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Multiple-choice questions (MCQs) are widely used in educational assessments and professional certification exams. Managing large repositories of MCQs, however, poses several challenges due to the high volume of questions and the need to maintain their quality and relevance over time. One of these challenges is the presence of questions that duplicate concepts but are formulated differently. Such questions can indeed elude syntactic controls but provide no added value to the repository. In this paper, we focus on this specific challenge and propose a workflow for the discovery and management of potential duplicate questions in large MCQ repositories. Overall, the workflow comprises three main steps: MCQ preprocessing, similarity computation, and finally a graph-based exploration and analysis of the obtained similarity values. For the preprocessing phase, we consider three main strategies: (i) removing the list of candidate answers from each question, (ii) augmenting each question with the correct answer, or (iii) augmenting each question with all candidate answers. Then, we use deep learning-based natural language processing (NLP) techniques, based on the Transformers architecture, to compute similarities between MCQs based on semantics. Finally, we propose a new approach to graph exploration based on graph communities to analyze the similarities and relationships between MCQs in the graph. We illustrate the approach with a case study of the Competenze Digitali program, a large-scale assessment project by the Italian government.

In light of the recent interest in mathematical competencies and the ways in which students communicate their ideas, this study aims to explore how undergraduate students communicate their ideas about mathematical tasks through written texts. Forty-three first-year undergraduate students participated in this study. They were given a graph of a function and tangent line and were asked to estimate the value of the derivative at the tangent point justifying their answer. We analyzed the justification of students to the given task by referring to the cooperative principle and to the Anthropological Theory of the Didactic. For the former, we employed the four Grice maxims: Quantity, Quality, Relation and Manner. For the latter, we employed the main components of praxeologies: the type of task, the technique needed to solve the task, the technology as knowledge needed to explain the technique, and a theory as basis to justify the technology. A model of the students' communication about mathematical ideas emerges and is described with reference to data analysis. The model sheds light on the relationship between the discourse of a student solving a mathematical task and how she performs the related problem-solving activity.

In 2020, the emergency due to the COVID-19 pandemic brought a drastic and sudden change in teaching practices, from the physical space of the classrooms to the virtual space of an e-environment. In this paper, through a qualitative analysis of 44 collected essays composed by Italian mathematics teachers from primary school to undergraduate level during the spring of 2020, we investigate how the Italian teachers perceived the changes due to the unexpected transition from a face-to-face setting to distance education. The analysis is carried out through a double theoretical lens, one concerning the whole didactic system where the knowledge at stake is mathematics and the other regarding affective aspects. The integration of the two theoretical perspectives allows us to identify key elements and their relations in the teachers' narratives and to analyze how teachers have experienced and perceived the dramatic, drastic, and sudden change. The analysis shows the process going from the disruption of the educational setting to the teachers' discovery of key aspects of the didactic system including the teacher's roles, a reflection on mathematics and its teaching, and the attempt to reconstruct the didactic system in a new way.

In this paper we analyse the role of the teacher in a Digital interactive Storytelling in Mathematics (DiST-M) activity. involved in the story as a character (the Guru, a math expert), the teacher acts as a mediator in students' problem-solving process. We analyse how the teacher may orchestrate the mathematical discussions to allow students achieve the foreseen educational objectives. We also investigate how to exploit technology to support this activity and increase the reach of her educational interventions by means of an 'augmented reality dashboard' arising from the collection of data from all students' social interactions.

This paper concerns the design of a specific computer-based educational environment fostering students' shift from argumentation to proof in geometry. In particular, we focus on the language difficulties that such a shift might present and on the need for suitable interventions to overcome them. In this respect, we designed a specific device, named Digital Toolkit for Proof (DTP), based on the use of suitable digital tiles, to promote the transition from colloquial register to literate register, used in mathematical communication. We discuss the findings of the experimentation in valving 14-15 years old students from high school who conjecture and prove within the designed environment. The analysis presented shows how the DTP device can promote the emergence of new formulation of justifications that make explicit references to geometric theory. However, the DTP device also shows the occurrence of new specific language issues highlighting difficulties hidden by the use of the colloquial register.

Most researchers have assessed cognitive functions in post-COVID-19 patients by means of screening tools and found cognitive sequelae in addition to anxiety, stress, depression, and a reduced quality of life (QoL). This study was aimed at investigating cognitive and psychological sequelae in patients admitted to the intensive care unit (ICU) six months (t6) and one year (t12) after discharge from the hospital, the impact of critical illness on well-being and QoL, and the protective role of cognitive reserve (CR). Twenty-three ICU patients underwent an extensive neuropsychological test battery at t6 and t12; a healthy control group underwent the same evaluation. Patient scores were compared with control scores: patients reported significantly lower scores in visual–spatial functions, both at t6 (U = 122; p = 0.033) and at t12 (U = 70; p = 0.003), and higher levels of anxiety (U = 126; p = 0.043) and depression (U = 97; p = 0.005) at t6; the levels of anxiety decreased at t12, while only depression symptoms persisted (U = 99.5; p = 0.025). Regarding the QoL, patients obtained lower scores in the physical component of QoL, both at t6 (U = 72; p = 0.008) and at t12 (U = 56.5; p = 0.005). Few and moderate correlations emerged between isolated cognitive functions and CR and the length of hospital stay. The results suggest a prevalent visual–spatial involvement, the medium- and long-term persistence of psychological sequelae, and a reduced QoL in ICU patients. [ABSTRACT FROM AUTHOR]

On 20 May 2012, an Mw 5.8 earthquake, followed by an Mw 5.6 event nine days later, struck the Emilia-Romagna region in northern Italy, causing substantial damage and loss of life. Post-mainshock, several water-related phenomena were observed, such as changes in the groundwater levels in wells, the expulsion of sand–water mixtures, and widespread liquefaction evidence such as sand boils and water leaks from cracks. We analyzed the Earth's surface displacement during and after the Emilia 2012 seismic sequence using synthetic aperture radar images from the COSMO-SkyMed satellite constellation. This analysis revealed post-seismic ground subsidence between the Sant'Agostino and Mirabello villages. Specifically, the displacement time series showed a slight initial uplift followed by rapid subsidence over approximately four to five months. This widespread ground displacement pattern likely stemmed from the extensive liquefaction of saturated sandy layers at depth. This phenomenon typically induces immediate post-seismic subsidence. However, the observed asymptotic subsidence, reaching about 2.1 cm, suggested a time-dependent process related to post-liquefaction consolidation. To test this hypothesis, we analytically estimated the consolidation subsidence resulting from earthquake-induced excess pore pressure dissipation in the layered soil deposits. The simulated subsidence matched the observed data, further validating the significant role of excess pore pressure dissipation induced by earthquake loading in post-seismic ground subsidence. [ABSTRACT FROM AUTHOR]

