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Background: In 2020 the world faced the spread of the coronavirus infection disease (Covid-19). This was a general public health emergency but many people with disabilities might have been particularly affected. Objective: This paper aims to investigate the impact of the Covid-19 pandemic on children with Cerebral Palsy (CP) and their families. Methods: 110 parents of children with CP (aged 2 to 19) who completed a questionnaire were included. These children were under the care of one of the Italian Children Rehabilitation Centers. Socio-demographic and clinical information about patients and their families were collected. In addition, difficulties on adopting protective measures and in respecting lockdown rules by children were explored. We adopted the ICF (International Classification of Functioning, Disability and Health) framework to create multiple choice questions. Descriptive statistics were reported and logistic regression analyses were run in order to identify the predictors of perceived impairment in motor, speech, manual and behavioral abilities. Results: Daily activities of children, as well as rehabilitation and fitness sessions, underwent a change during the pandemic. Spending more time with family due to lockdown measures, has had, in some cases a positive effect however there was a perceived decrease in rehabilitation support and school activities. The age range (between 7 and 12 years) and difficulty in respecting rules emerged as significant predictors of the perceived impairment due to Covid-19 pandemic. Conclusions: The pandemic has had different impacts on children and their families on the basis of children's characteristics. Rehabilitation activities during a hypothetic lockdown should consider these characteristics. [ABSTRACT FROM AUTHOR]

Here, we report on the exceptionally well-preserved deer record from the locality of Pantalla (central Italy), dated in the Early Pleistocene (ca. 2.1–2.0 million years ago). The fossils show a combination of characters that allows an unambiguous attribution to 'Pseudodama' nestii, of which they represent one of the most informative collections to date. Our comparisons—also conducted through CT-based methods on endocranial structures—reveal that the cranial and postcranial skeleton of 'P.' nestii displays a mosaic of intermediate characters between extant Dama and Cervus, but also that the affinities with Dama are prevalent. Some Cervus-like features especially in cranial morphology, can be interpreted as plesiomorphic characters supporting a basal position of 'Pseudodama' among the Cervini. Interestingly, three bone anomalies are described in the two male crania of 'P.' nestii from Pantalla and are interpreted as palaeotraumatological evidence resulting from different injuries suffered by the deer during their life. This allows opening a treasure trove of information on paleobiological aspects, including ontogeny and antler cycle and function. [ABSTRACT FROM AUTHOR]

In this article we argue that transnational social protection (TSP) is becoming the norm in the context of globalisation, heightened mobility and neoliberalism, but cannot be understood without addressing its religious components. TSP differs significantly from national welfare state regimes, which place the responsibility for providing social support firmly on the shoulders of the state. In contrast, TSP regimes involve multiple actors and opportunities in origin and receiving states and place most of the onus for social protection on individuals and families. This article investigates church and state interaction in the development of TSP across the Italian, Mexican and Filipino contexts. It advances scholarship in three key ways: first, it showcases how TSP is replacing state social welfare arrangements and brings to light those shifting church-state entanglements that are central to this shift; second, it highlights the historically rooted trajectories of church-state entanglements that these three cases have in common; and third, it shows that as TSP becomes a state tool in governing non-resident citizens, the church's critical stance in relation to state provisioning is central to TSP as a mode of migration government. [ABSTRACT FROM AUTHOR]

Background and Aims: In Italy, domestic plasma toll fractionation, performed until 2014 by only one company, had limited access to different technologies and products and to price competition. In 2017, four companies acted as competitive toll fractionators for 827,720 kg of plasma. Here, we evaluate the contribution of toll manufacturing and the effects of competition on national self-sufficiency. Results: An increase in immunoglobulin production is granted by new fractionators (11-41%, in some regions adequate for self-sufficiency), although the rise in demand will still require market contribution. The decrease in albumin use (-2.6% in 2015 vs. 2014) is probably due to a better control of an impressively high demand (35.4 t in 2015). Factor VIII demand is still higher than production, but domestic plasma cannot serve as its unique source. New tenders enlarged the portfolio of products and a theoretical self-sufficiency is granted for Factor IX, prothrombin complex concentrates, antithrombin, fibrinogen, and alpha-1-antithrypsin. Conclusions: Competition among companies resulted in higher yields of albumin and immunoglobulin, decreasing their level of market dependence, an increase in the portfolio of medicines, and a decrease in price due to fractionation (20-30%), thus improving perspectives of the national program for self-sufficiency in plasma-derived medicinal products. [ABSTRACT FROM AUTHOR]

