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Objective. To compare etanercept and adalimumab biosimilars (SB4 and ABP501) and respective bioriginators in terms of safety and efficacy in a real-life contest. Methods. We consequently enrolled patients affected by rheumatoid arthritis, psoriatic arthritis, and ankylosing spondylitis, treated with SB4, and ABP501, or with corresponding originators, belonging to the main biological prescribing centers in the Lazio region (Italy), from 2017 to 2020. Data were collected at recruitment and after 4, 8, 12, and 24 months of therapy. Results. The multicenter cohort was composed by 455 patients treated with biosimilars [SB4/ABP501 276/179; female/male 307/146; biologic disease-modifying anti-rheumatic drug (b-DMARD) naïve 56%, median age/ interquartile range 55/46-65 years] and 436 treated with originators (etanercept/adalimumab 186/259, female/ male 279/157, b-DMARD naïve 67,2%, median age/interquartile range 53/43-62 years). No differences were found about safety, but the biosimilar group presented more discontinuations due to inefficacy (p

When treating structured health-system-related knowledge, the establishment of an over-dimension to guide the separation of entities becomes essential. This is consistent with the information retrieval processes aimed at defining a coherent and dynamic way – meaning by that the multilevel integration of medical textual inputs and computational interpretation – to replicate the flow of data inserted in the clinical records. This study presents a strategic technique to categorize the clinical entities related to patients affected by neurodegenerative diseases. After a pre-processing range of tasks over paper-based and handwritten medical records, and through subsequent machine learning and, more specifically, natural language processing operations over the digitized clinical records, the research activity provides a semantic support system to detect the main symptoms and locate them in the appropriate clusters. Finally, the supervision of the experts proved to be essential in the correspondence sequence configuration aimed at providing an automatic reading of the clinical records according to the clinical data that is needed to predict the detection of neurodegenerative disease symptoms.

The purpose of this article is to examine the potential of truffle production and its market in the Aspromonte area. Through interviews with leading operators, collectors, transformers, retailers and restaurateurs, the strengths and weaknesses of the sector, the risks to the external environment and the opportunities offered by the economic system, as well as the needs raised by the operators who in various ways deal with truffles in the Calabria Region was considered. The results show that truffles are natural biological products and play an important role in the management of woodlands: if they are present they are a formidable indicator of environmental health. The results showed that the truffle supply chain can contribute to the promotion of growth strategies for Calabria as indicated among the objectives of the 2030 Strategy Agenda in Goal 11.a Session 1, point 1 which aims at the conservation, redevelopment and promotion of poor or fragile areas with qualitatively significant cultural and environmental heritage. The truffle sector's ability to attract new economic flows generated by production activities, from territorial marketing, from fresh or processed product marketing and from services capable of guaranteeing additional income for farmers and supply chain operators was also highlighted. The results finally showed that the use of SWOT analysis in niche food products provides useful indications for regional development planning actions, for marketing activities, for the promotion of sustainable tourism, for the recovery and enhancement of rural buildings and for the food and wine routes that revolve around the production of truffles and the gastronomy based on fresh and / or processed truffles. Produzioni di pregio, tutela e recupero delle aree interne aspromontane: il ruolo del tartufo Scopo di questo articolo è esaminare le potenzialità della produzione e del mercato del tartufo nell’area aspromontana. Attraverso interviste ad opinioni leader, operatori, raccoglitori, trasformatori, rivenditori e ristoratori, sono stati messi in luce i punti di forza e di debolezza del comparto, i rischi dell’ambiente esterno e le opportunità offerte dal sistema economico, nonché le necessità sollevate dagli operatori che a vario titolo si occupano di tartufo nella Regione Calabria. I risultati mostrano che i tartufi sono prodotti biologici naturali e che svolgono un ruolo importante nella gestione dei terreni boschivi: se sono presenti rappresentano un formidabile indicatore di salubrità ambientale. I risultati hanno evidenziato, altresì che la filiera del tartufo può contribuire alla promozione di strategie di crescita per la Calabria come indicato tra gli obiettivi della Strategia Agenda 2030, Goal 11.a Sessione 1, punto 1, che punta alla conservazione, riqualificazione e promozione di aree disagiate o fragili con patrimoni culturali e ambientali qualitativamente significativi. Si è inoltre evidenziata la capacità del settore tartuficolo di attrarre nuovi flussi economici generati dalle attività di produzione, dal marketing territoriale, dal marketing del prodotto fresco o trasformato e dai servizi idonei a garantire reddito supplementare aggiuntivo per gli agricoltori e per gli operatori della filiera. I risultati hanno infine mostrato che l'uso dell'analisi SWOT in prodotti alimentari di nicchia fornisce indicazioni utili per le azioni di pianificazione dello sviluppo regionale, per le attività di marketing, per la promozione del turismo sostenibile, per il recupero e la valorizzazione dei fabbricati rurali e per i percorsi enogastronomici che ruotano intorno alla produzione di tartufi e alla gastronomia a base di tartufi freschi e/o trasformati.

