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Background: Patients' compliance to inhalation therapy is usually sub-optimal in young asthmatics. Adolescents poorly compliant to regular anti-asthma treatments and those with tattoos (and the associated attitude) can share some personality traits and maladaptive behaviors. This relationship has not been investigated. Objective: To assess if "extended" tattoos can predict long-term compliance to regular therapy of adolescents with mild-to-moderate asthma. Methods: A 12-month retrospective observational investigation was conducted on non-smoker asthmatic adolescents of both genders. Patients assuming <70% of prescribed vilanterol/fluticasone furoate o.d. were defined as "non-compliant". Tattoo surfaces were defined as "mild" or "extended" if they were < or ≥400 cm2, respectively. The relationship between tattoos and compliance on the evolution of resources consumption at 6 and 12 months was assessed by generalized estimating equation (GEE) models at the first and second semester of the treatment period. Results: It was found that 13.2% of compliant adolescents had mild tattoos, while 47.2% of non-compliant adolescents had mild-to-extended tattoos (odds ratio (OR) 6.91, 95% CI 2.49 to 19.17, p < 0.001). The mean annual adherence to treatment was 57.8% ± 10.1 SD expected doses in non-compliant subjects with "mild tattoos" (54.8 cm2 ± 36.9 SD), but 38.6% ± 11.4 SD expected doses in those with "extended tattoos" (568.4 cm2 ± 111.6 SD, p < 0.001). Total cost proved to be a linear trend from the lowest values of compliant patients with no/mild tattoos (EUR 65.22 at 6 months and EUR 33.63 at 12 months) to the highest values of non-compliant adolescents with extended tattoos (EUR 330.75 at 6 months and EUR 297.34 at 12 months). Conclusions: Tattoo extension might be used as a reliable predictor of poor compliance and higher health care costs in adolescents with mild-to-moderate asthma. Patients characterized by poor compliance to a long-term therapeutic strategy and tattooing attitude likely share some aspects of their personality profile. [ABSTRACT FROM AUTHOR]

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To investigate demographic/cinical variables associated to dual diagnosis and the psychological reaction of dual-diagnosis patients to COVID-19 pandemic. Information was collected at the Addiction Service of Monza, Italy. The Impact of Event Scale-Revised (IES-R), a self-report questionnaire measuring the subjective response to a traumatic event, was administered. Univariate analyses and binary logistic regression were performed. IES-R scores were compared between groups defined by qualitative variables through one-way analyses of variance (ANOVA). 118 outpatients were included, 48.3% with dual diagnosis. Alcohol use disorder and being female were associated to dual diagnosis. IES-R scores were significantly higher in the dual-diagnosis group, especially for personality disorders (PDs). IES-R scores were higher in patients taking treatment for substance use disorder (SUD). Females and alcohol abusers were at-risk subjects for dual diagnosis. Patients with SUD and PDs may benefit from additional support, especially when traumatic life events occur. ClinicalTrials.gov Identifier: NCT04694482 [ABSTRACT FROM AUTHOR]

Simple Summary: Rehabilitation might play a crucial role in malignant pleural mesothelioma (MPM), but its role is still debated in MPM patients. The intervention comprised multidisciplinary educational sessions, physical rehabilitation, and respiratory physiotherapy. Feasibility was evaluated based on dropout rates, adherence to the rehabilitation program, safety, and patient-reported outcomes. In light of the current evidence, we have conducted a pilot study to assess the feasibility of tailored pulmonary rehabilitation in terms of physical and respiratory function in MPM. Twelve patients were initially enrolled, with seven completing the study. High adherence to physical (T1: 93.43%, T2: 82.56%) and respiratory (T1: 96.2%, T2: 92.5%) rehabilitation was observed, with minimal adverse events reported. Patient satisfaction remained high throughout the study (GPE scores at T1: 1.83 ± 1.17; T2: 2.0 ± 1.15), with improvements noted in physical function, pain management, and health-related quality of life. Despite its promising outcomes, further research with larger samples is warranted to validate its efficacy and integrate rehabilitation as a component into the multidisciplinary management of MPM. Malignant pleural mesothelioma (MPM) represents a significant health burden, with limited treatment options and poor prognosis. Despite advances in pharmacological and surgical interventions, the role of rehabilitation in MPM management remains underexplored. This study aims to assess the feasibility of a tailored pulmonary rehabilitation intervention addressing physical and respiratory function in MPM patients. A prospective pilot study was conducted on surgically treated MPM patients referred to a cardiopulmonary rehabilitation service. The intervention comprised multidisciplinary educational sessions, physical rehabilitation, and respiratory physiotherapy. Feasibility was evaluated based on dropout rates, adherence to the rehabilitation program, safety, and patient-reported outcomes. Twelve patients were initially enrolled, with seven completing the study. High adherence to physical (T1: 93.43%, T2: 82.56%) and respiratory (T1: 96.2%, T2: 92.5%) rehabilitation was observed, with minimal adverse events reported. Patient satisfaction remained high throughout the study (GPE scores at T1: 1.83 ± 1.17; T2: 2.0 ± 1.15), with improvements noted in physical function, pain management, and health-related quality of life. However, some issues, such as time constraints and lack of continuous supervision, were reported by participants. This pilot study demonstrates the feasibility and potential benefits of a tailored pulmonary rehabilitation intervention in MPM patients. Despite its promising outcomes, further research with larger samples is warranted to validate its efficacy and integrate rehabilitation as a component into the multidisciplinary management of MPM. [ABSTRACT FROM AUTHOR]

This essay aims to provide a contribution to the global discourse of fragmentology. The authors envisage fragmentology as a discipline that includes research on various materials like clay, papyrus, parchment, and paper and from both European and non-European contexts. At the same time, the authors argue for the greater role of fragment philology as a constituent part of fragmentology. After presenting their definition of both a fragment as a concept and fragmentology as a discipline, the essay problematizes the role of textual philology in fragmentology. Authors then present the practical application of their propositions on the basis of an in-depth analysis of two case studies from the Italian State Archive, a bifolium from a Latin antiphonary and a group of strips from a Middle Dutch lectionary. [End Page 102] [ABSTRACT FROM AUTHOR]

Mycobacterium avium subsp. paratuberculosis (MAP) is the aetiological agent of paratuberculosis (Johne's disease) in both domestic and wild ruminants. In the present study, using a whole-genome sequence (WGS) approach, we investigated the genetic diversity of 15 Mycobacterium avium field strains isolated in the last 10 years from red deer inhabiting the Stelvio National Park and affected by paratuberculosis. Combining de novo assembly and a referencebased method, followed by a pangenome analysis, we highlight a very close relationship among 13 MAP field isolates, suggesting that a single infecting event occurred in this population. Moreover, two isolates have been classified as Mycobacterium avium subsp. hominissuis, distinct from the other MAPs under comparison but close to each other. This is the first time that this subspecies has been found in Italy in samples without evident epidemiological correlations, having been isolated in two different locations of the Stelvio National Park and in different years. Our study highlights the importance of a multidisciplinary approach incorporating molecular epidemiology and ecology into traditional infectious disease knowledge in order to investigate the nature of infectious disease in wildlife populations. [ABSTRACT FROM AUTHOR]