Simple Summary: In clinical trials, ibrutinib was found to be effective and well-tolerated in patients with chronic lymphocytic leukemia (CLL). To confirm these findings, data on unselected patients treated in clinical practice are necessary. The aim of our observational, prospective Italian cohort study was to describe the real-world persistence rate, patterns of use, and clinical outcomes in patients with CLL treated with single-agent ibrutinib across various treatment lines. We found that, despite the high burden of patient comorbidities and unfavorable genetic features, the majority of patients (217/309, 70%), especially those treated in first line (75%), continued ibrutinib treatment for ≥2 years. The most common reasons for treatment discontinuation were adverse events, primarily infections. We reported positive clinical and survival outcomes, especially in the first-line cohort, and a safety profile consistent with clinical trial data. Our data suggest that ibrutinib is a valuable option for both treatment-naïve and previously treated patients with CLL. Real-world data in clinical practice are needed to confirm the efficacy and safety that ibrutinib has demonstrated in clinical trials of patients with chronic lymphocytic leukemia (CLL). We described the real-world persistence rate, patterns of use, and clinical outcomes in 309 patients with CLL receiving single-agent ibrutinib in first line (1L, n = 118), 2L (n = 127) and ≥3L (n = 64) in the prospective, real-world, Italian EVIdeNCE study. After a median follow-up of 23.9 months, 29.8% of patients discontinued ibrutinib (1L: 24.6%, 2L: 29.9%, ≥3L: 39.1%), mainly owing to adverse events (AEs)/toxicity (14.2%). The most common AEs leading to discontinuation were infections (1L, ≥3L) and cardiac events (2L). The 2-year retention rate was 70.2% in the whole cohort (1L: 75.4%, 2L: 70.1%, ≥3L: 60.9%). The 2-year PFS and OS were, respectively, 85.4% and 91.7% in 1L, 80.0% and 86.2% in 2L, and 70.1% and 80.0% in ≥3L. Cardiovascular conditions did not impact patients' clinical outcomes. The most common AEs were infections (30.7%), bleeding (12.9%), fatigue (10.0%), and neutropenia (9.7%), while grade 3–4 atrial fibrillation occurred in 3.9% of patients. No new safety signals were detected. These results strongly support ibrutinib as a valuable treatment option for CLL. [ABSTRACT FROM AUTHOR]

Background: Our aim was to understand how musculoskeletal training is structured in Italian residency programmes and the needs of young trainees. Methods: We sent out an online questionnaire (17 questions) to Italian Society of Radiology residents and board-certified radiologists aged up to 39 years. Results: A total of 1144 out of 4210 (27.2%) members participated in the survey; 64.7% were residents and 35.3% were board-certified radiologists. Just 26.6% of participants had dedicated rotations for musculoskeletal training during their residency, although this percentage substantially increased in replies from northern Italy. One-fourth of residents had a scheduled period of musculoskeletal ultrasound. Most participants (76.3%) had <20 h per year of musculoskeletal lessons. The majority considered their musculoskeletal education poor (57.7%) or average (21.9%). According to 84.8% of replies, no dedicated training period about interventional musculoskeletal procedures was scheduled. Further, just 12.8% of residents took active part in such interventions. Nearly all participants believed that the musculoskeletal programme during residency needs to be improved, particularly concerning practices in ultrasound (92.8%), MRI cases interpretation/reporting (78.9%), and practice in ultrasound-guided interventional procedures (64.3%). Conclusions: Despite some differences in the structure of musculoskeletal education provided by different regions, there is a shared demand for improvement in musculoskeletal training. [ABSTRACT FROM AUTHOR]

Rhodoliths, formed by free‐living coralline algae, are distributed worldwide, and the rhodolith beds (RBs) that they form are recognized as structurally complex habitats. In the Mediterranean, they are generally distributed in the mesophotic zone, at depths of 30–100 m; so far, only a few shallow RBs (<2 m) have been reported (e.g. Îles Kuriat, Tunisia, and Stagnone Marsala, Italy).Here a shallow‐water RB located in the Mar Piccolo of Taranto (south‐eastern Italy, Mediterranean Sea) is described. The diversity of associated invertebrates, the rhodolith‐forming algal species, the type of sediments, and the bed extent are characterized.The RB investigated extends over 5 ha at depths of 0.5–1.5 m. The rhodoliths vary in shape and size, from pralines to large spherical structures, and are formed by a single species, Neogoniolithon brassica‐florida, growing around nuclei of both natural and anthropogenic origin. The associated fauna consisted of 158 taxa, 79 (50%) of which were new basin records. The associated diversity was approximately twice that of the underlying and nearby sediments.The structural complexity of the RBs promotes biodiversity and provides shelter, food, and a breeding ground for numerous species, including seahorses, which are a conservation priority in this basin. [ABSTRACT FROM AUTHOR]

Asylum-seeking migrants represent a vulnerable segment of the population, and among them, women constitute an even more vulnerable group. Most of these women and girls have been exposed to threats, coercion, and violence of many kinds, including rape, forced prostitution, harassment, sexual slavery, forced marriage and pregnancy, female genital mutilation/excision, and/or other violations of their rights (e.g., deprivation of education, prohibition to work, etc.). The perpetrators of the violence from which they flee are often their own families, partners, and even institutional figures who should be in charge of their protection (such as police officers). In the process for the acceptance/rejection of an asylum application, the forensic and psychological certification can make the difference between successful and unsuccessful applications, as it can support the credibility of the asylum seeker through an assessment of the degree of compatibility between the story told and the diagnostic and forensic evidence. This is why constant and renewed reflection on the ethical, forensic, and methodological issues surrounding medico-legal and psychological certification is essential. This article aims to propose some reflections on these issues, starting from the experience of the inward healthcare service dedicated to Migrant Victims of Maltreatment, Torture, and Female Genital Mutilation operating since 2018 at the Institute of Forensic Medicine of the University Hospital of Palermo. [ABSTRACT FROM AUTHOR]

Background: the deficiency of 5,10-Methylenetetrahydrofolate reductase (MTHFR) constitutes a rare and severe metabolic disease and is included in most expanded newborn screening (NBS) programs worldwide. Patients with severe MTHFR deficiency develop neurological disorders and premature vascular disease. Timely diagnosis through NBS allows early treatment, resulting in improved outcomes. Methods: we report the diagnostic yield of genetic testing for MTHFR deficiency diagnosis, in a reference Centre of Southern Italy between 2017 and 2022. MTHFR deficiency was suspected in four newborns showing hypomethioninemia and hyperhomocysteinemia; otherwise, one patient born in pre-screening era showed clinical symptoms and laboratory signs that prompted to perform genetic testing for MTHFR deficiency. Results: molecular analysis of the MTHFR gene revealed a genotype compatible with MTHFR deficiency in two NBS-positive newborns and in the symptomatic patient. This allowed for promptly beginning the adequate metabolic therapy. Conclusions: our results strongly support the need for genetic testing to quickly support the definitive diagnosis of MTHFR deficiency and start therapy. Furthermore, our study extends knowledge of the molecular epidemiology of MTHFR deficiency by identifying a novel mutation in the MTHFR gene. [ABSTRACT FROM AUTHOR]

