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The purpose of this article is to describe the helicopter emergency medical services (HEMS) presently operating in Italy. The article details all currently operational HEMS bases and all currently used helicopters. A comparison with the HEMS situation in Italy as it was previously described in 2005 is discussed., (Copyright © 2021. Published by Elsevier Inc.)

The present article shows the current neonatal air transport organization and activity in Italy. The results were obtained on the basis of a recent 2019 survey (year of activity 2018) performed by the Neonatal Transport Study Group of the Italian Society of Neonatology. The total number of newborn transports during the year 2018 was 6,464. The air-suitable transports were 512 of 5,852 (8.74%), and among them, 101 of 512 (19.72%) were performed by helicopter and 34 by airplane. Besides the availability of air transport, the interfacility distance, weather and traffic conditions, and rural mountainous roads were the main factors in determining the vehicle choice. Neonatal air transport in Italy is not homogeneously distributed and needs organizational corrections. The high density of neonatal emergency transport services on the national territory indicates the need to overcome the limits imposed by regional administrative borders, thus expanding the geographic area of competence., (Copyright © 2021. Published by Elsevier Inc.)

Objectives: This article describes the detailed project aimed to realize a dedicated ground ambulance for neonatal emergency transport service (NETS). To date, the European Community rules specify requirements for the design, testing, performance, and equipping of road ambulance used for transport and care of adult injured or ill patients, completely ignoring neonatal transport., Methods: The project consisted of electric and gas supply planning, interior design taking into account ergonomic and occupant protection principles, both during travel and during medical care performances., Results: A detailed project is presented. Main differences between European Type C ambulance and the new proposed Type D neonatal ground ambulance are the presence on board of air compressed cylinder, iNO cylinders and delivery system, phototheraphy, shock adsorbing stretcher support, cooling device, patient's placenta (refrigeration box), and transcutaneous gas analyzer., Conclusion: The European Community rules specify requirements for road ambulance used for transport and care of adult injured or ill patients, completely ignoring neonatal transport. This study describes the detailed project aimed to realize a dedicated ground ambulance for neonatal emergency transport service. This study demonstrated that it is not possible simply to adapt the currently dedicated ambulance for mobile intensive care and resuscitation services (actual type C European Community) in a modern dedicated NETS ambulance; it is of paramount importance suggesting to European Community to introduce a further ambulance type, to be identified type D, strictly reserved to neonatal transport activities.

Background: Despite regionalization of perinatal care provides for the "in utero" transfer of high-risk pregnancies, there will always be a number of neonates who undergo acute inter-facility transport. The presence of a well-organized Neonatal Emergency Transport Service (NETS) can prevent and reduce risks of transportation, especially for very preterm infants, and is therefore mandatory for any program of regionalization of perinatal care. Italian National Health System is highly decentralized and Regions are autonomous to structure, plan and delivery their regional health services. Consequently, organization models and resources available vary widely and significant regional differences in access and quality of health services have been reported in the past years. A national survey was conducted in 2015 by the neonatal transport study group of the Italian Society of Neonatology with the aim to describe neonatal transfer practices and to assess the Neonatal Emergency Transport Services (NETS) status in the 20 Italian regions., Methods: A questionnaire regarding neonatal transfer practices and NETS activity for the previous year (2014) was sent to the 44 NETS operating in the 20 Italian regions. Demographic data were obtained from the Italian National Statistical Institute (ISTAT)., Results: The overall survey response rate was 100%. In 2014, only 12 (60%) of the 20 Italian regions were fully covered by NETS, 3 (15%) regions were partially covered, while neonatal transport was not available in 5 (25%) regions. Overall, in 2014, the 44 NETS operating in Italy transported a total of 6387 infants, including 522 (8.17%) having a gestational age < 28 weeks., Conclusions: The organization of NETS in Italy is devolved on a regional basis, resulting in a large heterogeneity of access and quality to services across the country. Where available, NETS are generally well-equipped and organized but limited volume of activities often cannot guarantee adequate levels of skills of personnel or an appropriate cost-efficiency ratio. The regions reported with lack of NETS have managed, or are trying, to fill the gap, but continuing efforts to reduce regional differences in the availability and quality of services are still needed.

Aim: Neonatal endotracheal intubation is a challenging procedure during transport. The aim of this study was to evaluate the effectiveness of the emergency intubation guidelines followed by our Neonatal Emergency Transport Service (NETS)., Methods: Our transport intubation guidelines follows a weight-based nomogram for nasal intubation, and the tube position is clinically verified after intubation, while the postintubation chest X-ray is postponed to Neonatal Intensive Care Unit (NICU) admission. Data on postnatal age, weight and tube insertion depth were obtained from the online NETS clinical database, and the postintubation chest X-ray images were assessed., Results: During the study period, 161 newborn infants were nasally intubated during transport, and received a postintubation radiograph at NICU admission. A total of 130 neonates (80.7%) had the endotracheal tube (ETT) correctly positioned between T1 and T2 vertebrae, while 12 (7.5%) was at C7 vertebrae level and 19 (11.8%) at T3. No patients had ETT tip positioned at T4 vertebrae level or below. No adverse events related to intubation were observed., Conclusion: Our intubation procedure showed a good reliability and safety in neonatal critical care transport, although chest X-ray to confirm the tube placement is postponed to NICU arrival. Based on our results, we suggest a revised version of weight-based nomogram for nasal intubation., (©2018 Foundation Acta Paediatrica. Published by John Wiley & Sons Ltd.)

