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Discards remain among the main negative impacts of fishing activities, and their reductions are strengthened by the European Common Fisheries Policy (European Regulation 1380/2013). Trammel net fisheries appear more sustainable compared with other fishing techniques, especially from an ecological viewpoint. Despite this, reports show that trammel net fisheries deliver discard quantities between 10% and 43% of the total catch biomass. To supplement existing information, this current work attempts to address the discard reduction using guarding net in the small-scale fisheries of Egadi Islands MPA (Western Sicily, Central Mediterranean Sea). To assess the reduction of unwanted catches, 48 experimental fishing trials were conducted within a 6-month period. The experimental fishing trial employed a trammel net made up of 20 panels alternated with two different net configurations. The control panels (CN) held a large outer (180 mm) and small inner (31.25 mm) meshes. The test panels (GN) with guarding net constituted a three-mesh-high (50-mm mesh size) net placed between trammel net panels and a lead line. A total of 3,310 individuals belonging to 106 taxa and nine phyla were caught. Crustaceans were the most abundant unwanted catches in the control panels, whereas bioconstructions occurred in the guarding net panels. The discard ratios of CN and GN panels were statistically different (t-value = –2.55; p< 0.05). The analysis of catch per unit effort showed higher catches of CN panels for both commercial and discard fractions (p< 0.05). Moreover, the guarding net panels caught the main discarded species at 20% lower compared with the control. The overall value of the catch at the CN panels (€ 3,366.90) was higher than the total income (€ 2,043.70) generated using the GN panels, which suggests a significant commercial loss of 40% (p< 0.05).

Gas-chromatography/mass-spectrometry and sensory descriptive analyses were applied to provide new data on volatile and olfactory properties of Aglianico and Primitivo (Zinfandel), Italian red wines of growing interest. The relationships between data sets were investigated by multivariate statistical analyses: Principal Component and Hierarchical Clustering Analyses (PCA, HCA). A total of 35% of the volatiles varied significantly (ANOVA) between the two wines, mostly showing higher amounts in the Aglianico samples. Multivariate analyses showed intra-varietal similarity and inter-varietal diversity in terms of aromatic characteristics. PCA indicated that Aglianico wines were mainly related to the main fermentative alcohols, with a sensory impact, and to terpenols, suggesting a potential discriminating power at a compositional level. Primitivo wines formed two groups, one of which correlated to the floral aroma vector linked to beta-phenethyl acetate and beta-ionone. These findings may be valuable for updating the information on these wines and for future research to improve and obtain more targeted production and communication approaches.

Purpose: This study aims to outline the influence of various combinations of antecedent conditions for startups being accepted into business incubators in Italy and Romania. The degree to which these conditions affect acceptance is referred to here as the Business Ideas Acceptance Degree (BIAD). The antecedent conditions considered are business idea potential, business plan quality, entrepreneurial team features, business project progress stage, available financial resources, debts of potential incubated companies, commitment to apply for national/EU funds, business area related to incubator mission, proposed technological content level, technological transfer from university/research centres and spin-off of a partner-entity of the incubator. Design/methodology/approach: The methodological toolkit used was mixed: correlation-based analysis (CBA), machine learning (ML) techniques and fsQCA. Principal component analysis enabled the selection of the most representative antecedent conditions from both business incubator samples in Italy and Romania, further used in fsQCA analyses. XGBoost algorithm has been also used. K-Means clustering, an unsupervised learning algorithm that groups unlabeled dataset into different clusters, led to the configuration of two clusters associated to each of the countries involved in this study (Romania and Italy). Findings: The findings reveal the differences between the different antecedent conditions that can contribute to startups being accepted into business incubators in Italy and Romania. The validation of the fsQCA equifinality principle in both samples shows that the selected antecedent conditions, mixed in combinations of “causal recipes”, lead to a high BIAD by business incubators from both countries. Originality/value: This study reveals the differences between different antecedent conditions, capable to contribute to the start-up acceptance within business incubators from Italy and Romania. Furthermore, the validation of fsQCA equifinality principle in both samples highlight that the selected antecedent conditions, mixed in combinations of causal recipes, lead to a high degree of business ideas' acceptance in business incubators. This study aims to outline the influence of various combinations of antecedent conditions for startups being accepted into business incubators in Italy and Romania. The degree to which these conditions affect acceptance is referred to here as the Business Ideas Acceptance Degree (BIAD). The antecedent conditions considered are business idea potential, business plan quality, entrepreneurial team features, business project progress stage, available financial resources, debts of potential incubated companies, commitment to apply for national/EU funds, business area related to incubator mission, proposed technological content level, technological transfer from university/research centres and spin-off of a partner-entity of the incubator. Design/methodology/approach The methodological toolkit used was mixed: correlation-based analysis (CBA), machine learning (ML) techniques and fsQCA. Principal component analysis enabled the selection of the most representative antecedent conditions from both business incubator samples in Italy and Romania, further used in fsQCA analyses. XGBoost algorithm has been also used. K-Means clustering, an unsupervised learning algorithm that groups unlabeled dataset into different clusters, led to the configuration of two clusters associated to each of the countries involved in this study (Romania and Italy). Findings The findings reveal the differences between the different antecedent conditions that can contribute to startups being accepted into business incubators in Italy and Romania. The validation of the fsQCA equifinality principle in both samples shows that the selected antecedent conditions, mixed in combinations of “causal recipes”, lead to a high BIAD by business incubators from both countries. Originality/value This study reveals the differences between different antecedent conditions, capable to contribute to the start-up acceptance within business incubators from Italy and Romania. Furthermore, the validation of fsQCA equifinality principle in both samples highlight that the selected antecedent conditions, mixed in combinations of causal recipes, lead to a high degree of business ideas' acceptance in business incubators.