The geochemical conditions conducive to dolomite formation in shallow evaporitic environments along the Triassic Tethyan margin are still poorly understood. Large parts of the Triassic dolomites in the Austroalpine and the southern Alpine realm are affected by late diagenetic or hydrothermal overprinting, but recent studies from the Carnian Travenanzes Formation (southern Alps) provide evidence of primary dolomite. Here a petrographic and geochemical study of dolomites intercalated in a 100 m thick Carnian sequence of distal alluvial plain deposits is presented to gain better insight into the conditions and processes of dolomite formation. The dolomites occur as 10 to 50 cm thick homogeneous beds, millimetre-scale laminated beds, and nodules associated with palaeosols. The dolomite is nearly stoichiometric with slightly attenuated ordering reflections. Sedimentary structures indicate that the initial primary dolomite or precursor phase consisted largely of unlithified mud. Strontium isotope ratios (87Sr/86Sr) of homogeneous and laminated dolomites reflect Triassic seawater composition, suggesting precipitation in evaporating seawater in a coastal ephemeral lake or sabkha system. However, the setting differed from modern sabkha or coastal ephemeral lake systems by being exposed to seasonally wet conditions with significant siliciclastic input and the inhibition of significant lateral groundwater flow by impermeable clay deposits. Thus, the ancient Tethyan margin was different from modern analogues of primary dolomite formation. [ABSTRACT FROM AUTHOR]

Preserving cultural heritage doesn't simply imply handing down the image of a building as a whole, it also means safeguarding its material nature through knowing its construction-related features. The need to make buildings meet present-day requirements as regards acoustic and thermal performances must come to terms with the demand of preserving what has been built, avoiding marring its features. This is particularly felt in Italy, since most of the buildings in historical towns were built before the nineteen century. The object of the research is studying plastered wooden-structure partition walls to be found in brick-work Venetian buildings with a view of their refurbishment and conservation. Such walls, consisting in boards and wooden strips (scorzoni and cantinelle) play an important functional and construction-related role inside Venetian buildings. The resort to other materials unconnected with Venetian building tradition has often led to their being substituted with walls built according to more up-to-date techniques which has caused the loss of historical identity as well as quite different thermal-acoustic, rigidity and weight performances. The paper presents the first results of the construction-related analysis of the existing walls and some guidelines aiming to improve their performances, at the same time making their preservation viable. [ABSTRACT FROM AUTHOR]

Gilbert-type deltas are inherently associated with stressful conditions for the benthic infauna, i.e. highly shifting substrates, coarse-grained sediments, traction sedimentation, supercritical flows, and salinity fluctuations. Nevertheless, trace fossils are locally abundant in the Gilbert-type delta system of Ventimiglia (NW Italy), representing the Pliocene infill of an incised valley that developed during the Messinian sea-level fall. The seismic-scale outcrops of the Ventimiglia delta system allow to link ichnological features (ichnotaxa, bioturbation intensity) to the major depositional environments of the deltaic system. Accordingly, rhizoliths characterize the delta plain, whereas delta top deposits are virtually unbioturbated. The delta slope is characterized by Planolites , Thalassinoides , Scolicia -like burrows , and Ophiomorpha. Proximal prodelta deposits show a characteristic Skolithos - Chondrites ichnoassociation, whereas Chondrites and sharp-walled burrows (Thalassinoides ?) dominate the distal prodelta. Reworked beach deposits occasionally present bioerosional ichnotaxa (Entobia , Gastrochaenolites , and Maeandropolydora), which suggest the presence of a nearby rocky coast. Overall, bioturbation intensity increases with increasing distance from the delta-top setting, whereas ichnodiversity has its maximum in delta-toe and prodelta units. Moreover, a clear sequence-stratigraphic signature is observed for the Ventimiglia ichnoassociations. The ichnological evolution of the Ventimiglia delta system, with bioturbation intensity increasing in forced-regressive systems tracts of successive sequences, is here hypothesized as a signature of overfilled incised valleys. The Skolithos-Chondrites ichnoassociation is especially common in the highstand systems tract, possibly reflecting higher amounts of suspended matter during the sedimentation of the highstand systems tract itself. The basal surface of forced regression usually preserves passively filled burrows with a sharp unlined margin, which fits well with a sediment-starved seafloor. • The first palaeoecological model of a Gilbert-type delta is described. • Low bioturbation intensity is a salient characteristic of Gilbert-type deltas. • Bioturbation intensity increases with increasing distance from the delta top setting. • Ichnodiversity is maximum in delta toe and prodelta units. • Skolithos and Chondrites are common in the highstand systems tract. [ABSTRACT FROM AUTHOR]