The purpose of this article is to describe the long-distance, nonstop intercontinental transport of a severely ill, mechanically ventilated newborn from Shanghai, China, to Genoa, Italy focusing in particular on the clinical and planning difficulties. The aircraft equipment, the assessment and preparation for transport are discussed., (Copyright © 2018 Air Medical Journal Associates. Published by Elsevier Inc. All rights reserved.)

A reconstruction of the vegetation surrounding the Bronze Age archaeological site of San Lorenzo a Greve (Florence) based on pollen and seed/fruit records is presented. Pollen analysis suggests the presence of prevailingly open and damp landscapes, typically occurring on alluvial soils. Patches of woodland, mostly formed by deciduous Quercus, Ulmus, Salix, were alternated to the grasslands. Vitis also probably grew in these damp thickets together with Alnus and Hedera. The forests on the hilly slopes included deciduous Quercus, Carpinus betulus, Corylus, Cornus mas, and Sambucus nigra. Where the soil was well drained, Ostrya carpinifolia and Mediterranean evergreen elements such as Q. ilex and Viburnum tinus grew. In the landscape scenario reconstructed by pollen analysis, seeds/fruits indicated the presence of specific plants which produce a low amount of pollen: they are seldom recorded in pollen spectra but their fruits were commonly gathered in prehistory. [ABSTRACT FROM AUTHOR]

The Otorhinolaryngologist (ENT) frequently has to deal with OSA or suspicious OSA patients and undergone polysomnography (PSG) or portable monitoring (PM) and should be confident about the quality and consistency of the polysomnographic diagnosis. The main polysomnographic traces compressed in a unique epoch, defined as compact PSG/PM (CP), could represent an efficient tool to confirm the quality of PSG/PM Sleep Breathing Disorders diagnosis. This is a validation's study of a CP interpretation's method, analyzing the learning curve, the level of diagnostic accuracy, and the inter-operator agreement in interpreting the CP pattern between a group of ENT specialists not skilled in PSG/PM scoring, but managing SBD patients during daily practice. Seven ENT specialists have been enrolled in the study. 50 CP traces (ranging from normal to all main SBD patterns) have been showed to each participant for the interpretation and scoring process, before and after a 2-h theoretical-practical interactive lesson, focusing on the recognition of the four main oximetric patterns on CP traces (normal, phasic, prolonged, and overlap patterns)., Results: before and after the theoretical-practical interactive lesson, the whole diagnostic accuracy in interpreting the 50 CP has been reported improved from 0.12 to 0.80 (median 0.52) to 0.82-0.96 (median 0.92) (p = 0.006) and the inter-scorers' agreement showed a kappa value increased from of 0.18 to 0.75 (p < 0.0001). A complete clinical diagnostic evaluation is essential in OSA patients and the ENT specialist should be concerned to verify if the patient, suitable for surgical therapy, is affected really by an isolated form of OSA. The CP interpretation allows a checking of the proper nosographic SBD framework and could be significantly important for all ENT specialists not skilled in PSG/PM scoring, but managing SBD patients during daily practice. The data reported in our validation's study showed that the CP interpretation's method is easy to apply, with a rapid learning curve. The level of diagnostic accuracy is high with a high inter-scorer agreement in interpreting the CP patterns.

Endoscopic dacryocystorhinostomy (DCR) is a well-established alternative to external approaches in the treatment of nasolacrimal canal obstruction. From July 2004 to December 2008, 92 endoscopic DCRs were performed on 88 patients at the Department of Otorhinolaryngology, San Raffaele Hospital, Milan. All patients were affected by chronic dacryocystitis with epiphora. Preoperative work-up included Jones tests, lacrimal pathways irrigation, nasal endoscopy, and imaging evaluation by computed tomography. The technique involved anastomosis of nasal mucosal, lacrimal sac flaps and a large bony ostium. A silicone tube was inserted in all patients that remained for a period of 3 months. The first endoscopic intervention was successful in 91.30% of patients. After a second revision endoscopic DCR, the overall success rate raised to 95.65%. Anastomosis of nasal mucosal between lacrimal sac flaps plays a key role in endoscopic DCR with a high success rate both in primary nasolacrimal obstructions and in revision cases. [ABSTRACT FROM AUTHOR]

Abstract: The recovery of a Middle Bronze Age pit in Florence offered the opportunity of studying seeds/fruits and pollen coming from the pit fill layers. Both datasets resulted similar in their mixed composition of cultivated, synanthropic, and wild plants. They represent different traces coming from the plants which were stored and voluntarily or involuntarily introduced into the structure. Foodstuff and fodder storage activities are testified in the pit. Particularly, plant gathering is better represented by seed/fruit remains, while fodder procurement is mainly clarified by pollen. In this study, the use of pollen as evidence of economic activity is validated by the hypothesis that the origin of the pollen in the pit is from the stored plant material more than from the pollen rain. Therefore, comparing these datasets proved to be useful to assess the sources of the plant remains found in the pit, to interpret the origin of the fill layers and make some inferences on the structure and its uses, and to attempt some palaeoethnobotanical considerations. [Copyright &y& Elsevier]

