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Due to the progressive lowering of the age of peak performance among swimmers, it became important to better understand the factors influencing performance in prepuberal boys and girls. Aim of this study is to compare two different racial/ethnic groups of young swimmers, one from Nord-Europe, Estonia (Tartuma Region), and the other from China (Shanghai District) in order to assess existing differences in respect to body dimension, body fat, technical parameters of swimming performance and maximum lactate production. 26 Estonian and 7 Chinese female and 25 Estonian and 10 Chinese male, from two swimming schools, took part in the study. Anthropometric parameters were measured in accord with ISAK guidelines. BMI, Stroke Index, Stroke Length, mean velocity on a 200 m freestyle all out, and blood lactate after three minutes were measured. Significant differences exist in anthropometry between Nord-European and Asian young swimmers. These differences are more pronounced in female, with higher fat tissue in Nordic girls. Leg lengths are different between Chinese and Estonian girls having the Estonian longer legs. Hands lengths are different both in male and in female subjects. Being the Chinese groups of higher level of performance (higher mean velocity in the 200 m freestyle, such differences seems not to be as major determinants of the performance, also if they are often indicated as determinants of buoyancy and stroke efficiency.

The energy demand in healthcare and hospital premises has distinctive features. Due to specific constraints in terms of service continuity and indoor air quality, the demand is at a large extent constant during the day and throughout the year. Indeed, a healthcare facility must fulfil several different activities. Medical equipment needs electric energy, while the Heating, Ventilation and Air Conditioning systems require thermal energy. It is extremely difficult to define reference characteristics for the energy demand, since the proportions of the different consumptions are strongly connected with the specific activities/services carried out within each structure. The present work aims at analysing the energy demand of a healthcare facility located near Firenze (Italy). The energy demand has been analysed by means of the available documentation to get a basic knowledge of the expected consumption of each component of the facility. These data have been then correlated with information on the actual healthcare activity parameters (e.g. staff in service, medical services) and on weather conditions. As a result, the study led to the definition of the principal energy drivers that characterize the Healthcare Facility. The analysis procedure is thought of general interest for the community working in the field, representing a benchmark for the calibration of energy digital twins and a reference data set useful to carry out building energy efficiency optimization strategies.

Abstract Background Systematic reviews have shown that, although well prepared, the Consensus Guidelines have failed to change clinical practice. In the healthcare district of Castelnovo né Monti (Reggio Emilia, Italy), it became necessary for the GPs and Clinical Pathologists to work together to jointly define laboratory profiles. Methods Observational study with two cycles of retrospective audit on test request forms, in a primary care setting. Objectives of the study were to develop pathology-specific laboratory profiles and to increase the number of provisional diagnoses on laboratory test request forms. A Multiprofessional Multidisciplinary Inter-hospital Work Team developed pathology-specific laboratory profiles for more effective test requesting. After 8 training sessions that used a combined strategy with multifaceted interventions, the 23 General Practitioners (GPs) in the trial district (Castelnovo nè Monti) tested the profiles; the 21 GPs in the Puianello district were the control group; all GPs in both districts participated in the trial. All laboratory tests for both healthcare districts are performed at the Laboratory located in the trial district. A baseline and a 1-year audit were performed in both districts on the GPs’ request forms. Results Seven pathology-specific laboratory profiles for outpatients were developed. In the year after the first audit cycle: 1) the number of tests requested in the trial district was distinctly lower than that in the previous year, with a decrease of about 5% (p Conclusions The first audit cycle showed a significant decrease in the number of tests ordered only in the trial district. The combined strategy used in this study improved the prescriptive compliance of most of the GPs involved. The presence of the clinical pathologist is seen as an added value.

Abstract Background We report age-dependent penetrance estimates for leucine-rich repeat kinase 2 (LRRK2)-related Parkinson's disease (PD) in a large sample of familial PD. The most frequently seen LRRK2 mutation, Gly2019Ser (G2019S), is associated with approximately 5 to 6% of familial PD cases and 1 to 2% of idiopathic cases, making it the most common known genetic cause of PD. Studies of the penetrance of LRRK2 mutations have produced a wide range of estimates, possibly due to differences in study design and recruitment, including in particular differences between samples of familial PD versus sporadic PD. Methods A sample, including 903 affected and 58 unaffected members from 509 families ascertained for having two or more PD-affected members, 126 randomly ascertained PD patients and 197 controls, was screened for five different LRRK2 mutations. Penetrance was estimated in families of LRRK2 carriers with consideration of the inherent bias towards increased penetrance in a familial sample. Results Thirty-one out of 509 families with multiple cases of PD (6.1%) were found to have 58 LRRK2 mutation carriers (6.4%). Twenty-nine of the 31 families had G2019S mutations while two had R1441C mutations. No mutations were identified among controls or unaffected relatives of PD cases. Nine PD-affected relatives of G2019S carriers did not carry the LRRK2 mutation themselves. At the maximum observed age range of 90 to 94 years, the unbiased estimated penetrance was 67% for G2019S families, compared with a baseline PD risk of 17% seen in the non-LRRK2-related PD families. Conclusion Lifetime penetrance of LRRK2 estimated in the unascertained relatives of multiplex PD families is greater than that reported in studies of sporadically ascertained LRRK2 cases, suggesting that inherited susceptibility factors may modify the penetrance of LRRK2 mutations. In addition, the presence of nine PD phenocopies in the LRRK2 families suggests that these susceptibility factors may also increase the risk of non-LRRK2-related PD. No differences in penetrance were found between men and women, suggesting that the factors that influence penetrance for LRRK2 carriers are independent of the factors which increase PD prevalence in men.