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Through the lenses of Entrepreneurial Event Theory and the Affective Processing Principle, this study aims to explore the interplay between cognition and emotion in the entrepreneurship education-entrepreneurial intention link, exploring the specific role of fear, conceptualized as a negative, avoidance-oriented, emotion. A moderation- mediation empirical model was tested on a sample of Italian University students. The results of the study discovered significant interactions. Fear decreases all the direct and mediating relations, suggesting that an assessment of the importance of emotions in the students' learning and decision-making processes is a vital issue that entrepreneurship scholars are advised to take into account to foster the formation of intentional behavior. Theoretical advancements and implications for academics, professors, and students will be finally discussed.

This paper reports the results of the Inf@nziaDigiTales3.6 project on the design, development and evaluation of an augmented reality application to support situated learning experiences in a smart city. The users of the application are primary school children and the case study refers to recognition of road signs as geometric shapes. The objective is to allow children to comprehend the meaning of road signs of a city and to guide them in the recognition of the geometric shapes and colors connected to these signs. The mobile application is based on the paradigm of games and uses a virtual character with the role of intelligent tutor. The results of the evaluation confirm the expected benefits related to the adoption of augmented reality and mobile technologies, mainly in terms of involvement, pleasantness and willingness to repeat the experience. The results show that the re-mediation of augmented reality and the intelligent tutoring system have influenced the memorization processes of figures and colors, as well as of the contents of most of the signals presented. The application has been also deployed on smart glasses and shown in the context of an international event for children and teenagers, the Giffoni Film Festival 2018.

Objective: We aimed to evaluate the clinical usefulness of the systemic score in the prediction of life‐threatening evolution in Still disease. We also aimed to assess the clinical relevance of each component of the systemic score in predicting life‐threatening evolution and to derive patient subsets accordingly. Methods: A multicenter, observational, prospective study was designed including patients included in the Gruppo Italiano Di Ricerca in Reumatologia Clinica e Sperimentale Adult‐Onset Still Disease Study Group and the Autoinflammatory Disease Alliance Network Still Disease Registry. Patients were assessed to see if the variables to derive the systemic score were available. The life‐threatening evolution was defined as mortality, whatever the clinical course, and/or macrophage activation syndrome, a secondary hemophagocytic lymphohistiocytosis associated with a poor prognosis. Results: A total of 597 patients with Still disease were assessed (mean ± SD age 36.6 ± 17.3 years; male 44.4%). The systemic score, assessed as a continuous variable, significantly predicted the life‐threatening evolution (odds ratio [OR] 1.24; 95% confidence interval [CI] 1.07–1.42; P = 0.004). A systemic score ≥7 also significantly predicted the likelihood of a patient experiencing life‐threatening evolution (OR 3.36; 95% CI 1.81–6.25; P < 0.001). Assessing the clinical relevance of each component of the systemic score, liver involvement (OR 1.68; 95% CI 1.48–2.67; P = 0.031) and lung disease (OR 2.12; 95% CI 1.14–4.49; P = 0.042) both significantly predicted life‐threatening evolution. The clinical characteristics of patients with liver involvement and lung disease were derived, highlighting their relevance in multiorgan disease manifestations. Conclusion: The clinical utility of the systemic score was shown in identifying Still disease at a higher risk of life‐threatening evolution in a large cohort. Furthermore, the clinical relevance of liver involvement and lung disease was highlighted. [ABSTRACT FROM AUTHOR]

Background: COVID-19 pandemic represented a shock for healthcare systems. Italy was one of the first country to deal with a huge number of patients to be diagnosed, isolated, and treated with scarce evidence-based guidelines and resources. Several organizational and structural changes were needed to face the pandemic at local level. The article aims at studying the perceived impact of the newly implemented District Operation Centres (DOCs) of Local Health Authority (LHA) Roma 1 in managing active surveillance and home care of COVID-19 patients and their close contacts in cooperation with general practitioners (GPs). Methods: A questionnaire, developed according to Delphi methodology, was validated by 7 experts and administered to a randomized sample of GPs and family paediatricians (FPs). All medical doctors selected received a phone interview between December 2020 and January 2021. The questionnaire investigated general characteristics of the sample, relations with DOC and its usefulness, and potential developments. A descriptive analysis was performed and inferential statistical tests were used to assess differences. Results: In April 2020 the LHA Roma 1 implemented one DOCs in each local health district. 215 medical doctors were interviewed, reaching the sample target for health districts (80% CL and 10% MOE) and the whole LHA (90% CL and 5% MOE). Several aspects in the management of COVID-19 cases and close contacts of COVID-19 cases, and of the support of DOCs to GPs/FPs were investigated. More than 55% of the GPs and FPs interviewed found the DOCs useful and more than 78% would recommend a service DOC-like to other LHAs. The medical professionals interviewed would use DOCs in the future as support in treating vulnerable patients, utilizing digital health tools, enlisting specialist doctors, establishing networks, and facilitating professional counselling by nurses. Conclusions: This study is an attempt to evaluate an organizational change happened during COVID-19 pandemic. DOCs were created to support GPs and FPs as a link between primary healthcare and public health. Although several difficulties were disclosed, DOCs' experience can help to overcome the fragmentation of the systems and the duality between primary care and public health and make the system more resilient. [ABSTRACT FROM AUTHOR]

Background The Russian invasion of Ukraine caused millions of Ukrainian refugees to flee to other nations. To provide the most appropriate assistance, host nations necessitate up-to-date information regarding Ukrainian refugee's demographic and epidemiological conditions. We aim to investigate the demographic composition, the COVID-19 vaccinations performed, specialist care provided and the prevalence of non-communicable diseases (NCDs) in refugees assisted by an Italian Local Health Authority (LHA). Methods We conducted a retrospective cross-sectional analysis from March to June 2022, analyzing the demographic and epidemiological status of Ukrainians. Statistical analyses were carried out to assess possible associations between NCDs distribution, age and gender. Results LHA Roma 1 assisted 9349 Ukrainian refugees. Of these, 2784 (29.8%) were males and 6565 (70.2%) were females, with a median age of 25 years. Two thousand four hundred and eighty-five Ukrainian refugees were vaccinated against COVID-19. Among them, 401 (16.1%) had at least one NCD. The most frequent groups of diseases were related to the circulatory system (50.6%), the endocrine system (24.9%), and mental and behavioral disorders (6.5%). Conclusion Refugees need healthcare services targeted mainly towards minors and females. It is essential to analyze and monitor the demographic and epidemiological conditions to provide evidence about patient management and the best care integrated into the health service of host countries. [ABSTRACT FROM AUTHOR]