Context In 2005, a nationwide program of iodine prophylaxis on a voluntary basis was implemented in Italy by law. However, recent data on iodine status are lacking. Objective The aim of this study was to evaluate efficiency, effectiveness, and possible adverse effects (increased occurrence of thyroid autoimmunity and hyperthyroidism) of the Italian iodine prophylaxis program. Methods From 2015 to 2019, a nationwide survey was performed. The use of iodized salt was evaluated in a sample of 164 593 adults and in 998 school canteens. A sample of 4233 schoolchildren (aged 11-13 years) was recruited to assess urinary iodine concentration, prevalence of goiter, and thyroid hypoechogenicity on ultrasound, with the latter being an indirect indicator of thyroid autoimmunity. Neonatal TSH values of 197 677 infants screened in regions representative of Northern, Central, and Southern Italy were analyzed to investigate the percentage of TSH values >5.0 mIU/L. Data on methimazole prescriptions were analyzed as indirect indicators of new cases of hyperthyroidism. Results The prevalence of the use of iodized salt was 71.5% in adult population and 78% in school canteens. A median urinary iodine concentration of 124 μg/L, a prevalence of goiter of 2.2%, and a prevalence of thyroid hypoechogenicity of 5.7% were observed in schoolchildren. The percentage of neonatal TSH values >5.0 mIU/L resulted still higher (5.1%) than the World Health Organization threshold of 3.0%, whereas the prescriptions of methimazole showed a reduction of 13.5%. Conclusion Fifteen years of iodine prophylaxis have led to iodine sufficiency in Italy, although there still is concern about iodine nutritional status during pregnancy. [ABSTRACT FROM AUTHOR]

In the context of the Covid-19 pandemic, we evaluate the effects of vaccines and virus variants on epidemiological and macroeconomic outcomes by means of Monte Carlo simulations of a macroeconomic-epidemiological agent-based model calibrated using data from the Lombardy region of Italy. From simulations we infer that vaccination plays the role of a mitigating factor, reducing the frequency and the amplitude of contagion waves and significantly improving macroeconomic performance with respect to a scenario without vaccination. The emergence of a variant, on the other hand, plays the role of an accelerating factor, leading to a deterioration of both epidemiological and macroeconomic outcomes and partly negating the beneficial impacts of the vaccine. A new and improved vaccine in turn can redress the situation. Vaccinations and variants, therefore, can be conceived of as drivers of an intertwined cycle impacting both epidemiological and macroeconomic developments. [ABSTRACT FROM AUTHOR]

Landscape configuration and forest structure assume an increasing importance as determinants of animal communities. This paper focused on nocturnal Lepidoptera inhabiting alder patches in the Sila National Park, Italy. According to their shapes, patches were divided into linear and compact ones to disentangle the roles of forest structure and landscape configuration in determining the composition of nocturnal Lepidopteran communities at different observation scales. We used the Mann–Whitney test for medians and Shannon diversity, equitability, Fisher's alpha, and nestedness to test differences among moth communities. We found that compact patches inhabited richer and more abundant communities. The abundance-based Correspondence Analysis showed moth communities clustered according to woodlot shape, except a compact woodlot with a linear-like moth community because it was entirely surrounded by grasslands. Percentage of forested area and abundance and composition of communities were positively correlated at 50 and 200 m buffers, while correlations were absent at smaller and larger buffers. Our results demonstrated that a width of 50 m may not be sufficient to give proper functionality to the wooded area, at least for moths. As a consequence, planning of forest restorations should consider the importance of increasing the structural habitat continuity at larger scales. [ABSTRACT FROM AUTHOR]

Simple Summary: Pest molecular characterization is an essential practice to support and complete the classical morphological taxonomy of insects, as well as to provide helpful information that may lead to finding alternative control strategies or detection methods. Molecular biology methods are of great importance, especially for the species whose identification requires highly qualified operators or the support of optical tools for microscopic organisms. This fact is even more amplified if the pest under study is an alien species that can quickly spread into a new area, as in the case of Toumeyella parvicornis (Cockerell) in Italy and Europe at large. This species demonstrates the need for molecular characterization, inspiring the present study. Toumeyella parvicornis (Cockerell) (Hemiptera, Coccidae) is becoming a potential main pest of stone pine plants (Pinus pinea L.), both in urban parks and pinewood forests in Europe. Its recent distribution is a source of concern in several regions of Italy and in France. The early detection of this pest plays a fundamental role to contain its geographical expansion, but its taxonomic identification is still based on laborious observations of the morphological traits. The identification is also complicated by the small size of the pest, which makes the observations possible only through a stereomicroscope. Molecular identification is beneficial for detection, but currently, there is only a single gene sequence available for this pest. This study fills this gap in knowledge by providing the sequences of five different genes (COI, 28S, elongation factor (EF-1α), wingless (wg), and histone H3 (HexA)), together with a phylogenetic analysis carried out among species belonging to Coccidae, one of the most important families of scale insects. The results provide new valuable information about T. parvicornis and may represent useful data for its detection and management practices. [ABSTRACT FROM AUTHOR]

The main purpose of this study was to characterize Freisa red wines from Piedmont (northern Italy) according to their volatile organic compounds (VOCs) and elemental composition. Moreover, the authors investigated whether it was possible to distinguish among the five different DOCs produced in Piedmont on the basis of these chemical parameters. The VOCs profile of Freisa wines was very similar, and the most abundant species detected were isoamyl alcohol, phenylethyl alcohol, ethyl octanoate, and diethyl succinate. Conversely, elemental composition allowed us to partially distinguish one Freisa DOC with respect to the others. Multivariate statistical analysis applied to elemental composition revealed differences among Freisa wines and other red wines from different regions of Italy. In particular, Freisa wines featured higher concentrations of Cr and Ni metals, which are strongly correlated with the composition of the soil of Piedmont. These two elements are hence good candidates as chemical markers for Freisa wines from Piedmont. [ABSTRACT FROM AUTHOR]

COVID-19 pandemic had a great impact on mental health, both in the general population and psychiatric patients. Little is known about the difference between these two populations in perceiving the pandemic as a traumatic event. The aim of the study was to compare psychiatric patients and healthy controls (HC) in terms of change over time of post-traumatic (PTSD) symptoms. Demographic and clinical variables were collected. Impact of Event Scale Revised (IES-R) scores were registered at T1 as lockdown period (March–April 2020) and T2 as restarting (May–June 2020). Descriptive analyses and linear regression models were performed. A total of 166 outpatients and 57 HC were recruited. Time (F = 15.76; p < 0.001) and diagnosis (F = 4.94; p < 0.001) had a significant effect on the change of IES-R scores, which resulted T1 > T2 (p < 0.001), except for subjects affected by Obsessive-Compulsive Disorder (OCD). Overall, IES-R scores were < in patients than in HC (p = 0.02), particularly in the schizophrenia (SKZ) subgroup (p < 0.001). IES-R scores of subjects with personality disorders (PDs) resulted to be > HC, although not statistically significant. The lockdown period was perceived as more traumatic than the reopening phase by both groups, with the exception of OCD patients, probably because of the clinical worsening associated with the urge of control against risks of contamination. Overall, HC reported more PTSD symptoms than psychiatric patients did, particularly SKZ ones. PD patients, in contrast, may be more vulnerable to PTSD symptoms probably as a result of poor coping skills. Together with OCD patients, subjects with PDs may need closer monitoring during the different phases of the pandemic. Trial Registration: ClinicalTrials.gov Identifier: NCT04694482 [ABSTRACT FROM AUTHOR]