Instrument automation, technological advancements and improved computational power made separation science an extremely data-rich approach, requiring the use of statistical and data analysis tools that are able to optimize processes and combine multiple outputs. The use of chemometrics is growing, greatly improving the ability to extract meaningful information. Separation–multidetection generates multidimensional data, whose elaboration should not be left to the discretion of the operator. However, some applications or techniques still suffer from the lack of method optimization through DoE and downstream multivariate analysis, limiting their potential. This review aims at summarizing how chemometrics can assist analytical chemists in terms of data elaboration and method design, focusing on what can be achieved by applying chemometric approaches to separation science. Recent applications of chemometrics in separation analyses, in particular in gas, liquid and size-exclusion chromatography, together with field flow fractionation, will be detailed to visualize the state of the art of separation chemometrics, encompassing volatile, soluble and solid (colloidal) analytes. The samples considered will range from food chemistry and environmental chemistry to bio/pharmaceutical science.

Purpose: We aimed to investigate the clinical performance of edoxaban for the treatment of pulmonary embolism (PE) in hospitalized COVID-19 patients. Methods: We conducted a retrospective analysis selecting hospitalized patients with COVID-19 admitted to our Institution from 20 May 2020 to 20 November 2020 with computer tomography (CT) detected PE at admission, treated with edoxaban after initial parenteral therapy. Clinical outcomes were compared between patients with and without ARDS at admission and between those with and without CT confirmed PE resolution. Results: 50 patients were included. Mean follow-up was 42.5±10days. No baseline differences were found between patients with ARDS (30%) and those without ARDS at admission. Patients with PE resolution (84%) were younger (P =0.03), had a shorter duration of fondaparinux therapy (9.9±3.8 vs 15.8±7.5days; P =0.0015) and length of hospitalization (36±8 vs 46±9days: P =0.0023) compared with those without PE resolution. 2 patients experienced major bleedings. At multivariate analysis the time to edoxaban switch was the only predictor of the PE resolution (HR: 0.92; 95% C.I. 0.86 to 0.99). Conclusion: Edoxaban was an effective and safe treatment for acute PE in COVID-19 setting.

This paper investigates the meso dimension of the Italian territorial capital. Multivariate explorative analysis was carried out on Italian municipalities using several original statistical indicators. We detected two latent dimensions on which three clusters of municipalities were identified: the prevalence of cultural endowments and typicality, the prevalence of environmental and natural endowments, and the prevalence of other endowments. These clusters were then used for analytical purposes, crossing demographic and socio-economic variables. The results showed that some elements of “‘disadvantage,” such as poor accessibility, can, in reality, represent strengths, provided that such an endowment is exploited in sectors that can benefit from it, such as, for example, culture and tourism.

Objective To evaluate the independent impact of age, obesity and metabolic risk factors on 13 circulating steroid levels; to generate reference intervals for adult men. Design Cross-sectional study. Methods Three hundred and fifteen adults, drug-free and apparently healthy men underwent clinical and biochemical evaluation. Thirteen steroids were measured by LC-MS/MS and compared among men with increasing BMI. Moreover, the independent impact of age, BMI and metabolic parameters on steroid levels was estimated. Upper and lower reference limits were generated in steroid-specific reference sub-cohorts and compared with dysmetabolic sub-cohorts. Results We observed lower steroid precursors and testosterone and increase in estrone levels in men with higher BMI ranges. By multivariate analysis, 17-hydroxyprogesterone and dihydrotestosterone decreased with BMI, while cortisol decreased with waist circumference. Estrone increased with BMI and systolic blood pressure. Testosterone decreased with worsening insulin resistance. 17-hydroxypregnenolone and corticosterone decreased with increasing total/HDL-cholesterol ratio. Age-related reference intervals were estimated for 17-hydroxypregnenolone, DHEA, 17-hydroxyprogesterone, corticosterone, 11-deoxycortisol, cortisol and androstenedione, while age-independent reference intervals were estimated for progesterone, 11-deoxycorticosterone, testosterone, dihydrotestosterone, estrone and estradiol. Testosterone lower limit was 2.29 nmol/L lower (P = 0.007) in insulin resistant vs insulin sensitive men. Furthermore, the upper limits for dihydrotestosterone (−0.34 nmol/L, P = 0.045), cortisol (−87 nmol/L, P = 0.045–0.002) and corticosterone (−10.1 nmol/L, P = 0.048–0.016) were lower in overweight/obese, in abdominal obese and in dyslipidaemic subjects compared to reference sub-cohorts, respectively. Conclusions Obesity and mild unmedicated metabolic risk factors alter the circulating steroid profile and bias the estimation of reference limits for testosterone, dihydrotestosterone, cortisol and corticosterone. Applying age-dependent reference intervals is mandatory for steroid precursors and corticosteroids.

Introduction The clinico-pathological and molecular factors that drive the prognosis of invasive lobular breast carcinoma (ILC) are not entirely explored. In this regard, the development and validation of a prognostic model for ILC and the investigation of the distribution of molecular abnormalities (focusing on CDK4/6 alterations) according to prognosis were the aims of this study. Patients and methods Two clinico-pathological multi-center data-sets of early-stage ILC patients (Training/Validation Set, TS/VS) were gathered. A 3-class model was developed according to the multivariate analysis for disease-free-survival (DFS) and externally validated. Mutational, copy number variation and transcriptomic analyses by targeted next generation sequencing (NGS) were performed (and validated with quantitative PCR) in an explorative cohort of patients with poor and good prognosis. Results Data from overall 773 patients (TS/VS: 491/282) were gathered. The developed model significantly discriminated low/intermediate/high risk in the TS (10-years DFS: 76.3%/67.6%/39.8%, respectively, p, Highlights • The current multicenter analysis developed and validated a prognostic nomogram for early stage ILC. • A next-generation sequencing analysis was performed in prognostic ‘outlier’ patients. • CDK4 gain emerges as a potential negative prognostic factor in ILC patients. .