Starting from October 2021, several outbreaks of highly pathogenic avian influenza virus (HPAIV) subtype H5N1 were reported in wild and domestic birds in Italy. Following the detection of an HPAIV in a free-ranging poultry farm in Ostia, province of Rome, despite the lack of clinical signs, additional virological and serological analyses were conducted on samples collected from free-ranging pigs, reared in the same holding, due to their direct contact with the infected poultry. While the swine nasal swabs were all RT-PCR negative for the influenza type A matrix (M) gene, the majority (%) of the tested pigs resulted serologically positive for the hemagglutination inhibition test and microneutralization assay, using an H5N1 strain considered to be homologous to the virus detected in the farm. These results provide further evidence of the worrisome replicative fitness that HPAI H5Nx viruses of the 2.3.4.4b clade have in mammalian species. Moreover, our report calls for additional active surveillance, to promptly intercept occasional spillover transmissions to domestic mammals in close contact with HPAI affected birds. Strengthened biosecurity measures and efficient separation should be prioritized in mixed-species farms in areas at risk of HPAI introduction. [ABSTRACT FROM AUTHOR]

This paper reports an investigation of governance issues in Italian academic spin-offs that arise from the need to balance the powers of two categories of partner: academic inventors and external investors (such as established companies and venture capital funds). The relationship between inventors and external investors, jointly pursuing a research-based entrepreneurial opportunity, provides an interesting case for the application of the agency theory construct to define adequate corporate governance procedures. The paper has two main objectives: to analyse the governance models adopted by academic spin-offs and to ascertain whether the very nature of entrepreneurial opportunity, and the associated uncertainties that a new venture faces, influence the choice of the governance model adopted. A sample group of 30 Italian academic spin-offs is analysed and three different governance models, inventor-led spin-offs, mixed-led spin-offs and investor-led spin-offs, are defined. (Contains 1 note and 2 tables.)

Punta Licosa promontory is located in the northern part of the Cilento coast, in the southern Tyrrhenian basin. This promontory is bordered by sea cliffs connected to a wide shore platform sloping slightly towards the sea. This area has been considered stable at least since Late Pleistocene, as testified by a series of evidence well known in the literature. The aim of this research is to reconstruct the main coastal changes that have occurred in this area since the middle Holocene by means of the literature data, aerial photo interpretation, satellite images, GPS measurements, direct underwater surveys, GIS elaborations of high-resolution DTMs, bathymetric data and high-resolution orthophotos taken by UAV. Particular attention was paid to the wide platform positioned between −7.2 ± 1.2 m MSL and the present MSL, this being the coastal landform interpreted as the main consequence of sea cliff retreat. The elevation of this landform was compared with the GIA models calculated for the southern Tyrrhenian area, allowing establishing that it was shaped during the last 7.6 ± 1.1 ky BP. Moreover, the interpretation of archaeological and geomorphological markers led to the reconstruction of the shoreline evolution of this coastal sector since 7.6 ky BP. This research evaluates the cliff retreat under the effect of Holocene RSL variation on Cilento promontories, located in the western Mediterranean and characterised by the presence of monophasic platforms, and the applied method can be considered more effective and less complex and expensive if compared to other effective approaches such as those based on the usage of cosmogenic nuclides. [ABSTRACT FROM AUTHOR]

Growing evidence is emerging on the higher risk of infection and adverse outcomes for the most disadvantaged groups of the population, and COVID-19 vaccination campaigns worldwide are struggling to ensure equitable access to immunization for all. From 21 June 2021 to 15 October 2021, the Local Health Unit ASL Roma 1 adopted a tailored immunization strategy to reach socially vulnerable groups of the population with the primary vaccination course. This strategy was developed with a step-by-step, participatory approach. Through engagement with internal and external stakeholders, target groups were identified, potential barriers analyzed, solutions discussed, and tailored interventions designed. Over nine thousand individuals from among irregular migrants, homeless people and hard-to-reach communities were contacted and vaccinated. [ABSTRACT FROM AUTHOR]

A booster dose after primary COVID-19 vaccination series was considered crucial after the emergence of the B.1.617.2 (Delta) and B.1.1.529 (Omicron) variants. Active surveillance was used to investigate reporting of adverse events post-booster dose of either of the licensed mRNA Comirnaty (Pfizer/BioNTech) or Spikevax (Moderna) vaccines in adult (17 years and older) recipients in central Italy. Eligible participants were enrolled and interviewed via phone using a structured questionnaire. Primary outcomes related to the occurrence of adverse events post-booster were stratified by vaccine, and frequency of local/systemic, mild/moderate/severe events. Of a total of 622 participants interviewed, 554 (89.1%) reported at least one adverse event (88.2% and 92.9% after the Comirnaty or Spikevax vaccine, respectively): 63.4% were female, and 78.5% aged 17 to 64 years, regardless of vaccine. 87.7% and 68.2% of all recipients described at least one local or systemic reaction, respectively: 97.3, 38.6 and 4.7% reported mild, moderate, or severe events, respectively. The most frequent adverse reactions were pain, redness, or swelling at the injection site and fatigue, while malaise and fever significantly occurred after the Comirnaty, and vomiting after the Spikevax booster. Compared to the primary vaccination, lymphadenopathy was more common after the booster (p < 0.001), especially after Comirnaty vaccine. The study findings revealed no serious or unexpected adverse events, and are in agreement with data available on booster dose for both mRNA vaccines. The transient, mild to moderate, and common to very common side reactions reported should be used to reassure potential recipients of the lack of safety concerns. [ABSTRACT FROM AUTHOR]

Background: Assessment of mucosal healing is important for the management of patients with inflammatory bowel disease (IBD), but endoscopy can miss microscopic disease areas that may relapse. Histological assessment is informative, but no single scoring system is widely adopted. We previously proposed an eight-item histological scheme for the easy, fast reporting of disease activity in the intestine. The aim of the present study was to evaluate the performance of our Simplified Histologic Mucosal Healing Scheme (SHMHS). Methods: Between April and May 2021 pathologists and gastroenterologists in Italy were invited to contribute to this multicenter study by providing data on single endoscopic–histological examinations for their IBD patients undergoing treatment. Disease activity was expressed using SHMHS (maximum score, 8) and either Simple Endoscopic Score for Crohn's Disease (categorized into grades 0–3) or Mayo Endoscopic Subscore (range 0–3). Results: Thirty hospitals provided data on 597 patients (291 Crohn's disease; 306 ulcerative colitis). The mean SHMHS score was 2.96 (SD = 2.42) and 66.8% of cases had active disease (score ≥ 2). The mean endoscopic score was 1.23 (SD = 1.05), with 67.8% having active disease (score ≥ 1). Histologic and endoscopic scores correlated (Spearman's ρ = 0.76), and scores for individual SHMHS items associated directly with endoscopic scores (chi-square p < 0.001, all comparisons). Between IBD types, scores for SHMHS items reflected differences in presentation, with cryptitis more common and erosions/ulcerations less common in Crohn's disease, and the distal colon more affected in ulcerative colitis. Conclusions: SHMHS captures the main histological features of IBD. Routine adoption may simplify pathologist workload while ensuring accurate reporting for clinical decision making. [ABSTRACT FROM AUTHOR]