We present direct evidence of early grape domestication in southern Italy via a multidisciplinary study of pip assemblage from one site, shedding new light on the spread of viticulture in the western Mediterranean during the Bronze Age. This consist of 55 waterlogged pips from Grotta di Pertosa, a Middle Bronze Age settlement in the south of the Italian peninsula. Direct radiocarbon dating of pips was carried out, confirming the chronological consistency of the samples with their archaeological contexts (ca. 1450-1200 BCE). The extraordinary state of conservation of the sample allowed to perform geometric morphometric (GMM) and paleogenetic analyses (aDNA) at the same time. The combination of the two methods has irrefutably shown the presence of domestic grapevines, together with wild ones, in Southern Italy during the Middle/Late Bronze Age. The results converge towards an oriental origin of the domestic grapes, most likely arriving from the Aegean area through the Mycenaeans. A parent/offspring kinship was also recognised between a domestic/wild hybrid individual and a domestic clonal group. This data point out a little known aspect of the diffusion of the first viticulture in Italy, and therefore in the western Mediterranean, which involved the hybridization between imported domestic varieties with, likely local, wild vines., (© 2023. Springer Nature Limited.)

Objectives: To report the wide clinical experience and the research studies in the microsurgical treatment of peripheral lymphedema., Methods: More than 1800 patients with peripheral lymphedema have been treated with microsurgical techniques. Derivative lymphatic microvascular procedures recognize today its most exemplary application in multiple lymphatic-venous anastomoses (LVA). In case of associated venous disease reconstructive lymphatic microsurgery techniques have been developed. Objective assessment was undertaken by water volumetry and lymphoscintigraphy., Results: Subjective improvement was noted in 87% of patients. Objectively, volume changes showed a significant improvement in 83%, with an average reduction of 67% of the excess volume. Of those patients followed-up, 85% have been able to discontinue the use of conservative measures, with an average follow-up of more than 10 years and average reduction in excess volume of 69%. There was a 87% reduction in the incidence of cellulitis after microsurgery., Conclusions: Microsurgical LVA have a place in the treatment of peripheral lymphedema, and should be the therapy of choice in patients who are not sufficiently responsive to nonsurgical treatment., (2010 Wiley-Liss, Inc. Microsurgery, 2010.)

The early times of aviation medicine were dominated by military actions and needs. This article describes the pioneering era of Italian air medical transport during the period between World War I and early World War II.

Objectives: The risk of uniparental disomy (UPD) occurrence associated with the prenatal finding of balanced nonhomologous Robertsonian translocations (NHRTs) has been estimated only on limited empirical data. The aim of the study was to verify the estimate of the general risk, to get narrower confidence intervals by cumulating the data and to obtain risk estimates for specific translocation types., Methods: We tested for UPD 160 prenatal specimens referred to the participant centers after the cytogenetic finding of NHRT., Results: One case of upd(14)mat was found, associated with a 45,XX,der(14;22)mat fetal karyotype. The general empirical risk of UPD occurrence in NHRT carrier fetuses, corrected for the actual number of chromosomes analyzed, was 0.76% (95% CI 0.02-4.25%). Cumulative data with previous studies gives a general risk of UPD associated with NHRT of 0.80% (95% CI 0.17-2.34%). The UPD risk for the specific NHRT der(13;14) did not significantly differ from that of the other NHRTs taken together., Conclusion: The present survey confirms the previously estimated risk of occurrence of UPD in offspring of NHRT carriers as a low, but not negligible risk, worth being investigated in prenatal diagnosis., (Copyright 2004 John Wiley & Sons, Ltd.)

In the present study the entire NF1 coding region was analyzed for mutations in 132 unrelated Italian NF1 patients. Using PTT, SSCP, and DNA sequencing, we found 8 novel mutations. Clinical diagnosis of NF1 was established according to the NIH consensus criteria. We detected 59 truncated fragments, and 46 of them were characterized by SSCP and direct sequencing. Eight mutations represent novel changes that contribute to the germline mutational spectrum of the NF1 gene. In two patients, premature termination was due to substitutions at nucleotide c.3982C>T (Q1298X) and c.7411C>T (Q2471X), respectively. Two other mutations were caused by the deletions (1756delA, 4699delA), and two by the insertions (c.5266&#95;5267insT, c.7464&#95;7465insTCCA) of a small number of nucleotides. Lastly, we found 2 splice-site mutations (c.2252-2A>C, c.2251+1G>A)., (Copyright 2003 Wiley-Liss, Inc.)

The entire NF1 coding region was analyzed for mutations in a panel of 108 unrelated Italian NF1 patients. Using PTT, SSCP, and DNA sequencing, we found 10 mutations which have never been reported before. Clinical diagnosis of NF1 was established according to the NIH consensus criteria in 100 individuals, while 8 were young children with only multiple cafè-au-lait spots. We detected 46 truncated fragments, and 24 of them were fully characterized by SSCP and direct sequencing. Of the 24, 14 were known mutations (R304X, R681X, Q682X, R1306X, R1362X, R1513X, R1748X, Q1794X, R1947X, Y2264X, R2237X, 2674delA, 6789delTTAC, 2027insC). The other 10 mutations represent novel changes that contribute to the germline mutational spectrum of the NF1 gene (K810X, Q2595X, 6772delT, 7190delCT, 7331delA, 1021insTT, 3921insT, 4106insTA, 7149insC, 2033insCG / 2034delA). PTT in a large number of Italian NF1 patients supports the usefulness of this method for characterization of mutations in disorders where the responsible gene is very large and the disease-causing mutations often create a stop codon. In agreement with previous reports, no mutational hotspots within the NF1 gene were detected., (Copyright 2002 Wiley-Liss, Inc.)