Water abstraction is a key aspect when performing drinking water risk assessment within the scope of Water Safety Plan (WPS). In this context, evaluating aquifer vulnerability could be not exhaustive. Care must be taken to consider the well structure and dynamic behavior that can determine different water quality and vulnerability than those of the tapped aquifer. Here, a methodological approach to assess well vulnerability to natural and anthropogenic pollution is proposed. A data-driven hydrogeochemical conceptual modeling was performed through cluster analysis, supporting the identification of the main features determining well vulnerability. Well vulnerability was then assessed through a semi-quantitative method based on a well-specific analysis of the tapped aquifer type, water table depth, vadose zone permeability, natural redox conditions, and qualitative classification of the tapped groundwater age, considering evidence of mixing processes induced by the well dynamic behavior. Each feature was categorized into several classes, and a score was associated with each class according to the vulnerability induced by that specific condition. The method was applied to a dataset of ∼200 wells, in northern Italy. Each well was classified, and its vulnerability was assessed. The method was validated by analyzing the distribution of wells affected by natural or anthropogenic pollution in each of the vulnerability classes. Results of the chi-square test showed that the distribution of the polluted wells was associated with vulnerability classes, which is evidence of the robustness and reliability of the proposed method. This method was developed exploiting only hydrogeological information and raw water quality data, largely available to water managers from routine monitoring, which makes this approach widely applicable and cost-effective.

Calculating natural background levels (NBLs) in groundwater is vital for supporting a sustainable use of groundwater resources. Although NBLs are often assessed through a unique concentration value per groundwater body, where hydrogeochemical features are highly variable, spatial heterogeneity needs to be accounted for, leading to the calculation of so-called “local” NBLs. Despite much research devoted to the identification of the best performing techniques for local NBLs spatialization, a deep understanding of the link between local NBL values and their generating hydrogeochemical processes is often lacking and so is addressed here for the redox-sensitive species As, NH4, Fe and Mn in the groundwater bodies of Lombardy region, N Italy. Local NBLs were calculated by a tired approach involving the hybridization of preselection and probability plot methods. Since the spatial variability of the target species depends mainly on redox conditions, a redox zonation was performed using multivariate statistical analysis. A conceptual model was developed and improved combing factor and cluster analysis. Results showed that NBLs for arsenic were up to 291 μg/L, reached in groundwaters under methanogenesis, a condition related to the prolonged degradation of peat buried in aquifer sediments. Ammonium NBLs up to 6.62 mg/L were generated by the upwelling of fluids from deep sediments hosting petroleum systems; ammonium NBLs up to 4.48 mg/L were generated as the accumulation of by-products of peat degradation. Iron and manganese NBLs up to, respectively, 6.0 and 1.51 mg/L were generated by the oxidation of younger and less stable Mn and Fe oxides within river valleys, mostly the Po River valley. The evaluation of local NBLs, and their association to generating natural hydrogeochemical processes/conditions, achieves a step forward from the commonly used approach of a single NBL per groundwater body, improving decision-support tools for sustainable groundwater management and protection.

Drimia maritima (L.) Stearn (squill), belonging to the Asparagaceae family, is acknowledged as a medicinally valuable species from the Drimia genera. In this study, water, methanol, and ethyl acetate extracts of D. maritima aerial parts and bulbs were investigated for their polyphenols profile and evaluated for their antioxidant and enzyme inhibition properties. Phenolics were profiled through an untargeted metabolomics approach using an ultra-high pressure liquid chromatograph coupled to quadrupole-time-of-flight mass spectrometry (UHPLC-QTOF-MS). This analysis revealed an enrichment of low molecular weight phenolics and flavonoids in the aerial parts of D. maritima, while lignans mainly characterized bulb extracts. Antioxidant capacity was investigated by different assays, including phosphomolybdenum assays, radical scavenging (DPPH: 2,2-diphenyl-1-picrylhydrazyl; ABTS: 2,2′-azino-bis(3-ethylbenzothiazoline-6-sulfonic acid)), as well as reducing ability (CUPRAC: cupric reducing antioxidant capacity; FRAP: ferric reducing antioxidant power), and metal chelating. In radical scavenging and reducing power assays, the water extract of aerial parts exhibited the strongest ability (DPPH: 36.99 mg trolox equivalent (TE)/g; ABTS: 85.96 mg TE/g; CUPRAC: 87.37 mg TE/g; FRAP: 55.43 mg TE/g). In general, the ethyl acetate extracts from aerial parts and bulbs provided the weakest antioxidant capacity. Concerning enzyme inhibitory activities, the water extracts of the bulb were poorly active, while the ethyl acetate extracts from both plant portions displayed the best α-amylase inhibitory abilities. The best acetylcholinesterase (AChE) and butyrylcholinesterase (BChE) abilities were recorded by ethyl acetate extract of aerial parts (2.36 mg galantamine equivalent (GALAE)/g) and bulbs (5.10 mg GALAE/g), respectively. Overall, these results support the medicinal aptitude of D. maritima and its possible use as a natural source of antioxidants and enzyme inhibitors with functional potential.

Macrophages are among the first immune cells involved in the initiation of the inflammatory response to protect the host from pathogens. THP-1 derived macrophages (TDM) are used as a model to study the pro-inflammatory effects of lipopolysaccharide (LPS) exposure. Intact TDM cells were analysed by Fourier transform infrared (FTIR) microspectroscopy, supported by multivariate analysis, to obtain a snapshot of the molecular events sparked by LPS stimulation in macrophage-like cells. This spectroscopic analysis enabled the untargeted identification of the most significant spectral components affected by the treatment, ascribable mainly to lipid, protein, and sulfated sugar bands, thus stressing the fundamental role of these classes of molecules in inflammation and in immune response. Our study, therefore, shows that FTIR microspectroscopy enabled the identification of spectroscopic markers of LPS stimulation and has the potential to become a tool to assess those global biochemical changes related to inflammatory and anti-inflammatory stimuli of synthetic and natural immunomodulators different from LPS.