The seeds of modern Artificial Intelligence (AI) were planted by classical philosophers who attempted to describe the process of human thinking as the mechanical manipulation of symbols. AI is an area of computer science that emphasises the creation of intelligent machines that work and react like humans. Some of the activities computers with artificial intelligence are designed for include: Speech Recognition, Learning, Planning, Problem Solving and Fuzzy Sets. In the past 15 years, Amazon, Google and others leveraged machine learning to their huge commercial advantage. In this talk, we discuss Machine learning, and Fuzzy Settings theory. Machine Learning at its most basic is the practice of using algorithms to parse data, learn from it, and then make a determination or prediction about something in the world. Fuzzy Modelling helps us to deal with the phenomena including uncertain parameters and conditions. It gives us enough tools to model a real-world system and approaches our behaviour much closer. The Fuzzy Set represent a class of objects with a continuum of grades of membership. So the above framework of consideration gives us a natural way of dealing with imprecise phenomena, when classes of objects lack precise criteria of membership for their elements. The context to be considered as scientific fertile ground concerns the management of the complexity of modern anthropic socio-economic systems (Cities, Urban areas and their socio-sustainable development). Intelligenza artificiale per la gestione della complessità dei sistemi socio-economici verso Horizon 2020 e Agendo 2030 I semi dell'Intelligenza Artificiale (AI) furono piantati da filosofi classici che tentarono di descrivere il processo del pensiero umano come la manipolazione meccanica dei simboli. L'AI è un'area di informatica che enfatizza la creazione di macchine intelligenti che funzionano e reagiscono come gli umani. Alcune delle attività che i computer con AI possono progettate includono: riconoscimento vocale, apprendimento, pianificazione, problem solving e set fuzzy. Negli ultimi 15 anni, Amazon, Google e altri hanno sfruttato l'apprendimento automatico per il loro enorme vantaggio commerciale. L'apprendimento automatico alla base dell'AI è la pratica dell'uso di algoritmi per analizzare i dati al fine di fare una determinazione o una previsione su qualche fenomeno. La modellazione fuzzy ci aiuta ad affrontare i fenomeni inclusi i parametri e le condizioni incerti, ci fornisce strumenti per modellare il sistema considerato nel mondo reale e avvicinarci molto più al suo comportamento. Il set fuzzy, quindi, rappresenta una classe di oggetti con un continuum di gradi di appartenenza. Il quadro sopra descritto ci dà un modo naturale di affrontare fenomeni così imprecisi, quando le classi di oggetti mancano di criteri precisi di adesione per i loro elementi. Il contesto da consideare terreno fertile scientico concerne la gestione della complessità dei moderni sistemi antropici socio-economici (città, aree urbane e il loro sviluppo socio-sostenibile).