Plastic litter is a global threat affecting all marine ecosystems. Utilizing digital media platforms like Google, Facebook, and Instagram we assessed the detrimental effects of marine plastic litter on the biodiversity of the Italian marine ecosystem. We noted that marine plastic litter had adverse consequences on marine reptiles, mammals, sea birds, fish, crustaceans, and mollusks, including endangered and vulnerable marine species. The loggerhead sea turtle (Caretta caretta) was the most recorded species found entangled in plastic litter. Our investigation revealed that abandoned, lost, or otherwise discarded fishing gear are the primary contributors to the entanglement of numerous marine species. The current study represents a preliminary step towards establishing databases that document records of entanglement, which may be useful in adopting new conservation measures in the Mediterranean geographical subareas. Our results emphasize the critical need for collaborative efforts among all stakeholders and policymakers to effectively manage marine plastic litter. [ABSTRACT FROM AUTHOR]

The advent, in 2004, of online universities in Italy followed the global trend of open and distance learning institutions. Within a brief span, the authorization of as many as 11 online universities was granted. Despite ongoing regulatory revisions and a prevailing skepticism regarding the actual quality of education these institutions furnish, student enrollment continues to rise annually. This study explores enrollment trends in Italian online universities from their inception through 2021, considering concurrent enrollment trends in traditional public and private universities. Additionally, we examine in detail the gender composition, subject areas of degree programs, and, most importantly, the geographic origins of enrolled students. [ABSTRACT FROM AUTHOR]

Copyright of Papers of the British School at Rome is the property of Cambridge University Press and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Some newborns require acute transport to a Neonatal Intensive Care Unit (NICU) due to unpredicted or unpredictable reasons. To describe the activity of the Neonatal Emergency Transport Service (NETS) in Northeast Italy. An observational retrospective study was performed between 1 January 2018, and 31 December , 2019. A total of 133 transports were collected, with a neonatal transport index of 1.4%. Infants ≤2500 grams were more frequently transferred by NETS than those in the normal group (n = 34/563, 6.0% vs. n = 99/8,437, 1.2%; p <.001). The incidence of preterm birth among transferred newborns was 42/133 (31.6%). For the newborns with >2500 grams, there was a low incidence of a cesarean birth compared to vaginal delivery (23.2% versus 63.5%; p =.001), while the percentages were reversed in the group of infants ≤2500 grams (67.7% versus 20.6%) (p =.001). Infant stabilization time was higher in the underweight group compared to those weighed >2500 grams (31.5 versus 23.0 min; p <.001), as well as the median length of stay in NICU (18.0 versus 8.0 days, respectively, p <.001). The group of infants ≤2500 grams received more intravenous therapy (47.1% vs. 26.2%) and invasive ventilation (26.5% vs. 8.1%), compared to the group of infants who weighed >2500 grams. This study described a local reality by showing the characteristics of the neonatal transports that took place in a metropolitan area in Northeast Italy. Wider database is necessary to achieve a better knowledge in the field of perinatal outcomes. [ABSTRACT FROM AUTHOR]

The Italian Society of Clinical Biochemistry and Clinical Molecular Biology (SIBioC) Big Data and Artificial Intelligence (BAI) Working Group promoted a survey to frame the knowledge, skills and technological predisposition in clinical laboratories. A questionnaire, focussing on digitization, information technology (IT) infrastructures, data accessibility, and BAI projects underway was sent to 1,351 SIBioC participants. The responses were evaluated using SurveyMonkey software and Google Sheets. The 227 respondents (17%) from all over Italy (47% of 484 labs), mainly biologists, laboratory physicians and managers, mostly from laboratories of public hospitals, revealed lack of hardware, software and corporate Wi-Fi, and dearth of PCs. Only 25% work daily on clouds, while 65%—including Laboratory Directors—cannot acquire health data from sources other than laboratories. Only 50% of those with access can review a clinical patient's health record, while the other access only to laboratory information. The integration of laboratory data with other health data is mostly incomplete, which limits BAI-type analysis. Many are unaware of integration platforms. Over 90% report pulling data from the Laboratory Information System, with varying degrees of autonomy. Very few have already undertaken BAI projects, frequently relying on IT partnerships. The majority consider BAI as crucial in helping professional judgements, indicating a growing interest. The questionnaire received relevant feedback from SIBioC participants. It highlighted the level of expertise and interest in BAI applications. None of the obstacles stands out more than the others, emphasising the need to all-around work: IT infrastructures, data warehouses, BAI analysis software acquisition, data accessibility and training. [ABSTRACT FROM AUTHOR]

This study investigates changes in dietary practices and subsistence strategies in Bronze Age Italy integrating isotopic analyses with archaeobotanical and archaeozoological data. By investigating food habits, we contribute to reconstructing human lifestyles and highlighting possible links with the economic/social organization when the rise of stratified societies and new economic activities affected subsistence practices. Stable isotopes analyses in humans and animals were performed on 6 Italian sites dating from 2300 to 900 cal. BC, followed by a complete review of additional 19 sites, which forms the basis of a diachronic and geographic comparison for Bronze Age Italy. The geographic analysis shows a more varied diet in northern and central Italy, compared to the south. The diachronic analysis highlights the homogeneity of food habits during the Early Bronze Age, contrary to the later phases when an increase in dietary variability and a higher animal protein consumption are revealed. The Middle Bronze Age appears as a pivotal moment in protohistoric societies, a phase of transition. The consumption of different foodstuffs highlights the importance of cultural exchanges, resulting in a sort of "food globalization", although environmental and climatic fluctuations could also have affected dietary patterns, favoring some crops over others. [ABSTRACT FROM AUTHOR]