Phytoplankton assemblages are privileged descriptors of the ecological status of marine ecosystems regularly included in routine monitoring programmes. The high spatial and temporal variability of phytoplankton and the intrinsic difficulties of species identifications, however, combine in making reiterate assessments of this component of marine biota particularly demanding. Coarse levels of taxonomic resolution (e.g., genus, family) or morpho-functional categories have been proposed to reduce identification efforts or to ease the analysis of phytoplankton assemblages for monitoring purposes, although with contrasting outcomes. A major issue is that, in the absence of control for the loss of information associated to these alternative approaches, their application may lead to poor representations of genuine spatial and/or temporal patterns of assemblages in relation to natural and anthropogenic sources of variation. We provided a new approach to reduce the efforts required to analyse phytoplankton assemblages that integrate morpho-functional classification of phytoplankton with the use of null models to estimate the consequent loss of information on species-level community patterns. Null models for information loss were built by randomly grouping the original species variables into a progressively decreasing number of groups, in order to identify the minimum number of aggregate variables needed to detect community patters as at species level. Aggregate variables were then defined as morpho-functional groups, by grouping species on the basis of a combination of morpho-functional traits, including general taxonomy, cell size, shape, elongation and complexity. We applied the approach to six case studies investigating the response of phytoplankton assemblages from marine and transitional water ecosystems under different environmental settings in areas spanning the world’s ocean, including coral atolls, mangroves, estuaries, coastal lagoons and inlets. The approach allowed obtaining parsimonious sets of morpho-functional groups, which were suitable to detect changes in phytoplankton assemblage structure as at species level in all case studies. Trait-based approaches to phytoplankton research and monitoring are crucial to shed light on processes underlying phytoplankton community assembly and dynamics in the face of global change. In this perspective, our framework incorporates cost-effectiveness, instances from traditional monitoring programmes aiming at the detection of community patterns, and the current need for a deeper understanding of functional responses of phytoplankton to environmental drivers.

The European Food Safety Authority asked for novel approaches for identifying mechanically separated meat (MSM) in meat products, due to food safety concern. In this study, a novel approach based on multivariate analysis of 43 trace elements in meat products is described. Overall, 27 trace elements and 16 rare earth elements were determined by using ICP-MS after sample mineralization of 100 meat samples, composed of different percentages of MSM, obtained at low and high pressure, and without MSM. After development and optimization, the multivariate approach was validated by analyzing and then classifying 10 "blind" meat samples, obtaining method accuracy equal to 90%. Thus, the applicability of this new analytical approach was demonstrated. The method represents a significant improvement for this type of determination, especially when MSM is obtained at low pressure, since this product is characterized by chemical characteristics very similar to fresh meat.

Heavy metals represent a serious issue regarding both environmental and health status. Their monitoring is necessary and it is necessary the development of decentralized approaches that are able to enforce the risk assessment. Electrochemical sensors and biosensors, with the various architectures, represent a solid reality often involved for this type of analytical determination. Although these approaches offer easy-to-use and portable tools, some limitations are often highlighted in presence of multi-targets and/or real matrices. However, chemometrics- and artificial intelligence-based tools, both for designing and for data analyzing, display the capability in producing novel functionality towards the management of complex matrices which often contain more information than those that are visualized with sensor detection. Design of experiment, exploratory, predictive and regression analysis can push the world of electrochemical (bio)sensors beyond the state of the art, because is still too large the number of analytical chemists that do not deal with multivariate thinking. In this paper, the use of multivariate methods applied to electrochemical sensing of heavy metals is showed, and each approach is described in terms of efficacy and outputs.

Following the One Health principles in food science, the challenge to valorize byproducts from the industrial sector is open. Hemp (Cannabis sativa subsp. sativa) is considered an important icon of sustainability and as an alternative food source. Hemp seed bran, in particular, is a byproduct of industrial hemp seed processing, which is not yet valorized. The success, and a wider market diffusion of hemp seed for food applications, is hindered by its unpleasant taste, which is produced by certain compounds that generally overwhelm the pleasant bouquet of the fresh product. This research concerns the exploration of hemp seed bran through fermentation using beneficial lactobacilli, focusing on the sensorial and bioactive traits of the products when they are subjected to bacterial transformation. By studying of the aromatic profile formation during the fermentation process the aim was to modulate it in order to reduce off-odors without affecting the presence of healthy volatile organic compounds (VOCs). Applying multivariate analyses, it was possible to target the contribution of processing parameters to the generation of flavoring and bioactive compounds. To conclude, the fermentation process proposed was able to reduce unpleasant VOCs, whilst at the same time keeping the healthy ones, and it also improved nutritional quality, depending on time and bacterial starters. The fermentation proposed was a sustainable biotechnological approach that fitted perfectly with the valorization of hemp byproducts from the perspective of a green-oriented industrial process that avoids synthetic masking agents.

The use of seawater for mining purposes in Chile has progressively increased in recent years as fast as the interest on the negative effects of biofouling on the inner part of pipelines used to transport seawater. To prevent biofouling, chemical antifouling compounds are traditionally used, thus, causing negative environmental impacts. The aim of this research has, therefore, been to evaluate the efficiency of static magnetic fields (SMF) generators to mitigate the biofouling. Hence, experimental activities have been conducted on high density polyethylene (HDPE) pipes equipped with neodymium magnets during two experimental periods in the year of 2019, i.e., autumn–winter (A–W) and spring–summer (S–S), and under two types of SMF, i.e., continuous-type (PCS) and pulse-type (PPS). Physicochemical parameters and cell viability of microorganisms composing the biofilm were investigated. Metagenomic analyses on biofilm were conducted as well. The results showed that the cell viability was the highest, i.e., 757,780 cells/cm2, during S–S and the lowest, i.e., 349,151 cells/cm2, in A–W, both under PCS. In S–S, as well as A–W, biofilm was characterized for the most abundant eukaryotic operational taxonomic units (OTUs) under PPS conditions. The presence of OTUs, such as Articiflavibacter spp., Chaetonotida spp. and Desmodorida spp., was observed only from SMF tests., This research was funded by ANID/FONDEF/IDEA, grant number ID15I10487, and, in part, by the Programa Semilleros de Investigación: “Caracterización de una línea base para el análisis y determinación de los componentes celulares”, by the Fondo para el Desarrollo en investigación científica y/o tecnológica de actividades de titulación de pregrado 2018: “Producción de metabolitos de alto valor económico mediante exposición a un campo magnético estático tipo continuo y tipo pulso en las microalgas Scenedesmus obliquus y Nannochloropsis gaditana”, by Programa Asignación año 2021 de Asistentes de investigación de la Universidad de Antofagasta código ANT20992 and partially supported by “Antonio Panico visit at the Universidad de Antofagasta” and supported by MINEDUC-UA project code ANT1999.