Forest management is a complex topic at the interface between sustainability and the resilience of socioeconomic and environmental systems. The influence of market forces, supranational, country and regional policies, as well as climate change, on forest goods and services, is expected to increase in the near future. Such a complex interplay between economic and environmental forces is common to most European countries. The aim of this study is to operationally delineate and discuss the transition of the environmental sustainability and economic viability of forestry in Italy. This country encompasses the typical Mediterranean ecosystems with broad forest coverage in mountainous and hilly areas, where expanding woodland areas have been observed in the last decades mainly as a consequence of the decline of agropastoral activities, especially in disadvantaged and marginal areas. The consequent increase in wood biomass was frequently conceived as an element of environmental criticality, exposing woods to high vulnerability to wildfires and a consequent reduction in their economic value, possibly exacerbated by local warming. These dynamics usually took place in contexts where only a part of the overall forest heritage was subjected to regular management, despite the efforts made through various policies such as the Constitutional Law 3/2001 and the recent Law on Forests and Forestry Supply Chains. The latter policy tool, enhancing the concept of "active forest management" aimed to establish a sustainable approach to forest resources, leading to a broader forest area for formal planning and controlled harvesting. These dynamics took place in parallel with the inherent expansion in forest certification schemes formally promoting long-term environmental sustainability and a wider spectrum of forest ecosystems. Timber and non-wood materials and products are key elements from the perspective of achieving sustainable (climate-neutral) development in advanced economies. [ABSTRACT FROM AUTHOR]

Bronchial asthma has a high socio-economic impact in Western countries. Low adherence to prescribed inhalation treatments contributes to poor asthma control and the higher utilization of healthcare resources. Although adolescents usually do not comply with long-term inhaled treatments prescribed on a regular basis, the related economic consequences still are poorly investigated in Italy. Aim: A 12-month estimation of the economic impact of non-adherence to inhalation treatments in adolescents with mild-to-moderate atopic asthma. Methods: Non-smoking adolescents aged 12–19 years, without any significant comorbidity, prescribed with inhaled cortico-steroids (ICS) or ICS/long-acting beta(2)-adrenergics (LABA) via dry powder inhalers (DPIs) on a regular basis were automatically selected from the institutional database. Spirometric lung function, clinical outcomes, and pharmacological information were collected. The adolescents' adherence to their prescribed regimen was calculated monthly. Adolescents were divided in two sub-groups based on their adherence to prescriptions: ≤70% (not adherent) or >70% (adherent), and statistically compared (Wilcoxon test, assuming p < 0.05). Results: Overall, 155 adolescents fulfilled the inclusion criteria (males, 49.0%; mean age, 15.6 years ± 2.9 SD; mean BMI, 19.1 ± 1.3 SD). Mean values of lung function were: FEV1 = 84.9% pred. ± 14.8 SD, FEV1/FVC = 87.9 ± 12.5 SD; MMEF = 74.8% pred. ± 15.1 SD and V25 = 68.4% pred. ± 14.9 SD. ICS had been prescribed in 57.4% of subjects and ICS/LABA in 42.6%. Mean adherence to original prescriptions was 46.6% ± 9.2 SD in non-adherent and 80.3% ± 6.6 SD in adherent adolescents, respectively (p < 0.001). The mean rates of hospitalizations, exacerbations, and GP visits; the average duration of absenteeism; the frequency of systemic steroids and antibiotics courses needed over the study period were significantly and substantially lower in adolescents adherent to prescriptions (all p < 0.001). The mean total annual extra cost calculated in the two sub-groups was EUR 705.8 ± 420.9 SD in non-adherent adolescents and EUR 192.1 ± 68.1 SD in adherent adolescents, respectively (p < 0.001), which was 3.7 times higher than in non-adherent adolescents. Conclusions: In adolescents, the clinical control of mild-to-moderate atopic asthma is directly and strictly related to the degree of adherence to prescribed inhalation therapies. All clinical and economic outcomes prove dramatically poor when adherence is low, and treatable asthma can be frequently mistaken for refractory asthma in these cases. Adolescents' non-adherence impacts the burden of the disease quite substantially. Much more effective strategies centered specifically on adolescents' asthma are needed. [ABSTRACT FROM AUTHOR]

The Prunus genus encompasses a group of economically important and closely related crops, sharing an essentially common genome and, thereby, a high level of conserved and transferable microsatellite (SSR) loci. In Southern Italy, many of the local and/or neglected varieties are abandoned and at risk of extinction due to the high degree of urbanization and agricultural intensification, despite their value as genetic resources for crop improvement. This research aimed to genetically and morphologically characterize the traditional apricot (P. armenica) and peach (P. persica) germplasms collected in old family orchards. Most of the official descriptor categories were scored, thus revealing a rather high level of phenotypic variation in both collections. Genetic data allowed the discovery of diversity masked by morphological traits. Genotyping in 15 and 18 SSRs, eight of which were transferable across both species, showed an average polymorphic informativeness (PIC) of 0.44 and 0.59 for apricot and peach, respectively, and a total of 70 and 144 alleles. A reliable identification of each genotype was achieved, and the presence of possible mislabeling and/or erroneous denominations was solved. These results are encouraging for the valorization of the still poorly explored Italian Prunus germplasm, with significant economic consequences for bioresource conservation and management. [ABSTRACT FROM AUTHOR]

Papillomaviruses (PVs) are small, non-enveloped viruses, ubiquitous across the animal kingdom. PVs induce diverse forms of infection, such as cutaneous papillomas, genital papillomatosis, and carcinomas. During a survey on the fertility status of a mare, a novel Equus caballus PV (EcPV) has been identified using Next Generation Sequencing, and it was further confirmed with genome-walking PCR and Sanger sequencing. The complete circular genome 7607 bp long shares 67% average percentage of identity with EcPV9, EcPV2, EcPV1, and EcPV6, justifying a new classification as Equus caballus PV 10 (EcPV10). All EcPV genes are conserved in EcPV10, and phylogenetic analysis indicates that EcPV10 is closely related to EcPV9 and EcPV2, genus Dyoiota 1. A preliminary EcPV10 genoprevalence study, carried out on 216 horses using Real Time PCRs, suggested a low incidence of this isolate (3.7%) compared to EcPVs of the same genus such as EcPV2 and EcPV9 in the same horse population. We hypothesize a transmission mechanism different from the one observed in the closely related EcPV9 and EcPV2 that particularly infect Thoroughbreds. This horse breed is usually submitted to natural mating, thus indicating a possible sexual diffusion. No differences were detected for breeds in terms of susceptibility to EcPV10. Further studies are needed to investigate the molecular mechanisms behind the host and EcPV10 infection to explain the reduced viral spread. [ABSTRACT FROM AUTHOR]

During the summer season, the Italian territory is vulnerable to extended wildfires, which can have dramatic impact on human activities and ecosystems. Such wildfire events are usually associated with the presence of drought conditions and are generally more severe in southern Italy, owing to the high temperatures and reduced precipitation that characterize this geographical region. In this work, we discuss the statistical analysis of the burned area (BA) in Italy and build simple data-driven models linking BA to different climatic drivers, comparing the relevance of direct surface soil moisture information to that provided by drought indices such as the Standardized Precipitation Index and the Standardized Precipitation Evapotranspiration Index (SPEI). We show that considering surface soil moisture alone is sufficient to produce reliable out-of-sample predictions in a large part of the country. By contrast, SPEI allows for better model performances in the more arid regions. [ABSTRACT FROM AUTHOR]

