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This article analyses the ongoing processes in the organisational field of Italian schools in light of the innovations induced by digital education policies. Specifically, it focuses on the relationship between actors and digital policies concerning the experience of distance learning (DL) that characterised the period of the COVID-19 pandemic. The paper reflects on DL outcomes regarding the three expectations that have often characterised the rhetoric associated with the promotion of digital educational policies, namely: the raising of learning levels, the development of digital competences and the increase in school inclusion. Through an analysis of a series of empirical studies exploring the point of view of the paper, this paper highlights what progress has been made in the digital schooling in Italy and what are still its main limitations. The results of the study show both the limits of the effectiveness of educational policies constructed with a top-down approach and highlight the potential for policy recalibration offered by a reorganisation of the decision-making process through the active involvement of all the actors in the educational system. [ABSTRACT FROM AUTHOR]

Nursing research is rapidly increasing, yet contributions from numerous countries that may interest the international nursing community are impeded because many research articles are published in authors' native language and not in English. The objectives of this work were to systematically review papers published in Italian related to job satisfaction and the quality of nursing care, and to discuss their findings in light of the international literature. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) method was used. The Directory of Open Access Journals (DOAJ) and Indice della Letteretura Italiana di Scienze Infermieristiche (ILISI) databases were consulted for eligible studies published from January 2015 to November 2022. Two hundred sixteen papers were identified, 11 of which were selected for review: 8 on job satisfaction, two on workload issues, and 1 on quality of nursing care. The quality of included studies was assessed through the Effective Public Health Practice Project quality assessment tool (EPHPP). The results of our review were in line with those of international literature, and they can help to fill the knowledge gap on the quality of nursing performance in Italian care settings. In addition, the proposed method can provide further elements of discussion among literature providers and reviewers. [ABSTRACT FROM AUTHOR]

Air conditioning systems can play a positive or negative role in the spread of COVID-19 infection. The importance of sufficient outdoor air changes in buildings was highlighted by the World Health Organization, therefore these should be guaranteed by mechanical ventilation systems or adequate air conditioning systems. The proposed case study concerns the optimal number of outdoor air changes to limit COVID-19 contagion for a school building in Central Italy. The Wells–Riley model is used to assess the risk of airborne infection, while energy consumption is calculated by a dynamic energy simulation software. The scope of the paper offers an innovative method to define the optimal ventilation strategy for the building's HVAC system design to reduce the risk of infection with limited increases in energy consumption and greenhouse gas emissions. Results show that the desirable approach is the one in which the same low value of contagion risk is set in all rooms. This new approach results in significant energy savings, compared to the most common ones (setting the same high outdoor air rates for all rooms) to counteract the risk of infection. Finally, the zero-emission building target is verified by introducing a suitable photovoltaic system to offset pollutant emissions. [ABSTRACT FROM AUTHOR]

This paper discusses the protagonism expressed by immigrant women in religion via a series of leadership roles and expands on this theme by considering the pandemic as an emblematic period in which such female activism revealed itself. While the literature gives important details on gender inequalities generated by COVID-19, this article brings to attention agency, resilience and innovation. The case of catholic ethnic churches in Italy, a country particularly hit by the implications of COVID-19, is the empirical field. This paper uses qualitative data obtained through prolonged fieldwork (2018–2022), allowing to discuss the role of ethnic churches before and after the pandemic. The empowerment processes of women in religion and their leading role in terms of welfare provision and activism are detailed, concluding by considering the implications of these. While public institutions were in trouble, religious minorities, and notably their female members, acted to ensure the survival of non-Italian citizens. [ABSTRACT FROM AUTHOR]

At the beginning of 2023, the Italian former prime minister, the former health minister and 17 others including the current president of the Lombardy region were placed under investigation on suspicion of aggravated culpable epidemic in connection with the government's response at the start of the COVID-19 pandemic. The charges revolve around the failure by authorities to take adequate measures to prevent the spread of the virus in the Bergamo area, which experienced a significant excess of deaths during the initial outbreak. The aim of this paper is to analyse the pandemic data of Italy and the Lombardy region in the first 10 days of the pandemic, spanning from the 24th of February 2020 to the 4th of March 2020. The objective is to determine whether the use of early warning indicators could have facilitated the identification of a critical increase in infections. This identification, in turn, would have enabled the timely formulation of strategies for pandemic containment, thereby reducing the number of deaths. In conclusion, to translate our findings into practical guidelines, we propose a low-cost early warning method for infectious respiratory diseases with asymptomatic carriers. [ABSTRACT FROM AUTHOR]

During the first wave of the COVID-19 pandemic in Italy, practitioners had to make tragic decisions regarding the allocation of scarce resources in the ICU. The Italian debate has paid a lot of attention to identifying the specific regulatory criteria for the allocation of resources in the ICU; in this paper, however, we argue that deciding such criteria is not enough for the implementation of fair and transparent allocative decisions. In this respect, we discuss three ethical issues: (a) in the Italian context, the treating physician, rather than a separate committee, was generally the one responsible for the allocation decision; (b) although many allocative guidelines have supported moral equivalence between withholding and withdrawing treatments, some health professionals have continued to consider it a morally problematic aspect; and (c) the health workers who have had to make the aforementioned decisions or even only worked in ICU during the pandemic often experienced moral distress. We conclude by arguing that, even if these problems are not directly related to the above-mentioned issues of distributive justice, they can nevertheless directly affect the quality and ethics of the implementation of allocative criteria, regardless of those chosen. [ABSTRACT FROM AUTHOR]

2020 will be remembered worldwide as the year of COVID-19 outbreak. The onset of this pandemic abruptly changed everybody's life and, in a particular manner, doctors' lives. Our hand surgery department became rapidly one of the first COVID-19-specialized wards in Italy, impacting considerably the authors' routines and activities. In this paper, the authors focus on how the demographics of patients with hand trauma changed and how they had to modify their activity. The authors retrospectively took into consideration all patients reaching their emergency department (ED) with hand trauma between 9 March 2020 (the day of the beginning of the first lockdown in Italy) and 8 March 2021 and compared them to those who reached the ED in the three previous years. Authors have analyzed the number of patients, their gender and age, the severity of their trauma, where the trauma occurred, the type of lesion, the percentage of patients who underwent surgery, and the percentage of patients who had an emergency admission. In the last year, the number of patients reaching the ED for a hand trauma has been reduced by two thirds (975 patients during the past year), the mean age of those patients has slightly increased, the severity of cases has increased, places of trauma and type of lesions have changed, and, lastly, the percentage of patients needing surgery who were admitted immediately has increased. This paper shows how the type of patients reaching the ED changed and discusses how surgeons evolved and modified their habits in treating those patients during the first lockdown and the year that followed. [ABSTRACT FROM AUTHOR]

The indoor climate of non-climatized churches is usually subject to cyclical fluctuations of temperature and relative humidity induced by external climate conditions which might be dampened by the high thermal capacity of their envelope. However, several phenomena affect their indoor climate (e.g., internal gains due to people and artificial lighting, air infiltration, etc.), which lead to environmental variations that might jeopardize the artworks contained within. In particular, one of the most influential parameters that may affect non-climatized churches is the massive and intermittent presence of people who constantly visit their spaces. In such regard, long-term monitoring allows the collection of environmental data with different building operation conditions and visitor fluxes. This paper analyses the indoor climate of the Milan Cathedral (Duomo di Milano) in Italy for three continuous years (including the lockdown period that occurred in 2020 caused by the COVID-19 pandemic), with a focus on visitors' effects on the indoor environment and the conservation of the main artworks contained within. The results of the analysis have shown that spaces with huge volume are most influenced by the opening of the doors rather than the hygrothermal contribution of the intermittent presence of massive crowds. Moreover, the absence of visitors for a prolonged period correlates with an improvement in the indoor conservation conditions for artworks, especially those made of hygroscopic materials, due to the reduction in short, rapid climate fluctuations. [ABSTRACT FROM AUTHOR]