In the regime of sources of Italian law, the taxation of family income has undergone profound changes, in line with the 1975 family law reform, which marked the transition from the patriarchal family, based on the figure of the pater familias, to the nuclear family, composed of spouses and children. Also thanks to the intervention of the Constitutional Court, the model of legal cumulation, in which the husband, in his role as head of the family, was taxed on the income produced by the members of the household, was followed by the system of decumulation, characterized by individual (or separate) taxation of the income produced by each family member. The essay analyses the taxation regime of family income in the Italian legal system, examining its compatibility with the principle of ability to pay, foundation and limit of taxation. [ABSTRACT FROM AUTHOR]

This study describes a SARS-CoV-2 outbreak caused by the Delta (B.1.617.2) variant in a nursing home in Central Italy during October–November 2021. Trained interviewers collected data from residents, staff, and administration officers with an agreed informed consent procedure. Thirty-two (44.5%) out of 72 residents (median age 89 years) and six (26.1%) of 23 healthcare workers were found to be infected with SARS-CoV-2. Infections occurred more often among residents with a higher index of independence in daily living activities, suggesting an increased risk for those with more interactions. Twenty-five infected residents (78.1%) received the booster dose of mRNA anti-COVID-19 vaccine > 7 days before SARS-CoV-2 onset. Half of the infected residents had mild symptoms, and only three required hospitalisation, one of whom died from COVID-19 complications. The study underlines the effectiveness of a booster dose in providing a high protection against severe disease and hospitalisation even among vulnerable individuals infected with the Delta variant of concern. [ABSTRACT FROM AUTHOR]

Infertility constitutes an essential source of stress in the individual and couple's life. The Infertility-Related Stress Scale (IRSS) is of clinical interest for exploring infertility-related stress affecting the intrapersonal and interpersonal domains of infertile individuals' lives. In the present study, the IRSS was translated into Brazilian–Portuguese, and its factor structure, reliability, and relations to sociodemographic and infertility-related characteristics and depression were examined. A sample of 553 Brazilian infertile individuals (54.2% female, mean aged 36 ± 6 years) completed the Brazilian–Portuguese IRSS (IRSS-BP), and a subsample of 222 participants also completed the BDI-II. A sample of 526 Italian infertile individuals (54.2% female, mean aged 38 ± 6 years) was used to test for the IRSS measurement invariance across Brazil and Italy. Results of exploratory structural equation modeling (ESEM) indicated that a bifactor solution best represented the structure underlying the IRSS-BP. Both the general and the two specific intrapersonal and interpersonal IRSS-BP factors showed satisfactory levels of composite reliability. The bifactor ESEM solution replicated well across countries. As evidence of relations to other variables, female gender, a longer duration of infertility, and higher depression were associated with higher scores in global and domain-specific infertility-related stress. The findings offer initial evidence of validity and reliability of the IRSS-BP, which could be used by fertility clinic staff to rapidly identify patients who need support to deal with the stressful impact of infertility in the intrapersonal and interpersonal life domains, as recommended by international guidelines for routine psychosocial care in infertility settings. [ABSTRACT FROM AUTHOR]

The main objective of this study was to compare readmitted (RW) and non-readmitted (NRW) female psychiatric patients after being conditionally or unconditionally released from Italian inpatient forensic psychiatry services, in order to identify variables that were significantly linked with readmission. This study included all patients who were discharged from the female Residences for the Execution of the Security Measure (REMS) of Castiglione delle Stiviere from January 2008 to June 2015 who were not readmitted until December 31, 2018 (48). In addition, data were collected on female patients who were discharged from the same REMS before 2008 and readmitted from January 2008 to December 2018 (42). A key finding of our study was that the readmission into a female REMS was positively associated with the presence of substance use disorders (SUD) and a primary diagnosis on Axis II. To a lesser extent, younger age, being unconditionally discharged when first released, having had a shorter length of inpatient stay and having committed a crime against property for the first REMS admission was also variables that were apparently linked with readmission. The present research continues the previous research on gender-specific mentally ill offenders. Hence, the decision to proceed separately with a sample of men only and one of women only. For all these reasons, young female patients with personality disorder and SUD perhaps should remain longer in REMS and be released with conditions. In most European countries, the length of stay depends on the clinical condition and risk assessment, with some exception s where the courts set a maximum length of stay at the outset, as in Italy. All the factors listed above influence the risk assessment. Finally, from integrating these findings into the increasing international literature on conditional release and considering the recent changes in the Italian forensic treatment model, we recommend continuing research on individual risk and protective factors as well as risk assessment instruments on conditionally and unconditionally released inpatients with genders studied separately. [ABSTRACT FROM AUTHOR]

In Italy, among the priorities of the National Recovery and Resilience Plan (PNRR), a strategic position is taken by the tax reform, which is part of the actions to remedy the structural weaknesses of the country's system and to stimulate economic recovery after the Covid-19 crisis. In this context, in order to design a new tax structure, in terms of economic growth and competitiveness, a legislative rethink of indirect taxation of trusts and other destination constraints is desirable. In fact, the current tax rules of these negotiation models, in addition to giving rise to numerous disputes, often discourage their use in regulating new interests and needs. [ABSTRACT FROM AUTHOR]

Introduction: Type 2 diabetes is an important public health issue, yet adherence to drugs and regular clinical follow-up is still suboptimal. This study aims to evaluate a community pharmacy programme for monitoring and enhancing adherence to prescribed pharmacological therapies and recommended examinations among patients with confirmed diabetes. Methods: The intervention was conducted in different Italian areas between April 2017 and January 2018. All adult patients who entered a pharmacy with a personal prescription for any antidiabetic drug and agreed to participate, were interviewed. Those found to be non-adherent received counselling from the pharmacists. All patients were invited for a follow-up interview after 3 months. Results: Overall, 930 patients were enrolled and completed the baseline interview. We found low rates of non-adherence, ranging from 8% to 13% for prescribed pharmacological therapies, and 11–29% for the recommended clinical examinations. Non-adherence to oral therapies was higher among younger and recently diagnosed patients; that to clinical examinations was higher in men, those with an intermediate duration of diabetes and less educated patients. Large geographical differences persisted after the adjustment for individual factors. Only 306 patients (32.9%) returned for the follow-up interview, most of whom were already adherent at baseline. Conclusions: Poor adherence to drugs or clinical examinations is not easy to identify in the usual operating setting of community pharmacies. Furthermore, the majority of patients did not return for follow-up, making it impossible to evaluate the efficacy of the pharmacists' counselling. It might be more effective to plan interventions addressed to specific subgroups of patients or areas. [ABSTRACT FROM AUTHOR]