The use of pre‐procurement normothermic regional perfusion (NRP) allowed us to implement controlled DCD liver transplantation with results comparable to brain death donors, but the use of uncontrolled DCD is declining due to logistic challenges and the high incidence of post‐transplant complications. In Italy, the mandatory stand‐off period of 20 min for DCD donors has driven the combined use of NRP and ex‐situ machine perfusion with the intent to counterbalance the negative impact of prolonged warm ischemia. Organ viability during NRP is based on duration of warm ischemia, regional perfusion flow, lactate, transaminases values and histology, and those used in Italy are the widest worldwide. However, this evaluation can be difficult, especially when the acute damage is particularly severe. The use of ex‐situ NRP could provide a safe organ evaluation. In the period from 06/2020 to 06/2022, all DCD grafts exceeding NRP viability criteria at a single center were eventually evaluated using ex‐situ normothermic machine perfusion. Machine perfusion viability criteria were based on lactate clearance, irrespectively to bile production, unless 1‐h transaminases perfusate level were not exceeding 5000 IU/L. Three cases of uncontrolled DCD grafts in excess of NRP viability criteria underwent ex‐situ graft evaluation. Two matched ex‐situ normothermic machine perfusion viability criteria and were successfully transplanted. Both recipients are doing well after 26 and 5 months after surgery with no signs of ischemic cholangiopathy. This experience suggests that the sequential use of NRP and normothermic machine perfusion may further expand the boundaries of organ viability in uncontrolled DCD liver transplantation. [ABSTRACT FROM AUTHOR]

Healthy olives were surface sterilised and inoculated with mycelial plugs (Markakis et al., [4]), with or without artificial wounding, while olive fruits inoculated with only sterile PDA plugs served as a control. Keywords: fungal plant disease; Olea europaea EN fungal plant disease Olea europaea 1 3 3 09/28/23 20230701 NES 230701 Olive ( I Olea europaea i ) is affected by different fungal pathogens causing fruit rot which decrease the overall productivity in terms of oil quantity and/or quality (Lazzizera et al., [2]). [Extracted from the article]

The fungus Gnomoniopsis castaneae is the causal agent of the "brown rot" of sweet chestnut fruits. These days, this pathogen represents one of the main limiting factors for the sustainability of fruit production worldwide. Although heat treatment post-harvest is efficient in completely inactivating the pathogen, the application of appropriate protocols to control "brown rot" in chestnut orchards is required to help in reducing the latent population of the fungus in fruit tissues, and the consequent development of "brown rot" symptoms in the field before the post-harvest handling process. The present study aims to evaluate and compare the efficiency of products at a minimum environmental impact in experimental trials conducted in chestnut orchards in Central Italy for two consecutive years in 2019 and 2020. Phosphonate-based salts and, specifically, Zn-phosphonate were efficient in reducing the impact of the disease and the pathogen inoculum in fruits with an efficacy comparable to the fungicide Tebuconazole. A unique treatment at the blooming time produced the best results for both Zn-phosphonate and Tebuconazole, also giving indirect evidence of female flowers as a main site of infection. Phosphonate salts, and at first Zn-phosphonate, are highly effective to protect chestnut fruits from the 'brown rot' fungus G. castaneae. Its use in orchard management may complement the post-harvest heat treatment during the processing of fruits. Although a still ongoing debate on phosphonate salts use and efficacy in agriculture, they can be considered an optimal fungicide in chestnut orchards because of the low environmental impact when used at the recommended doses, the high translocability and stability, and the multiple mechanisms of action. [ABSTRACT FROM AUTHOR]

Papillomavirus (PV) infections may be related to anogenital lesions and cancer development in humans and several other animal species. To date, 11 different PVs have been reported in horses. Among them, a newly described PV named Equus caballus Papillomavirus Type9 (EcPV9) was thus far only reported in the semen of a stallion with penile lesions in Australia. This study reports for the first time the presence of EcPV9 in asymptomatic Italian horses. From July 2020 to January 2022, genital brush samples were collected from 209 horses with no apparent signs of neoplastic disease and no PV-associated lesions, clinically examined at the Didactic Veterinary University Hospital (OVUD) of Perugia and at the Veterinary University Hospital (OVU) of Turin. Brushes were submitted to real-time PCR targeting the EcPV9-L1 region. The first amplification targeted a region of ~116 bp, followed by the amplification and sequencing of ~533 bp of the positive samples. EcPV9-L1 DNA was found in eleven horses (5.3%), all female and mainly English Thoroughbred. Co-infection with EcPV2-L1 was found in 7 out of the 11 EcPV9-L1 positive horses (63.6%). This study contributes to the description of the prevalence of exposure or infection of EcPVs in the horse population in Italy, for which data are still limited. In this regard, here we provide a phylogenetic analysis and the completely reconstructed viral genomes of two Italian EcPV type 9 isolates, as well as four EcPV type 2 obtained from co-infected animals. [ABSTRACT FROM AUTHOR]

Equine Papillomavirus 2 (EcPV2) is responsible for squamous cell carcinomas (eSCCs) of external genitalia of both male and female horses. However, few studies report the EcPV2 prevalence among healthy horses. Currently, the lack of these data does not permit identifying at-risk populations and, thus, developing screening protocols aimed at the early detection of the infection, as for humans. The aim of our study was to estimate the genoprevalence of EcPV2 in clinically healthy horses in Italy and to evaluate their innate immune response. For this purpose, penile and vulvar swabs of 234 healthy horses were collected through sampling with sterile cytobrushes. Nucleic acids were isolated and EcPV2-L1 presence (DNA) and gene expression (RNA) were checked by RT-qPCR. Our results showed EcPV2-L1 DNA presence in 30.3% of the samples and L1 expression in 48% of the positive samples. No statistically significant differences were found in genoprevalence in relation to sex, age, and origin, while, concerning breeds, the Thoroughbred had the highest risk of infection. Concerning specifically the mares, 40.2% of them resulted in being positive for EcPV2; our findings show a major positivity in pluriparous (p = 0.0111) and mares subjected to natural reproduction (p = 0.0037). Moreover, samples expressing L1 showed an increased expression of IL1B (p = 0.0139) and IL12p40 (p = 0.0133) and a decreased expression of RANKL (p = 0.0229) and TGFB (p = 0.0177). This finding suggests the presence of an effective immune response, which could explain the low incidence of SCCs in positive horses, despite a high EcPV2 genoprevalence (30%). [ABSTRACT FROM AUTHOR]

Hazelnut kernels inoculated using both techniques showed the same severe necrosis and rotting seven to ten days after inoculation, whereas the controls remained non-symptomatic (Fig. Keywords: Hazelnut; Kernel rot; Italy EN Hazelnut Kernel rot Italy 1 3 3 05/30/23 20230401 NES 230401 Hazelnut ( I Corylus avellana i ) is one of the most cultivated nut crops worldwide, with Turkey (665,000 tonnes) and Italy (140,560 tonnes) representing the leading countries in global production (Król & Gantner, [2]). [Extracted from the article]