From March 2020, Italians experienced lockdown due to COVID-19 pandemic. People had to share common living spaces with family members for an extended period converting their home into workplaces. This resulted in changes to everyday life noises with implications in terms of perception of indoor acoustic quality. An online survey was designed and distributed to Italian residents to assess how they perceived the indoor quality of domestic spaces when working from home. A total of 330 questionnaires were collected and analyzed. The paper reports the results of the analyses carried out, focusing on the acoustic quality in home spaces and the satisfaction of the respondents, including an analysis of the housing context. Most respondents attach great importance to the acoustic aspects in judging the quality of the living environment and believe that the acoustic quality can improve the performance of their work. The comparison between pre-lockdown and lockdown periods shows that noises inside the building prevail over those coming from the outside and annoyance is mainly due to noise from shared spaces. The results of this study highlighted how the COVID-19 lockdown was a unique opportunity to draw attention to the importance of the indoor acoustic quality. [ABSTRACT FROM AUTHOR]

Simple Summary: During COVID 19 pandemic, cancer patients, their caregivers and physicians needed to balance the challenges associated with pandemic ensuring cancer care. In this paper, we analysed ED visits during the 72 days of the pandemic in 2020 (Italian lockdown period) and compared them to the ED visits in the same calendar days in 2019 and 2021. We compared their severity, outcome (admission vs. discharge vs. death vs. hospice/palliative care), method of arrival to the ED and type of tumours affecting patients, suggesting that pandemic related emotional distress and hospital departmental reorganization could have nega-tively influenced ED admissions. Our aim was to highlight how much the government restrictive measures could have had an impact on emergency care for fragile patients such as cancer patients and help to understand how to reconcile the health needs of a specific class of patients with the need to protect public health. The coronavirus disease 2019 (COVID-19) pandemic has had a global impact. Patients with cancer, their caregivers, and physicians need to balance the challenges associated with COVID-19 while ensuring cancer care. Nevertheless, emotional distress and hospital departmental reorganization could have led to a decrease in ED admissions even among oncological patients. Methods: We compared the 72 days of the pandemic in 2020 with the same calendar days in 2019 and 2021, defining a 20% decrease in ED visits as clinically significant. We studied the cause for visit, its severity, outcome (admission vs. discharge vs. death vs. hospice/palliative care), the tumor site, and method of arrival to the ED for the 3 time periods. Results: A significant decrease in ED oncological visits was found in 2020 compared to 2019, before returning to similar numbers in 2021. Fear, anxiety, and worry, in addition to hospital departmental reorganization, surely had an important role in the delay of ED visits, which resulted in irreparable consequences. [ABSTRACT FROM AUTHOR]

During the COVID-19 lockdown, especially in the first wave of pandemic (March 2020), sedentary lifestyle and calorie intake increase in children became considerably more prevalent. The aim of the present paper was to evaluate changes in children's weights and nutritional habits during the COVID-19 pandemic in Italy. In this cross-sectional observational study, for 3 years, as part of the corporate wellness program (2019–2021) in Emilia Romagna region of Italy, anthropometric data of Ferrari car company employers' children were collected, analyzed, and compared. Moreover, at the visit of November 2020, performed after the first wave of the pandemic with the most rigorous lockdown rules in Italy, a questionnaire on nutritional and lifestyle habits was administered. We evaluated 307 children (163 M, 10.1 ± 2.3 mean aged in 2019). A significant increase in BMI percentile in 2020 (65.2) compared to 2019 (49.2) was observed; it was confirmed, albeit slightly decreased, in 2021 (64.5). About one-third of participants reported an increase in consumption of fatty condiments and more than half report an increase in consumption of junk food. Levels of physical activity were still high during the COVID-19 lockdown, while sleeping time was significantly reduced. Our findings alert us to the importance of carefully monitoring eating behaviors in young to avoid the adoption of unhealthy food habits and prevent childhood obesity, especially during the period of COVID-19 lockdown. [ABSTRACT FROM AUTHOR]

This paper proposes a methodology for sentiment analysis with emphasis on the emotional aspects of people visiting the Herculaneum Archaeological Park in Italy during the period of the COVID-19 pandemic. The methodology provides a valuable means of continuous feedback on perceived risk of the site. A semantic analysis on Twitter text messages provided input to the risk management team with which they could respond immediately mitigating any apparent risk and reducing the perceived risk. A two-stage approach was adopted to prune a massively large dataset from Twitter. In the first phase, a social network analysis and visualisation tool NodeXL was used to determine the most recurrent words, which was achieved using polarity. This resulted in a suitable subset. In the second phase, the subset was subjected to sentiment and emotion mapping by survey participants. This led to a hybrid approach of using automation for pruning datasets from social media and using a human approach to sentiment and emotion analysis. Whilst suffering from COVID-19, equally, people suffered due to loneliness from isolation dictated by the World Health Organisation. The work revealed that despite such conditions, people's sentiments demonstrated a positive effect from the online discussions on the Herculaneum site. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak has raised several global challenges related to disease management while highlighting the need to embrace a multidimensional approach in dealing with events such as. Due to the singular features of SARS-CoV-2, an appropriate medical response was required to develop new vaccines able to tackle it effectively. Mass vaccination plans were thus promptly launched around the world. However, vaccine uptake has been coupled with growing concerns that have affected people's willingness to get vaccinated. To promote compliance with vaccination campaigns, many governments introduced the use of vaccination certificates and immunization passports. Studies have discussed some benefits and cons coupled with the rollout of vaccine passports or certificates. This paper takes up and extends this discussion by showing the results of a mini- narrative review we undertook with the aim of critically summarizing the existing scholarly research on the Green Pass in Italy. In analyzing the 12 included records, we explored the scientific viability of this measure, as well as the concerns and criticisms it has raised and the recommendations that have been proposed to address them, as a starting point to consider how the lesson learned in the Italian context can contribute to informing future reflections and strategies in view ofanother pandemic event. [ABSTRACT FROM AUTHOR]

Background: The COVID-19 pandemic has profoundly transformed the global scenario, marked by overwhelming infections, fatalities, overburdened healthcare infrastructures, economic upheavals, and significant lifestyle modifications. Concurrently, the Russian full-scale invasion of Ukraine on 24 February 2022, triggered a severe humanitarian and public health crisis, leading to healthcare disruptions, medical resource shortages, and heightened emergency care needs. Italy emerged as a significant refuge for displaced Ukrainians during this period. Aim: This research aims to discern the impact of the Russian full-scale invasion of Ukraine on the COVID-19 transmission dynamics in Italy. Materials and Methods: The study employed advanced simulation methodologies, particularly those integrating machine learning, to model the pandemic's trajectory. The XGBoost algorithm was adopted to construct a predictive model for the COVID-19 epidemic trajectory in Italy. Results: The model demonstrated a commendable accuracy of 86.03% in forecasting new COVID-19 cases in Italy over 30 days and an impressive 96.29% accuracy in estimating fatalities. When applied to the initial 30 days following the escalation of the conflict (24 February 2022, to 25 March 2022), the model's projections suggested that the influx of Ukrainian refugees into Italy did not significantly alter the country's COVID-19 epidemic course. Discussion: While simulation methodologies have been pivotal in the pandemic response, their accuracy is intrinsically linked to data quality, assumptions, and modeling techniques. Enhancing these methodologies can further their applicability in future public health emergencies. The findings from the model underscore that external geopolitical events, such as the mass migration from Ukraine, did not play a determinative role in Italy's COVID-19 epidemic dynamics during the study period. Conclusion: The research provides empirical evidence negating a substantial influence of the Ukrainian refugee influx due to the Russian full-scale invasion on the COVID-19 epidemic trajectory in Italy. The robust performance of the developed model affirms its potential value in public health analyses. [ABSTRACT FROM AUTHOR]