Simple Summary: From April 2017 to December 2020, 29 patients with prostate cancer recurrence were selected. They received Cyberknife® (CK) treatment (17 pts) or alternatively VMAT (Volumetric Modulated Arc Technique) therapy by IGRT (Image-Guided Radiation Therapy)/Clarity® (12 pts). Urinary (GU), rectal (GI) toxicities, and biochemical control were investigated. Further, the two techniques were dosimetrically compared by rival plans. The VMAT-IGRT Clarity® treatments were replanned applying a template developed for prostate VMAT-SBRT in FFF mode, keeping the same dose/fractionation scheduled for the CK Group (30 Gy in 5 fx at 80% isodose). In the CK group, 23% of patients experienced grade 2 acute GU, while 6% showed grade 2 acute GI. In the VMAT-Clarity® group, 17% of patients showed acute GU toxicity, while for 8% grade 2 late toxicity was recorded. The dosimetric analysis shows that VMAT-FFF allows to deliver a biological equivalent dose to CK, with the advantage of reducing the likelihood of toxicities arising. The management of prostate cancer recurrence following external beam radiotherapy is not defined yet. Stereotaxic body reirradiation therapy showed encouraging results for local and biochemical control. From April 2017 to December 2020, 29 patients with prostate cancer recurrence were collected, joining the retrospective studies CyPro (prot. 46/19 OSS) and CLARO (Prot. 19/20 OSS) trials. Patients received Cyberknife® treatment (17 pts) or alternatively VMAT (Volumetric Modulated Arc Technique) therapy by IGRT (Image-Guided Radiation Therapy)/Clarity® (12 pts). By comparing the reirradiation of two groups, urinary (GU), rectal (GI) toxicities, and biochemical control were investigated. Further, the two techniques were dosimetrically compared by rival plans. The VMAT-IGRT Clarity® treatments were replanned with an optimized template developed for prostate VMAT-SBRT in FFF mode keeping the same dose and fractionation scheduled for Cyberknife Group (30 Gy in 5 fx, at 80% isodose). In the CK group, 23% of patients experienced grade 2 acute GU, while 6% grade 2 acute GI. In the VMAT-Clarity® group, acute GU toxicity was recorded in 17%, while for 8% grade 2 late toxicity was recorded. The dosimetric analysis shows that the VMAT-FFF allows to deliver a biological equivalent dose to CK, with the advantage of reducing the likelihood of toxicities arising. [ABSTRACT FROM AUTHOR]

Purpose: The existence of black horizons (BHs) is often highlighted in European soils, and in the Po River plain of northern Italy. Nevertheless, BH chronological frameworks and genetic models are still debated. The present study investigated the genesis of BHs in the eastern Po Plain where they are buried at various depths. Materials and methods: Soil sequences were investigated with a multidisciplinary approach integrating geomorphologic, stratigraphic, pedologic, geochemical, isotopic, palynological, and radiometric analyses. Results and discussion: The formation of the studied BHs was scattered over time from the Last Glacial Maximum to at least the middle Holocene. The new data indicate that BHs developed when the landscape was dominated by coniferous forest during conditions that were totally different from the current pedoclimatic setting. The recurrent presence of black particles indicates that this vegetation cover was systematically affected by fire episodes that induced soil degradation and mineralization processes of the original organic compounds, thus contributing to darkening of the upper soil horizons. Conclusions: BH formation clearly coincided with cold time lapses. Evidence for repeated fire events (natural or human-induced?) provides insights for the controversial debate on early anthropogenic impacts on the environment. [ABSTRACT FROM AUTHOR]

Fagus sylvatica (beech) dominates the montane forests of the Apennines and builds old-growth high-conservation value stands. However, recent severe drought-induced diebacks raise concern on the future persistence of these forests and of Southern European mesophilous woodlands overall, growing at their dry edge. To explore the history of Apennine beech-dominated forests, we draw on the multiproxy paleoecological record from Lago Verdarolo, which includes a robust vegetation-independent temperature reconstruction. Numerical techniques are used to investigate the drivers of long-term Mediterranean mountain forest dynamics. Specifically, we focus on disentangling the ecological factors that caused the shift from high-diversity mixed forests to beech-dominated stands and on assessing the occurrence of legacy effects on present-day forests. Abrupt climate change largely drove vegetation dynamics during the Late Glacial and Early Holocene. Species-rich mixed Abies alba (silver fir) forests dominated about 10,500—5500 years ago, under rather dry and warmer-than-today conditions (+ 1—2 °C) and limited fire occurrence. Cooler and moister summers and increasing fire activity caused declines in several fire-sensitive temperate deciduous trees (for example, Ulmus, Tilia, Fraxinus) and favored the establishment of fir-beech forests around 5500 years ago. Further enhancement of fire activity and farming around 2000 years ago led to local Abies alba extinction and forest impoverishment. We conclude that the currently widespread monospecific Apennine beech forests are the result of multi-millennial land-use intensification superimposed on Late Holocene cooling and moistening. Given their higher drought-tolerance compared to beech stands, reviving ancient species-rich mixed fir forests represents a feasible and 'tested' possibility to adapt forests to climate change. [ABSTRACT FROM AUTHOR]