Valorisation of food by-products has recently attracted considerable attention due to the opportunities to improve the economic and environmental sustainability of the food production chain. Large quantities of non-edible parts of the artichoke plant (Cynara cardunculus L.) comprising leaves, stems, roots, bracts, and seeds are discarded annually during industrial processing. These by-products contain many phytochemicals such as dietary fibres, phenolic acids, and flavonoids, whereby the most challenging issue concerns about the recovery of high-added value components from these by-products. The aim of this work is to develop a novel valorisation strategy for the sustainable utilisation of artichoke leaves’ waste, combining green pressurised-liquid extraction (PLE), spectrophotometric assays and UPLC–HRMS phytochemical characterization, to obtain bioactive-rich extract with high antioxidant capacity. Multivariate analysis of the major selected metabolites was used to compare different solvent extraction used in PLE.

BackgroundIn this study, we investigated the impact of the new haemodynamic definition of pulmonary arterial hypertension (PAH) as proposed by the 6th PH World Symposium on phenotypes and survival in patients with systemic sclerosis (SSc).MethodsIn SSc patients who were prospectively and consecutively screened for PAH including right heart catheterisation in Heidelberg or Zurich, haemodynamic and clinical variables have been reassessed according to the new PAH definition. Patients have been followed for 3.7±3.7 (median 3.4) years; Kaplan-Meier survival analysis was performed. Patients with significant lung or left heart disease were excluded from comparative analyses.ResultsThe final dataset included 284 SSc patients, 146 patients (49.2%) had mean pulmonary arterial pressure (mPAP) ≤20 mm Hg, 19.3% had mPAP 21–24 mm Hg and 29.4% had mPAP ≥25 mm Hg. In the group of mildly elevated mPAP, only four patients (1.4% of the whole SSc cohort) had pulmonary vascular resistance (PVR) values ≥3 Wood Units (WU) and could be reclassified as manifest SSc-APAH. Twenty-eight (9.8%) patients with mPAP of 21–24 mm Hg and PVR ≥2 WU already presented with early pulmonary vascular disease with decreased 6 min walking distance (6MWD) (pConclusionThe data of this study show that a PVR threshold ≥3 WU is too high to enable an early diagnosis of PAH. A PVR threshold ≥2 WU was already associated with pulmonary vascular disease, significantly reduced survival and would be more appropriate in SSc patients with mild PAH.

Objectives: The aims of this study were to assess (i) the prevalence of antibiotic use, (ii) factors associated with their use and (iii) the association with in-hospital mortality in a large sample of hospitalised older people in Italy.Methods: Data were obtained from the 2010-2017 REPOSI register held in more than 100 internal medicine and geriatric wards in Italy. Patients aged >= 65 years with at least one antibiotic prescription during their hospitalisation were selected. Multivariable logistic regression models were used to determine factors associated with antibiotic use.Results: A total of 5442 older patients were included in the analysis, of whom 2786 (51.2%) were prescribed antibiotics during their hospitalisation. The most frequently prescribed antibiotic class was beta-lactams, accounting for 50% of the total prescriptions. Poor physical independence, corticosteroid use and being hospitalised in Northern Italy were factors associated with a higher likelihood of being prescribed antibiotics. Antibiotic use was associated with an increased risk of in-hospital mortality (odds ratio = 2.52, 95% confidence interval 1.82-3.48) also when accounting for factors associated with their use.Conclusion: Hospitalised older people are often prescribed antibiotics. Factors related to poor physical independence and corticosteroid use are associated with increased antibiotic use. Being prescribed antibiotics is also associated with an increased risk of in-hospital death. These results demand the implementation of specific stewardship programmes to improve the correct use of antibiotics in hospital settings and to reduce the risk of antimicrobial resistance. (C) 2019 International Society for Antimicrobial Chemotherapy. Published by Elsevier Ltd. All rights reserved.

BackgroundNonalcoholic fatty liver disease (NAFLD) is the commonest liver disease in children and adolescents in Western countries. Complex traits arise from the interplay between environmental and genetic factors in the pathogenesis of NAFLD.AimsWe examined the association between NAFLD and eleven single nucleotide polymorphisms (SNPs) at genetic loci potentially associated with liver damage (GCKR, MBOAT7, GPR120), oxidative stress (SOD2), lipid metabolism (PNPLA3, TM6SF2, LPIN1, ELOVL2, FADS2, MTTP) and fibrogenesis (KLF6) in a paediatric population. A genetic risk score (GRS) was performed taking into account both these SNPs and clinical risk factors.MethodsWe recruited a cohort of 514 obese children and adolescents (mean age [±SD]: 11.2 ± 2.8 years, z-BMI 3.3 ± 0.8). NAFLD was identified by ultrasonography. Genotyping was performed by TaqMan-based RT-PCR system.ResultsThe overall prevalence of NAFLD was 67.5% (347 patients). Among the eleven genotyped SNPs, the genetic variants in TM6SF2 rs58542926 (OR = 4.13, p = 0.002), GCKR rs1260326 (OR = 1.53, p = 0.003), PNPLA3 rs738409 (OR = 1.58, p = 0.004) and ELOVL2 rs2236212 (OR = 1.34, p = 0.047) were significantly associated with a higher risk of NAFLD. Addition of a 11-polymorphism GRS to established clinical risk factors significantly (albeit modestly) improved the discriminatory capability of the regression model for predicting the risk of NAFLD (with SNPs C-statistic 0.81 [95%CI 0.75–0.88] vs. 0.77 [0.70–0.84] without SNPs; p = 0.047).ConclusionsNAFLD was strongly associated with three genetic variants, TM6SF2 rs58542926, PNPLA3 rs738409 and GCKR rs1260326, and more slightly with ELOVL2 rs2236212, in obese children and adolescents. Addition of a 11-polymorphism GRS to clinical risk factors improved the predictability of NAFLD.