The coronavirus disease 2019 pandemic still represents a global public health emergency, despite the availability of different types of vaccines that reduced the number of severe cases, the hospitalization rate and mortality. The Italian Vaccine Distribution Plan identified healthcare workers (HCWs) as the top-priority category to receive access to a vaccine and different studies on HCWs have been implemented to clarify the duration and kinetics of antibody response. The aim of this paper is to perform a literature review across a total of 44 studies of the serologic response to COVID-19 vaccines in HCWs in Italy and to report the results obtained in a prospective longitudinal study implemented at the Fondazione IRCCS Istituto Nazionale Tumori (INT) of Milan on 1565 HCWs. At INT we found that 99.81% of the HCWs developed an antibody response one month after the second dose. About six months after the first serology evaluation, 100% of the HCWs were still positive to the antibody, although we observed a significant decrease in its levels. Overall, our literature review results highlight a robust antibody response in most of the HCWs after the second vaccination dose. These figures are also confirmed in our institutional setting seven months after the completion of the cycle of second doses of vaccination. [ABSTRACT FROM AUTHOR]

Background: The aim of this paper is to measure for the first time in Italy the progressivity of healthcare financing systems at the regional level by using the Kakwani index (KI), the most widely used summary measure of progressivity in the healthcare financing literature. Methods: KIs were reported by region and by health financing sources for the year 2015. Results: There were significant vertical inequities in healthcare financing at both national and regional level. OOP (out-of-pocket) payments and value added tax were slightly regressive; income taxation on firms and households was progressive. Conclusions: After the introduction of fiscal federalism during the 90s, the healthcare financing system became regressive. A regional divide emerged: Overall regressivity is higher in the south and lower in the north, partly compensated by the interregional equalization mechanism, based on the redistribution of VAT from northern to southern regions. In times of policy interventions aiming at recovering the economy during the COVID-19 pandemic, it is important to monitor equity in healthcare financing. [ABSTRACT FROM AUTHOR]

COVID-19 is likely to be the 2020s' deadliest pandemic according to the World Health Organization (WHO). There have been more than 3.7 million confirmed deaths after 15 months spread. Besides the loss of human lives, COVID-19 has other unfavorable impacts on society, education, and the economy. Due to successive lockdowns and the continuous quarantines, the demands on power resources have reduced. Therefore, there is a need to investigate the impacts of the COVID-19 pandemic on electricity prices (EP). In this paper, a set of six economic factors that are affected by COVID-19 and affect EP are considered. These factors were fed into a functional link artificial neural network (FLANN) to model the relationships between them and the EP. An empirical equation was formulated to help decision makers and strategic developers in the electricity markets come up with more appropriate plans. Italy, the Czech Republic, and China were used as case studies in this research. [ABSTRACT FROM AUTHOR]

Testing for the SARS-CoV-2 infection is critical for tracking the spread of the virus and controlling the transmission dynamics. In the early phase of the pandemic in Italy, the decentralized healthcare system allowed regions to adopt different testing strategies. The objective of this paper is to assess the impact of the extensive testing of symptomatic individuals and their contacts on the number of hospitalizations against a more stringent testing strategy limited to suspected cases with severe respiratory illness and an epidemiological link to a COVID-19 case. A Poisson regression modelling approach was adopted. In the first model developed, the cumulative daily number of positive cases and a temporal trend were considered as explanatory variables. In the second, the cumulative daily number of swabs was further added. The explanatory variable, given by the number of swabs over time, explained most of the observed differences in the number of hospitalizations between the two strategies. The percentage of the expected error dropped from 70% of the first, simpler model to 15%. Increasing testing to detect and isolate infected individuals in the early phase of an outbreak improves the capability to reduce the spread of serious infections, lessening the burden of hospitals. [ABSTRACT FROM AUTHOR]

In this article we present a case study concerning a simple but efficient technical and logistic concept for the realization of blended teaching of mathematics and its applications in theoretical mechanics that was conceived, tested and implemented at the Department of Civil, Environmental and Mechanical Engineering (DICAM) of the University of Trento, Italy, during the COVID-19 pandemic. The concept foresees traditional blackboard lectures with a reduced number of students physically present in the lecture hall, while the same lectures are simultaneously made available to the remaining students, who cannot be present, via high-quality low-bandwidth online streaming. The case study presented in this paper was implemented in a single University Department and was carried out with a total of n = 1011 students and n = 68 professors participating in the study. Based on our first key assumption that traditional blackboard lectures, including the gestures and the facial expressions of the professor, are even nowadays still a very efficient and highly appreciated means of teaching mathematics at the university, this paper deliberately does not want to propose a novel pedagogical concept of how to teach mathematics at the undergraduate level, but rather presents a technical concept of how to preserve the quality of traditional blackboard lectures even during the COVID-19 pandemic and how to make them available to the students at home via online streaming with adequate audio and video quality even at low internet bandwidth. The second key assumption of this paper is that the teaching of mathematics is a dynamic creative process that requires the physical presence of students in the lecture hall as audience so that the professor can instantaneously fine-tune the evolution of the lecture according to his/her perception of the level of attention and the facial expressions of the students. The third key assumption of this paper is that students need to have the possibility to interact with each other personally, especially in the first years at the university. We report on the necessary hardware, software and logistics, as well as on the perception of the proposed blended lectures by undergraduate students from civil and environmental engineering at the University of Trento, Italy, compared to traditional lectures and also compared to the pure online lectures that were needed as emergency measure at the beginning of the COVID-19 pandemic. The evaluation of the concept was carried out with the aid of quantitative internet bandwidth measurements, direct comparison of transmitted video signals and a careful analysis of ex ante and ex post online questionnaires sent to students and professors. [ABSTRACT FROM AUTHOR]

This study provides a descriptive analysis of the Lègami/Legàmi service, a free psychological support service in maternal and childcare, offered through the internet and by telephone that was initiated by the Italian Society of Pediatric Psychology (S.I.P.Ped.) during the COVID-19 medical emergency as an act of solidarity, first independently, and then in collaboration with the Italian Ministry of Health. This paper presents findings related to the "universe" of people who called the toll-free service, from the sociocultural characteristics of the users to the information collected by the professionals during the psychological pathways until human satisfaction was achieved. We provide a retrospective description of an experience that took place between April and June 2020, and which involved users of the maternal-infant area calling from the whole Italy. (1) Methods: The aims of this study were to investigate the configuration of the indicators identified and to detect the possible correlations between them in the sample. There were 193 users who took advantage of the Service, 160 of whom continued beyond the reception service; it is this group that we report the findings from here. The tool used was a form reporting access to care and interventions, and the resulting data underwent a content analysis and the indicators were subject to non-parametric statistical analysis to analyze differences and relationships. (2) Results: There were many correlations among the indicators that revealed a high prevalence of calls due to personal motivations and requests for support, which later allowed users to gain a greater understanding of the underlying problems they were facing. The professionals running the service noticed a prevalence of weaknesses attributable to the negative emotions of its users, alongside a presence of cognitive and relational resources. The professionals' interventions, which can be characterized by a prevalence of social support, psychological rehabilitation, and psychoeducation, achieved outcomes of redefining users' relationships with themselves and others. All of the service's users have expressed a high level of satisfaction with it. (3) Discussion: Our results revealed the protective and transformative effects of the service for its users and the underlying importance of having an easily accessible psychological support system in place during emergencies, like the recent pandemic. In conditions like these, the great value of a remote support service should be noted, and despite its limitations, assures its own efficacy when a medical emergency precludes closer in-person forms of psychological assistance. [ABSTRACT FROM AUTHOR]

Due to its high short-term global warming potential (GWP) compared to carbon dioxide, methane (CH4) is a considerable agent of climate change. This research is aimed at analyzing data on methane gathered at the GAW (Global Atmosphere Watch) station of Lamezia Terme (Calabria, Southern Italy) spanning seven years of continuous measurements (2016–2022) and integrating the results with key meteorological data. Compared to previous studies on detected methane mole fractions at the same station, daily-to-yearly patterns have become more prominent thanks to the analysis of a much larger dataset. Overall, the yearly increase of methane at the Lamezia Terme station is in general agreement with global measurements by NOAA, though local peaks are present, and an increase linked to COVID-19 is identified. Seasonal changes and trends have proved to be fully cyclic, with the daily cycles being largely driven by local wind circulation patterns and synoptic features. Outbreak events have been statistically evaluated depending on their weekday of occurrence to test possible correlations with anthropogenic activities. A cross analysis between methane peaks and specific wind directions has also proved that local sources may be deemed responsible for the highest mole fractions. [ABSTRACT FROM AUTHOR]