Clostridioides difficile infection (CDI) is a significant cause of morbidity and mortality, mostly in frail patients. Notification is not mandatory in Italy, and data on incidence, risk of death, and recurrence are lacking. The purpose of this study was to determine CDI incidence and risk factors for mortality and recurrence. The "ICD-9 00845" code in hospital-standardized discharged forms (H-SDF) and microbiology datasets were used to retrieve CDI cases at Policlinico Hospital, Palermo between 2013 and 2022. Incidence, ward distribution, recurrence rate, mortality, and coding rate were considered. The risk of death and recurrence was predicted through multivariable analysis. There were 275 CDIs, 75% hospital-acquired, the median time between admission and diagnosis was 13 days, and the median stay was 21 days. Incidence increased from 0.3 to 5.6% (an 18.7-fold increase) throughout the decade. Only 48.1% of cases were coded in H-SDF. The rate of severe/severe-complicated cases increased 1.9 times. Fidaxomicin was used in 17.1% and 24.7% of cases overall and since 2019. Overall and attributable mortalities were 11.3% and 4.7%, respectively. Median time between diagnosis and death was 11 days, and recurrence rate was 4%. Bezlotoxumab was administered in 64% of recurrences. Multivariable analysis revealed that only hemodialysis was associated with mortality. No statistically significant association in predicting recurrence risk emerged. We advocate for CDI notification to become mandatory and recommend coding CDI diagnosis in H-SDF to aid in infection rate monitoring. Maximum attention should be paid to preventing people on hemodialysis from getting CDI. [ABSTRACT FROM AUTHOR]

Little is known about the behavior of preschool children belonging to peer sociometric status groups (popular, average, rejected, neglected, and controversial) in cultural contexts outside North America. This study examined the social interactions of Italian preschoolers. The sample consisted of 266 Italian preschoolers (mean age of 64 months). Physical and relational subtypes of aggression and victimization, as well as sociable behavior, were measured by peer nominations and teacher ratings. Peer nominations of acceptance and rejection (like and dislike nominations) were also collected in order to form the sociometric status groups. Results of confirmatory factor analyses showed that items developed with US preschoolers appeared to work fairly well in identifying behavioral constructs in Italian preschoolers. Findings generally supported previous research with American preschoolers. Sociometrically popular children were highest in sociability, and lowest in physical and relational aggression and victimization. The opposite pattern emerged for rejected status children. Neglected status children were generally not distinguished from average status children. Results also suggested that the enactment of relational aggression promotes greater social impact for some Italian children (controversial children), and this aggression also invites more conflict and victimization. However, the sociability of controversial children appears to buffer them from rejected group status.

Simple Summary: We investigated the role of mullet as a biological tag to evaluate environmental status, mainly in a specific and circumscribed area, between March and June 2021, by conducting a survey of 150 mullet caught from Ganzirri Lagoon (Messina, Sicily, Italy), in order to describe the helminth fauna. All retrieved parasite specimens were investigated by morphological and molecular analysis. Morphological evaluation allowed us to describe the Acanthocephalan Neoechinorhynchus agilis; however, identification of the digenean trematode Haploporus benedeni was only possible using molecular analysis. None of the parasite species isolated in the present study presents a risk to human health. Mullets (Osteichthyes: Mugilidae) are a euryhaline species widely distributed all over the world, thus representing an excellent study model for host–parasite interactions. From March to June 2022, 150 mullets, belonging to Chelon labrosus (n = 99), Chelon auratus (n = 37), and Oedalechilus labeo (n = 14) species, were caught to identify the helminth parasite fauna of the different mullet species present in the Ganzirri Lagoon (Messina, Sicily, Italy). A parasitological evaluation of the gastrointestinal tract (GIT) was carried out with a total worm count technique (TWC) to detect helminth presence. All collected parasites were stored in 70% ethanol until morphological evaluation, and frozen at −80 °C for subsequent molecular analysis, using 28S, ITS-2, 18S primers. The morphological evaluation allowed for the identification Acanthocephalan parasites (Neoechinorhynchus agilis) from two C. labrosus specimens. Sixty-six samples were positive for adult digenean trematodes (C. labrosus, 49.5 %; C. auratus, 27%, and O. labeo, 50%), molecularly identified as Haploporus benedeni. This study represents the first survey of helminthic parasite fauna of mullets from the south of Italy. The presence of Hydrobia sp. in the stomach contents of mullets allowed us to infer the H. benedeni life cycle in the Ganzirri lagoon. [ABSTRACT FROM AUTHOR]

Residences for elderly and sick people, self-sufficient or dependent, are varied. To date, the liability profiles of these structures are not clearly delineated, and increasingly often, their operating and organization criteria are entrusted to subnational, regional, or local regulations. Among the various deficits, there is the keeping of a complete and detailed documentation/diary of the patient, the lack of which can generate medico-legal problems. In this paper, we present three cases of guests in residences for a dependent person brought to the attention of the Institute of Forensic Medicine of the University Hospital of Palermo due to criminal proceedings, where the lack of existing documentation in the structure and, in some cases, the behavior of the professionals working there, led the evaluator to deduce the organization's culpability. [ABSTRACT FROM AUTHOR]

Objective: The aim of this study was to examine the processes involved in a guided self‐help (GSH) pre‐treatment intervention (RecoveryMANTRA) for patients with anorexia nervosa (AN), by measuring the levels of patient/mentor Language Style Matching (LSM). RecoveryMANTRA was supported by student mentors or peer mentors (recovered individuals) over six weekly chat‐based sessions. We examined whether LSM during RecoveryMANTRA predicted patients'working alliance with the clinic therapist, motivation, eating disorder (ED) and general psychopathology. A further aim was to examine differences in LSM between student mentors and peer mentors. Method: 87 AN adults received RecoveryMANTRA plus treatment as usual. The LSM algorithm was used to calculate verbal attunement between patient and mentor. Participants were assessed at baseline and at the end of the intervention. Results: Both early (1st session) and late (6th session) LSM predicted higher working alliance with the clinic therapist. Moreover, late LSM predicted lower EDs symptoms at the end of the RecoveryMANTRA intervention. Patient/peer mentor dyads showed higher late verbal attunement than patient/student mentor dyads. Conclusions: These findings suggests that in the early phase of treatment relational aspects can impact on engagement with treatment. Verbal attunement in a GSH for AN is associated with working alliance and better clinical outcome. Highlights: Language Style Matching (LSM) between patients and mentors in both the early and late phase of the RecoveryMANTRA intervention predicted higher working alliance with the clinic therapist.LSM in the last phase (6th session) was associated with lower eating disorders (EDs) symptoms at the end of the RecoveryMANTRA intervention.Patients/peer mentors dyads showed higher late LSM than patients/student mentors dyads. [ABSTRACT FROM AUTHOR]