Background Implementation of high-quality national audits for perinatal mortality are needed to improve the registration of all perinatal deaths and the identification of the causes of death. This study aims to evaluate the implementation of a Regional Audit System for Stillbirth in Emilia-Romagna Region, Italy. Methods For each stillbirth (≥ 22 weeks of gestation, ≥ 500 g) occurred between January 1, 2014 to December 1, 2016 (n = 332), the same diagnostic workup was performed and a clinical record with data about mother and stillborn was completed. Every case was discussed in a multidisciplinary local audit to assess both the cause of death (ReCoDe classification) and the quality of care. Data were reviewed by the Regional Audit Group. Stillbirth rates, causes of death and the quality of care were established for each case. Results Total stillbirth rate was 3.09 per 1000 births (332/107,528). Late stillbirth rate was 2.3 per 1000 (251/107,087). Sixteen stillbirths were not registered by the Regional Birth Register. The most prevalent cause of death was placental disorder (33.3%), followed by fetal (17.6%), cord (14.2%) and maternal disorders (7.6%). Unexplained cases were 14%. Compared to local audits, the regional group attributed different causes of death in 17% of cases. At multivariate analysis, infections were associated with early stillbirths (OR 3.38, CI95% 1.62–7.03) and intrapartum cases (OR 6.64, CI95% 2.61–17.02). Placental disorders were related to growth restriction (OR 1.89, CI95% 1.06–3.36) and were more frequent before term (OR 1.86, CI95% 1.11–3.15). Stillbirths judged possibly/probably preventable with a different management (10.9%) occurred more frequently in non-Italian women and were mainly related to maternal disorders (OR 6.64, CI95% 2.61–17.02). Conclusions Regional Audit System for Stillbirth improves the registration of stillbirth and allows to define the causes of death. Moreover, sub-optimal care was recognized, allowing to identify populations which could benefit from preventive measures.

Introduction Xylella fastidiosa (Xf) is a pathogenic bacterium that causes diseases in olive trees. Therefore, analytical methods for both the characterisation of the host/pathogen interaction and infection monitoring are needed. Volatile organic compounds (VOCs) are emitted by plants relate to their physiological state, therefore VOCs monitoring can assist in detecting stress or infection states before visible signs are present. Objective In this work, the headspace-solid phase microextraction-gaschromatography-mass spectrometry (HS-SPME-GC-MS) technique was used for the first time to highlight VOCs differences between healthy and Xf-infected olive trees. Methodology VOCs from olive tree twig samples were extracted and analysed by HS-SPME-GC-MS, and hence identified by comparing the experimental linear retention indexes with the reference values and by MS data obtained from NIST library. Data were processed by principal component analysis (PCA) and analysis of variance (ANOVA). Results The HS-SPME step was optimised in terms of adsorbent phase and extraction time. HS-SPME-GC-MS technique was applied to the extraction and analysis of VOCs of healthy and Xf-infected olive trees. More than 100 compounds were identified and the differences between samples were evidenced by the multivariate analysis approach. The results showed the marked presence of methyl esters in Xf-infected samples, suggesting their probable involvement in the mechanism of diffusible signal factor. Conclusion The proposed approach represents an easy and solvent-free method to evaluate the presence of Xf in olive trees, and to evidence volatiles produced by host/pathogen interactions that could be involved in the defensive mechanism of the olive tree and/or in the infective action of Xf.

Patterns di recidiva dopo intervento di laringectomia parziale orizzontale tipo II e III: analisi univariata e regressione logistica dei fattori di rischio.Nella scelta del trattamento chirurgico (laringectomia totale o parziale) in pazienti affetti da carcinoma laringeo, è ancora necessaria l’identificazione di una correlazione tra fattori prognostici e risultati oncologici. Una coorte multi-istituzionale di 819 pazienti affetti da carcinoma laringeo e sottoposti a laringectomia parziale orizzontale (OPHL) tipo II e tipo III dal 1995 al 2014 è stata suddivisa in base alla comparsa o meno di recidiva (108 vs 711) ed alla sede di ricomparsa di malattia (loco-regionale, locale, a distanza). Sono state analizzate, mediante analisi uni e multivariata, tredici variabili cliniche e istologiche nei due gruppi, in relazione agli esiti oncologici (OS, DFS, DSS, LSF, FFL). All’analisi multivariata quattro sono risultati i fattori determinanti rischio di recidiva: sede del tumore (maggiormente nei tumori sopraglottici), invasione cartilaginea (maggiormente se presente), invasione perineurale (maggiormente se presente) ed il tipo di OPHL (maggiormente in caso di OPHL tipo III). La conoscenza e la detezione dei fattori prognostici negativi per il rischio di recidiva (classificazione pN, interessamento cartilagineo, invasione perineurale e quindi trattamento chirurgico adottato) potrebbero aumentare le già note potenzialità delle OPHL nel trattare casi con indicazione certa dopo attenta discussione collegiale.In choosing the best surgical treatment (total or partial laryngectomy) for patients affected by laryngeal squamous cell carcinoma (SCC), it is still necessary to identify a link between prognostic factors and oncological outcomes. A retrospective analysis of clinical outcomes of 819 patients affected by laryngeal cancer who underwent OPHL type II and III between 1995 to 2014 was carried out. Focusing on recurrence and its site (local, regional or distant), our cohort has been divided in two groups: patients showing recurrence (n = 108) vs those without recurrence (n = 711). Thirteen clinical-pathological parameters have been studied by univariate and multivariate analysis to identify possible correlations between recurrence and oncological outcomes (overall survival (OS), disease free survival (DFS), disease specific survival (DSS), laryngectomy free survival (LSF), laryngectomy free freedom (FFL). In multivariate analysis, we found 4 negative prognostic factors for recurrence: site of tumour (supraglottic), cartilage invasion (if present), perineural invasion (if present) and type of OPHL (in OPHL type III). The knowledge and detection of negative prognostic factors for the risk of recurrence (pN classification, cartilage involvement, perineural invasion, and thus the type of surgical treatment adopted) could increase the already well-established potentiality of OPHLs in treating cases with a safe indication after careful discussion in the tumour board.