Background: Coronavirus Disease 2019 (COVID-19) is the main discussed topic worldwide in 2020 and at the beginning of the Italian epidemic, scientists tried to understand the virus diffusion and the epidemic curve of positive cases with controversial findings and numbers. Objectives: In this paper, a data analytics study on the diffusion of COVID-19 in Lombardy Region and Campania Region is developed in order to identify the driver that sparked the second wave in Italy. Methods: Starting from all the available official data collected about the diffusion of COVID-19, we analyzed Google mobility data, school data and infection data for two big regions in Italy: Lombardy Region and Campania Region, which adopted two different approaches in opening and closing schools. To reinforce our findings, we also extended the analysis to the Emilia Romagna Region. Results: The paper shows how different policies adopted in school opening/closing may have had an impact on the COVID-19 spread, while other factors related to citizen mobility did not affect the second Italian wave. Conclusions: The paper shows that a clear correlation exists between the school contagion and the subsequent temporal overall contagion in a geographical area. Moreover, it is clear that highly populated provinces have the greatest spread of the virus. [ABSTRACT FROM AUTHOR]

This study aimed to explore the effect of socioeconomic disadvantage accumulated in marginalised Roma communities (MRCs) on early childhood development and to assess the role of selected socioeconomic indicators in the association between belonging to MRCs vs. the majority and early childhood development. We obtained cross-sectional data from 232 mother–child dyads from MRCs and the majority population. The differences in early childhood development and background variables between the two groups were tested using chi-square and Mann–Whitney U tests. The moderated mediation was tested using PROCESS Macro in SPSS Model 14 on 5000 bootstrap samples. Statistically significant differences between children from MRCs and the majority were found in terms of maternal age, parental education, household equipment, as well as early childhood development. Household equipment moderated the indirect effect of being from MRCs vs. the majority on early childhood development through parental education. The indirect effect through parental education was high at a low household equipment level, reduced at an average level and non-significant at a high level of household equipment. Our study uncovered disparities in early childhood development between children from MRCs and the majority population. Parental education significantly influenced developmental outcomes, while household equipment mitigated its impact. [ABSTRACT FROM AUTHOR]

Efficiency in stock markets is essential for economic stability and growth. This study investigates the efficiency and herding behavior of the stock markets from the top economies of the world (known as G20 countries). We classify stock market indices using MSCI classification for the developed and emerging markets to provide a comparative examination using the latest data and by employing the robust multifractal detrended fluctuation (MFDFA) method. In addition to the full sample, the analysis uses sub-sample periods to reveal the hidden features and efficiencies of the G20 markets during the Russia–Ukraine War and COVID-19 for the first time. The findings show the availability of varied multifractality among all G20 stock markets during the overall and crisis periods, exhibit long-range correlations, and may support the fractal market hypothesis. In addition, Italy remains the least efficient, while Germany remains the most efficient stock market. The sub-sample results further reveal unevenness in the local fluctuations and resultant higher inefficiency considering the sheer magnitude and impact of crises on the G20 stock markets. However, the efficiency of developed stock markets performed better as compared to emerging markets. The study of G20 stock markets is useful and provides several implications for a wider audience. [ABSTRACT FROM AUTHOR]

Background: Tdap and flu immunization in pregnancy has been proven to be both effective and safe. Despite this, the vaccination rate in pregnant women is low in Italy. The COVID-19 pandemic has focused the attention of public opinion on communicable diseases, underlining the importance of primary prevention measures such as vaccination. We conducted a survey to investigate the behavior of pregnant women during the COVID-19 pandemic regarding maternal immunization to identify the reasons for vaccine hesitancy in order to overcome them. The new challenge is COVID-19 vaccination in pregnancy, and preliminary data show hesitancy towards it. Our analysis may be useful to improve immunization in the pregnant population, including through the COVID-19 vaccine. Methods: A targeted survey was performed in Italy including 520 women who experienced in the first trimester of pregnancy, prior to the novel coronavirus spread, the 2019–2020 influenza vaccination campaign and the Tdap vaccine recommendation in the third trimester during the COVID pandemic. They represent a unique model to investigate if the new coronavirus outbreak might have changed attitudes towards vaccination in pregnancy in the same patients. Data were collected from a self-completed paper questionnaire. Descriptive statistics were calculated and percentages were compared using the chi-2 test or Fisher's exact test. Results: We obtained data from 195 of the 520 women who gave birth during the inclusion period; 325 cases declined to participate in the survey. A total of 8.7% (17 cases) performed flu vaccination in the first trimester of pregnancy (pre-COVID era), 50.8% (99 cases) accepted Tdap immunization during their third trimester of gestation (COVID-19 pandemic) and 6.7% (13 cases) received both vaccines during pregnancy. For both the flu and Tdap shots, pregnant patients were more likely to accept the vaccines if they were recommended by a healthcare provider, whereas the main reason not to be vaccinated was the lack of such a recommendation. Conclusions: Our survey shows that the COVID-19 experience, which has raised awareness as to the role of vaccines in preventable diseases, may positively change attitudes toward immunization in pregnancy. Vaccination must be recommended to all pregnant women and organized during routine prenatal care as an important element for the prevention of communicable diseases. Vaccination hesitancy can be minimized through consistent recommendation to all pregnant women offered by obstetric staff during routine prenatal care. This approach is likely to be effective in terms of building trust in flu and Tdpa immunization among pregnant women, as well as to avoid unjustified hesitancy towards the more recent COVID-19 vaccines. [ABSTRACT FROM AUTHOR]

Background: The aim of this study is to investigate the potential occurrence of post-traumatic stress disorder (PTSD) symptoms, following exposure to traumatic events, in Italian midwives and their consequent influence on the quality of midwives' professional lives. In addition, data were collected on the major traumatic events described by midwives. Method: A cross-sectional study related the socio-demographic characteristics of 286 midwives with the scores obtained on two assessment scales, one for post-traumatic stress disorder (IES-R) and the other for quality of life (ProQOL V). The percentage of midwives who obtained a score higher than the predetermined threshold value in both questionnaires was noted, and the correlations that emerged were highlighted. Through this qualitative method, their significant work-related traumatic events were investigated to finally detect the prevalence percentage of each category. Results: The proportion of midwives scoring higher than 33 on the IES-R scale, indicating a higher likelihood of PTSD, was 48.6%. Freelancers or outpatient clinic midwives had lower mean IES scores (p = 0.049). A significant inverse correlation was observed between age and IES-R score and between the compassion satisfaction subscale and time since completing education (p = 0.028). A comparison between the IES-R and ProQOL scales showed a statistically significant correlation (p < 0.001), in particular, between the burnout (BO) (p < 0.001) and secondary traumatic stress (STS) (p < 0.001) subscales. The thematic categorization of traumatic events included mother/child death, mother/child medical complications, relational problems with patients or team members, and organizational problems/medical staff's inexperience. Conclusions: The emerging data may confirm the data in the literature, namely those showing that midwives are prone to developing work-related PTSD, particularly due to their exposure to traumatic events such as maternal and neonatal death. [ABSTRACT FROM AUTHOR]

Background: Identifying predictive factors of long COVID syndrome (LCS) is essential to preventing and managing this condition. We investigated the prevalence, symptoms, and risk factors of LCS in a cohort of Italian children and adolescents. Methods: We carried out a cross-sectional survey on demographic characteristics and clinical data related to COVID-19 phase and LCS in a cohort of children and adolescents, sending a questionnaire by using the PEDIATOTEM platform. Results: The prevalence of LCS was 25% (99/396). The most frequent symptoms of LCS included nasal congestion, diarrhea, headache, and fatigue. We found no association between demographic data (gender, age, and ethnicity) and LCS. Additionally, we showed that patients with concurrent allergic rhinitis, atopic dermatitis, respiratory disease, gastrointestinal disease, and rheumatologic disease had a higher risk of LCS than patients without those comorbidities. Patients experiencing fatigue, muscle, and abdominal pain in COVID-19 showed a higher risk of LCS than patients complaining of other symptoms. We found no association between vaccination and LCS. Conclusions: Specific comorbidities or symptoms during acute illness were identified as being risk factors for LCS. Understanding which are the risk factors for LCS could yield a clearer picture of its pathogenesis. [ABSTRACT FROM AUTHOR]