A nearly complete fallow deer skeleton from the lower levels (early Middle Pleistocene) of Valdemino Cave (northwestern Italy) is attributed to the recently described Dama roberti Breda and Lister. The dental and postcranial anatomy of this specimen is analysed in detail. Some anatomical elements show a mosaic of characters of living D. dama and Cervus elaphus, but with only a minor part resembling the latter. Each element is compared with other representatives of the fallow deer lineage, in particular to the type series of the early Middle Pleistocene D. roberti from the British Cromer Forest Bed Formation and from the French locality of Soleilhac, with its possible descendant D. dama (both the late Middle Pleistocene D. d. clactoniana and modern D. d. dama) and with its possible parent species (several representatives of the Late Pliocene-Early Pleistocene ' Pseudodama' group). The variability of selected characters has enabled a better morphological characterization of the species. The skeleton from Valdemino matches very precisely the morphology of the few existing postcranial elements of the D. roberti holotype and paratype. This will allow future identification of isolated postcranial bones from other localities. The Valdemino skeleton also perfectly matches the size of the type populations and confirms that D. roberti is larger than the living fallow deer D. dama. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The deer remains from the renowned Palaeolithic site of Isernia la Pineta (southern Italy) are revised. Both material already published, and new specimens from the last 15 years of excavation, is taken into account and some identifications are revised. The published assemblage consists of Megaceroides solilhacus, Cervus sp. cf. C. elaphus acoronatus, Dama sp. cf. D. clactoniana and Capreolus sp. The literature dealing with these species is discussed and the problems still unresolved are outlined. The giant deer, now assigned by most authors to the genus Praemegaceros as P. solilhacus, is the largest and most common deer species at the site, represented by numerous antler fragments plus a few isolated teeth and fragmentary postcranial elements. The retrieval of new, well-preserved specimens, namely one nearly complete antler, plus a distal portion of palmation, two neural skulls and one premaxillary bone, allows a better characterization of this otherwise still poorly understood species. The sub-specific attribution of the red deer, in the lack of more complete antler specimens, is still dubious. The fallow deer remains probably belong to Dama roberti, a recently described species from the early Middle Pleistocene of Western Europe. The morphology of the lower portion of the only preserved antler fits better with this species rather than with D. clactoniana, to which it was previously tentatively assigned. At last, the specific identity of the few roe deer remains from Isernia is discussed, but the problem remains unanswered because of lack of agreement, in the literature, about the taxonomy of the Pleistocene species. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: A new web-based food frequency questionnaire (the ASSO-FFQ) was developed within the ASSO Project funded by the Italian Ministry of Health. Objective: The aim of the present study is to assess the validity of the ASSO-FFQ at food groups, energy, and nutrients level. Design and subjects: The validation study compared the ASSO-FFQ against a weighted food record (WFR) measuring foods, beverages and supplements intake, compiled during the week following the ASSO-FFQ administration. Ninety-two subjects aged 14-17, recruited from secondary schools in Palermo (Italy), completed the ASSO-FFQ and WFR. The intake of 24 food groups, energy, and 52 nutrients were taken as main outcomes. Tests for paired observations, Spearman and Pearson's correlation coefficients (cc), kappa statistics and classification in quintiles, Bland-Altman plots and multiple regressions, on untransformed and transformed data were used for the statistical analysis. Results: High cc (≥0.40) were found for soft drinks, milk, tea/coffee, vegetables, and lactose; fair energy-adjusted cc (0.25-0.40) for water, alcoholic drinks, breakfast cereals, fishery products, savory food, fruit juice, eggs, and 19 nutrients. The subjects classified in the same or adjacent quintile for food groups ranged from 40% (alcoholic drinks) to 100% (dried fruit); for energy and nutrients from 43% (phosphorus, thiamin, niacin) to 77% (lactose). Mean differences were not significant for water, soft drinks, meat, sweets, animal fats, milk and white bread, and vitamin B12 and folate. Limits of Agreement were broad for all food groups and nutrients. School, gender, alcohol consumption and between meals mainly affected most food groups' intake differences. Gender stratification showed females had increased Pearson's cc for energy and 28 nutrients, such as almost all fats, carbohydrates, vitamins and minerals. Conclusions: The ASSO-FFQ could be applied in epidemiological studies for the assessment of dietary consumption in adolescents to adequately rank food, energy and nutrient intakes at a group level. [ABSTRACT FROM AUTHOR]