People who use drugs are a key population in global HCV control. We evaluated the efficacy of an innovative model to eliminate HCV infection in a high‐risk population of PWUD in a service for substance use disorder (SUD). Between January 2018 and December 2018, we conducted a prospective, interventional, before and after study, based on audits performed by Infectious Diseases physicians in a SUD facility in Piedimonte Matese, in southern Italy, to improve the knowledge about HCV infection; a shared protocol for screening and linkage to care of patients was implemented. The pre‐intervention period was defined as January‐December 2017 and the post‐intervention period as January‐December 2018. The subjects followed up at SUD facility in the pre‐intervention and post‐intervention periods were 318 and 275, respectively. Compared with the pre‐intervention period, the number of anti‐HCV–positive subjects tested for HCV RNA was higher in the post‐intervention period (91% vs 27%, P <.0001), as was the number who started directly acting antivirals (DAAs). Of the 18 HCV RNA–positive subjects in the pre‐intervention period, only 3 (16.6%) started DAA, a percentage decisively lower than that observed after the start of the programme, 63 (84%) of 75 subjects (P <.0001), and all obtained SVR. The data were similar for people who inject drugs (PWID) and non‐PWID sub‐populations. The use of our innovative model with close interaction between the Infectious Disease Unit and the SUD facility determined a significant increase in HCV RNA testing, linkage to care and the start of DAA in the PWUD population. [ABSTRACT FROM AUTHOR]

Background and aims: Given the paucity of symptoms in the early stages of type 2 diabetes, its diagnosis is often made when complications have already arisen. Although systematic population-based screening is not recommended, there is room to experience new strategies for improving early diagnosis of the disease in high risk subjects. We report the results of an opportunistic screening for diabetes, implemented in the setting of community pharmacies. Methods and results: To identify people at high risk to develop diabetes, pharmacists were trained to administer FINDRISC questionnaire to overweight, diabetes-free customers aged 45 or more. Each interviewee was followed for 365 days, searching in the administrative database whether he/she had a glycaemic or HbA1c test, or a diabetologists consultation, and to detect any new diagnosis of diabetes defined by either a prescription of any anti-hyperglycaemic drug, or the enrolment in the register of patients, or a hospital discharge with a diagnosis of diabetes. Out of 5977 interviewees, 53% were at risk of developing diabetes. An elevated FINDRISC score was associated with higher age, lower education, and living alone. Excluding the number of cases expected, based on the incidence rate of diabetes in the population, 51 new cases were identified, one every 117 interviews. FINDRISC score, being a male and living alone were significantly associated with the diagnosis. Conclusions: The implementation of a community pharmacy-based screening programme can contribute to reduce the burden of the disease, particularly focusing on people at higher risk, such as the elderly and the socially vulnerable. [ABSTRACT FROM AUTHOR]

Headache disorders are the third among the worldwide causes of disability, measured in years of life lost to disability. Given the pharmacies' importance in general in headache patient and, in particular in migraine patient management, various studies have been carried out in recent years dealing with this issue. Indeed, in 2014, our research group first analysed publications on a number of studies conducted worldwide. As five years have passed since our first analysis of the literature and having carried out a number of specific studies in Italy since 2014, we wish to analyse once again the studies carried out globally on this topic to evaluate how the situation has evolved in the meantime. The key words used for the bibliographic search were "community pharmacy" and "headache"; we considered articles published between 2014 and 2018. The selected studies regarded Sweden USA, Belgium, Ireland, Jordan and Ethiopia. From the analysis of the international research papers, it is evident that, despite the time that has passed since the previous analyses and the general agreement that pharmacists find themselves in an ideal position to offer adequate levels of counselling to headache patients, the knowledge of pharmacists is not yet sufficient. Clearly, there is a strong need to develop training programmes specifically focused on this subject. Regarding Italy, a national study, commenced in 2016, was designed as a cross-sectional survey employing face-to-face interviews between pharmacist and patient using a questionnaire drawn up by experts in compliance with best practice from scientific literature. Six hundred ten pharmacists followed a specific training course; 4425 questionnaires were correctly completed. The use of pharmacies as epidemiological sentinels, given their capillarity and daily contact with the local population in Italy, enabled us to obtain an epidemiological snapshot closer to the real-life situation compared to specialist headache centres. Over the course of this study, data on headaches were gathered in Italian pharmacies with the highest levels of numerosity in the world. [ABSTRACT FROM AUTHOR]

Chickenpox is a highly contagious disease caused by primary infection of varicella zoster virus (VZV). The disease is spread worldwide and is usually benign but, in some groups of population like pregnant women, can have a severe outcome. Due to a not optimal vaccination coverage, a relatively high number of childbearing-aged women in a European country such as Italy tested seronegative for VZV and so are currently at risk of acquiring chickenpox during pregnancy, especially if they live in contact with children for family or work reasons. Only few data are available about the risk of infection in this setting: the incidence of chickenpox may range from 1.5 to 4.6 cases/1000 childbearing females and from 1.21 to 6 cases/10,000 pregnant women, respectively. This review is aimed to focus on the epidemiology and the clinical management of exposure to chickenpox during pregnancy. Particular emphasis is given to the accurate screening of childbearing women at the time of the first gynecological approach — the females who tested susceptible to infection can be counseled about the risks and instructed on procedure should contact occur — and to the early prophylaxis of the at-risk exposure. Lastly, the achievement of adequate vaccination coverage of the Italian population remains a cornerstone in the prevention of chickenpox in pregnancy. [ABSTRACT FROM AUTHOR]

The article focuses on a university education based on disciplinary integration based on the principle of dealing with the needs that come from the territory in a country like Italy, rich in cultural heritage. It refers to representation technologies and software that offer increasingly advanced tools.

Infertility has been negatively associated with sexual satisfaction. This study aimed to estimate the relation of infertility to sexual satisfaction from a cross-cultural perspective, comparing Italian and Brazilian women. Between June 2012 and January 2013, 528 women seeking assisted reproduction technology (ART) treatment in Italy (39%) or Brazil (61%) completed self-reports of sexual satisfaction (ISS) and infertility-related stress in the marital domain (IRS). IRS was the same across countries. ISS differed, with 34.31% of the Italians and 43.52% of the Brazilians being sexually dissatisfied at a clinical level (ISS score >30). Multiple logistic regression models showed that being sexually dissatisfied at a clinical level was associated with lower education and higher IRS among Italian women, regardless of having a diagnosed cause of infertility. It was instead associated with higher IRS only among the Brazilian women who had a diagnosed cause of infertility. These findings suggest that, regardless of nationality, sexual satisfaction and infertility-related stress need to be addressed in the treatment of infertile women turning to ART. However, as factors associated with these dimensions vary across countries, interventions to promote sexual satisfaction among infertile women should be adapted to their specific socio-cultural context. [ABSTRACT FROM AUTHOR]

Migraine is a disabling neurovascular syndrome which affects 12-15% of the global population and it represents the third cause in years lived with disability in both males and females aged 15-49 years. Among migraineurs, the symptomatic drug abuse may be a risk factor in the development of medication overuse headache (MOH). Detecting cases of MOH is not straightforward; community pharmacists may, therefore, be in a strategic position to identify individuals who self-medicate, particularly with respect to prevent the development of MOH. In 2014, our group published the results of a survey conducted in Piedmont, Italy, on the patterns of use and dispensing of drugs in patients requesting assistance from pharmacists for relief of a migraine attack. We decided, now, to expand the scope of the model to a national level. The study is based on cross-sectional face-to-face interviews using questionnaires, presented in this paper, consisting of a first part regarding the socio-economic situation and a second part which aimed to classify the disease and any excessive use of drugs. Of the 610 pharmacists trained with an online course, 446 gathered a total of 4425 correctly compiled questionnaires. The participation of community pharmacies has highlighted various criticalities especially of an organisational nature; however, it also revealed the power of this method as a means of gathering epidemiological data with a capillarity which few other methods can match. The objective was also to identify each territory's requirements and facilitate the decision-making process in terms of understanding what patients/citizens actually require. [ABSTRACT FROM AUTHOR]