Background: This study aimed to evaluate the survival rate and medium-term outcomes of patients after cemented posterior-stabilized (PS) mobile-bearing (MB) total knee arthroplasty (TKA) using a telemedicine platform during the COVID-19 pandemic in Italy. Methods: A total of 100 consecutive patients (mean age 73.5 ± 13.2 years) who received a cemented PS MB TKA were enrolled. The mean age of patients who did not complete the telemedicine follow-up (58%) was 75.8 ± 9.7 years. A dedicated software that makes it possible to perform video calls, online questionnaires, and acquire X-rays remotely was used. Subjective clinical scores and objective range-of-motion (ROM) measurements were observed at an average follow-up of 54 ± 11.3 months. Results: A total of 42 of 100 enrolled patients (mean age 70.3 ± 8.4 years) completed the telemedicine follow-up. The mean age of patients who did not complete the telemedicine follow-up (58%) was 75.8 ± 9.7 years. Age was found to be a statistically significant difference between the group that completed the telemedicine follow-up and the one that did not (p < 0.004). KOOS scores improved from 56.1 ± 11.3 to 77.4 ± 16.2, VAS scores decreased from 7.2 ± 2.1 to 2.8 ± 1.6, KSSf scores increased from 47.2 ± 13.3 to 77.1 ± 21.1, FJS scores improved from 43.4 ± 12.3 to 76.9 ± 22.9, and OKS scores increased from 31.9 ± 8.8 to 40.4 ± 9.9. All the differences were statistically significant (p < 0.05). The mean flexion improved from 88° ± 8° to 120° ± 12°. A radiographic evaluation showed a mean pre-operative mechanical axis deviation of 5.3 ± 8.0 degrees in varus, which improved to 0.4 ± 3.4 degrees of valgus post-operation. The survivorship at 5 years was 99%. Conclusions: Subject to small numbers, telemedicine presented as a useful instrument for performing remote monitoring after TKA. The most important factor in telemedicine success remains the patient's skill, which is usually age-related, as older patients have much more difficulty in approaching a technological tool. [ABSTRACT FROM AUTHOR]

Myasthenia gravis (MG) is the most common neuromuscular junction disorder. We evaluated the MG incidence rate in the province of Ferrara, Northern Italy, over two time frames (2008–2018 and 2019–2022, i.e., the COVID-19 pandemic) and considered early-onset (EOMG), late-onset (LOMG), and thymoma- and non-thymoma-associated MG. Moreover, in the second period, we assessed its possible relationship with SARS-CoV-2 infection or COVID-19 vaccination. We used a complete enumeration approach to estimate the MG incidence and its temporal trend. For the period of 2008–18, 106 new cases were identified (mean incidence rate 2.7/100,000 people). The highest rates were observed for the over-70 age group and in rural areas, with 17% of thymoma-associated MG. During the COVID-19 period, 29 new cases were identified (average incidence rate 2.1/100,000 people), showing a marked (though not statistically significant) decrease in the mean annual incidence compared to the previous period. Again, the highest rate was observed for the over-70 age group. The first period was in line with our previous observations for the period between 1985 and 2007, highlighting a rising incidence of LOMG and a marked decrease in EOMG. During the COVID-19 period, incidence rates were lower in the first years whereas, when the pandemic ended, the previous trend was confirmed. [ABSTRACT FROM AUTHOR]

Background: Young adults, aged between 17 and 25 years, experienced a strong impact on both their mental health and well-being due to COVID-19. Indeed, they were simultaneously faced with the normative tasks of their age and stressors associated with the long-lasting COVID-19 pandemic. This study offers further insights into the perceptions of the well-being (stress, anxiety, and depression) and social bonds in young Italian adults during and after the COVID-19 pandemic. Methods: The first survey was conducted between December and February 2021 (i.e., during the second wave in Italy) and included a total sample of 347 participants. The second survey took place between April and May 2022 (i.e., at the end of the health emergency in Italy) and consisted of a total sample of 313 participants. Results: T-tests, correlations, and linear regressions were performed. Overall, our findings showed an increased mood disturbance was positively correlated with having contracted COVID-19 and negatively associated with social connectedness. Furthermore, social assurance was found to negatively predict mood disorders during COVID-19. Conclusion: While numerous studies have focused on mental health, there has been limited exploration of protective factors, which could represent a different perspective that emphasizes individuals' resources rather than their vulnerabilities. [ABSTRACT FROM AUTHOR]

Endometrial cancer represents an ideal target to evaluate the impact of COVID-19 being the most frequent gynecological malignancy in Italy, generally detected at early stages and correlated with favorable oncological outcomes. The present comparative retrospective study carried out at Campus Bio-medico University Foundation in Rome aims to evaluate the impact of the COVID-19 pandemic on the presentation, diagnosis and treatment of EC. All women with a histological diagnosis of non-endometrioid and endometrioid endometrial cancer between 1 March 2018 and 31 October 2022 were included. The number of cases was higher in period 2 (95 vs. 64 cases). Time to diagnosis did not show statistically significant differences but in period 2, 92.06% of the diagnoses were made following abnormal uterine bleeding, while in period 1, only 67.02% were. The waiting time for the intervention was significantly shorter in period 2. Definitive histology, FIGO staging, surgical technique and adjuvant therapy did not show significant differences between the two periods. The study demonstrates that the impact of the COVID-19 pandemic did not have a direct effect on the diagnostic delay, tumor staging and type of therapy but rather on the presentation pattern of endometrial cancer. [ABSTRACT FROM AUTHOR]

The present research aimed at understanding individuals' vaccination intentions and protective behaviours against COVID-19 through two different studies. In Study 1 (N = 213, 73% women; mean age = 24.03) the Protection Motivation Theory model was tested considering the fear of COVID-19 as a possible mediator between threat appraisal (in terms of both health and social life) and intentions to get vaccinated when the vaccination was not yet available. Study 2 (N = 1111, 68.9% women; mean age = 38.33) was conducted when the vaccine became available for the entire population. Through this study, by adopting the 5C model of vaccine hesitancy as a theoretical framework, we aimed to understand how people who got vaccinated and the ones who did not differed, considering fear of vaccination, personality and vaccination hesitancy. In Study 1, social limitations, perceived severity and COVID-19 perceived vulnerability were significantly and positively related to fear of COVID-19. Contrary to what we expected, fear of COVID-19 was not a significant predictor of vaccination intention, which was predicted by both response efficacy and self-efficacy. In Study 2, in line with previous studies, vaccine hesitancy was negatively related to vaccination. More specifically, the social-oriented dimension of collective responsibility was the strongest predictor of effective behaviour. Our findings provide insights into the complexity of vaccine acceptance and emphasise the need for targeted interventions to promote vaccination and mitigate the spread of infectious diseases. [ABSTRACT FROM AUTHOR]