Objective: With an estimated incidence of 77 new cases per 100,000 population aged 65 years or above, idiopathic sudden sensorineural hearing loss (ISSNHL) is a common clinical finding in elderly patients. There is a shortage of information on the clinical factors capable of predicting hearing recovery and response to therapy. The aim of the present study was to retrospectively investigate the prognostic value of clinical variables in relation to hearing recovery in a cohort of consecutive elderly patients with ISSNHL. Study design: This investigation considered 49 consecutive elderly patients (≥ 65 years of age) treated for ISSNHL. Clinical parameters (signs, symptoms, comorbidities and treatments) and audiometric data were analysed using univariate and multivariate statistical approaches for prognostic purposes, i.e. to identify any correlation with hearing recovery, expressed according to Wilson's criteria. Results/Conclusions: No clinical signs and symptoms, and no specific therapeutic approaches correlated significantly with hearing recovery after ISSNHL in our multivariate model ( p > 0.05). In the univariate analysis, vascular disease correlated significantly with hearing gain after treatment ( p = 0.01). Further studies based on larger cohorts (especially in a prospective setting) are needed to further elucidate the prognostic role of clinical parameters in ISSNHL involving elderly patients. [ABSTRACT FROM AUTHOR]

This article discusses the limits of Italian immigration policies and their effects on the Italian market of highly skilled individuals. Italian statutory provisions aimed at regulating immigration focus on limiting immigration without a reasoned distinction being made between skilled and unskilled immigrants. The first part of the article argues that a combination of historical and sociological factors makes Italy uncompetitive in the global market of highly skilled individuals. The second part suggests two pilot schemes for policies that might help in addressing the issue. First, the introduction of a medium-/long-term visa for highly skilled individuals, and second, the establishment of private multinational universities modelled on the European Institute ( EI) in Florence. These new institutions would open up the academic job market to overseas researchers and, at the same time, would provide a more solid base for the retrieval of Italian academics working abroad. [ABSTRACT FROM AUTHOR]

Abstract: The present work examines the abundant dental remains from the renowned anthropic site of Isernia La Pineta (Molise, Italy), early Middle Pleistocene (Middle Galerian). The rhinoceros, Stephanorhinus hundsheimensis, is the most represented species after Bison, and is represented mainly by skull and dental remains and by strongly fractured long bones (suggesting exploitation of the carcasses by the hominine). The high sample size of the dental remains allowed a detailed analysis of the dental morphology. The frequency analysis of the morphological characters shows a high degree of regional variation within the species with the Isernia population significantly widening the morphological variability of S. hundsheimensis (thus limiting the diagnostic power of several characters). In particular, comparing S. hundsheimensis from Isernia with coeval British populations, some specimens could be safely assigned to S. hundsheimensis that do look strongly anomalous within the British sample but find a match in the wider morphological range of the Isernia specimens. From a biometrical point of view, the Isernia population attains slightly smaller sizes than the coeval British specimens, suggesting a latitudinal size increase gradient. [Copyright &y& Elsevier]

The Health Commission of the Conference between the Italian State and Regions recognized the need to establish an institutional accreditation model for Haemophilia Centres (HCs) to be implemented by 21 Regions in order to provide patients with haemophilia and allied inherited coagulations disorders with high and uniform standards of care. The Italian National Blood Centre, on behalf of the Commission, convened a panel of clinicians, patients, experts, representatives from Regions and Ministry of Health. The agreed methodology included: systematic literature review and best practice collection, analysis of provisions and regulations of currently avalable services, priority setting, definition of principles and criteria for the development of recommendations on the optimal requirements for HCs. The result was the formulation of two recommendations sets. Two sets of recommendations were produced. The first concerns regional policy planning, in which the following aspects of comprehensive haemophilia care should be considered for implementation: monitoring and auditing, multidisciplinary approach to clinical care, protocols for emergency management, home treatment and its monitoring, patient registries, drug availability and procurement, recruitment and training of health care professionals. The second set concerns the accreditation process and lists 23 organizational requirements for level 1 HCs and 4 additional requirements for level 2 HCs. These recommendations help to provide Italian Regional Health Authorities with an organizational framework for the provision of comprehensive care to patients with inherited coagulation disorders based on current scientific evidence. [ABSTRACT FROM AUTHOR]