Background and study aims: Colorectal cancer (CRC) screening aims to reduce mortality by detecting cancers at an early stage and removing adenomatous polyps at an acceptable cost. The aim of the current study were to assess the outcomes and costs of the first two biennial rounds of a population-based CRC screening program using the immunochemical fecal occult blood test (i-FOBT) in a northern Italian province. Methods: All residents aged 50-69 yearswere invited to take part in a biennial screening program using a 1-day i-FOBT, followed by colonoscopy in positive individuals. The i-FOBT uptake, compliance to colonoscopy, detection rate for cancer or advanced adenomas according to age and sex, and direct cost analysis were carried out separately for the 1st and 2nd rounds of screening. Results: In 78083 (1st round) and 81619 (2nd round) individuals whowere invited to screening, the participation rates were 49.7% and 54.4% and i-FOBT positivity rates were 6.2% and 5.8 %, respectively. Detection rates for cancer and advanced adenomas were lower in the 2nd screening compared with the 1st one (1.6‰ vs. 2.5‰ for cancers and 15.8‰ vs. 17.9‰ for advanced adenomas, respectively), whereas positive predictive values for cancer and advanced adenoma were similar in both rounds. In 165 adenocarcinomas detected, 52% were Dukes' stage A and 21% were stage B. All cost indicators were slightly higher in the 1st round of screening compared with the 2nd. The direct cost per cancer or advanced adenoma detection was similar in the two rounds (€1252 and €1260, respectively). Conclusions: Compliance and diagnostic yield of i-FOBT screening were satisfactory. Most detected cancers were at a very early stage. Program costs were reasonable and did not increase with repeat screening. Screening could contribute to decreasing the cost of CRC care by improving the stage at diagnosis. [ABSTRACT FROM AUTHOR]

Objective: Antibiotic prophylaxis (AP) is useful to prevent antimicrobial overuse, misuse and abuse, as well against the occurrence of surgical site infections (SSIs). This study aimed to describe the implementation of a quality improvement intervention on AP for elective surgery, as informal interviews showed a lower than expected compliance with internal recommendations, and to evaluate intervention's effect in terms of main drug consumption.Design: A quality improvement intervention on all elective cases within 14 main surgical departments was performed. SQUIRE 2.0 guidelines were used in designing and reporting.Setting: The intervention was implemented in an Italian Teaching Hospital 2 years after the adoption of internal evidence-based AP recommendations.Participants: Professionals involved in elective surgery.Interventions: The intervention was structured into two phases: a survey was conducted during two non-consecutive weeks period (April-May 2013) to assess the adherence to the international guidelines in AP; survey's results were presented and discussed with all the surgical teams (December 2013-April 2014).Main Outcome Measures: Impact on cefazolin consumption (in defined daily doses per 100 procedures).Results: Data of AP for 653 surgical procedures in terms of type, timing, duration, excess and defect were analyzed. An optimal AP rate resulted in 48.1% cases. Reduction in cefazolin use (-21.5%) and cost (-22.9%) was registered.Conclusions: Though results cannot be generalized to all hospital populations, the implemented intervention is likely to improve AP consequently improving quality of care and reducing costs. Further studies are needed to evaluate specific outcomes such as rate of SSIs and antibiotic resistance. [ABSTRACT FROM AUTHOR]

In relation to 3D bathymetric modelling, this article aims to analyze the performance of Kriging approaches in dependence of the location and density of the measured depth points. The experiments were carried out on a multi-beam sonar (MBS) dataset that includes 240,000 soundings covering a sea-bottom area near Giglio Island (Italy). Seven subsets were derived in random way from the initial regular MBS dataset, selecting an increasing number of points uniformly spaced. Seven models were generated for both Ordinary Kriging and Universal Kriging. Each model was submitted to leave-one-out cross-validation to define the exactness of the predictive values and compared with the initial grid to better evaluate the accuracy in dependence of the point number and dissemination. To investigate this relationship, a new index called MVI (Morphological Variation Index) was introduced as a measurement of the level of variation of seabed morphology. The results validate the efficiency of the Kriging methods and remark the influence of the dataset distribution on the 3D model, highlighting MVI as a useful index to represent the seabed variation as a unique value. Finally, in no rugged areas using 1 point every 1000 m2, the RMSE of the differences between measured and interpolated values falls below 1 m, while a further increment of soundings is required in the presence of a high level of variation of seabed morphology. [ABSTRACT FROM AUTHOR]

Introduction: COVID-19 is an infectious disease caused by SARSCoV-2. The WHO on March 11, 2020, has declared the novel coronavirus outbreak a global pandemic. Several studies found an association between the COVID-19 pandemic and psychiatric symptoms, such as distress, anxiety, fear of infection, depression and insomnia in the general population. Therefore, psychiatrists have been professionally overloaded, trying to manage the psychosocial impact of the pandemic and suffering its effects in person. Objectives: To evaluate the disease perceptions, distress and burnout among psychiatrists from the Department of Mental Health and Addictions of Pavia in three different times, which correspond to the three main phases of the pandemic management in Italy: T0 is the first peak of the infections and the lock-down, from March to June; T1 is the reduction of the infections and the reopening, from June to October; T2 is the second wave of infections with a new progressive closure, the current one. Methods: We used three questionnaires: the BIPQ (Brief Illness Perception Questionnaire), the PSS-10 (Perceived Stress Scale-10), the PED (Profile of emotional distress). We also used a survey (6 items) in T0, T1 and T2 to evaluate exposure, perception, quality of life and burnout.table 1,2,3. BIPQ: no one was exposed. Conclusions: The increase of individual, who seeking help for mental health, impact on the perception of stress and on the emotional distress, even though psychiatrists have an adequate perception of COVID-19. [ABSTRACT FROM AUTHOR]

Background and Objective The purpose of the present study was to establish whether any correlation exists between tooth shapes and patient-related factors such as gingival and periodontal characteristics. Material and Methods Clinical measurements, including the width and the height of maxillary central incisor crowns, the apico incisal height of the keratinized mucosa ( KM), the buccal gingival thickness ( GT), the depth of the sulcus ( SD), the bone-sounding depth ( BS) and the height of the interproximal maxillary central papilla ( Ph), were investigated in 50 healthy individuals. These individuals were then divided into three groups based on the shape of their maxillary central incisor crowns: triangular; square; or square-tapered. The three groups were analyzed to determine any significant differences among the groups in the values obtained for clinical measurements. Results There were no significant differences among the three groups in terms of the SD ( p = 0.11) or the BS ( p = 0.54), whilst statistically significant differences were observed for the KM ( p < 0.001), the GT ( p = 0.012) and the Ph ( p < 0.001). Conclusion The results of this study indicate that different tooth shapes are associated with significantly different values for the extent of the KM, its bucco-lingual thickness and the height of the interproximal maxillary central papilla. [ABSTRACT FROM AUTHOR]