The Italian peninsula offers an excellent case study within which to investigate long-term regional demographic trends and their response to climate fluctuations, especially given its diverse landscapes, latitudinal range and varied elevations. In the past two decades, summed probability distributions of calibrated radiocarbon dates have become an important method for inferring population dynamics in prehistory. Recent advances in this approach also allow for statistical assessment of spatio-temporal patterning in demographic trends. In this paper we reconstruct population change for the whole Italian peninsula from the Late Mesolithic to the Early Iron Age (10,000–2800 cal yr BP). How did population patterns vary across time and space? Were fluctuations in human population related to climate change? In order to answer these questions, we have collated a large list of published radiocarbon dates (n = 4010) and use this list firstly to infer the demographic trends for the Italian peninsula as a whole, before addressing each of five sub-regions in turn (northern, central, and southern Italy, Sicily, Sardinia). We also compare population fluctuations with local paleoclimate proxies (cave, lake, marine records). At a pan-regional scale, the results show a general rapid and substantial increase in population in the Early Neolithic with the introduction of farming at around 8000 cal yr BP and further dramatic increases during the Bronze and Iron Age (~ 3800–2800 cal yr BP). However, different regional demographic trajectories exist across different regions of Italy, suggesting a variety of localised human responses to climate shifts. Population and climate appear to have been more closely correlated during the early–mid Holocene (Mesolithic–Neolithic), while later in the Holocene (Bronze–Iron Ages) they decouple. Overall, across the Holocene the population dynamics varied by region and depended on the long-term socio-ecological dynamics prevailing in a given area. Finally, we include a brief response to the paper 'Radiocarbon dated trends and central Mediterranean prehistory' by Parkinson et al. (J Word Prehist 34(3), 2021)—synchronously published by Journal of World Prehistory but wholly independently developed—indicating how our conclusions accord with or differ from one another. [ABSTRACT FROM AUTHOR]

Copyright of Journal of World Prehistory is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Context: The importance of societal factors in shaping forest area, structure and composition through economic activity, policy, governance, and population changes is frequently acknowledged in ecologic studies, however the specific socioeconomic factors that lead to land use change through time are rarely articulated. Objectives: We present a consilience-driven approach for integrating socioeconomic and paleoecologic data to explore land use legacies and interpret causes of past abrupt environmental change. Methods: We combine paleoecologic history reconstructed from pollen analysis of lake sediments and contemporary historical narratives of socioeconomic change developed from archival sources illustrated by three case studies from two sites in the Italian Apennines. Results: We found that in the Rieti Basin, central Italy, between 850 and 900 AD (coeval with the beginning of the Medieval Climate Anomaly—MCA), under the new Carolingian rule, the imperially sponsored monastery at Farfa consolidated small landholdings, leading to more active land management and significant forest loss for agricultural activities. In contrast, at Pollino in southern Italy between 1050 and 1100 AD, also during the MCA, Norman conquest helped to convert a deforested landscape into an actively managed fir forest for timber needed for construction. At both sites, depopulation and land management between 1350 and 1400 AD caused by the Black Death, led to forest rewilding, however each site took a different trajectory. Conclusions: The studies presented offer examples of how the integration of detailed historical narratives with high-resolution paleoecologic reconstructions can provide a more nuanced examination of the interrelationship between societal factors and climate forcing in shaping land-use legacies and has the capacity to illuminate the link between specific human pressures and pathways of ecological change over many centuries. [ABSTRACT FROM AUTHOR]

In Italy, aerobiological monitoring is usually carried out by the regional agencies for environmental protection (ARPA [Agenzia Regionale per la Protezione Ambientale]) using volumetric samplers. Another widespread method for the study of airborne pollen is the analysis of moss cushions, generally used to relate pollen rain to flora and vegetation. In this study, we compare the data coming from these two pollen monitoring methods: volumetric samplers and moss cushions. The study was carried out in the city of Florence (Italy) and took into consideration two different spans of time. The two pollen monitoring methods show quantitative and qualitative differences. The main discrepancy seems to be the direct consequence of the different preservation time of the grains in the moss cushions depending on the features of the pollen grains. The study also provides an estimate of the period of pollen accumulation and preservation in moss cushions, which turned out to be more than five years. The two sampling methods furnish complementary information; volumetric samplers especially suited for aerobiological studies and moss cushions for environmental and palaeobotanical research. [ABSTRACT FROM AUTHOR]

Italy displays a high level of agrobiodiversity due to its diversified pedoclimatic zones. The Administrative Region of Campania includes several and divergent biomes, occurring close to each other. In fact, the distance between a sea level environment and that of high mountains can be less than 20 km. These environmental conditions allow the cultivation of many different crops and vegetables, represented by diverse ecotypes and varieties that are well adapted to the distribution range where they have been selected and grown. Efforts to maintain and further increase biodiversity in farming systems require a better understanding of the existing diversity created by traditional farming practices. The aim of our study was to identify and molecularly characterize several ecotypes belonging to five horticultural species commonly cultivated in Campania. In particular, we analysed five ecotypes of maize, two of garlic, four of onion, one of escarole, and two of courgette by means of simple sequence repeat (SSR) markers in order to evaluate their level of genetic biodiversity. The results reveal, for the first time, the high genetic biodiversity of horticultural ecotypes of the Campania Region. This feature is very important to improve the quality and productivity of agroecosystems. [ABSTRACT FROM AUTHOR]