Ravines are typical morphological elements of the landscape of central Apulia and south-east Basilicata, in south Italy. These are deep narrow valleys located at the south-west bound of the Apulian foreland, namely Murgia. Ravines mainly carve the poorly cemented Plio-Pleistocenic sandy levels, belonging to the unit of the Gravina Calcarenites and the underlying cretaceous limestone of Murgia platform. In particular, the upper levels of ravine flanks show collapses and fractures, which alter the landscape of ravines. This work focuses on the geometric reconstruction of the fractures and collapses on the calcarenitic levels of the east flank of the ravine of Matera. This shows a number of fractures, some of them are very recent, which are modifying the flanks, damaging the archeological heritage and precluding the access to the ravine. Therefore, identifying the open fractures and their potential triggers is important for planning a strategy of preservation of this peculiar landscape. [ABSTRACT FROM AUTHOR]

Juvenile idiopathic arthritis (JIA) is a chronic inflammatory disease common in children and young adults. Uveitis is the most frequent serious extra-articular JIA manifestation and can lead to severe ocular complications, vision loss, and permanent blindness. This study aims to evaluate the psychological condition and the quality of life of children affected by JIA associated with uveitis (JIA-U) and the repercussion of this condition on parents. Thirty children and adolescents with active uveitis (Uveitis group) and comorbid joint symptoms of JIA were referred to the Unit of Ophthalmology, Giovanni XXIII Hospital of Bari, and 30 age-matched healthy controls (Healthy group) were enrolled with their parents. Four questionnaires were administered: Child Behaviour Checklist (CBCL), Parent Stress Index in Short Form (PSI), Pediatric Quality of Life Inventory (PedsQL), and Coping Inventory for Stressful Situations (CISS). The data were collected from February 2021 to December 2021. No significant differences between the two groups in CBCL, PSI, or CISS tests were shown (p > 0.05). Conversely, significant differences between the two groups were observed in the PedsQL (p < 0.05). This study shows how several ocular complications, recurrent eye examinations, and the rigor of long-term treatment may negatively influence health-related quality of life in children with JIA-U. [ABSTRACT FROM AUTHOR]

In the summer of 2019, DiaSorin Molecular started designing a multiplex respiratory panel with pan-coronavirus detection as one of the planned targets. The R&D team in Gerenzano, Italy was already searching databases, performing alignments and assessing preliminary target regions for common coronavirus RT-PCR, including SARS and MERS-CoV. In December 2019, we were vigilant and following a cluster of pneumonia cases with undetermined etiology in Wuhan, China. As we now know, the cause of the respiratory infections was the new SARS-CoV-2 virus. DiaSorin Molecular swiftly responded in line with our heritage and company history in detecting emerging infectious diseases. Early in the pandemic and in record time, using research and development teams in both Italy and the U.S. together with the U.S. manufacturing team, we were able to develop and commercialize a new diagnostic test, Simplexa™ COVID-19 Direct, to detect SARS-CoV-2. Our unique platform allowed development of a rapid diagnostic test without the need for extraction reagents. Challenges with control materials, quarantines, clinical samples, raw materials and production were overcome and the entire company worked side by side for accelerated delivery of this assay to clinical labs in Europe, the U.S. and Canada. [ABSTRACT FROM AUTHOR]

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]

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In this paper, Mixed Reality (MR) has been exploited in the operating rooms to perform laparoscopic and open surgery with the aim of providing remote mentoring to the medical doctors under training during the Covid-19 pandemic. The employed architecture, which has put together MR smartglasses, a Digital Imaging Player, and a Mixed Reality Toolkit, has been used for cancer surgery at the IRCCS Hospital 'Giovanni Paolo II' in southern Italy. The feasibility of using the conceived platform for real-time remote mentoring has been assessed on the basis of surveys distributed to the trainees after each surgery. [ABSTRACT FROM AUTHOR]

Background: Cutaneous squamous cell carcinoma (CSCC) is the second most common skin cancer whose incidence is growing parallel to the lengthening of the average lifespan. Cemiplimab, an antiPD-1 monoclonal antibody, is the first approved immunotherapy for patients with locally advanced CSCC (laCSCC) or metastatic CSCC (mCSCC) thanks to phase I and II studies showing high antitumor activity and good tolerability. Nevertheless, at present, very few data are available regarding cemiplimab in real-life experience and in frail, elderly, and immunosuppressed patients as well as regarding biomarkers able to predict response so as to guide therapeutic choices. Patients and Methods: We built a retroprospective cohort study including 30 non-selected patients with laCSCC (25) and mCSCC (five) treated with cemiplimab from August 2019 to November 2020. Clinical outcomes, toxicity profile, and correlations with disease, patients, and peripheral blood parameters are explored. Results: The median age was 81 years (range, 36–95), with 24 males and five patients having an immunosuppressive condition, while the frailty prevalence was 83% based on index derived from age, Eastern Cooperative Oncology Group performance status, and Charlson Comorbidity Index. We reported 23 responses (76.7%) with nine complete responses (30%). A statistically significant higher response rate was observed in head and neck primary tumors and in patients with hemoglobin level >12 g/dl. No difference was observed with respect to frailty, median age, sex, and body mass index. The baseline low neuthophil/lymphocyte ratio and low platelet/lymphocyte ratio resulted to be also correlated with a better response. Moreover, lymphocyte, neutrophil, and monocyte behaviors had an opposite trend in responders and non-responders. An overall response was reported in four of five immunosuppressed patients. Seventeen patients (57.6%) have an ongoing response and are still alive. Six responders had interrupted treatment (two for toxicity and four for personal choice) but maintained their response. The treatment was well tolerated by the majority of patients. The most common adverse events were fatigue in seven patients (23.3%) and skin toxicity in 10 patients (33.3%), including pruritus in six patients, rash in three patients, and bullous erythema in one patient. Conclusions: In our real-life experience, cemiplimab showed a high antitumor activity with acceptable safety profile similar to those in trials with selected patients. Moreover, its antitumor activity resulted to be not impaired in very elderly patients and in those with immunocompromised status. [ABSTRACT FROM AUTHOR]

The COVID-19 outbreak is having a profound impact on individuals' psychological and physical wellbeing. The aim of this study was to assess the extent of this impact and its mechanisms on a sample of adults living in Italy during the first lockdown (April–May 2020). Two hundred ninety-two individuals (67.1% females) were recruited from the community through social media. They completed baseline online questionnaires to collect demographic information, data on past and present general health and health behaviours, and to assess emotion regulation strategies. Participants completed a brief survey to assess mood and health behaviours three times a week, for three weeks. Individuals with lifetime psychiatric disorders (about 50%) reported greater negative mood and use of unhealthy behaviours over time, compared to those with no psychiatric vulnerability. The use of cognitive reappraisal to regulate emotions was associated with greater resilience (i.e., feelings of hope and resourcefulness, and ability to seek social support and enjoyable activities). Cognitive reappraisal is a skill that can be trained and could be utilised to buffer the effect of general stress (i.e. stress caused by the pandemic) on individuals' wellbeing. [ABSTRACT FROM AUTHOR]