OBJECTIVES:In 2005, the National Health Service recommended a population-based colorectal cancer (CRC) screening program using biennial fecal occult blood testing (FOBT), followed by total colonoscopy in positive patients. So far, no studies have been performed to evaluate the impact of a mass-screening CRC campaign on the health system services at the community level in Italy. We have therefore assessed the workload generated by the first two biennial rounds of screening program on the activity of hospital services involved in CRC diagnosis in the Lecco province.METHODS:Routine data from all hospital services of our province were collected on activity levels related to CRC diagnosis from January 2003 to December 2009. This time span covered the 2 years prior to, as well as the two biennial rounds of the CRC screening program. In particular, we focused on the volume of outpatient FOBTs and colonoscopies (both diagnostic and interventional) performed among subjects outside the screening program. Joinpoint models were used to test whether an apparent change in trend of examination over time was statistically significant in different age cohorts of the population (<50 years, 50-69 years, and ≥70 years).RESULTS:The volume of 'extra-screening' per-patient/FOBTs and colonoscopies increased significantly over the evaluated periods in all ages, until year 2008, when a steady trend was beginning; the AAPCs (average of the annual percent changes) values were 5.7, 3.1, and 8.4 for FOBT and 14.6, 13.4, and 16.7 for colonoscopy in the three age cohorts, respectively. However, the increase in both FOBT and colonoscopy demand was maximal in the cohort ≥70 years, where three statistically significant annual percent changes (APCs) were identified (in 2003-2005, 2005-2006, and 2006-2007 APCs were 12.3, 14.9, and 15.9 for FOBT, and 18.7, 36.8, and 25.4 for colonoscopy, respectively).CONCLUSIONS:After the implementation of a FOBT-based mass-screening program for CRC, careful consideration must be given to the significant increase in the workload of hospital services involved in CRC diagnosis, outside the screening campaign. The extra-work mainly involves gastroenterologists performing colonoscopy, whose activity increased over the 5-year period by 118%, as well as laboratory services, where the demand of FOBTs rose by 40%. This phenomenon, mainly attributable to a profound change in the attitude toward CRC screening by those age cohorts outside the program, covers a time span of two full rounds of screening, whereupon a steady trend for colonoscopy is apparent. [ABSTRACT FROM AUTHOR]

Abstract: Galeotti et al. (2009; Galeotti S., Rusciadelli G., Sprovieri M., Lanci L., Gaudio A., Pekar S., A record of glacio-eustatic fluctuations during the Cretaceous greenhouse? Palaeogeogr. Palaeoclimatol. Palaeoecol. 276, 196–205) (hereafter Getal09) use the sequence stratigraphic record of a Cenomanian–Coniacian base-of-slope succession, exposed in the Morrone mountain of central Italy, to calibrate the sea-level history inferred from the adjacent Lazio-Abruzzi carbonate platform. The episodes of sea-level fall recorded by this carbonate platform and slope in the western Tethys are said to coincide with episodes of global cooling and sea-level fall recorded in the New Jersey margin (Miller, K.G., Sugarman, P.J., Browning, J.V., Kominz, M.A., Hernández, J.C., Olsson, R.K., Wright, J.D., Feigenson, M.D., Van Sickel, W., 2003. Late Cretaceous chronology of large rapid sea-level changes: glacioeustasy during the greenhouse world. Geology 31, 585–588). On the basis of this correlation, Getal09 claim that the Late Cretaceous sea-level history of the Lazio-Abruzzi carbonate platform was controlled by glacio-eustatic fluctuations. This conclusion conflicts with a wealth of published data supporting the view that the major unconformities in the Cretaceous carbonate platforms of central-southern Italy were controlled by regional tectonics. We will show how the sea-level history of the Lazio-Abruzzi carbonate platform proposed by Getal09, and its correlation with the base-of-slope section, hinge on a misrepresentation of the chronostratigraphic resolution attainable with biostratigraphy in shallow-water carbonate facies. We will also show how, contrary to what claimed by Getal09, the age-model for their base-of-slope section does not support the correlation with the New Jersey margin sequences. Finally, we will argue that, in Upper Cretaceous carbonate platforms, the integration of bio- and chemostratigraphy can greatly improve stratigraphic resolution and chronostratigraphic correlation. This is a prerequisite for using the shallow-water record to test the hypothesis of global glacio-eustatic fluctuations in the Cretaceous greenhouse. [Copyright &y& Elsevier]

The article presents a study which analyzes the results of biennial colorectal cancer screening program based on immunochemical faecal occult blood test (FOBT) in Lecco, Italy. Lecco residents aging 50-69 years were asked to participate in the program and those found cancer-positive were offered colonoscopy. It found out that men were more prone to cancer and advanced adenomas than in women. It adds that study results confirm colorectal cancer screening extension to other areas of Italy.

A two-step pattern in the extinction of larger foraminifers is recorded in the upper Cenomanian shallow-water carbonates of the southern Apennines (Italy). The first step eliminated the alveolinids, the most extreme oligotrophs, and reduced dramatically the diversity of larger foraminifers. The second step wiped out the few survivors, seemingly able to tolerate mesotrophic conditions, leaving a disaster fauna dominated by small heterotrophs. This pattern of extinction parallels the ecological succession of shallow-water benthic foraminiferal assemblages along a gradient of increasing nutrient availability. High-resolution carbon isotope stratigraphy shows that the extinction of alveolinids was contemporaneous with the extinction of rotaliporid planktic foraminifers, the drowning of certain Tethyan carbonate platforms, and an episode of thermal instability recorded in sea-surface temperature in the open ocean. Ocean stratification, during the first phase of Oceanic Anoxic Event 2, would have promoted oligotrophic conditions in surface tropical waters and maximum diversity of larger foraminifers. Following this, ocean overturning caused by surface-water cooling is credited with delivering to shallow-water environments the excess nutrient loads previously stored at depth, triggering the environmental changes leading to stepwise extinction of larger foraminifers. [ABSTRACT FROM AUTHOR]