The objective of this study was to evaluate the efficacy of the endothelin receptor antagonist, bosentan, in patients with Raynaud’s phenomenon secondary to systemic sclerosis never treated with prostanoids and without digital ulcers. The study design is a preliminary, prospective open label trial. The patients recruited took one 62.5 mg dose of bosentan twice daily for 4 weeks, followed by 125 mg twice daily for 24 weeks. Of the 10 patients recruited, all completed the study. The reduction in Raynaud’s phenomenon attacks at week 24 from the baseline was statistically significant (Δ-1.3, P=0.0126). The Raynaud’s condition score showed a statistically significant improvement (Δ-1.4, P=0.0279), as did the visual analog pain scale (Δ-1.5, P=0.0016) at the 24th week. Bosentan appears to be effective and may be a valid alternative for the treatment of severe secondary Raynaud’s phenomenon for patients where prostanoids therapy is contraindicated or refused.

“Regenerative Design, Green Strategy” is a research placed within the debate on the management of construction projects in urban areas with the aim of providing a scientific methodology of control of the effects (taking into consideration the relations among buildings, the environment and non-material elements of an urban area); this is also useful to reevaluate the pri- orities of construction projects, considering all the environmental, social, economic and technological aspects of the place; in other words, it represents a framework that gives same value to both the control of the transformation of the elements within the urban area and to the linkages among those elements. The testing phase takes place in the creation of design guidelines, structured at different levels, for regenerative interventions on the environmental system of the axis of the “Torrente Calopinace”, in the southern part of Reggio Calabria.

Objective: To propose a standardized protocol for the evaluation of Legionella contamination in air., Design: A bathroom having a Legionella contamination in water >1,000 cfu/l was selected in 10 different healthcare facilities. Air contamination was assessed by active (Surface Air System, SAS) and passive (Index of Microbial Air, IMA) sampling for 8 hours, about 1 m away from the floor and 50 cm from the tap water. Two hundred liters of air were sampled by SAS every 12 min, after flushing water for 2 min. The IMA value was calculated as the mean value of colony forming units/16 plates exposed during sampling (2 plates/hour). Water contamination was evaluated at T0, after 4 and 8 hours, according to the standard methods., Results: Air contamination by Legionella was found in three healthcare facilities (one with active and two with passive sampling), showing a concomitant tap water contamination (median=40,000; range 1,100-43,000 cfu/l). The remaining seven hospitals isolated Legionella spp. exclusively from water samples (median=8,000; range 1,200-70,000 cfu/l)., Conclusions: Our data suggest that environmental Legionella contamination cannot be assessed only through the air sampling, even in the presence of an important water contamination.

In this paper, the authors discuss energy sources, highlighting their impact on the environment and on human beings, their influence in economy and finance and on relations between governments. They attempt to analyse whether the above factors together can lead to a negative impact on health, defined as an individual's "complete physical social and psychological well being". The role of petroleum in the world economy is understandable if one considers that energy, heat, light, electricity, transportation and large part of mass production are all dependent on this energy resource. From petroleum one obtains fuel, fertilizers, pesticides, plastic, pharmaceutical products and clothing. Petroleum has become increasingly important in conjunction with expanding globalization and consumerism and the continuous growth of demand for petroleum has led to a corresponding decrease in its production and availability and an increase in its cost, all factors which have led to strong tensions between world States. The authors discuss sea and air pollution and global warming, citing some of the most relevant climatic incidents of recent years and tracing the most important events regarding attempts to contain pollution. They highlight the impact of contaminants such as greenhou se gases, electromagnetic pollution, synthetic chemicals, domestic, industrial and electronic waste products, responsible, according to neo-Lamarckian evolutionists, for the increasing incidence of chronic degenerative diseases. In conclusion the authors stress that there is a need to pursue energy efficiency while awaiting that world States succeed in their common objective of adopting new energy policies, with the use of clean energy at low cost.