In this study, morphometric analyses were conducted to explore and characterise the differences and analogies between almost all O. fusca s.l. taxa occurring in Apulia. Numerous morphological characters were considered, including 20 continuous variables, 5 ratios and one multistate condition. Our results constitute an exhaustive morphometrical analysis of taxa belonging to the O. fusca group found in Apulia, showing that most of the analysed species are morphologically well defined. Using morphological, phenological and chorological evidence, a new species from southern Italy, Ophrys japigiae sp. nov. is described and illustrated. Some conclusions are drawn with regard to species delimitation, comparing morphology, phenology, chorology and habitat markers. [ABSTRACT FROM AUTHOR]

Summary: Pseudomonas savastanoi pv. savastanoi, the causal agent of olive knot disease, is a fluorescent Gram‐negative bacterium classified, according to the specific LOPAT profile, as Ib. However, during the 90s, a number of atypical non‐fluorescent levan‐positive strains of Pseudomonas savastanoi pv. savastanoi have been unexpectedly isolated from olive knots in Central Italy. Since its first report, several studies were conducted on this species variant, but its genome sequence has never been reported. The complete genome sequence and two additional plasmids of PVFi1, a representative strain, were here obtained using a hybrid sequencing approach with both Oxford Nanopore Technology and Illumina sequencing. A thorough genomic analysis unravelled several genetic features of this peculiar strain, showing a transposase insertion downstream a fragmented copy of the levansucrase gene. The same features were previously reported on levan‐negative Pseudomonas savastanoi pv. savastanoi strains. In addition, a second copy of the levansucrase gene fully equipped for a gene expression and comparable to the levan‐positive Pseudomonas savastanoi pv. glycinea, may explain the levan‐positive test. This result provides a solid genetic demonstration that the bacterial species Pseudomonas savastanoi contains either levan‐positive or levan‐negative strains, providing insights for an update of the related LOPAT classification. [ABSTRACT FROM AUTHOR]

Purpose: Eco-museums safeguard the cultural authenticity and the historical identity of the place in which they operate. Conventional organizational models and management practices are generally employed to achieve this institutional aim. Conversely, innovative solutions – such as digitization – are overlooked. Adopting a service quality management perspective, the article intends to examine the role of managerialization and professionalization in triggering eco-museums' digitization. Design/methodology/approach: An empirical analysis involving 126 eco-museums operating in Italy as of 2018 was designed to investigate the implications of managerialization and professionalization on the eco-museums' propensity to embark on a digitization process. Two different forms of digitization were examined: (1) the presence of eco-museums in the digital environment; and (2) the exploitation of digital tools for service delivery. The mediating role of two "soft" total quality management (TQM) practices, i.e. people centredness and strategic focus on visitors' experience, was contemplated in the empirical analysis. Findings: The research findings suggest that managerialization and professionalization have ambiguous effects on eco-museums' digitization. Nevertheless, they indirectly contribute to a greater digital presence of eco-museums and to a larger use of digital tools for service delivery through an increased use of soft TQM practices. Research limitations/implications: Managerialization and professionalization are likely to foster the digital transition of eco-museums, which advances their ability to protect and promote the local cultural heritage. Soft TQM practices intended to achieve people-centredness and to enhance the visitors' experience should be exploited to stimulate the eco-museums' digitization. Originality/value: The article examines the triggers of eco-museums' digitization, providing some food for thought to scholars and practitioners. [ABSTRACT FROM AUTHOR]

Several factors affect drug delivery from dry powder inhalers (DPIs). Some are related to patient's physiological characteristics, while others depend on DPIs' technical aspects. The patient's inspiratory airflow rate (IAR) affects the pressure drop and the turbulence needed to disaggregate the powder inside a DPI. The present study investigated whether lung function limitations occurring in asthmatic adolescents affect their IAR when inhaling through a DPI simulator. Eighteen consecutive adolescents with asthma were recruited, and IAR was randomly assessed at low-, mid-, and high-resistance regimens. A multiple logistic model was developed to evaluate the association of patients' lung function characteristics and devices' resistance with the probability to achieve the expected IAR (E-IAR). The mean value of E-IAR achieved seemed to be sex- and age-independent. Low- and high-resistance regimens were less likely to consent the E-IAR level (odds ratio [OR] = 0.035 and OR = 0.004, respectively). Only the basal residual volume and the inspiratory resistance, but not the Forced Expiratory Volume in 1 s (FEV1), seemed to affect the extent of IAR in asthmatic adolescents (OR = 1.131 and OR = 0.290, respectively). The results suggest that the assessment of current lung function is crucial for choosing the proper DPI for asthmatic adolescents. [ABSTRACT FROM AUTHOR]

Background: Chronic obstructive pulmonary disease (COPD) is a complex, progressive respiratory condition characterized by heterogeneous clinical presentations (phenotypes). The aim of this study was to assess the prevalence of the main COPD phenotypes and match each phenotype to the most fitting clinical and lung function profile. Methods: The CLIMA (Clinical Phenotypes in Actual Clinical Practice) study was an observational, cross-sectional investigation involving twenty-four sites evenly distributed throughout Italy. Patients were tentatively grouped based on their history and claimed prevailing symptoms at recruitment: chronic cough (CB, suggesting chronic bronchitis); dyspnoea (possible emphysema components, E); recurrent wheezing (presuming asthma components, A). Variables collected were: anagraphics; smoking habit; history of asthma; claim of >1 exacerbations in the previous year; blood eosinophil count; total blood IgE and alpha1 anti-trypsin (α1-AT) levels; complete lung function, and the chest X-ray report. mMRC, CAT, BCS, EQ5d-5L were also used. The association between variables and phenotypes were checked by Chi-square test and multinomial logistic regression. Results: The CB phenotype was prevalent (48.3%), followed by the E and the A phenotypes (38.8% and 12.8%, respectively). When dyspnea was the prevailing symptom, the probability of belonging to the COPD-E phenotype was 3.40 times higher. Recurrent wheezing was mostly related to the COPD-A phenotype. Lung function proved more preserved in the COPD-CB phenotype. Smoke; n. exacerbations/year; VR, and BODE index were positively correlated with the COPD-E phenotype, while SpO2, FEV1/FVC, FEV1/VC, and FEV1 reversibility were negatively correlated. Lower DLco values were highly probative for the COPD-E phenotype (p<0.001). Conversely, smoke, wheezing, plasma eosinophils, FEV1 reversibility, and DLco were positively correlated with the COPD-A phenotype. The probability of belonging to the COPD-A phenotype raised by 2.71 times for any increase of one unit in % plasma eosinophils (p<0.001). Also multiparametrical scores contributed to discriminate the three phenotypes. Conclusion: the recognition of the main phenotypes of COPD can be effectively pursued by means of a few clinical and instrumental parameters, easy to obtain also in current daily practice. The phenotypical approach is crucial in the management of COPD as it allows to individualize the therapeutic strategy and to obtain more effective clinical outcomes [ABSTRACT FROM AUTHOR]