Purpose: This study investigated the impact of the COVID-19 pandemic on mental health, quality of life, and family functioning in a sample of the general female population, exploring difficulties encountered in managing family and work responsibilities and burden of care when taking care of a loved one. This study was, moreover, aimed at investigating factors capable of influencing severe depressive symptomatology in the context of socio-demographics, traumatic events, individual vulnerability, and family functioning. Method: The sampling method used in this research was non-probability sampling. The survey took place during a Hospital Open Weekend (8–10 October 2021) organized by the National Gender Observatory on Women's Health "Fondazione Onda" on the occasion of the World Mental Health Day. Results: A total of 211 women were interviewed (mean age = 35.6, 53% living alone, more than 15% with financial difficulties, 47% exposed to the 2009 L'Aquila earthquake). More than 50% of the sample reported a higher complexity in managing their lives during the COVID-19 pandemic compared to their previous routine, with no statistically significant differences between working women and non-workers, although the latter obtained higher scores for depressive symptomatology and poorer quality of life. Compared to non-caregivers, female caregivers (22.3%) in charge of the care of loved ones affected by physical (10.9%) or psychiatric disabilities (11.4%) complained of a poorer quality of life, especially in general health perception (p = 0.002), physical function (p = 0.011), role limitations related to physical problems (p = 0.017), bodily pain (p = 0.015), mental health (p = 0.004), and social functioning (p = 0.007). Women caring for people affected by mental disorders seemed to experience a more significant worsening in vitality (p = 0.003) and social functioning (p = 0.005). Approximately 20% of the total sample reported severe depressive symptomatology. Previous access to mental health services (O.R. 10.923; p = 0.000), a low level of education (O.R. 5.410; p = 0.021), and difficulties in management of everyday lives during the COVID-19 pandemic (O.R. 3.598; p = 0.045) were found to be the main variables predictive of severe depressive psychopathology. Old age, good problem-solving skills, and ability to pursue personal goals were identified as protective factors. Conclusions: The COVID-19 pandemic underlined the need for support amongst emotionally vulnerable women with pre-existing mental health conditions, partly reflecting the cumulative effects of traumas. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic affected the perinatal emotional landscape in Italy, a country that had high mortality and implemented a strict lockdown during the pandemic. This study explores the emotions and challenges of pregnant and postpartum women during the pandemic, using AI-based mixed methods. The study analyzed 1774 women from the national survey COVID-ASSESS: 1136 pregnant and 638 postpartum women. The survey had qualitative questions on emotions and feelings related to birth, communication with healthcare professionals, media, and peers and family. We used natural language processing and machine learning to classify emotions, identify themes, and extract citations from the data. Fear and anxiety replaced joy as dominant emotions during the pandemic: trust and joy decreased by 49.3% and 36.4%, respectively, while sadness and fear increased by 52.3% and 49.3%, respectively. The pandemic also induced loneliness, isolation, frustration, and anger. Women faced challenges related to birth, communication with HCPs, media, and peers and family. They also used coping strategies such as self-care, news limitation, and trying to cultivate gratitude and hope. This study provides a comprehensive exploration of the perinatal emotional landscape of Italian women during the pandemic. The findings underscore the significant psychological impact of the pandemic and also highlight women's resilience and coping strategies. [ABSTRACT FROM AUTHOR]

The Sars-CoV-2 pandemic has had important economic, health, political, and jurisprudential implications all over the world. According to innovations already introduced by Law 24/2017, with Decree Law no. 44 of 1 April 2021 and the subsequent conversion law no. 71 of 2021, Italy is the only country in which ad hoc rules have been introduced to limit the professional liability of healthcare professionals during the health emergency. The "criminal shield" can be defined as the Legislator response to the extreme pressure on healthcare professionals during the pandemic. [ABSTRACT FROM AUTHOR]

Introduction: Total knee arthroplasty is an effective operation. Post-surgery rehabilitation, based on early and intensive progressive exercise programs, plays a substantial role and telerehabilitation can be an effective safe option. This retrospective study aimed to compare traditional in-presence rehabilitation and telerehabilitation for total knee arthroplasty, based on our experience during the Italian COVID-19 lockdown. Materials and methods: We retrospectively analyzed 164 patients (94 females and 70 males) enrolled in 2020 within 2 weeks after total knee replacement to perform post-operative outpatient rehabilitation. The clinical results of 82 patients (mean age 66.8 ± 10.2 years) performing telerehabilitation with those obtained from a similar cohort of 82 patients (mean age 65.4 ± 11.8 years) performing traditional in-presence outpatient rehabilitation were compared. Clinical outcomes were examined by comparing the gait speed (Time Up and Go-TUG test), the range of motion, the pain intensity (VAS), the functional status (Oxford Knee Score—OKS and Knee injury and Osteoarthritis Outcome Score—KOOS) and the overall satisfaction (Self-administered patient satisfaction scale) 12 weeks after the beginning of the physiotherapeutic protocol. Results: Telerehabilitation was non-inferior to traditional in-presence rehabilitation in all of the investigated areas and no statistical difference in terms of effectiveness was detected at 12 weeks, as confirmed by the respective patient-reported outcome scores such as TUG test (reduced from 20 ± 2 s to 12 ± 1.5 s for the telerehab cohort and from 18 ± 1.5 s to 13.1 ± 2 s for the in-presence rehabilitation one), pain VAS, OKS (improved from 22 ± 1.3 to 36 ± 2.7 for the telerehab cohort and from 23 ± 2.1 to 35.1 ± 4.2 for the in-presence group), KOOS (improved from 46.2 ± 10.2 to 67.4 ± 3.8 for the telerehabilitation cohort and from 48.4 ± 8.4 to 68.3 ± 6.6 for the other group), and the Self-administered patient satisfaction scale (more than two-thirds of patients globally satisfied with the results of their surgery in both groups). Conclusion: The telerehabilitation program was effective after total knee replacement and yielded clinical outcomes that were not inferior to conventional outpatient protocols. [ABSTRACT FROM AUTHOR]

The objective of this study is to investigate the impact of the COVID-19 pandemic on the carbon footprint (CF) of two research projects. These projects were initiated prior to the onset of the pandemic and subsequently concluded afterward, serving as the Base Case (BC) for analysis. Furthermore, the study seeks to explore the potential applicability of measures implemented during the period of lockdown for future mitigation of CF. The applied methodology, which adheres to the guidelines provided by the GHG Protocol and the Department for Environment Food & Rural Affairs (DEFRA) emission factors, is utilized to examine the CF of the projects under two different scenarios. The first scenario assumes that the projects were implemented without the pandemic, while the second scenario considers that the projects were conducted entirely during the pandemic. Among the two projects under review, one emphasizes innovation and entails a collaboration between academia and business. This project is supported by a limited number of employees, exclusively from domestic partners. The other project is more oriented toward policy-making and involves a larger group of partners from Greece and Italy. Its main priority is dissemination. Carbon dioxide (CO2) emissions associated with project activities mainly stem from electricity use, material consumption, project-hosted events, project participation in events, employees commuting, and equipment. Results show that in the first scenario, the projects exhibit a more than 40% increase in CO2 emissions compared to the BC, while in the second scenario, the implementation of measures such as teleworking, virtual participation in events, and digitization of bureaucratic processes lead to a reduction in emissions by at least 20%. The study suggests that adopting such measures after the COVID-19 pandemic could significantly decrease greenhouse gas emissions. [ABSTRACT FROM AUTHOR]

Background. The COVID-19 pandemic has transformed people's lifestyles by imposing social, economic, and labor changes. Health professionals have been in the spotlight, occasionally even elevated to the status of "heroes", as they have been at the forefront of the health emergency. Media exposure has undoubtedly played a pivotal role in the evolution and perception of the public's image of nurses, especially within the Italian context. Currently, there is only one study conducted in Italy during the pandemic period. For this reason, we have opted to delve further into this subject during the post-pandemic period, with the ultimate goal of identifying this perceptual evolution. Methods. An online snowball sampling survey was conducted among the Italian population using social networks between August 2022 and January 2023. The survey utilized the Nursing Attitude Questionnaire (NAQ) to collect data. Results. The sample consisted of 564 individuals. Among the respondents, 63.8% (n = 360) were familiar with the nursing pathway, and the level of agreement regarding the training of nurses was 81.5% (n = 260). In terms of recognizing the professional role of nurses, variations emerged in certain domains of the NAQ. Specifically, professional values of nurses were more pronounced in northern and central Italy (M = 26.27). Moreover, stereotypes were more prevalent in the north (23.73 ± 3.538) and the center (23.13 ± 4.104) (p = 0.001). Conclusions. The sample acknowledged a unique competence inherent to nurses that cannot be replaced by other professionals. The study population perceives the nursing profession as pivotal within the IHS (Integrated Health System). However, the attractiveness of the profession remains exceedingly low. This study was not registered on a publicly available registry. [ABSTRACT FROM AUTHOR]