Aim: We assessed the efficacy, reliability and cost of an in-home control service, devoted to debilitated patients with pacemakers, during long-term follow up. Methods: We admitted 802 patients (mean age 87.8 ± 6.9 years) with pacemakers into our program, which were monitored periodically during in-home visits by nurses. During these controls, patients underwent a standard electrocardiogram with and without magnet, during which stimulation intervals were measured. In-home pacemaker assessments were performed by a portable programmer only for patients with Biotronik pacemakers. Electrocardiograms and technical data were evaluated at hospital, and a report was sent by mail to the patient. Moreover, we compared the costs for the hospital, patients and society between in-home and ambulatory assessments. Results: During 80 months of follow up, 2418 controls were performed. The monthly average of patients who were followed at home was 283.9 ± 23.9. The mean number of controls per month was 30.2 ± 10 (range 4-51). One hundred and twenty-three pacemakers were replaced due to battery exhaustion, after a mean device longevity of 7.4 years (range 4.9-12.4 years). Four hundred and sixty-eight patients died (8.7% annual mortality). Fifteen patients (annual incidence 0.3%) were invited to in-hospital visits for reprogramming. The cumulative cost for in-home assessment were 20.5% lower than conventional in-hospital controls and 66.5% lower if patients are transported by ambulance. Conclusion: Elderly debilitated patients can be monitored by effective and reliable pacemaker assessments at home, alleviating them and their families from the issues that are associated with their transfer from the home to the hospital and concurrently reducing overall costs. Geriatr Gerontol Int 2012; 12: 30-35. [ABSTRACT FROM AUTHOR]

The Travenanzes Formation is a terrestrial to shallow-marine, siliciclastic-carbonate succession (200 m thick) that was deposited in the eastern Southern Alps during the Late Triassic. Sedimentary environments and depositional architecture have been reconstructed in the Dolomites, along a 60 km south-north transect. Facies alternations in the field suggest interfingering between alluvial-plain, flood-basin and shallow-lagoon deposits, with a transition from terrestrial to marine facies belts from south to north. The terrestrial portion of the Travenanzes Formation consists of a dryland river system, characterized by multicoloured floodplain mudstones with scattered conglomeratic fluvial channels, merging downslope into small ephemeral streams and sheet-flood sandstones, and losing their entire discharge subaerially before the shoreline. Calcic and vertic palaeosols indicate an arid/semi-arid climate with strong seasonality and intermittent discharge. The terrestrial/marine transition shows a coastal mudflat, the flood basin, which is usually exposed, but at times is inundated by both major river floods and sea-water storm surges. Locally coastal sabkha deposits occur. The marine portion of the Travenanzes Formation comprises carbonate tidal-flat and shallow-lagoon deposits, characterized by metre-scale shallowing-upward peritidal cycles and subordinate intercalations of dark clays from the continent. The depositional architecture of the Travenanzes Formation suggests an overall transgressive pattern organized in three carbonate-siliciclastic cycles, corresponding to transgressive-regressive sequences with internal higher-frequency sedimentary cycles. The metre-scale sedimentary cyclicity of the Travenanzes Formation continues without a break in sedimentation into the overlying Dolomia Principale. The onset of the Dolomia Principale epicontinental platform is marked by the exhaustion of continental sediment supply. [ABSTRACT FROM AUTHOR]