To understand how COVID-19 pandemic has changed radiology research in Italy. A questionnaire (n = 19 questions) was sent to all members of the Italian Society of Radiology two months after the first Italian national lockdown was lifted. A total of 327 Italian radiologists took part in the survey (mean age: 49 ± 12 years). After national lockdown, the working-flow came back to normal in the vast majority of cases (285/327, 87.2%). Participants reported that a total of 462 radiological trials were recruiting patients at their institutions prior to COVID-19 outbreak, of which 332 (71.9%) were stopped during the emergency. On the other hand, 252 radiological trials have been started during the pandemic, of which 156 were non-COVID-19 trials (61.9%) and 96 were focused on COVID-19 patients (38.2%). The majority of radiologists surveyed (61.5%) do not conduct research. Of the radiologists who carried on research activities, participants reported a significant increase of the number of hours per week spent for research purposes during national lockdown (mean 4.5 ± 8.9 h during lockdown vs. 3.3 ± 6.8 h before lockdown; p =.046), followed by a significant drop after the lockdown was lifted (3.2 ± 6.5 h per week, p =.035). During national lockdown, 15.6% of participants started new review articles and completed old papers, 14.1% completed old works, and 8.9% started new review articles. Ninety-six surveyed radiologists (29.3%) declared to have submitted at least one article during COVID-19 emergency. This study shows the need to support radiology research in challenging scenarios like COVID-19 emergency. • COVID-19 outbreak drastically impacted on Italian radiological research. • Most ongoing radiological trials have been stopped during the first national lockdown. • Italian radiologists spent even more time on radiology research during the lockdown. • Many COVID-19 and non-COVID-19 trials have been pushed forward during the lockdown. [ABSTRACT FROM AUTHOR]

The preparation, initiation and occurrence dynamics of earthquakes in Italy are governed by several frequently unknown physical mechanisms and parameters. Understanding these mechanisms is crucial for developing new techniques and approaches for earthquake monitoring and hazard assessments. Here, we develop a first-order numerical model simulating quasi-static crustal interseismic loading, coseismic brittle episodic dislocation and post-seismic relaxation for extensional and compressional earthquakes in Italy based on a common framework of lithostatic and tectonic forces. Our model includes an upper crust, where the fault is locked, and a deep crust, where the fault experiences steady shear. The results indicate that during the interseismic phase, the contrasting behaviour between the upper locked fault segment and lower creeping fault segment generates a stretched volume at depth in the hangingwall via extensional tectonics while a contracted volume forms via compressional tectonics. The interseismic stress and strain gradients invert at the coseismic stage, with the interseismic dilated volume contracting during the coseismic stage, and vice versa. Moreover, interseismic stress gradients promote coseismic gravitational subsidence of the hangingwall for normal fault earthquakes and elastic uplift for reverse fault earthquakes. Finally, the post-seismic relaxation is characterized by further ground subsidence and uplift for normal and reverse faulting earthquakes, respectively, which is consistent with the faulting style. The fault is the passive feature, with slipping generating the seismic waves, whereas the energy activating the movement is stored mostly in the hangingwall volume. The main source of energy for normal faulting and thrust is provided by the lithostatic load and elastic load, respectively. [ABSTRACT FROM AUTHOR]

The warning by the Italian Medicines Agency on the high shortage of azithromycin in the country in January 2022 represents a paradigmatic lesson learnt from improper use of antibiotics during COVID-19 pandemic. [ABSTRACT FROM AUTHOR]

Summary: We report the impact of the COVID-19 pandemic on bone densitometry practice in a Northern Italy Orthopedic Hospital, comparing the first 4 months of 2020 with the corresponding period of 2019. COVID-19 pandemic had a disruptive effect on the daily practice of bone densitometry (about − 50% of examinations). Introduction: The Coronavirus Disease 2019 (COVID-19) pandemic radically changes hospital organization to guarantee patient and staff safety, with the unavoidable cessation of normal outpatient activities. We report the impact of the COVID-19 pandemic on dual energy x-ray absorptiometry (DXA) testing in a Northern Italy Orthopedic Hospital. Methods: We analyzed the number of DXA examinations performed at our Institution before, during the lockdown, and immediately after outpatient practice reopening (January 24th to May 27th, 2020), comparing them with the corresponding period of 2019. Results: The number of DXA examinations showed a tremendous reduction from n = 1247 performed from January to May 2019 to n = 623 of 2020 (− 49.9%). No exams were performed in April 2020 (− 100%). On May 2020, a faint resume was observed, with n = 43 DXA (− 84.4% compared to 2019). Conclusion: COVID-19 pandemic had a disruptive effect on the daily practice of bone densitometry with DXA. After reopening, we observed a persistence of DXA examination reduction, confirming the fact that returning to normality will probably be a slow process. [ABSTRACT FROM AUTHOR]

Since previous evidence suggested a risky alcohol consumption among healthcare workers (HCW), this study aimed to investigate the patterns of alcohol use in a sample of HCWs in Italy, through the Alcohol Use Disorders Identification Test Consumption (AUDIT-C). Overall, 639 HCWs participated in the study. 43.8% of them reported a score of 0 at AUDIT-C test. Drinkers were divided into "low-risk" and "at-/high-risk," being respectively the 47.1% and 9.1% of the whole sample. There were significant differences between abstainers and drinkers, and between low-risk and at-/high-risk drinkers. In the multivariate logistic regression model, being younger, male, and physicians was associated with the profile of regular alcohol drinkers. A high risk AUDIT-C score was more likely in older and female HCWs. Briefly, this study confirmed the hypothesis of a risky level of drinking in HCWs. Educational preventive measures should be implemented to reduce alcohol consumption in this population. [ABSTRACT FROM AUTHOR]

Background: Merkel-cell carcinoma (MCC) is a rare, highly aggressive skin cancer typically involving elderly people. Surgery is usually the first treatment for primary tumor. In adjuvant setting, radiotherapy is effective in reducing local recurrence and in improving overall survival. Regarding advanced disease, systemic chemotherapy ended up disappointing results whereas antiPD1/antiPD-L1 immunotherapy recently gave relevant clinical benefits. Interestingly, about the half of MCC patients expresses high somatostatin receptors (SRs) to possibly represent a target for the therapeutic use of somatostatin analogs (SSAs). Nevertheless, SSAs have been little studied in MCC and cases treated with SSAs in association with checkpoint inhibitor immunotherapy have not been published yet. Case Report: We report the case of a 73-year-old man affected by metastatic MCC of right arm previously treated with surgery and adjuvant radio and chemotherapy. Three years later the patient presented loco-regional relapse involving lateral-cervical, mediastinal, and submandibular lymph nodes with high value of chromogranin A and neuron specific enolase. Due to the high expression of SRs at octreoscan and immunoistochemistry, patient started octreotide 30 mg i.m. every 28 days with a good control of disease for about 2 years. A widespread progression of disease was reported afterwards. The patient started the antiPD-L1 avelumab immunotherapy, only recently available in Italy, while still taking SSA. The patient showed an impressive regression of the disease after only four cycles of avelumab until complete remission. Conclusions: SSA could be a valid therapeutic option in patients with MCC with high SR expression. When combined with PD-1/PD-L1 immune-checkpoint inhibition, SSA is likely to enhance antiproliferative activity. Our case report provides the rationale to conduct a prospective trial and translational research to verify the efficacy and safety of combined SSA and checkpoint inhibitors for advanced MCC. [ABSTRACT FROM AUTHOR]