In summer 2019, during a survey on the health status of a hazelnut orchard located in the Tuscia area (the province of Viterbo, Latium, Italy), nuts showing symptoms, such as brown-grayish spots at the bottom of the nuts progressing upward to the apex, and necrotic patches on the bracts and, sometimes, on the petioles, were found and collected for further studies. This syndrome is associated with the nut gray necrosis (NGN), whose main causal agent is Fusarium lateritium. Aiming to increase knowledge about this fungal pathogen, the whole-genome sequencing of a strain isolated from symptomatic hazelnut was performed using long Nanopore reads technology in combination with the higher precision of the Illumina reads, generating a high-quality genome assembly. The following phylogenetic and comparative genomics analysis suggested that this isolate is caused by the F. tricinctum species complex rather than F. lateritium one, as initially hypothesized. Thus, this study demonstrates that different Fusarium species can infect Corylus avellana producing the same symptomatology. In addition, it sheds light onto the genetic features of the pathogen in subject, clarifying facets about its biology, epidemiology, infection mechanisms, and host spectrum, with the future objective to develop specific and efficient control strategies. [ABSTRACT FROM AUTHOR]

The article discusses the decline of Monkeypox virus (MPXV) cases in Italy and the reasons behind it. The report mentions that there has been a steady decline in new diagnoses globally, but surveillance systems should still be maintained, especially in high-risk categories. The article presents a case of a 59-year-old Italian man who visited a dermatology center with symptoms of MPXV after a recent trip to Germany. The reduction in MPXV cases in Italy is attributed to factors such as vaccination campaigns and natural infection-induced herd immunity. However, the article emphasizes the need for further research and clinical trials to evaluate the long-term efficacy of the vaccine. [Extracted from the article]

The mental health care system in Italy is based on Law 180/70 which leaves great regional autonomy about the management of adolescent patients suffering from psychiatric diseases. The aim of this study is the evaluation of demographic, social, and clinical features of minors admitted to psychiatric wards, as starting point to improve individualized services for them. Data about all under 18s consecutively admitted to Parma's psychiatric wards from 2013 to 2015 were retrospectively collected from medical records. Diagnoses were classified according to ICD-10 criteria, and statistical analysis was performed using SPSS statistical software (IBM SPSS Statistics 22.0) for Windows. Clinical samples include 51 cases, 30 males (mean age: 15.5 years, ranging from 12 to 17 years) and 21 females (mean age: 15.9, ranging from 14 to 17 years). The most frequent diagnosis is conduct disorder (39.2%), with higher prevalence among males. Following this, 23.5% of the patients present comorbidity issues and 9.8% suffer from personality disorders, which is more frequent among females. High percentages of foreigners (31.4%), adopted minors (15.7%), and drug users (40%) are reported. Furthermore, data reveal that unprotective family environment, registered in 80.4% of cases, plays an important role as risk factor for the development of mental disease, readmissions in psychiatric wards, and discharge to residential facilities. Readmissions, as well as compulsory treatments (11 cases), are mainly required in case of conduct disorders and comorbidity diagnosis. Lastly, in contrast with the situation before hospital admission, most patients (63.3%) are discharged and sent to community residential facilities. Findings can be useful to improve the management of psychiatric emergencies in minors, focusing on their specific needs, such as conduct disorders and substance abuse, and to face emerging challenges, for example, mental health disease associated with the growing phenomenon of immigration. [ABSTRACT FROM AUTHOR]

This article reports the first case of anthracnose, a fungal plant disease, caused by Colletotrichum fioriniae on adult European beech trees (Fagus sylvatica) in a natural forest in Italy. The study was conducted in the UNESCO site "Faggeta Vetusta di Monte Raschio" in Oriolo Romano, Viterbo. The researchers identified the causal agent through morphological and molecular analysis, confirming the presence of C. fioriniae. This pathogen has previously only been reported on Fagus sylvatica seedlings in a nursery in Poland. The study was funded by the European Union Next-Generation EU. [Extracted from the article]

Introduction: Recto-vaginal endometriosis surgical management needing partial colpectomy is a surgically challenging condition and has been associated with a notable risk of major postoperative complications. In the present study we sought to compare feasibility and safety of total laparoscopic (TL) and vaginal-assisted (VA) routes in women affected by symptomatic recto-vaginal endometriosis with vaginal mucosa infiltration scheduled for minimally invasive surgery.Material and Methods: Multi-centric, retrospective cohort study on medical records of consecutive reproductive age women submitted to complete macroscopic eradication of symptomatic recto-vaginal endometriosis with vaginal mucosa infiltration between March 2013 and November 2017. The two groups were compared in terms of preoperative data and surgical outcomes.Results: 84 women were included in the study (TL = 57 and VA = 27). The two groups were comparable in terms of preoperative, surgical and postoperative data. The major postoperative complications rate was 5.3% (3 of 57) in the TL group and 7.4% (2 of 27) in the VA group, without a significant difference. In the TL group we reported one case of bowel anastomosis dehiscence and two cases of pelvic abscess. In the VA group, one case of small bowel perforation after extensive adhesiolysis treated with ileal resection and one case of rectal sub-occlusion after segmental resection and mechanical anastomosis were noticed.Conclusions: In women affected by recto-vaginal endometriosis with vaginal mucosal infiltration, perioperative outcomes do not seem to be influenced by the surgical route adopted. [ABSTRACT FROM AUTHOR]

Background: Sporadic Creutzfeldt-Jakob disease (CJD) is a rare neurodegenerative disease caused by prions that is randomly distributed in all countries, with an overall yearly mortality rate of about 1–2 cases per million people. On a few occasions, however, sporadic CJD occurred with higher than expected rates, but further investigations failed to recognize any convincing causal link. In Italy, cluster analyses of sporadic CJD cases have not been performed previously. Objective: To investigate the geographical distribution of sporadic CJD using municipality geographical data of Apulia with the aim of detecting spatial clusters of disease. Patients and Methods: Patients included in this study were diagnosed as probable or definite sporadic CJD and were residents of the Apulia Region (Italy). Bayesian hierarchical models with spatially structured and unstructured random components were used to describe the spatial pattern of the disease and to assess the extent of heterogeneity among municipalities. The Kulldorff-Nagarwalla scan test and the flexible spatial scan statistic were used for detecting spatial clusters. Results: Smoothed Bayesian relative risks above the null value were observed in a few adjacent municipalities in the north and middle areas of Apulia. However, both the circular scanning method and the flexible spatial scan statistic identified only a single cluster in the central part of the region. Conclusion: Geographical analyses and tests for spatial randomness identified a restricted area with an unusually high number of sporadic CJD cases in the Apulia region of Italy. Environmental and genetic risk factors other than mutations in the prion protein gene however, need to be investigated. [ABSTRACT FROM AUTHOR]

This research is carried out in order to characterize the actual contamination by two ubiquitous environmental pollutants, plasticizers and Bisphenol A, in spices (black pepper, caraway and coriander) and aromatic herbs (fennel, laurel, mint, oregano, rosemary, thyme and verbena) from Algeria (n = 26), Tunisia (n = 65) and Italy (n = 53). Algerian samples seem to contain fewer residues than Italian and Tunisian samples. Among the Italian samples, only aromatic herbs, precisely mint, oregano, and laurel, were contaminated. In general, all Tunisian samples showed five plasticizers residues: the caraway, among the spices, and the rosemary, among the aromatic herbs, are found to contain more residues. Also, dietary intake of these contaminants by spices and aromatic herbs under analysis seems not to constitute a risk to the consumers. [ABSTRACT FROM AUTHOR]