Abstract: Overfilled incised valleys develop when the rate of sediment supply outpaces the rate of accommodation. An overfilled incised valley presents simple or compound valley-fill architecture, depending on the depth of the valley incision, compared with the height reached by the following sea-level rise. The Ventimiglia incised valley, exposed on the Ligurian coast, north-western Mediterranean margin, presents a spectacular example of compound incised-valley fill, developed in perennial “overfill” conditions. The valley was subaerially incised during the Messinian Salinity Crisis and rapidly flooded by the sea at the beginning of Pliocene, then filled by eleven coarse-grained Gilbert-type deltas during Early–Middle Pliocene time. The basal Messinian unconformity is locally paved with subaerial scree breccias and bioclastic shallow-marine sandstones, and blanketed by bathyal marls. These deposits record the lowstand, transgressive and early-highstand systems tracts of the first valley-fill sequence. The subsequent progradation of Gilbert-type deltas occurred in four stages, or depositional sequences, separated by transgressive marine-marl intervals. Within each depositional sequence, the deltaic bodies display offlapping architecture, recording falling shoreline trajectory, downward shifts in facies, and overall forced regression. The water depth and accommodation in the inundated coastal valley was gradually decreasing with time. The reduced accommodation allowed the youngest deltas to prograde out to the shelf edge, triggering mass collapses and subsequent filling into the newly created slump scars. Some of the deltas probably acted as “canyon-perched deltas” and supplied sediment to the deep-water slope and floor of the Ligurian Basin. The vertical stacking of Gilbert-type deltas is usually attributed, in tectonically active basins, to fault-related subsidence pulses. In Ventimiglia, the accommodation was created by high-frequency eustatic sea-level rises that, probably accompanied by climate controlled reductions in sediment supply, temporarily outpaced uplift, leading to the development of multiple cycles of infill. [Copyright &y& Elsevier]

Abstract: We applied magnetostratigraphy and mammal biostratigraphy to date climate-sensitive pollen cycles and lithostratigraphic units of the Pliocene–Pleistocene Leffe sedimentary succession from the Southern Alps, Italy. The Leffe section was correlated to additional sections (Casnigo, Fornaci di Ranica, and Pianengo) to construct a stratigraphic network along a common fluviatile system (the Serio River) sourced in the Southern Alps and flowing southward into the Po River Basin. We obtained a coherent scenario of climate variability for the last ∼2 Myr. At Leffe, lacustrine deposition commenced during the Olduvai Normal Subchron (1.94–1.78 Ma) and lasted up to a chronologic level compatible with Marine Isotope Stage (MIS) 22 (0.87 Ma). Pollen analysis revealed that climate varied cyclically from warm-temperate to cool during this time interval, but never as cold as during glacial intervals. At around MIS 22, climate cooled globally. Gravels, attributed to high-energy braided river systems fed locally by alluvial fans, prograded from the Serio River catchment area over the Leffe Basin and toward the Po Plain in response to a generalized event of vegetation withdrawal and enhanced physical erosion. At this time, Alpine valley glaciers reached their first maximum southward expansion with glacier fronts located at only ∼5 km upstream from Leffe. [Copyright &y& Elsevier]

Background: It has been proposed that extending the platinum-free interval with intervening non-platinum therapy increases the efficacy of a later re-treatment with platinum in platinum-sensitive recurrent ovarian cancer. This hypothesis is based on data from small series and although it has not been validated prospectively, this strategy has entered general practice in Italy in the last years. The SOCRATES study retrospectively assessed the pattern of care of a cohort of patients with recurrent platinum-sensitive ovarian cancer observed in the years 2000–2002 in 37 Italian centres. Data were collected between April and September 2005. Methods: Patients with recurrent ovarian cancer with a platinum-free interval >6 months were eligible. 493 patient files were collected and 428 were eligible and analyzed. Results: The interval from the end of the 1st line to relapse was 6–12 months in 164 patients (39.5%) and >12 months in 251 cases (60.5%). Patients received a 2nd (100%), 3rd (80.1%), 4th (50.2%), 5th (28.3%), and 6th (11.9%) line of chemotherapy. At 2nd line 282 (65.9%) received platinum (group A), while 146 (34.1%) received non-platinum chemotherapy (group B). In the latter group, 67 patients received platinum at later progression (group B1), while 79 never received platinum (group B2). Median time to platinum re-treatment was 20 and 23.1 months in patients of groups A and B1, respectively. The response rate to the first platinum received was 74.4 and 57.4% in groups A and B1, respectively (p = 0.02). Group B2 was characterized by the worst response rate and survival. At multivariate analysis time of first platinum re-treatment (2nd line vs. later; p = 0.0132; OR = 2.34) and age (p = 0.0029; OR = 2.41) was independently associated with a higher possibility of response to platinum. Conclusions: With the limits of a retrospective study, our data question the hypothesis that extending the platinum-free interval with an intervening non-platinum therapy in patients with recurrent platinum-sensitive ovarian cancer improves the response rate of a further platinum re-treatment. Copyright © 2006 S. Karger AG, Basel [ABSTRACT FROM AUTHOR]