Highlights • FloodRisk GIS freeware was used to analyse flood damages in flat urban areas with complex geometries. • An uncertainty analysis connected with historical damage data was conducted. • The influence of the model parameters on the uncertainty was quantified. • Damage functions are mainly responsible for uncertainty in the study. • Adding knowledge on local characteristics can considerably reduce the uncertainties. Abstract The considerable increase in flood damages in Europe in recent decades has shifted attention from flood protection to flood risk management. Assessments of expected damage provide critical information for flood risk management efforts. The evaluation of potential damages under different flood scenarios through quantification of their ability to provide relative short-, medium- and long-term risk reduction, supports decision-makers in discriminating among several alternative mitigation actions. End-users should be aware of, and knowledgeable about, the limitations and uncertainties of such analyses, as well-informed decisions regarding efficient and sustainable flood risk management will become increasingly relevant under future climate and socio-economic changes. In this context, a method was developed to identify and quantify the role of the input parameters in the uncertainty of the potential flood economic damage assessment in urban areas with low sloping/flat terrain and complex topography using a GIS-based, free and open-source software called Floodrisk. Sets of plausible input parameters for the model’s two flood loss modelling subroutines (hydraulic modelling and damage estimation) were dynamically combined to quantify the contribution of their inner parameters to the total damage assessment uncertainty. To estimate the contributions of each input to overall model uncertainty, the combination of input parameters that minimized the error in the spatial distribution assessment of the extensive damages affecting (downtown) Albenga (Italy), enumerated after the historical Centa River flood of November 5, 1994, was taken as a reference. In this specific case, a high epistemic uncertainty for the damage estimation module was noted for the specific type and form of the damage functions used. In the absence of region-specific depth-damage functions, the vulnerability curves were adapted from a range of geographic and socio-economic studies. Given the strong dependence of model uncertainty and sensitivity to local characteristics, the epistemic uncertainty associated with the risk estimate was reduced by introducing additional information into the risk analysis. Implementing newly developed site-specific curves and a more detailed classification of the construction typology of the buildings at risk, led to a substantial decrease in modelling uncertainty, along with a decrease in the sensitivity of the flood loss estimation to the uncertainty in the depth-damage function input parameter. These findings indicated the need to produce and openly disseminate data in order to develop micro-scale risk analysis through site-specific vulnerability curves. Moreover, this study highlighted the urgent need for research on the development and implementation of methods and models for the assimilation of uncertainties in decision-making processes. [ABSTRACT FROM AUTHOR]

Although Deep-Seated Gravitational Slope Deformations are well-known in the literature, their evolution and kinematics are still poorly understood. Their behavior is often complex and characterized by small movements associated with steady-state creep, alternating with periods of stasis, or accelerating downslope movements that, in some cases, could result in sudden and catastrophic failure events. Therefore, a multidisciplinary approach is often required. In this work, we shed light on the complex geometry and kinematics of the Pisciotta DSGSD, a deep-seated roto-translational sliding involving structurally complex turbiditic rock mass and interacting with man-made infrastructures. To reveal the geometrical features and the spatial and temporal behavior of the analyzed phenomenon, a multidisciplinary investigation was performed. Typical DSGSD landforms were mapped employing in-situ surveys, aided by stereoscopic analysis of historical aerial images and high-resolution drone-based mapping. Structural data and ancillary ground-based surveys revealed the presence of a highly weathered and folded turbiditic sequence, with competent sandstone and calcarenite units alternated by tectonically disrupted, weak argillite and mudrock layers. Remote sensing measurements from optical imagery and Synthetic Aperture Radar satellite data assessed the DSGSD's past and current kinematics, allowing to distinguish a pre-failure period with accelerating displacement rates, a failure period with maximum displacement rates, and a current post-failure period with decelerating displacement rates. Analytical modeling established the deep reach (up to 85 m) of the studied DSGSD as it allowed the estimation of its bottom surface and volume, as verified by available boreholes and inclinometric measurements. Furthermore, numerical modeling outcomes highlighted how the progressive weakening and alteration of the DSGSD material, in conjunction with changes in groundwater dynamics, serve as the primary mechanisms driving the observed kinematics. The models also revealed the intricate interaction between the DSGSD and the neighboring infrastructures. • Kinematic analysis of the Pisciotta Deep-Seated Gravitational Slope Deformation. • Airborne and satellite optical data identified its long-term displacements. • The interferometric analysis provided insights into its current short-term behavior. • Ground-based surveys validated the observations from remote-sensing data. • Analytical and numerical models unveiled its complex geometry and kinematics. [ABSTRACT FROM AUTHOR]

An updated inventory of the vascular flora alien to Italy, providing details on the occurrence at regional level, is presented. The checklist includes 1597 species, subspecies, and hybrids, distributed in 725 genera and 152 families; 2 taxa are lycophytes, 11 ferns and fern allies, 33 gymnosperms, and 1551 angiosperms. 157 taxa are archaeophytes and 1440 neophytes. The alien taxa currently established in Italy are 791 (570 naturalized and 221 invasive), while 705 taxa are casual aliens, 4 are not assessed, 7 are of unknown regional distribution, 47 have not been confirmed in recent times, 3 are considered extinct or possibly extinct in the country, and 40 are doubtfully occurring in Italy. This checklist allows to establish an up-to-date number (9792) of taxa constituting the whole (native and alien) Italian flora. [ABSTRACT FROM AUTHOR]

An updated inventory of the native vascular flora of Italy, providing details on the occurrence at regional level, is presented. The checklist includes 8195 taxa (6417 species and 1778 subspecies), distributed in 1092 genera and 152 families; 23 taxa are lycophytes, 108 ferns and fern allies, 30 gymnosperms and 8034 angiosperms. The taxa currently occurring in Italy are 7483, while 568 taxa have not been confirmed in recent times, 99 are doubtfully occurring in the country and 19 are data deficient. Out of the 568 not confirmed taxa, 26 are considered extinct or possibly extinct. [ABSTRACT FROM AUTHOR]