Marine Protected Areas (MPAs) are at the core of management and conservation plans aimed at counteracting the ongoing widespread degradation of marine ecosystems. Although the outcomes of protection in enhancing marine biodiversity and restoring populations of exploited species are widely recognized, the putative effect of MPAs in increasing the resilience of marine communities and ecosystems is still underexplored. In this study, long-term data from a no-take area of a Mediterranean MPA and unprotected locations were used to investigate the effects of full protection on the temporal stability of sessile assemblages on shallow subtidal rocky reefs. Results highlighted that assemblages within the no-take area exhibited a more consistent structure over 20 years of study, whereas a significantly larger temporal variability characterized assemblages at the unprotected locations. Reduced levels of human pressure and stabilizing processes related to the re-establishment of the integrity of trophic networks within the MPA could underlie the observed patterns. Assessing whether MPAs may improve the ability of marine communities to absorb disturbance, from local to large scale sources, is essential to ascertain their contribution to future adaptive conservation strategies in the face of global change. This study provided evidence that MPAs, if well managed, can represent an effective tool to smooth fluctuations in the structure of marine communities, thus potentially reducing their vulnerability to natural and human-driven environmental changes.

Biological invasions result in negative and unpredictable impacts on oceans worldwide. Non-indigenous macrophytes often synthesize secondary metabolites for defensive purposes and increased competition efficiency: this is the case of Caulerpa cylindracea, which has entered the Mediterranean Sea in 1990 and competed against local flora and fauna since. It was demonstrated that the white seabream Diplodus sargus (i) has included the algae into its diet, (ii) is subject to the peculiar Abnormally Tough Specimen (ATS) condition post-cooking, and (iii) suffers physiological and behavioral disturbances from caulerpin, one of the three major algal secondary metabolites. This paper confirms a feeding relationship between the fish and the algae, quantifies caulerpin accumulation in the liver, suggests a possible mollusk- and echinoderm-driven biomagnification, and highlights the fact that all ATS specimens were males. Multivariate analyses on a multi-biomarker panel reveals differential correlations to key cellular processes such as oxidative stress, metabolism, neurotoxicity, and lipid peroxidation as well as to condition indexes.

Background Recipient selection for liver transplantation in hepatocellular carcinoma (HCC) is based primarily on criteria affecting the chance of long-term success. Here, the relationship between pretransplant bridging therapy and long-term survival was investigated in a subgroup analysis of the SiLVER Study. Methods Response to bridging, as defined by comparison of imaging at the time of listing and post-transplant pathology report, was categorized into controlled versus progressive disease (more than 20 per cent tumour growth or development of new lesions). Results Of 525 patients with HCC who had liver transplantation, 350 recipients underwent pretransplant bridging therapy. Tumour progression despite bridging was an independent risk factor affecting overall survival (hazard ratio 1.80; P = 0.005). For patients within the Milan criteria (MC) at listing, mean overall survival was longer for those with controlled versus progressive disease (6.8 versus 5.8 years; P

The SARS-CoV-2 pandemic is not only a threat to physical health but is also having severe impacts on mental health. Although increases in stress-related symptomatology and other adverse psycho-social outcomes, as well as their most important risk factors have been described, hardly anything is known about potential protective factors. Resilience refers to the maintenance of mental health despite adversity. To gain mechanistic insights about the relationship between described psycho-social resilience factors and resilience specifically in the current crisis, we assessed resilience factors, exposure to Corona crisis-specific and general stressors, as well as internalizing symptoms in a cross-sectional online survey conducted in 24 languages during the most intense phase of the lockdown in Europe (22 March to 19 April) in a convenience sample of N = 15,970 adults. Resilience, as an outcome, was conceptualized as good mental health despite stressor exposure and measured as the inverse residual between actual and predicted symptom total score. Preregistered hypotheses (osf.io/r6btn) were tested with multiple regression models and mediation analyses. Results confirmed our primary hypothesis that positive appraisal style (PAS) is positively associated with resilience (p

Multielement analysis and chemometric methods were proposed to discriminate the Sorrento lemon (PGI) juices according to geographical origin. In 2018 and 2019, 169 fruits from three farms in PGI area and two in not-PGI area were collected and analysed for essential and not-essential elements by ICP-MS. The PCA of multielement fingerprinting grouped lemon juices from PGI farms revealing a strong differentiation at small geographical scale. The S-LDA discriminated lemon juices for Mo, Ba, Rb, Mg, Co, Ca, Fe, Sr on the two production years, giving 97.7% correct classification, 98.5% accuracy and 93.8% external validation. The good correlation lemon juice vs cultivation soil and the soil discrimination by not-essential elements suggested the use of these elements as reliable indicators of lemon juice provenances. Despite lowering the number of variables, constituted by not-essential elements Ba, Rb, Ti, Co, the use of S-QDA discriminated the lemons juices with 87.5% accuracy and 83.9% validation.

Considering the growing number of extra virgin olive oil (EVOO) producers in the world, knowing the influence of olive oils with different geographical origins on the characteristics of the final blend becomes an interesting goal. The present work is focused on commercial organic EVOO blends obtained by mixing multiple oils from different geographical origins. These blends have been studied by 1H-NMR spectroscopy supported by multivariate statistical analysis. Specific characteristics of commercial organic EVOO blends originated by mixing oils from Italy, Tunisia, Portugal, Spain, and Greece were found to be associated with the increasing content of the Italian component. A linear progression of the metabolic profile defined characteristics for the analysed samples—up to a plateau level—was found in relation to the content of the main constituent of the Italian oil, the monocultivar Coratina. The Italian constituent percentage appears to be correlated with the fatty acids (oleic) and the polyphenols (tyrosol, hydroxytyrosol, and derivatives) content as major and minor components respectively. These results, which highlight important economic aspects, also show the utility of 1H-NMR associated with chemometric analysis as a powerful tool in this field. Mixing oils of different national origins, to obtain blends with specific characteristics, could be profitably controlled by this methodology.