Abstract  A total of 41 strains of lactic acid bacteria (LAB) isolated from durum wheat sourdoughs used to produce Cornetto di Matera bread, were identified by SDS-PAGE of whole cell proteins (WCP) and screened for acid production ability, antimicrobial activity and exopolysaccharide (EPS) production. The isolates were identified as Lactobacillus plantarum (49%), Leuconostoc mesenteroides (17%), Lactobacillus curvatus (15%), Lactobacillus paraplantarum (12%), Weissella cibaria (5%) and Lactobacillus pentosus (2%). Several strains of Lb. plantarum and Leuc. mesenteroides showed a high acid production ability. The antagonistic activity was tested using an agar-spot deferred antagonism assay against a set of five indicators. The species had different profiles of inhibition. Lb. plantarum had the largest spectrum of inhibition, while no isolates of W. cibaria and Leuc. mesenteroides showed antimicrobial activity. No strains had antimicrobial activity against Bacillus cereus. The inhibitory activity of five strains was confirmed to be sensitive to proteolytic enzymes and thus potentially due to bacteriocin production. All Leuc. mesenteroides and W. cibaria strains produced EPS from sucrose. Some Lb. plantarum and Lb. paraplantarum strains produced EPS from different sugars in solid media. EPS production in liquid media was different within the species, with the highest production in liquid media containing glucose and maltose. A defined strain starter culture (W. cibaria DBPZ1006, Lb. plantarum DBPZ1015 and S. cerevisiae MTG10) was selected on the basis of technological properties and tested in model sourdough fermentations. [ABSTRACT FROM AUTHOR]

Abstract: Proper management of Helicobacter pylori infection in clinical practice – when supported by evidence-based data – is expected to produce substantial cost-efficacy advantages. This consideration has prompted the Cervia Working Group to organise a meeting of experts to update the National Guidelines on the diagnosis and treatment of H. pylori infection in Italy. Recommendations in the new European Guidelines were considered in the National setting, here in the light of factors such as the incidence of gastric cancer and gastric lymphoma, the accessibility to different diagnostic tools, the prevalence of bacterial resistance against antibiotics, and the availability of different drugs. The main revisions in respect to the previous guidelines include H. pylori eradication in non-ulcer dyspepsia patients and in non-steroidal, anti-inflammatory drug users, as well as in patients with idiopathic thrombocytopenic purpura and iron deficiency anaemia. The stool antigen test is now accepted as a valid test for confirmation of H. pylori eradication following therapy. New therapeutic approaches have been recommended for both first- (sequential therapy) and second-line (levofloxacin-based) treatment in our country. [Copyright &y& Elsevier]

Abstract: The objective of this work was to investigate the structure and diversity of lactic acid bacteria (LAB) communities in sourdough used for the production of traditional breads (Carasau, Moddizzosu, Spianata, Zichi) in Sardinia. 16S rDNA sequencing and Randomly Amplified Polymorphic DNA (RAPD-PCR) was applied for the identification and typing of the LAB isolated from 25 samples of sourdoughs. Multivariate statistical techniques were applied to RAPD-PCR pattern to study the biological diversity of sourdough samples. Twelve different species of LAB were identified, and most isolates were classified as facultative heterofermentative lactobacilli. Lactobacillus pentosus dominated the lactic microflora of many samples while Lactobacillus sanfranciscensis was isolated only from a limited number of samples. Although heterofermentative species represented between between 30% and 60% of the isolates in Carasau, Spianata and Zichi sourdoughs, only 2% of the isolates from Moddizzosu sourdoughs were identified as heterofermentative LAB. RAPD-PCR with a single primer followed by cluster analysis did not allow the identification of the isolates at the species level. However, a multidimensional scaling/bootstrapping approach on the RAPD-PCR patterns uncovered the diversity of the LAB communities of LAB showing differences both within and between bread types. [Copyright &y& Elsevier]

Tests whether the observed trend in the anatomical distribution of colorectal cancer also applies to countries other than the United States that are likely to share the same type of Western lifestyle and habits. Analysis of the Italian Vital Statistics database for long-time trends of diseases; Trend in mortality from colorectal; cancer in Italy; Check for potential differences between men and women.

Background: A regional initiative, called the `three-day rule', has recently been introduced in Italy to facilitate the earlier diagnosis of malignancy. It requires patients with suspected severe diseases to have a diagnostic procedure performed within three working days of referral by a general practitioner. Aim: To assess prospectively the effectiveness and compliance with the three-day rule for upper digestive malignancies. Methods: We compared patients referred for gastroscopy under the three-day rule initiative with contemporaneous open access referrals over a 12-month period at a single large teaching hospital in west Milan. We compared the prevalence of malignancies and other serious non-neoplastic diseases as well as the waiting times in the two groups. The appropriateness of the indications for each referral was also reviewed by a gastroenterologist blind to the outcome of the test. Results: One hundred and forty-two patients referred for gastroscopy under the three-day rule scheme and 767 routine referrals were studied. Significantly more oesophageal/gastric cancers (6% vs. 1%) and serious benign gastrointestinal lesions (grade II–III oesophagitis or peptic ulcer) were diagnosed in three-day rule patients in comparison with routine referrals (P < 0.05). The rate of inappropriate referral was significantly lower in the three-day rule group than in the open access group (39% vs. 22%) (P < 0.01). The estimated cost of the three-day rule scheme (in extra list examinations alone) was 10 780 euros, with about 1198 euros per diagnosis of cancer, but only 229.5 euros per `useful' diagnosis (including peptic ulcer disease and oesophagitis). Conclusions: Significantly more upper gastrointestinal cancers and serious benign diseases can be found within a short period to comply with the three-day rule scheme. However, some general practitioners appear to over-interpret alarm symptoms, leading to some inappropriate referrals. Better awareness of appropriate... [ABSTRACT FROM AUTHOR]

E. PARENTE, S. GRIECO AND M.A. CRUDELE. 2001. Aims: to evaluate the evolution of lactic acid bacteria (LAB) populations in traditional fermented sausages (salsiccia and soppressata) produced in artisanal and industrial plants in Basilicata (Southern Italy). Methods and Results: Four hundred and fourteen lactic acid bacteria (LAB) cultures were isolated from samples of sausages at different stages of ripening. A phenotypic characterization of the isolates was carried out using a set of 28 tests, and 34 clusters were identified at the 80% similarity level using hierarchical cluster analysis. Of the isolates 50% were identified as Lactobacillus sakei (with several biotypes), 22% as Pediococcus spp. (mainly Ped. pentosaceus), 7% as Leuconostoc (Leuc. carnosum, Leuc. gelidum, Leuc. pseudomesenteroides), 6% as Lact. plantarum, 1% as Lact. curvatus. Other lactobacilli, including unidentified species, were present in lower numbers. Conclusions: The phenotypic diversity and composition of the LAB flora varied as a function of the production plant, product type and ripening time. Significance and Impact of the Study: A new procedure based on bootstrapping and Multidimensional Scaling was successfully used to obtain a graphical representation of the evolution of the LAB populations. [ABSTRACT FROM AUTHOR]