Introduction: The COVID-19 pandemic has had a considerable impact on the psychological and psychopathological status of the population and health care workers in terms of insomnia, anxiety, depression, and post-traumatic stress disorder. The primary aim of this study was to describe and evaluate the impact of the pandemic on insomnia levels of a cohort of Italian nurses, particularly those involved in the care of COVID-19 patients. The secondary aim was to identify the interaction between insomnia and hardiness, anxiety, and sleep disturbances. Materials and Methods: A descriptive–exploratory study was conducted using an online survey during the first wave of the COVID-19 pandemic (March to July 2020). The questionnaire consisted of multiple-choice, open-ended, closed, and semi-closed questions. The psychometric tools administered were the Dispositional Resilience Scale (DRS-15), the State–Trait Anxiety Inventory (STAI-Y), and the Insomnia Severity Index (ISI). Results: a cohort of 1167 nurses fully completed the questionnaire (86.2% of total respondents). The insomnia scale survey showed an increase in post-pandemic scores compared to those before the pandemic, implying that insomnia levels increased after the first pandemic wave. Insomnia scores were directly correlated with anxiety levels (r = 0.571; p ≤ 0.05) and inversely correlated with hardiness levels (r = −0.324; p < 0.001). Multivariate analysis revealed the following protective factors: not having worked in COVID-19 wards, high levels of hardiness (commitment), and the presence of high pre-pandemic insomnia disorder. The main risk factor for insomnia reported in the analysis was a high anxiety score. Discussion and Conclusion: Anxiety represented the main risk factor for insomnia severity in our sample, while hardiness was confirmed as a protective factor. Thus, it is necessary to design further studies to identify additional risk factors for poor sleep quality and to develop educational courses and strategies aimed at enhancing rest and sleep quality, especially for frontline nurses. [ABSTRACT FROM AUTHOR]

Human respiratory syncytial virus (hRSV) is an important pathogen of acute respiratory tract infection of global significance. In this study, we investigated the molecular epidemiology and the genetic variability of hRSV over seven surveillance seasons between 2015 and 2023 in Sicily, Italy. hRSV subgroups co-circulated through every season, although hRSV-B mostly prevailed. After the considerable reduction in the circulation of hRSV due to the widespread implementation of non-pharmaceutical preventive measures during the COVID-19 pandemic, hRSV rapidly re-emerged at a high intensity in 2022–2023. The G gene was sequenced for genotyping and analysis of deduced amino acids. A total of 128 hRSV-A and 179 hRSV-B G gene sequences were obtained. The phylogenetic analysis revealed that the GA2.3.5a (ON1) and GB5.0.5a (BA9) genotypes were responsible for the hRSV epidemics in Sicily.; only one strain belonged to the genotype GB5.0.4a. No differences were observed in the circulating genotypes during pre- and post-pandemic years. Amino acid sequence alignment revealed the continuous evolution of the G gene, with a combination of amino acid changes specifically appearing in 2022–2023. The predicted N-glycosylation sites were relatively conserved in ON1 and BA9 genotype strains. Our findings augment the understanding and prediction of the seasonal evolution of hRSV at the local level and its implication in the monitoring of novel variants worth considering in better design of candidate vaccines. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak involved a spread of prediction efforts, especially in the early pandemic phase. A better understanding of the epidemiological implications of the different models seems crucial for tailoring prevention policies. This study aims to explore the concordance and discrepancies in outbreak prediction produced by models implemented and used in the first wave of the epidemic. To evaluate the performance of the model, an analysis was carried out on Italian pandemic data from February 24, 2020. The epidemic models were fitted to data collected at 20, 30, 40, 50, 60, 70, 80, 90, and 98 days (the entire time series). At each time step, we made predictions until May 31, 2020. The Mean Absolute Error (MAE) and the Mean Absolute Percentage Error (MAPE) were calculated. The GAM model is the most suitable parameterization for predicting the number of new cases; exponential or Poisson models help predict the cumulative number of cases. When the goal is to predict the epidemic peak, GAM, ARIMA, or Bayesian models are preferable. However, the prediction of the pandemic peak could be made carefully during the early stages of the epidemic because the forecast is affected by high uncertainty and may very likely produce the wrong results. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate using quantitative analysis on chest CT images a possible lung volume reduction in Long COVID patients who complain mild respiratory symptoms, with chest CT negative for inflammatory findings. Materials and Methods: CT images of patients from 18 to 40 years old who underwent chest CT scan at our institution were analyzed retrospectively, using AwServer Thoracic VCAR software for a quantitative study. Exclusion criteria were inflammatory findings at CT, previous lung surgery, lung cancer, and breath artifacts that invalidate the quality of images. Patients were divided into two groups: in the first one ("post-COVID") were patients who had previous SARS-CoV-2 infection, confirmed by an RT-PCR, who underwent chest CT from 3 to 6 months after their negativization for long COVID symptoms; in the control group ("non-COVID"), were enrolled patients who underwent a chest CT scan from January 2018 to December 2019, before the spread of COVID in Italy. Results: Our final population included 154 TC, 77 post-COVID patients (mean age 33 ± 6) and 77 non-COVID patients (mean age 33 ± 4.9). Non statistical significative differences were obtained between groups in terms of age, sex, and other characteristics that affect total lung capacity such as obesity, thoracic malformations, and smoking habit. Mean values of the total lung volume (TV), right-lung volume (RV), and left-lung volume (LV) in the post-COVID group compared with non-COVID group were, respectively: 5.25 ± 0.25 L vs. 5.72 ± 0.26 L (p = 0.01); 2.76 ± 0.14 L vs. 3 ± 0.14 L (p = 0.01); 2.48 ± 0.12 L vs. 2.72 ± 0.12 L (p = 0.01). Conclusion: In patients with symptoms suggesting Long COVID and negative chest CT macroscopic findings, quantitative volume analysis demonstrated a mean value of reduction in lung volume of 10% compared to patients of the same age who never had COVID. A chest CT negative for inflammatory findings may induce clinicians to attribute Long COVID mild respiratory symptoms to anxiety, especially in young patients. Our study brings us beyond appearances and beyond the classic radiological signs, introducing a quantitative evaluation of lung volumes in these patients. It is hard to establish to what extent this finding may contribute to Long COVID symptoms, but this is another step to gain a wider knowledge of the potential long-term effects caused by this new virus. [ABSTRACT FROM AUTHOR]

The COVID-19 epidemic has recently led in Italy to the implementation of different external strategies in order to limit the spread of the disease in response to its transmission rate: strict national lockdown rules, followed first by a weakening of the social distancing and contact reduction feedback interventions and finally the implementation of coordinated intermittent regional actions, up to the application, in this last context, of an age-stratified vaccine prioritization strategy. This paper originally aims at identifying, starting from the available age-structured real data at the national level during the specific aforementioned scenarios, external-scenario-dependent sets of virulence parameters for a two-age-structured COVID-19 epidemic compartmental model, in order to provide an interpretation of how each external scenario modifies the age-dependent patterns of social contacts and the spread of COVID-19. [ABSTRACT FROM AUTHOR]

Cyanobacteria are ubiquitous photosynthetic microorganisms considered as important contributors to the formation of Earth's atmosphere and to the process of nitrogen fixation. However, they are also frequently associated with toxic blooms, named cyanobacterial harmful algal blooms (cyanoHABs). This paper reports on an unusual out-of-season cyanoHAB and its dynamics during the COVID-19 pandemic, in Lake Avernus, South Italy. Fast detection strategy (FDS) was used to assess this phenomenon, through the integration of satellite imagery and biomolecular investigation of the environmental samples. Data obtained unveiled a widespread Microcystis sp. bloom in February 2020 (i.e., winter season in Italy), which completely disappeared at the end of the following COVID-19 lockdown, when almost all urban activities were suspended. Due to potential harmfulness of cyanoHABs, crude extracts from the "winter bloom" were evaluated for their cytotoxicity in two different human cell lines, namely normal dermal fibroblasts (NHDF) and breast adenocarcinoma cells (MCF-7). The chloroform extract was shown to exert the highest cytotoxic activity, which has been correlated to the presence of cyanotoxins, i.e., microcystins, micropeptins, anabaenopeptins, and aeruginopeptins, detected by molecular networking analysis of liquid chromatography tandem mass spectrometry (LC-MS/MS) data. [ABSTRACT FROM AUTHOR]