Extensive skin defect represents a real problem and major challenge in plastic and reconstructive surgery. On one hand, skin grafts offer a practical method to deal with skin defects despite their unsuitability for several complicated wounds. On the other hand, negative pressure wound therapy (NPWT), applied before skin grafting, promotes granulation tissue growth. The aim of the study is to evaluate the improvement in wound healing given by the merger of these two different approaches. We treated 23 patients for large wounds of multiple factors. Of these, 15 were treated with the application of V.A.C.® Therapy (KCI Medical S.r.l., Milan, Italy), in combination with skin grafts after a prior unsuccessful treatment of 4 weeks with mesh skin grafts and dressings. Another 8 were treated with only mesh skin graft. Pain reduction and wound area reduction were found statistically significant (p<0.0009, p<0.0001). Infection was resolved in almost all patients. According to our study, the use of the negative pressure wound therapy over mesh skin grafts is significantly effective especially in wounds resistant to conventional therapies, thereby improving the rate of skin graft take. [ABSTRACT FROM AUTHOR]

BACKGROUND The identification of novel plant-based functional foods or nutraceutical ingredients that possess bioactive properties with antioxidant function has recently become important to the food, nutraceutical and cosmetic industries. This study evaluates the polyphenolic composition, identifies bioactive compounds and assays the total antioxidant capacity of Prunus mahaleb L. fruits collected from different populations and sampling years in the countryside around Bari (Apulia Region, Italy). RESULTS We identified nine polyphenolic compounds including major anthocyanins, coumaric acid derivatives and flavonols from P. mahaleb fruits. The anthocyanin content (in some populations > 5 g kg−1 fresh weight; FW) in the fruit was comparable to that reported for so-called superfruits such as bilberries, chokeberries and blackcurrants. Coumaric acid derivatives comprised a large portion of the total polyphenolic content in the P. mahaleb fruits. Antioxidant activities, assessed using ORAC and TEAC assays, measured up to 150 and 45 mmol Trolox equivalents kg−1 FW, respectively. Therefore antioxidant capacity of P. mahaleb fruits is relatively high and comparable to that of superfruit varieties that are often used in commercial nutraceutical products. CONCLUSION Our findings suggest that mahaleb fruit (currently not consumed fresh or used in other ways) could serve as a source of bioactive compounds and therefore find interest from the functional food and nutraceutical industries, as a natural food colorant and antioxidant ingredient in the formulation of functional foods. © 2015 Society of Chemical Industry [ABSTRACT FROM AUTHOR]

Background To assess the knowledge, the attitudes, and the behaviour towards influenza A/H1N1 and the vaccination among health-care workers (HCWs). Methods A sample of HCWs was selected from a random sample of non-teaching public hospitals, located in the cities of Naples and Avellino (Italy), received a self-administered anonymous questionnaire including questions about socio-demographic characteristics, knowledge on modes of transmission and preventative measures, attitudes and behaviour relating to influenza A/H1N1. Results Only 36.1% correctly knew the main modes of transmission, and that HCWs are a risk category and this level of knowledge was significantly higher in HCWs having received information through scientific journals. A higher perceived risk of contracting influenza A/H1N1 has been observed in the HCWs more knowledgeable, in those considering influenza A/H1N1 a serious disease, and in those working in surgical wards. Only 16.7% have received the influenza A/H1N1 vaccination and HCWs with more fear of contracting influenza A/H1N1, those considering vaccine more useful and less dangerous were more likely to receive vaccine. Conclusions Education and communication strategies for improving the level of knowledge and for the immunization uptake regarding influenza A/H1N1 HCWs are strongly needed. [ABSTRACT FROM AUTHOR]

Campania (southern Italy) is a region characterized by a high volcanic risk because of its active volcanoes. Five years of continuous gravity observations obtained in the Neapolitan volcanic area have been analysed. The tidal analysis of the gravity records over more than 5 years has provided amplitudes and phases of the main waves of the gravity tide. The availability of such a tidal model is necessary to extract, from the gravity records, the signal possibly associated to volcanic sources. The gravity contribution of the Ocean Tide Load has been computed and removed from the recorded changes in order to obtain the amplitudes, the amplification factors δ and the phase shifts of the main waves of the tidal field. The DDW99/NH Earth's model well fits the obtained results. Small values of the tidal residual vectors have been obtained, indicating that no significant tidal anomaly is affecting the Neapolitan area despite the presence of two very close active volcanoes. The obtained results are compared with those already obtained in the Vesuvius and Phlegraean Fields areas. Moreover a clear seasonal contribution of the rainfall is observed in the recorded gravity changes. [ABSTRACT FROM AUTHOR]

Background: This study assesses the level of knowledge, the attitudes and the behaviours relating to influenza A/H1N1 among parents in Italy. Methods: A random sample of 1299 parents aged 26–65 years received a self-reported questionnaire including questions about socio-demographic characteristics, knowledge on modes of transmission and preventative measures, attitudes and behaviours relating to influenza A/H1N1. Results: A total of 781 subjects participated with a response rate of 60.1%. Only 32.3% of the respondents correctly identified the main modes of transmission and the main preventative measures, and the results of the multivariate logistic regression analysis showed that this knowledge was significantly higher in those with a higher level of education and working as health-care personnel. The average level of perceived risk of contracting influenza A/H1N1 was 4.6 and the multivariate linear regression model showed that a greater perceived risk was significantly associated with being unmarried, having more than one son, not working in the health-care setting and needing additional information about influenza A/H1N1. Less than one-third (28.8%) of the respondents had visited a physician at least once in 2 months preceding the survey for any reason related to the influenza A/H1N1 and the multivariate logistic regression model indicated that females and those with more than one son were more likely to have a visit. Conclusion: Knowledge about influenza A/H1N1 is poor and the results could have significant implications for information provision and the targeting of future education programmes to this population. [ABSTRACT FROM AUTHOR]

The article reports on topics related to the Keats-Shelley House museum in Rome, Italy. Topics include the increase in the number of visitors at the museum, the education outreach workshops in partnership with ARTandSEEK with Romantic poets as the inspiration for children to write their own poems and create their own artwork, and the Keats-Shelley House Poetry Prize for Schools competition, as well as mentioned a lecture given by professor Sean Hughes of Imperial College London.

Background: This survey determined the practices about television (video inclusive), videogames, and computer use in children and adolescents in Italy. Methods: A self-administered anonymous questionnaire covered socio-demographics; behaviour about television, videogames, computer, and sports; parental control over television, videogames, and computer. Results: Overall, 54.1% and 61% always ate lunch or dinner in front of the television, 89.5% had a television in the bedroom while 52.5% of them always watched television there, and 49% indicated that parents controlled the content of what was watched on television. The overall mean length of time daily spent on television viewing (2.8 hours) and the frequency of watching for at least two hours per day (74.9%) were significantly associated with older age, always ate lunch or dinner while watching television, spent more time playing videogames and using computer. Those with parents from a lower socio-economic level were also more likely to spend more minutes viewing television. Two-thirds played videogames for 1.6 daily hours and more time was spent by those younger, males, with parents that do not control them, who watched more television, and who spent more time at the computer. The computer was used by 85% of the sample for 1.6 daily hours and those older, with a computer in the bedroom, with a higher number of computers in home, who view more television and play videogames were more likely to use the computer. Conclusion: Immediate and comprehensive actions are needed in order to diminish time spent at the television, videogames, and computer. [ABSTRACT FROM AUTHOR]