Objective: Narcolepsy is a lifelong disease, manifesting with excessive daytime sleepiness and cataplexy, arising between childhood and young adulthood. The diagnosis is typically made after a long delay that burdens the disease severity. The aim of the project, promoted by the "Associazione Italiana Narcolettici e Ipersonni" is to develop Red Flags to detect symptoms for early referral, targeting non-sleep medicine specialists, general practitioners, and pediatricians.Materials and Methods: A multidisciplinary panel, including patients, public institutions, and representatives of national scientific societies of specialties possibly involved in the diagnostic process of suspected narcolepsy, was convened. The project was accomplished in three phases. Phase 1: Sleep experts shaped clinical pictures of narcolepsy in pediatric and adult patients. On the basis of these pictures, Red Flags were drafted. Phase 2: Representatives of the scientific societies and patients filled in a form to identify barriers to the diagnosis of narcolepsy. Phase 3: The panel produced suggestions for the implementation of Red Flags.Results: Red Flags were produced representing three clinical pictures of narcolepsy in pediatric patients ((1) usual sleep symptoms, (2) unusual sleep symptoms, (3) endocrinological signs) and two in adult patients ((1) usual sleep symptoms, (2) unusual sleep symptoms). Inadequate knowledge of symptoms at onset by medical doctors turned out to be the main reported barrier to diagnosis.Conclusions: This report will hopefully enhance knowledge and awareness of narcolepsy among non-specialists in sleep medicine in order to reduce the diagnostic delay that burdens patients in Italy. Similar initiatives could be promoted across Europe. [ABSTRACT FROM AUTHOR]

In 2008-2009, a rescue excavation uncovered an intact Late Bronze Age well in Sa Osa, Sardinia (Italy). The structure yielded a large number of waterlogged plant remains, of which a group of melon seeds (Cucumis melo L.) were some of the most remarkable. These seeds represent the earliest recorded remains of this taxon in the Western Mediterranean and are some of the oldest ever recorded. The plant remains were preserved in anoxic conditions and were found in a perfect state of conservation, making them ideal candidates for morphometric and molecular characterisation. A total of 96 parameters, measured using an automatic image analysis system, were specifically designed to evaluate the morphological features of 15 preserved whole seeds. DNA extraction from archaeological samples followed a procedure specifically set up to avoid any kind of contamination. A 123-SNP genotyping platform that had been validated previously was used. The morphological and molecular data of the archaeological seeds were successfully compared with those of a set of 179 accessions, including landraces, of feral and wild melons from Europe, Africa, and Asia. Both analyses confirmed that these ancient seeds did not belong to a wild melon, but instead to a cultivated one. This primitive melon could have belonged to a group of ancestral non-sweet or semi-sweet forms of chate, flexuosus, or ameri varieties, showing similarities to North African and Central Asian accessions. This finding is coherent with the reportedly important role of cucumber-like melons in the species' diversification process and with the accepted role of the ameri group as the ancestors of the modern sweet varieties. [ABSTRACT FROM AUTHOR]

This study investigates the evolution of accounting history research in Italy throughout the analysis of the historical publications on the most important generalist accounting journal—the 'Italian Accounting Review' (IAR, 'Rivista Italiana di Ragioneria'). Following the studies on the patterns of publications in the accounting history research, we tracked the accounting history contributions in IAR over 115 years, from 1901 to 2015. Our longitudinal analysis included number and subject areas of the tracked contributions. The findings support the consolidated tradition of the historical perspective for the Italian accounting researchers. They also reveal emerging topics and developing fields of historical enquiry that could be addressed in future. We make a call for more research on accounting history in specific contexts, through knowledge creation in diverse languages and settings. [ABSTRACT FROM AUTHOR]

In this paper, the variation in forest cover in the central Mediterranean region, reflected by percentage changes in the arboreal pollen record, has been examined in relation to the 4.2 ka event. A total of 36 well-dated and detailed pollen records from latitudes between 45 and 36 ∘ N were selected and their vegetation dynamics between 5 and 3 ka examined in relation to the physiographic and climatic features of the study area and to the influence of human activity on past vegetation, as suggested by anthropogenic pollen indicators. We have found that the sites located between 43 and 45 ∘ N do not show any significant vegetation change in correspondence with the 4.2 ka event. Several sites located on the Italian Peninsula between 39 and 43 ∘ N show a marked opening of the forest, suggesting a vegetation response to the climate instability of the 4.2 ka event. Between 36 and 39 ∘ N, a forest decline is always visible around 4.2 ka, and in some cases it is dramatic. This indicates that this region was severely affected by a climate change towards arid conditions that lasted a few hundred years and was followed by a recovery of forest vegetation in the Middle Bronze Age. Human activity, especially intense in southern Italy, may have been favored by this natural opening of vegetation. In Sardinia and Corsica, no clear change in vegetation is observed at the same time. We suggest that during the 4.2 ka event southern Italy and Tunisia were under the prevalent influence of a north African climate system characterized by a persistent high-pressure cell. [ABSTRACT FROM AUTHOR]