Spices and aromatic herbs can be contaminated with mycotoxins, since of their preharvest, postharvest, and storage conditions. In this study, 112 samples of different spices and aromatic herbs were evaluated for their mycotoxins content by HPLC-MS/MS in order to highlight their possible risk linked with human use. The results showed that mycotoxins were occasionally detected only in samples of coriander, laurel, mint, rosemary, and verbena. In both geographical origins a different contamination was detected. Among the investigated mycotoxins, AFB2, AFG1, AFG2, T2 and HT2 were detected, whereas none of the samples contained AFB1 and FB1. The co-occurrence of two toxins were observed for some samples of rosemary and verbena. This study indicates that it is essential minimize the toxins in agriculture, industry, and food-product manufacturing for the consumer health protection. [ABSTRACT FROM AUTHOR]

In this work 67 organic contaminants in Protected Geographical Indication (PGI) and non-PGI Interdonato Lemon pulps, peels, leave and related soils were evaluated by GC/MS-MS. It is possible to highlight that in Italian pulps and peels the residues were under LODs (0.10–10.30 ng·g−1), whereas the leaves showed piperonyl butoxide in 33% of samples (11.76 ± 1.24 ng·g−1) and cypermethrins in 33% of samples (Cypermethrin I, 6.12 ± 0.35 ng·g−1; Cypermethrin II, 8.67 ± 0.48 ng·g−1; Cypermethrin III, 8.90 ± 1.52 ng·g−1; Cypermethrin IV, 12.25 ± 2.46 ng·g−1). Turkish samples were mainly contaminated by piperonyl butoxide: it was revealed in the 33% of pulps (3.35 ± 1.03 ng·g−1), in 100% of peels (23.46 ± 17.69 ng·g−1) and in 100% of leaves (1302.44 ± 527.40 ng·g−1). In both soils a different contamination was detected. This study confirms that the European brand (PGI) of Interdonato Lemon Messina is a valuable instrument for the consumer protection. [ABSTRACT FROM AUTHOR]

Purpose. To compare the capsule edges ultrastructure obtained by two femtosecond laser-assisted cataract surgery (FLACS) platforms and manual continuous curvilinear capsulorhexis (CCC) using scanning electron microscopy (SEM). Setting. Eye Clinic, University of Trieste, Italy. Design. Experimental comparative study. Methods. 150 anterior capsules were collected and divided into three groups as follows: Group 1 (50 capsules) obtained with manual CCC, Groups 2 and 3 (each with 50 capsules) obtained with the Catalys Laser and the LenSx Laser, respectively. All samples were imaged by means of SEM and regularity of the cut surface, and thickness of the capsule edge were evaluated and compared. Results. All femtosecond laser (FSL) capsules were perfectly circular, whereas some alteration of the circular shape was observed in the manual ones. Group 1 showed a smooth and regular capsule edge without any surface irregularity, conversely Groups 2 and 3 showed postage-stamp perforations on the capsule edge. The cut surface irregularity value in Group 2 was 1.4 ± 0.63, while it was 0.7 ± 0.49 in Group 3 (p<0.05). Group 1 had a significantly lower thickness of the capsule edge than the FSL groups (p<0.05). No statistically significant difference in the capsule edge thickness between the FSL groups was found (p=0.244). Conclusions. Despite the presence of slight cut surface irregularities, both FSL capsulotomies showed a better geometry and circularity than the manual ones. Capsulotomy specimens obtained using both FSL capsulotomies showed laser-induced alterations of the capsule edge when compared with smooth and regular edges obtained using manual CCC. [ABSTRACT FROM AUTHOR]

In recent years, there has been an increasing attention towards the use of the BIM (Building Information Modeling) approach in the cultural heritage domain. The stringent regulatory requirements in terms of BIM adoption in the field of public works in the short term will also have an impact on the historical heritage that characterises most European cities. However, when it comes to historical architecture, especially if it is in a state of ruin/abandonment, several critical issues arise. The first issue concerns the geometric simplification of architectural components provided by common commercial BIM platforms, that leads to search for other solutions. Another theme is the software interoperability, when sharing data between different platforms in order to enrich the digital model with not geometric information. Therefore, this research explores the concept of model tolerance and level of accuracy referring to a very complex architectural building. As case of study the church of Santa Maria delle Grazie in ancient Misterbianco (Sicily) has been chosen. The church was covered by the Etna eruption of 1669 and was recently brought to light during the excavations carried out by the Superintendence to Cultural Heritage of Catania. The state of decay of the church (warped floor, curved and out of lead walls, deteriorated altars and undamaged surfaces) makes it an excellent test bench on which to explore all the emerged criticalities, set up a feasible workflow and define a Level of Accuracy for complex or ruined architectural heritage. [ABSTRACT FROM AUTHOR]

Contaminants belonging to various classes, including polychlorobiphenyls (PCBs), polycyclic aromatic hydrocarbons (PAHs), organochlorine pesticides (OCPs), organophosphorus pesticides (OPPs), pyrethroid insecticides (PYRs), fungicides (Fs), herbicides (Hs), synergists (SYNs) and insect growth regulators (IGRs) were analysed simultaneously in honey samples using a new simultaneous, easy and rapid method based on a liquid–liquid extraction with a mixture ofn-hexane and ethyl acetate. It allowed recoveries in the range 80–137%, with limits of detection (LODs) between 0.10 and 5.21 ng g–1, showing a good sensitivity and accuracy. All the analysed Italian honeys showed the presence of residues of OPPs; PAHs were in 46.8% of the samples and PCBs were always below the LODs; 53.2% of the samples were contaminated by OCPs, PYRs, SYNs and IGRs. In addition, 46.8% of the samples exceeded the maximum residue limits (MRLs) established by the European Community in honey for chlorfenvinphos (cis+trans), TPP, γ-HCH, tebuconazole, coumaphos and τ-fluvalinate (cis+trans). [ABSTRACT FROM AUTHOR]

Background: Asthma is a common disease of the airways with a significant burden for the society and for patients' quality of life. The Social Impact of Respiratory Integrated Outcomes (SIRIO) study estimated a mean cost of 1,177.40 € per patient/year in Italy, in 2007. The aim of the present study was to update the cost of persistent asthma patients in Italy. Methods: An observational, retrospective, bottom-up analysis was carried out starting from the data base operating in the Lung Unit of the Specialist Medical Centre (CEMS), Verona (Italy), over the period June 2013-December 2015. Patients' data were recorded over the 12 ± 2 months before the enrollment and during 12 ± 2 months of follow-up. The prospective was the Italian National Health Service and the broad Italian society. Clinical data were measured in terms of forced expiratory volume in 1 s (FEV1 %) and number of relapses. Healthcare resources (namely; number of hospitalizations and/or ER admissions; number of visits; drug use and duration, and indirect costs) were recorded. Results: The cohort consisted of 817 patients with persistent asthma of different severity. They had a 42.96% male prevalence; a mean (±SE) age of 49.06 (±0.64) years; a mean 87.47% (±0.81) FEV1 % pred. in baseline, and 69.16% of subjects had comorbidities. The mean (±SE) number of relapses was 0.91 (±0.09) per patient/year before the enrolment. After 12 months, FEV1 % significantly improved by +6.31% (±0.45) from the corresponding baseline value (p < 0.001). The number of relapses decreased of -0.46 (±0.09) (p < 0.001). The estimated total annual cost per asthmatic patient was 1,183.14 € (±65.79 €) during the 12 months before the enrolment, and 1,290.89 € (±68.74 €) throughout the follow-up. The increase was mostly due to the significantly increased duration of therapeutic strategies. The costs of hospitalization, general practitioner and rescue medications were significantly decreased. Conclusions: The periodic update of cost analysis is a key to monitor the trend of main asthma outcomes and related expenditure over time. It allows to plan the most convenient actions in terms of prevention strategies and effective interventions, with the aim of optimizing the healthcare resources consumption and maximizing the impact on clinical outcomes and patients' quality of life. The role of an appropriate pharmacological strategy still proves crucial in minimizing asthma morbidity and the corresponding socio-economic impact. [ABSTRACT FROM AUTHOR]