Aims: To investigate the diagnostic approach to and management of Helicobacter pylori infection at primary care level in Italy 2 years after the Maastricht consensus report. Methods: A total of 100 randomly selected general practitioners (GPs) answered a 12-item multiple-choice questionnaire, personally delivered and collected by non-medical staff. Results: In 25% of cases, GPs preferred a prompt referral of dyspeptic patients to the specialist. The favourite diagnostic test for H. pylori infection was gastroscopy with biopsies (55%), followed by standard and office-based serology (24% and 18%, respectively), and 13C urea breath test (5%). H. pylori-eradication was prescribed in patients with peptic ulcer, reflux oesophagitis and functional dyspepsia by 64%, 43% and 66% of GPs, respectively. Only 7% of GPs adopted a test-and-treat approach. Proton pump inhibitor-based triple therapies were used by almost all physicians. In peptic ulcer disease, most of GPs re-tested patients in order to confirm H. pylori eradication (50% by gastroscopy with biopsies and 30% by serology only 2 months after therapy). Conclusions: Uncertainty seems to persist among Italian GPs concerning the indications for H. pylori treatment, the use of diagnostic tests, and patient follow-up. In contrast, no doubts exist regarding the first choice eradication regimens. This survey suggests that further efforts should be made to spread scientific knowledge and guidelines on H. pylori diagnosis and management in primary care in Italy. [ABSTRACT FROM AUTHOR]

No abstract received. [ABSTRACT FROM AUTHOR]

Antibiotic resistance has become an emerging problem for treating Helicobacter pylori (H. pylori) infection. Clarithromycin and levofloxacin are two key antibiotics used for its eradication. Therefore, we reviewed our experience with genotypic resistance analysis in stools to both clarithromycin and levofloxacin in the last four years to evaluate time trends, both in naive and failure patients. Patients collected a fecal sample using the THD fecal test device. Real-time polymerase chain reaction was performed to detect point mutations conferring resistance to clarithromycin (A2142C, A2142G, and A2143G in 23S rRNA) and levofloxacin (substitutions at amino acid position 87 and 91 of gyrA). One hundred and thirty-five naive patients were recruited between 2017–2020. Clarithromycin resistance was detected in 37 (27.4%). The time trend did not show any significant variation from 2017 to 2020 (p = 0.33). Primary levofloxacin resistance was found in 26 subjects (19.2%), and we observed a dramatic increase in rates from 2017 (10%) to 2018 (3.3%), 2019 (20%), and 2020 (37.8%). Ninety-one patients with at least one eradication failure were recruited. Secondary resistance to clarithromycin and levofloxacin was found in 59 (64.8%) and 45 patients (59.3%), respectively. In conclusion, our geographic area has a high risk of resistance to clarithromycin. There is also a progressive spreading of levofloxacin-resistant strains. [ABSTRACT FROM AUTHOR]

A multidisciplinary study of the dolomitized bodies present in the Lower Cretaceous platform carbonates of Mt. Faito (Southern Apennines – Italy) was carried out in order to explore the connection between early dolomite formation and fluctuating climate conditions. The Berriasian-Aptian investigated succession is 466 m thick and mainly consists of shallow-water lagoonal limestones with frequent dolomite caps. The dolomitization intensity varies along the succession and reaches its peak in the upper Hauterivian-lower Barremian interval, where it is present a completely dolomitized interval about 100-m-thick. Field relations, petrography, mineralogy, and geochemistry of the analyzed dolomite bodies allowed identifying two populations of early dolomites, a fine-medium crystalline (FMdol) and a coarse crystalline dolomite (Cdol), both interpreted as the product of mesohaline water reflux. According to our interpretation, FMdol precipitated from concentrated brines in the very early stage of the reflux process, producing typical sedimentary features as dolomite caps. In the successive step of the process, the basin-ward ‘latent’ reflux precipitated Cdol from less concentrated brines. A peculiar feature of the studied succession is the great consistency between stratigraphic distribution of dolomite bodies and their geochemical signature. The completely dolomitized Hauterivian-Barremian interval, in fact, is characterized by geochemical values suggesting an origin from distinctly saltier brines. Considering that the observed near-surface dolomitization process is controlled by physical and chemical parameters reflecting the paleoenvironmental and paleoclimatic conditions during dolomite formation, we propose that the stratigraphically controlled dolomitization intensity reflects periodic fluctuations in the salinity of dolomitizing fluid, in turn controlled by long-term climate oscillations. The present work highlights that the stratigraphic distribution of early diagenetic dolomite may be used as proxy to define the climatic fluctuations that have influenced the sedimentary dynamics in the Early Cretaceous. Moreover, considering that a comparable early dolomite distribution is present also in the Dinaric Platform, we suggest that a regional scale climate control acted on early dolomite formation and distribution. Refining the knowledge of such a key control may have a significative impact on hydrocarbon reservoir characterization and exploration in the Periadriatic area. [ABSTRACT FROM AUTHOR]

Purpose: Amyotrophic lateral sclerosis (ALS) is the most common motor neuron disease in adults. It is almost invariably lethal within a few years after the onset of symptoms. No effective treatment is currently available beyond supportive care and riluzole, a putative glutamate release blocker linked to modestly prolonged survival. This review provides a general overview of preclinical and clinical advances during recent years and summarizes the literature regarding emerging therapeutic approaches, focusing on their molecular targets. Methods: A systematic literature review of PubMed was performed, identifying key clinical trials involving molecular therapies for ALS. In addition, the ALS Therapy Development Institute website was carefully analyzed, and a selection of ALS clinical trials registered at ClinicalTrials.gov has been included. Findings: In the last several years, strategies have been developed to understand both the genetic and molecular mechanisms of ALS. Several therapeutic targets have been actively pursued, including kinases, inflammation inhibitors, silencing of key genes, and modulation or replacement of specific cell populations. The majority of ongoing clinical trials are investigating the safety profiles and tolerability of pharmacologic, gene, and cellular therapies, and have begun to assess their effects on ALS progression. Implications: Currently, no therapeutic effort seems to be efficient, but recent findings in ALS could help accelerate the discovery of an effective treatment for this disease. [ABSTRACT FROM AUTHOR]

The Miocene transgression in central and southern Apennines is commonly represented by a sharp contact between shallow-water open-marine bioclastic limestones and the underlying Cretaceous or Eocene bedrock. Only in a few areas, very proximal marine or paralic deposits, witnessing the first stage of the transgression, have been preserved. These deposits contain rich foraminiferal assemblages commonly dominated by specimens of the genus Ammonia. The paleontological and paleoenvironmental analysis revealed that the Miocene Ammonia shared the same habitat and ecological requirements of living representatives from recent shoreline environments. Small Ammonia forma ' tepida ' have been found in Miocene marginal paralic organic-rich bottoms with restricted water circulation and possibly under natural metal pollution. Big Ammonia forma ' beccarii ' characterize Miocene nearshore marine bottoms with vegetated areas under fresh water inputs. The endoskeletal lamellar folding called tooth-plate, which characterizes recent representatives, is observed in fossil specimens of both tepida and beccarii morphogroups, testifying that there were no major changes in the shell architecture of Ammonia since the early Miocene. • Miocene paralic and proximal marine carbonates in the central and southern Apennines. • Age spans through Langhian to Messinian. • Miocene paralic environments indicated by modern Ammonia analogues. • Small forma ' tepida ' lived under stressed conditions and high salinity variations. • Big forma ' beccarii ' lived under fresh water inputs. [ABSTRACT FROM AUTHOR]