The COVID-19 crisis has strongly affected the school system. In Italy, at-distance forms of didactics have been activated, changing the physiognomy of schools in terms of social interaction, practices and the identity of the individuals. In this paper, we address the issue of how teachers are facing the crisis: our focus is on assessment, as a key variable catalyzing personal history; beliefs; the interface between students; teachers and the school system. We study teachers' beliefs as part of their identities and assessment as a fundamental variable of beliefs. A qualitative content analysis of the open-ended answers to an online questionnaire is carried out to understand the main characteristics associated with assessment by teachers and the obstacles to overcome in the context of long distance learning (LDL). The data show that teachers did not identify valid assessment methods for LDL during the lockdown, especially due to the lack of control over the students. A misconception emerges concerning the definition of formative assessment together with a new awareness of the possibilities offered by digital technologies regarding the individualization of didactics. This study helps to understand which teachers' beliefs are related to assessment are and how they are shaped. [ABSTRACT FROM AUTHOR]

This paper addresses the problem of describing the spread of COVID-19 by a mathematical model introducing all the possible control actions as prevention (informative campaign, use of masks, social distancing, vaccination) and medication. The model adopted is similar to SEIQR, with the infected patients split into groups of asymptomatic subjects and isolated ones. This distinction is particularly important in the current pandemic, due to the fundamental the role of asymptomatic subjects in the virus diffusion. The influence of the control actions is considered in analysing the model, from the calculus of the equilibrium points to the determination of the reproduction number. This choice is motivated by the fact that the available organised data have been collected since from the end of February 2020, and almost simultaneously containment measures, increasing in typology and effectiveness, have been applied. The characteristics of COVID-19, not fully understood yet, suggest an asymmetric diffusion among countries and among categories of subjects. Referring to the Italian situation, the containment measures, as applied by the population, have been identified, showing their relation with the government's decisions; this allows the study of possible scenarios, comparing the impact of different possible choices. [ABSTRACT FROM AUTHOR]

Vitamin D (VitD) is largely used in Italy, often inappropriately; thus, an evaluation of its safety is a crucial issue. This study analyses the adverse reactions (ARs) associated with the use of products containing VitD (VitDps) reported to the Italian National Pharmacovigilance and Phytovigilance networks. From March 2002 to August 2022, a total of 643 and 127 reports concerning 903 and 215 ARs were retrieved from Pharmacovigilance and Phytovigilance networks, respectively. Overall, 332 (29.6%) ARs were classified as serious, and the most described ones were hypercalcaemia, renal failure and tachycardia. Serious AR risk was significantly higher for subjects using more than four concomitant products (OR 2.44 [95% CI 1.30–4.60]) and VitD doses higher than 1000 IU/day (OR 2.70 [95% CI 1.30–5.64]). In Italy, there was a modest decrease in AR reporting, despite the slightly increased use of VitD during the COVID-19 pandemic. To the best of our knowledge, this is the first study describing all VitDps-related ARs observed in the Italian general population. Since underreporting is the main limitation of the safety reporting systems, the necessity to continue ARs monitoring, also using real-world data on VitDps prescription, use and outcome patterns is highlighted. [ABSTRACT FROM AUTHOR]

Underserved populations have a wide heterogeneity on healthcare provision and use. They also represent the key populations according to WHO 2030 goals for HCV micro-elimination. Our review evaluated the available literature on HCV diagnosis, staging, and treatment among underserved populations, such as incarcerated people, patients with psychiatric disorders, and migrants. A narrative review of literature was performed using key electronic databases (Scopus, Pubmed—MEDLINE) and search engines (Google Scholar). Peer-reviewed publications, grey literature on HCV, and recent models proposed for micro-elimination in underserved populations were included. An insight into the COVID-19 pandemic and its influence on HCV micro-elimination pathways will be also provided. Regarding prison settings, a progressive reduction in HCV epidemiology among incarcerated people in the last years was found (one-third of the level it had been before). People suffering from psychiatric disorders have a high anti-HCV prevalence, but there is a lack of data on active infections. A bidirectional relationship between HCV and psychiatric disorders was found. Migrants showed a very inconsistent assessment of HCV. Furthermore, available studies recorded data from populations with high heterogeneity of anti-HCV prevalence, Therefore, the reported results need caution in their evaluation. [ABSTRACT FROM AUTHOR]

Simple Summary: The present survey-type investigation aimed at assessing the sources and the level of information of Italian citizens on the risk of infection by SARS-CoV-2 at the human–animal interface. The findings of the study showed that (a) the potential risk of SARS-CoV-2 transmission from humans to companion animals has been only partially perceived during the COVID-19 pandemic, (b) the knowledge of preventive measures to avoid SARS-CoV-2 transmission between humans and animals received limited attention by the Italian population, and (c) the communication campaign on COVID-19 and companion animals was, overall, considered inadequate in Italy. The main source of information for Italian citizens was represented by television broadcasts, while few Italians relied on veterinarians to obtain information on the risk of SARS-CoV-2 transmission between humans and companion animals. However, veterinarians were among the most trustworthy sources of information, suggesting that they and veterinary scientists in general could play a key role in the public communication of zoonoses and zoonotic pathogens. This study analyzed data on the sources and the level of Italians' awareness on the risk of infection by SARS-CoV-2 at the human–animal interface. Data were collected through a survey-type investigation on a representative sample of the Italian population. Forty-five percent of the interviewees were aware that companion animals could be infected by SARS-CoV-2. However, 29.8% were familiar with preventive measures to adopt to avoid viral transmission between infected humans and companion animals, and only 20.7% knew which companion animals could be at risk of infection. Higher awareness regarding the risk of SARS-CoV-2 transmission between animals and humans (51.7%) and the measures to prevent it (33.3%) was detected among companion animals' owners. Notably, 40.4% of interviewees were not informed at all. Television broadcasts (26.4%) represented the main source of information, while only 3.5% of the interviewees relied on veterinarians, of which 31.9% considered this source of information as the most trustworthy. Overall, 72.4% of Italians recognized that the communication campaign on COVID-19 and companion animals was inadequate. This survey highlights the need for increasing the public awareness of the risk of companion animals being infected with SARS-CoV-2 and the involvement of professionals in the public communication on zoonoses. [ABSTRACT FROM AUTHOR]

To evaluate the adoption of an integrated eHealth platform for televisit/monitoring/consultation during the COVID-19 pandemic. Methods: During the lockdown imposed by the Italian government during the COVID19 pandemic spread, a dedicated multi-professional working group was set up in the Radiation Oncology Department with the primary aim of reducing patients' exposure to COVID-19 by adopting de-centralized/remote consultation methodologies. Each patient's clinical history was screened before the visit to assess if a traditional clinical visit would be recommended or if a remote evaluation was to be preferred. Real world data (RWD) in the form of patient-reported outcomes (PROMs) and patient reported experiences (PREMs) were collected from patients who underwent televisit/teleconsultation through the eHealth platform. Results: During the lockdown period (from 8 March to 4 May 2020) a total of 1956 visits were managed. A total of 983 (50.26%) of these visits were performed via email (to apply for and to upload of documents) and phone call management; 31 visits (1.58%) were performed using the eHealth system. Substantially, all patients found the eHealth platform useful and user-friendly, consistently indicating that this type of service would also be useful after the pandemic. Conclusions: The rapid implementation of an eHealth system was feasible and well-accepted by the patients during the pandemic. However, we believe that further evidence is to be generated to further support large-scale adoption. [ABSTRACT FROM AUTHOR]