Numerous studies have shown that critically ill infants and toddlers admitted to paediatric intensive care units (PICUs) have a lower mortality than those admitted to adult ICUs. In 2014, there were only 23 registered PICUs in Italy, most of which were located in the north. For this reason, in Italy and elsewhere in Europe, some neonatal ICUs (NICUs) have begun managing critically ill infants and toddlers. Our proposal for healthcare organization is to establish "extended NICUs" in areas where paediatric intensive care beds are lacking. While some countries have opted for a strict division between neonatal and paediatric intensive care units, the model of "extended NICUs" has already been set up in Italy and in Europe. In this instance, the management of critically ill infants and toddlers undoubtedly falls upon neonatologists, who, however, must gain specific knowledge and technical skills in paediatric critical care medicine (PCCM). Postgraduate residencies in paediatrics need to include periods of specific training in neonatology and PCCM. The Italian Society of Neonatology's Early Childhood Intensive Care Study Group is supporting certified training courses for its members involving both theory and practice., Conclusion: Scientific societies should promote awareness of the issues involved in the intensive management of infants and toddlers in NICUs and the training of all health workers involved. These societies include the Italian Society of Neonatology, the European Society of Paediatric and Neonatal Intensive Care, and the Union of European Neonatal and Perinatal Societies. They should also act in concert with the governmental institutional bodies to establish the standards for the "extended NICUs.", What Is Known: • The mortality of critically ill infants and toddlers admitted to PICUs is lower than that for those admitted to adult ICUs. • In Italy, there are only a handful of PICUs, located mainly in the north., What Is New: • Critically ill infants and small toddlers can be managed in "extended NICUs" in areas with a lack of paediatric intensive care beds. • "Extended NICUs" is our proposal for healthcare organization to compensate for the paucity of paediatric intensive care beds, but neonatologists must be trained to provide them with specific knowledge and technical skills in PCCM., (© 2021. The Author(s).)

This article focuses on the development of the study of accounting in the Italian education system between the nineteenth and twentieth centuries. It also focuses on the subsequent formation of a scientific and experimental forma mentis that would prepare students for administrative and managerial activities in industry, commerce and public administration. Starting from the second half of the nineteenth century – when the presence of accounting in education was limited to secondary school and implemented with sporadic educational initiatives by private bodies – and covering approximately the 50 years after the unification of Italy, this study analyses, through the lens of Foucault’s power–knowledge relationship, the institutional and structural measures adopted by the State to develop the study of accounting in Italy, in the period 1890–1935. [ABSTRACT FROM AUTHOR]

The discovery of the Nuragic culture settlement of Sa Osa, Cabras-Oristano, Sardinia, has made it possible to investigate the domestication status of waterlogged uncharred grape pips that were recovered from three wells dating from the Middle and Late Bronze Age (ca. 1350-1150 bc). Applying the stepwise linear discriminant analysis method, a morphological comparison of archaeological seeds and modern wild and cultivated Sardinian grapes pips was performed to determine the similarities between them. The results showed that the archaeological seeds from the Middle Bronze Age have intermediate morphological traits between modern wild and cultivated grape pips from Sardinia. In contrast, the analyses performed on the archaeological seeds from the Late Bronze Age showed a high degree of similarity with the modern cultivars in Sardinia. These results provide the first evidence of primitive cultivated Vitis vinifera in Sardinia during the Late Bronze Age (1286-1115 cal bc, 2σ). This evidence may support the hypothesis that Sardinia could have been a secondary domestication centre of the grapevine, due to the presence of ancient cultivars that still exhibit the phenotypic characteristics of wild grapes. [ABSTRACT FROM AUTHOR]

Plant macrofossil (carpological) and morphometric analyses were carried out on plant remains from the medieval castle of Miranduolo, Siena, a rural settlement in central Italy with a long sequence of occupation between the 8th and the 11th centuries a.d. The presence of Triticum aestivum/durum and Vicia faba var. minor from the first phase of the Lombard farming village suggests continuity with the agricultural tradition of the preceding Roman world, and the use of good cultivation techniques that allowed quality yields to be obtained from rather poor soils. At the same time, the significant presence of the primitive cereal T. monococcum, compared with the archaeobotanical literature of north-central Italy, allows to us consider it as a 'cultural' element of Lombard farming. In the next cultural phases, with the Carolingian manor and then with the feudal castle, the stable presence of T. aestivum/durum and the reduction of T. monococcum in favour of more productive cereals such as Secale cereale and Hordeum vulgare indicate a further improvement in productivity. This is also confirmed by the appearance of fruits and nuts such as Castanea sativa, Vitis vinifera and Prunus persica. The increase in caryopsis sizes of T. monococcum and T. aestivum/durum in the transition from the village to the manorial phase is a consequence of the improvements in farming. The decrease in caryopsis size of T. monococcum from the manor phase to that of the castle testifies the decreasing importance of this cereal. The good date resolution of this research allows us to detect the crops, the storage and the processing practices, as well as the changing role of crop plants in the rural economy. This highlights the geographical, historical-cultural and political factors of the medieval transition from the Lombard to the Carolingian and then to the feudal period in central Italy. [ABSTRACT FROM AUTHOR]

The drawings collection of the Venetian nobleman Gabriele Vendramin (1484–1552) is the earliest major collection that is documented. Three primary sources, the first dated 1530, make it possible to chart the evolution of the collection over the last two decades of Vendramin’s life, to identify important works which it contained, to recognize the high value attached to the drawings and to understand how they were presented and conserved. The most important source, the inventory composed between 1567 and 1569, has not previously been fully scrutinized from the point of view of the drawings. The collection included works attributed to Raphael, Jacopo and Giovanni Bellini, Mantegna, Parmigianino and Domenico Campagnola. Drawings were not the only objects Vendramin collected, or indeed the main ones. Collecting drawings was still a new activity in the early sixteenth century and evaluating Vendramin’s practices and priorities helps to illuminate this formative period. [ABSTRACT FROM PUBLISHER]