carbon nail. We focus on surgical technique, advantages and pitfalls related to the use of these devices.

Road accidents are the eighth cause of death worldwide and the first among young people, and, in turn, distraction is considered one of the main determinants of road accidents. One of the most important factors of distraction while driving appears to be the use of a mobile phone. This paper aims at simultaneously analyzing individual Knowledge, Attitudes, and Behaviors toward the use of mobile phones while driving in one of the largest and most populous metropolitan areas of Italy, Naples. The study analyzes a sample of 774 questionnaires which consist of 39 questions each. Several socio-demographic characteristics (i.e., gender, age, profession, and others) are considered within this study. A Structural Equation Model displays that the relationship between Knowledge and Behavior is not direct and it passes through the Attitude. The results of this study might be used for the creation of targeted educational programs, community-based interventions, and legal regulations.

The UN Sustainable Development Goals have set clear targets on global poverty, hunger and malnutrition to be achieved by 2030, which have prompted academics and policymakers to identify useful strategies and drivers. Moreover, the COVID19 pandemic has exacerbated inequalities at national and sub-national levels thus hampering the achievement of these goals. On considering the multifaceted nature of poverty, a recent research strand focuses on food poverty and insecurity issues in terms of economic access to food and healthy diet consumption, with moderate and extreme food insecurity affecting almost 9% of the population in Europe and North America. This paper aims to analyse food poverty and insecurity at regional level in Italy. Using micro-data from the Italian Household Budget Survey carried out by ISTAT, an analytical approach was proposed to define and measure the different degree of food poverty and insecurity. Moreover, to obtain insights into whether food poverty and insecurity can afford population healthy nutrition, inequality of the distributions of food expenditure categories are estimated. The results provided us with information on other important aspects of the poverty. Indeed, in Italy individuals who are at-risk-of-food-poverty or food insecure amount to 22.3% of the entire population. Furthermore, the at-risk-of-food-poverty-rate varies at regional level from 14.6% (Umbria) to 29.6% (Abruzzo), with high levels of food consumption inequalities observed above all for vegetables, meat and fish. All these issues could help policy makers to define economic intervention policies aimed at reducing social exclusion and achieving more equitable and sustainable living conditions for the entire population.

Composite indicators (CIs) are frequently employed to measure complex, multidimensional phenomena such as well-being, sustainability, or work quality. It is nowadays well studied, that the multiple decisions made in the construction process of building the CI strongly affect the result. These construction decisions range from the selection of a set of sub-indicators, to the standardization method, the weighting and the choice of the aggregation function. Sensitivity analysis is an established tool to analyze and quantify the impact of the choices made in this regard. Less attention has been paid to the impact of data quality on CIs: CIs are usally based on sub-indicators that are estimated from sample surveys and the resulting aggregated measure can only be as good as the underlying data. The uncertainty in the CI due to sampling and possible non-sampling errors is, however, frequently neglected. With this report we aim to fill this gap. To do so, we perform a sensitivity analysis for an example CI for working quality, that includes the selection of a sampling design and the sampling itself as possible sources of variability. Further, we propose a parametric bootstrap-based apporach to estimate the standard error of a CI and apply it to the illustrating example of a CI on environmental perfomance.

Additional file 1. Allelic profiles chracterizing the 11 varieties on trial.