Purpose: The existence of gender differences in the management of statin therapy among patients with chronic heart failure (HF) is still poorly investigated. We aimed at exploring the effect of gender on statin prescription rates and adequacy of dosing and on the association between statin therapy and all-cause 1-year mortality, after HF hospitalization in a community setting. Methods: Statin prescription rates, adequacy of dosing (estimated as a PDD/DDD ratio >0.80), and 1-year mortality were retrospectively assessed in 2088 consecutive patients discharged from 5 local community hospitals with a definite diagnosis of HF after a mean length of stay of 7.6 days. The effect of gender was explored using multivariable logistic and Cox analyses adjusting to confounders. Results: Women showed a lower statin prescription rate (25.7 vs 35.3 %, P < 0.0001) and a lower prevalence of adequate statin dose (32.6 vs 42.3 %, P < 0.0001) than men. Female gender was independently associated with a 24 % lower probability of statin prescription and a 48 % higher probability of inadequate statin dose. Statin prescription and adequacy of dosing were associated with 35 and 44 % decreases in the risk of 1-year mortality, respectively, irrespective of gender. A nested case/control analysis confirmed that adequate statin dose was associated with 48 % lower 1-year mortality, again without interaction with gender. Conclusions: In patients with chronic HF, female gender is independently associated with lower statin prescription rates and higher probability of inadequate dose. Statin therapy in these subjects is associated with improved 1-year survival in both men and women. This prognostic benefit is not affected by gender. [ABSTRACT FROM AUTHOR]

The present work aims to offer a contribute for the evaluation of the opportunity to adopt strategies based on state support or, alternatively, on the managerial autonomy of local bodies in financial trouble. The research, after analyzing the main guidelines at European level, presents the results of an empirical investigation on the economic effects produced on the local economy by the financial default of the Municipality of Taranto. The choice of the Municipality of Taranto is due both to the significant magnitude of the ascertained debt, which was one of the highest in the history of Italy, and to the considerable economic effects caused by the recovery procedure. Specifically, with reference to the companies admitted to the passive mass, we determined, firstly, the economic losses they suffered and, secondly, we took into consideration the survival state and the strategies adopted by the companies involved in the insolvency procedure which were located in the local area of reference. From this work can be drawn some major conclusions. In general, it can be said that the relevant legal standard proved to be ineffective, as it does not define the recovery ways and the timing for the closure of the procedure. In particular, it does produce relevant economic effects on local enterprises, only in part mitigated by the diversification strategies adopted by the enterprises. [ABSTRACT FROM AUTHOR]

A production-theory approach to migration is adopted in this paper to address the role of migrant workers from extra-EU countries in Italian manufacturing firms. The adoption of flexible functional forms to model firm-level technology lets us directly derive different measures of elasticity from the coefficients of the estimated production and cost functions. The use of foreign labour is shown to affect the industry composition in favour of low skill intensive sectors and the estimated cross demand elasticities confirm the complementarity between migrant and native workers found in previous studies. However, the two labour inputs prove to be substitutes in terms of the Morishima elasticity of substitution: in general, firms tend to increase the foreign labour intensity of production in response to a decline in migrants' wage, while the migrant to domestic labour ratio responds to changes in the domestic workers' wage only for firms in low skill intensive sectors. [ABSTRACT FROM AUTHOR]

We provide evidence on the firm level productivity effects of imports of intermediates. By exploiting a large panel of Italian manufacturing firms, we are able to separately explore the role of importing from high and low income countries. Importing does not permanently affect the firm productivity growth. This finding holds both when we test for the import entry by means of Propensity Score Matching techniques and when we analyse the import intensity within a dynamic panel data model framework. On the contrary, we confirm the existence of self-selection into importing. Also, our evidence supports the learning-by-exporting effects in Italian manufacturing and we prove that this result is robust to the control of firm import activity. [ABSTRACT FROM AUTHOR]

Objective: to evaluate the performance of the 4 ‘A’s Test (4AT) in screening for delirium in older patients. The 4AT is a new test for rapid screening of delirium in routine clinical practice.Design: prospective study of consecutively admitted elderly patients with independent 4AT and reference standard assessments.Setting: an acute geriatrics ward and a department of rehabilitation.Participants: two hundred and thirty-six patients (aged ≥70 years) consecutively admitted over a period of 4 months.Measurements: in each centre, the 4AT was administered by a geriatrician to eligible patients within 24 h of admission. Reference standard delirium diagnosis (DSM-IV-TR criteria) was obtained within 30 min by a different geriatrician who was blind to the 4AT score. The presence of dementia was assessed using the Alzheimer's Questionnaire and the informant section of the Clinical Dementia Rating scale. The main outcome measure was the accuracy of the 4AT in diagnosing delirium.Results: patients were 83.9 ± 6.1 years old, and the majority were women (64%). Delirium was detected in 12.3% (n = 29), dementia in 31.2% (n = 74) and a combination of both in 7.2% (n = 17). The 4AT had a sensitivity of 89.7% and specificity 84.1% for delirium. The areas under the receiver operating characteristic curves for delirium diagnosis were 0.93 in the whole population, 0.92 in patients without dementia and 0.89 in patients with dementia.Conclusions: the 4AT is a sensitive and specific method of screening for delirium in hospitalised older people. Its brevity and simplicity support its use in routine clinical practice. [ABSTRACT FROM AUTHOR]

In this study we compare three gridded observed datasets of daily precipitation (EOBS, MAP and NWIOI) over the Great Alpine Region (GAR) and a subregion in northwest Italy (NWI) in order to better understand the past variability of daily climate extremes and to set up a basis for developing regional climate scenarios. The grids are first compared with respect to their temporal similarity by calculating the correlation and relative mean absolute error of the time series. They are then compared with respect to their spatial similarity to the climatology of the ETCCDI indices (characterizing total precipitation, dry and wet spells and extremes with short return periods). The results indicate first that most EOBS gridpoint series in northeastern Italy have to be shifted back by 1 day to have maximum overlap of the measurement period and, second, that both the temporal and spatial similarities of most indices are higher between the NWIOI and MAP than between MAP or the NWIOI and EOBS. These results suggest that, although there is generally good temporal agreement between the three datasets, EOBS should be treated with caution, especially for extreme indices over the GAR region, and it does not provide reliable climatology over the NWI region. The high agreement between MAP and NWIOI, on the other hand, builds confidence in using these datasets. Users should consider carefully the limitations of the gridded observations available: the uncertainties of the observed datasets cannot be neglected in the overall uncertainties cascade that characterizes climate change studies. [ABSTRACT FROM AUTHOR]