Background: Crowding in hospital Emergency Departments (EDs) is a problem in several countries. We evaluated the number and characteristics of patients who make repeated visits to the EDs in Naples, Italy. Methods: All patients (≥ 16 years) who presented to the EDs of three randomly selected nonacademic acute care public hospitals, within randomly selected week periods, were studied. The two outcomes of interest were the re-utilization, within 72 hours, of the ED and the number of visits in the previous year. Results: Of the 1430 sampled patients, 51.9% self-reported multiple visits in the previous year and 10.9% and 1.6% used the ED for 3 and ≥4 times, respectively. The number of visits in the previous year was significantly higher in those who live closer to hospital, with a more severe burden of overall comorbidity, and who were on pharmacological treatment. Overall, 72-hours return visits were found in 215 patients (15.8%). Patients were more likely to re-use within 72 hours the ED if younger, were not on pharmacological treatment, attended the ED more times in the previous year, were referred by a physician, arrived at the ED by car driven by other person, had problems of longer duration prior to arrival at the ED, had a surgical ED discharge diagnosis, and were admitted to the hospital. Conclusion: The data may assist policymakers in the development and implementation of protocols to track changes in the re-utilization of the ED for the high financial impact and for the benefit of the patients. [ABSTRACT FROM AUTHOR]

Background: Several public health strategic interventions are required for effective prevention and control of avian influenza (AI) and it is necessary to create a communication plan to keep families adequately informed on how to avoid or reduce exposure. This investigation determined the knowledge, attitudes, and behaviors relating to AI among an adult population in Italy. Methods: From December 2005 to February 2006 a random sample of 1020 adults received a questionnaire about socio-demographic characteristics, knowledge of transmission and prevention about AI, attitudes towards AI, behaviors regarding use of preventive measures and food-handling practices, and sources of information about AI. Results: A response rate of 67% was achieved. Those in higher socioeconomic classes were more likely to identify the modes of transmission and the animals' vehicles for AI. Those older, who knew the modes of transmission and the animals' vehicles for AI, and who still need information, were more likely to know that washing hands soap before and after touching raw poultry meat and using gloves is recommended to avoid spreading of AI through food. The risk of being infected was significantly higher in those from lower socioeconomic classes, if they did not know the definition of AI, if they knew that AI could be transmitted by eating and touching raw eggs and poultry foods, and if they did not need information. Compliance with the hygienic practices during handling of raw poultry meat was more likely in those who perceived to be at higher risk, who knew the hygienic practices, who knew the modes of transmission and the animals' vehicles for AI, and who received information from health professionals and scientific journals. Conclusion: Respondents demonstrate no detailed understanding of AI, a greater perceived risk, and a lower compliance with precautions behaviors and health educational strategies are strongly needed. [ABSTRACT FROM AUTHOR]

Background: The severity of childhood gastroenteritis is generally believed to be age-related rather than aetiology-related. Rotavirus-induced gastroenteritis is more severe than gastroenteritis caused by other enteric pathogens and is also age-related. We thus addressed the question of whether the increased severity of rotavirus-induced gastroenteritis is related to age or to features intrinsic to the agent.Study Design: In this multicentre, hospital-based, prospective survey, we evaluated the severity of diarrhoea in rotavirus-positive and rotavirus-negative children up to 4 years of age. Severity was assessed with a score in four groups of age-matched children.Results: Rotavirus was detected in 381 of 911 children. Disease severity was evaluated in 589 cases for which clinical data were complete. The rotavirus-positive and rotavirus-negative groups differed with regards to diarrhoea duration, hospital stay, degree of dehydration and the number of episodes of vomiting. Gastroenteritis was more severe in rotavirus-positive than in rotavirus-negative children. In contrast, none of the main severity parameters differed in the four age groups, irrespective of the presence of rotavirus.Conclusions: These data provide the evidence that aetiology and not age determines diarrhoeal severity. The demonstration that diarrhoea was more severe in rotavirus-positive children supports the need for a rotavirus vaccine and for studies that address the duration of vaccine protection. [ABSTRACT FROM AUTHOR]

Discusses how investors should structure real-estate investment in Italy. Analysis of an investment in a large Italian real-estate portfolio, composed of both buildings and shares in real estate companies, carried out by Italian and foreign investors; Tax consequences for the Italian investor and for the foreign investor; Need for domestic and foreign investors to consider how to structure their investment in Italian real-estate portfolios.

Aim: To investigate rates and determinants of adherence to antiretroviral therapy in Italian children infected with the human immunodeficiency virus (HIV).Methods: An observational, cross-sectional multicentre study was performed through a structured interview with the caregivers of HIV-infected children. The interview included quantitative information on adherence in the 4 d before interview. Sociodemographic, clinical and psychosocial characteristics of children were recorded.Results: 129 children (median age 96 mo) were enrolled, of whom 94 were on highly active antiretroviral therapy (HAART). Twenty-one (16%) omitted more than 5% of total doses in 4 d and were considered non-adherent. However, only 11% of caregivers reported that therapy had been administered at the correct times. No significant difference was found between age and the stage of HIV infection. Children aware of their HIV status were less adherent. Individual drugs showed a broad adherence pattern and children who received HAART were more adherent. Children receiving therapy from foster parents were more adherent than those receiving drugs from biological parents or relatives.Conclusions: Adherence is a major problem in children. Psychological rather than clinical or sociodemographic features and types of drug are major determinants of adherence. [ABSTRACT FROM AUTHOR]

In the recent decades, satellite monitoring techniques have enhanced the discovery of non-catastrophic slope movements triggered by earthquake shaking involving old paleo-landslides with deep-seated sliding surfaces. Understanding the triggering and attenuation mechanisms of such mass movements is crucial to assessing their hazard. In December 2018, Etna volcano (southern Italy) began a very intense eruption, which was accompanied by a seismic swarm with magnitudes reaching 4.9. Synthetic aperture radar data identified local displacements over a hilly area to the west of Paternò village. We evaluated the contribution of seismically induced surface instability to the observed ground displacement by employing a multidisciplinary analysis comprising geological, geotechnical and geomorphological data, together with analytical and dynamic modelling. The results allowed us to identify the geometry and kinematics of a previously unknown paleo-landslide, which was stable before the volcanic eruption. The landslide was triggered by the light-to-moderate seismic shaking produced by the strongest event of the seismic sequence, namely, the December 26, M w 4.9 earthquake. This observation confirms that seismic shaking has a cumulative effect on landslides that does not necessarily manifest as a failure but could evolve into a catastrophic collapse after several earthquakes. • Ground movements were produced by the 2018 Etna volcano eruption and seismic swarm. • InSAR data detected local ground displacements over a hilly area. • Geomorphological analysis identified a previously unknown landslide body. • The landslide was reactivated by moderate seismic shaking in undrained conditions. [ABSTRACT FROM AUTHOR]