This investigation aimed to compare the effects of suspension training versus traditional resistance exercise using a combination of bands and bodyweight on body composition, bioimpedance vector patterns, and handgrip strength in older men. Thirty-six older men (age 67.4 ± 5.1 years, BMI 27.1 ± 3.3 kg/m2) were randomly allocated into suspension training (n = 12), traditional training (n = 13), or non-exercise (n = 11) groups over a 12-week study period. Body composition was assessed using conventional bioelectrical impedance analysis and classic and specific bioelectric impedance vector analysis, and handgrip strength was measured with a dynamometer. Results showed a significant (p < 0.05) group by time interaction for fat mass, fat-free mass, total body water, skeletal muscle index, classic and specific bioelectrical resistance, classic bioelectrical reactance, phase angle, and dominant handgrip strength. Classic and specific vector displacements from baseline to post 12 weeks for the three groups were observed. Handgrip strength increased in the suspension training group (p < 0.01, ES: 1.50), remained stable in the traditional training group, and decreased in the control group (p < 0.01, ES: −0.86). Although bodyweight and elastic band training helps to prevent a decline in muscle mass and handgrip strength, suspension training proved more effective in counteracting the effects of aging in older men under the specific conditions studied.

Background Sublingual varices (SV) are dilatations of tortuous veins that increased with age. Previous studies showed that this pathology could be correlated to some risk factors such as hypertension, age, gender and diabetes mellitus. In this study we evaluated, on a large number of subjects, the relationship between SV and different grades of hypertension as well as some risk factors extending the analysis to new risk factors such as dyslipidemia, obesity and antihypertensive therapy, modelling a possible dependence of SV on all these factors. Methods In the study 1008 subjects, 284 with and 724 without SV, were examined. The blood pressure was measured in office condition and, to exclude subjects with white coat syndrome or masked hypertension, also using a 24 h Holter pressure monitor. Hypertensive subjects were divided in resistant, drugs controlled (compensated) and patients with prior unknown hypertension (new diagnosed) groups. The presence or absence of SV as well as of the risk factors was assessed clinically. We tested the influence of age on the presence of SV by using the chi-square test and the relation between each risk factor and SV by the Cochran–Mantel–Haenszel test. Finally, we carried out a multivariate regression tree analysis in order to predict the presence of SV. Results We confirmed the influence of age on SV and found a significant relationship between SV and both the compensated and resistant hypertension grades. We highlighted a relationship between SV and dyslipidemia in subjects with new diagnosed hypertension, and between SV and smoking in subjects with compensated hypertension grade. The regression tree showed a classification accuracy of about 75% using as variables hypertension grades, age and antihypertensive treatment. Conclusions We confirmed the SV dependence on age, resistant hypertension and smoking, highlighting a new association with dyslipidemia in new diagnosed hypertensive subjects and new relations depending on the hypertension grades. Thus, the SV inspection could be used to suggest a lipidologist as well as a hypertension specialist visit for a pharmacological and pressure check particularly in subjects presenting SV and dyslipidemia. However, further parameters are to be considered to improve the sensitivity of the prognostic tree model.

Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflamació; Mediadors d'inflamació Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflamación; Mediadores de la inflamación Coronavirus SARS-CoV-2; COVID-19; 2019-nCoV; Inflammation; Inflammation mediators Background Patients with cancer are particularly susceptible to SARS-CoV-2 infection. The systemic inflammatory response is a pathogenic mechanism shared by cancer progression and COVID-19. We investigated systemic inflammation as a driver of severity and mortality from COVID-19, evaluating the prognostic role of commonly used inflammatory indices in SARS-CoV-2-infected patients with cancer accrued to the OnCovid study. Methods In a multicenter cohort of SARS-CoV-2-infected patients with cancer in Europe, we evaluated dynamic changes in neutrophil:lymphocyte ratio (NLR); platelet:lymphocyte ratio (PLR); Prognostic Nutritional Index (PNI), renamed the OnCovid Inflammatory Score (OIS); modified Glasgow Prognostic Score (mGPS); and Prognostic Index (PI) in relation to oncological and COVID-19 infection features, testing their prognostic potential in independent training (n=529) and validation (n=542) sets. Results We evaluated 1071 eligible patients, of which 625 (58.3%) were men, and 420 were patients with malignancy in advanced stage (39.2%), most commonly genitourinary (n=216, 20.2%). 844 (78.8%) had ≥1 comorbidity and 754 (70.4%) had ≥1 COVID-19 complication. NLR, OIS, and mGPS worsened at COVID-19 diagnosis compared with pre-COVID-19 measurement (p

Objectives The aim of the present study was to investigate whether peri-implant clinical parameters (modified plaque index (mPI), bleeding and/or suppuration on probing (B/SOP)) and local factors (type of prostheses, screw emergence, platform diameter, and abutment angulation) might contribute to the development of additional bone loss and peri-implantitis around dental implants. Materials and methods Two hundred seventy-seven external hex connection implants placed in the posterior maxilla of 124 patients were retrospectively evaluated. They were divided into two groups: physiologic bone loss < 2 mm (PBL) or additional bone loss ≥ 2 mm (ABL). GEE logistic regression was applied to evaluate the influence of type of prostheses (implant-supported single crown (ISSC), fixed partial denture (ISFPD), and full denture (ISFD)) and clinical parameters (mPI and S/BOP) on bone loss. Results Among the 277 implants, 159 (57.4%) presented PBL and 118 (42.6%) presented ABL. Within the ABL group, 20.6% implants were diagnosed with peri-implantitis. mPI significantly correlated with the type of prosthesis and the highest value of mPI (index = 3) was observed in ISFD (23.8%). Moreover, peri-implantitis was more frequently associated with ISFD (32.79%) than ISSC and ISFDP (13.79% and 13.48, respectively) Conclusions ISFD in the posterior maxilla presented high rates of ABL and showed a higher prevalence of peri-implantitis. None of the local factors seemed to contribute to the development of these conditions. Further investigations are needed to prospectively support the results of the present study. Clinical relevance Patients rehabilitated with ISFD should be carefully monitored and have more frequent maintenance visits to prevent or control peri-implant bone loss.

Adiponectin exerts relevant actions in immunity and is modulated in several disorders, such as multiple sclerosis (MS). In this study, we characterized adiponectin expression and profiles in cerebrospinal fluid (CSF) from MS patients to investigate its potential relationship with the severity and progression of the disease. Total adiponectin in CSF was measured by ELISA in 66 unrelated CSF MS patients and compared with 24 age- and sex-matched controls. Adiponectin oligomer profiles were analysed by Western blotting and FPLC chromatography. Total CSF adiponectin was significantly increased in MS patients compared with controls (9.91 ng/mL vs 6.02 ng/mL) (p