The birth of Hygiene Package and of the Reg. CE no 2073/2005 in the food production field signalled a change in Italy. This process started in Italy in 1997 with the legislative decree no 155 on Self-control but in reality, it was implemented in the UK in 1990 with the promulgation of the Food Safety Act. This legal act was influenced by some basic rules corresponding to the application of HACCP standards. Since 1990 the British chains of distribution (Retailers) have involved all aspects of the food line in this type of responsibility. Due to this growing awareness for a need for greater regulation, a protocol, edited by British Retail Consortium was created in 1998. This protocol acted as a "stamp" of approval for food products and it is now known as the BRC Global Food Standard. In July 2008, this protocol became effective in its fifth version. After the birth of BRC, also French and German Retailers have established a standard practically equivalent and perhaps more pertinent to safety food, that is International Food Standard (IFS). The new approach is specific to the food field and strictly applies criteria which will ensure "safety, quality and legality" of food products, similarly to ISO 22000:2005 (mainly based on BRC & IFS past experiences). New standards aim to create a sort of green list with fully "proper and fit" Suppliers only, because of comprehensible exigencies of Retailers. It is expected, as we have shown, that Auditor authorities who are responsible for ensuring that inspections are now carried out like the Hygiene Package, will find these new standards useful. The advantages of streamlining this system is that it will allow enterprises to diligently enforce food safety practices without fear of upset or legal consequence, to improve the quality (HACCP) of management & traceability system; to restrict wastes, reprocessing and withdrawal of products. However some discordances about the interpretation of certain sub-field norms (e.g., water management) are evident and should be carefully discussed once more.

Alcohol abuse represents a relevant social problem in industrialized countries. Italy has an age-long tradition of producing and drinking wine, a beverage which in moderate doses is considered to be part of the much appreciated "Mediterranean diet". However, drinking other alcoholic beverages is becoming increasingly common, especially among adolescents. In order to evaluate aspects of the "alcohol" phenomenon among adolescents in the city of Messina (Italy), an anonymous questionnaire was administered during school hours to 5,168 students aged 13 to 17 years. Results show that 989 (19.1%) students, of which 38.3% were females and 61.7% males, reported drinking alcohol. Beer was the preferred drink, followed by alcohol-containing aperitifs, spirits and wine. It was found that students begin drinking alcoholic beverages more regularly at 16 years of age and do so mainly during group encounters. Almost none of the interviewed students reported ever having been drunk, and for most students alcohol is considered to be dangerous only if drunk in excessive amounts (70.9% of females and 72.7% of males). Family habits were found to clearly influence students' degree of alcohol consumption. Information and education is needed by young adolescents regarding the responsible approach to alcoholic beverages.

Provision 13 January 2005 (Italy) gives guidelines for legionellosis control and prevention in hotel and thermal establishments. Considering that Legionella pneumophila is an ubiquitous organism , the implementation of actions to control the risk of Legionella in the water distribution systems of various types of establishments (hospital, hotel, thermal), or to at least reduce it to acceptable levels, is warranted. The authors have prepared a plan of action for Legionella which, besides describing the main points of the provision and the roles of managers and technicians, also includes the data sheets to be used during environmental monitoring procedures. The action plan will be freely available through local health authorities and professional associations.

Owing to the very frequent reports of Legionella's cases arising in italian hospitals we have done a microbiologic monitoring on some equipments utilized in a several ward, what represent a potential source of diffusion of germ. It has been analysed water collected from 135 bubblers for oxygen-therapy, 11 pediatric incubators and 10 dental chairs. The isolated strains ware 31 (19.23%), of which: 3 L. Pneumophila sgr. 1; 11 sgr. 3; 8 sgr. 6; 2 sgr. 7. For 6 strains identified as Legionella, have not been possible to establish sgr.

Forty-one strains of Listeria, Aeromonas and Vibrio have been isolated in 71 samples of seafood, both raw and ready to eat and frozen. L. monocytogenes, detected by PCR also, is found in the smoked salmon only. Aeromonas spp. and Vibrio spp. are isolated in the raw products (shrimps and shellfish). No relationship is found between the presence of such microrganisms and the common indicator bacteria. Finally, the health hazard related to strong contamination and the need to diversify the food safety assurance programmes, for the various products, are underlined.