Background. The COVID-19 lockdown determined important changes in the sleep of a large percentage of the world population. We assessed the modifications of reported sleep patterns and disturbances in Italian children and adolescents with autism spectrum disorders (ASD) or attention deficit hyperactivity disorders (ADHD), compared to control children, before and during the COVID-19 lockdown in Italy. Methods. Parents of 100 ASD, 236 ADHD patients, and 340 healthy children filled out an anonymous online survey and a modified version of the Sleep Disturbance Scale for Children (SDSC), advertised via social media, to evaluate sleep patterns and disturbances of their children before and during the lockdown. Results. Before the lockdown, bedtime and risetime were not different between the three groups. During the lockdown, ADHD children tended to have a later bedtime and risetime than ASD and controls, while ASD children tended to maintain similar bedtime and risetime. Overall, during the lockdown, a reduced sleep duration significantly differentiated clinical groups from controls. Anxiety at bedtime, difficulties in falling asleep, and daytime sleepiness increased in all groups during the lockdown. Hypnic jerks, rhythmic movement disorders, night awakenings, restless sleep, sleepwalking, and daytime sleepiness increased in ASD and ADHD patients, in particular. Conclusions. This is the first study comparing sleep habits and disorders in ASD and ADHD during the lockdown showing specific differences consistent with the core characteristics of two neurodevelopmental disorders. [ABSTRACT FROM AUTHOR]

Discusses the alternative measures to incarceration in Italy. Trial custody to social services; Day release; Changes in Italy's juridical philosophy and practice.

Background: The observed increase in body weight and cardiometabolic risk (CR) in youth from developed countries contributes to the global burden of chronic diseases in adult age. The aim of this work is to provide a patterning of the associations between different factors and the weight status and CR of the subjects involved in the Italian ministerial ASSO project. Methods: This study involved 919 students from high schools in Palermo. Weight, height and waist circumference were collected by trained teachers; weight status was estimated by the BMI cut-offs for adolescents and CR through the waist-to-height ratio. Questionnaires were administered through the web-based ASSO-NutFit software. Chi-square test investigated the variables significantly associated with the outcomes, which were then included in a Multiple Correspondence Analysis (MCA), to explore their dimensional relationship to weight status and CR. Poisson regressions were conducted separately for the two outcomes, reporting raw and adjusted prevalence ratios (PRs) and Bootstrap Method was used to determine confidence intervals (CIs), to assessing the degree of effect of the explanatory variables over the outcomes. Results: Two main dimensions were evidenced, with the overweight/obese group and the group at CR characterized by the following strongly associated factors: male gender, overweight/obese parents, following a slimming regime, caesarean birth, sedentariness, being under/overweight at birth, presence of metabolic risk, going to school by car/scooter, not using supplements. Conclusions: This study contributed to identifying those adolescents that should be prioritized in interventions aiming at reducing overweight/obesity and CR in this age group. [ABSTRACT FROM AUTHOR]

The article updates on acute rheumatic fever (ARF), insisting that it is far from being eradicated. Topics include the incidence of ARF in the Abruzzo region in central Italy between 2000 and 2009 and in the Marche region of central Italy where 43 ARF cases were detected between 2007 and 2011. Also mentioned are rheumatic heart disease (RHD) as a serious complication of ARF as well as the conclusion that ARF might be more common than expected among low-risk children in industrialized countries.

Abstract: We carried out a systematic investigation on the pollen content of sediment adhering to skeletal elements of large mammals which originate from the long lacustrine record of Leffe (Early Pleistocene of the Italian Alps). Three local faunas were discovered during mining activities along the intermediate part (spanning from 1.5 to 0.95Ma) of the basin succession. The excellent pollen preservation allowed testing the reproducibility of the pollen signal from single skeletons. A clear palaeoenvironmental patterning, consistent with the ecological preferences of the considered mammal species, emerged from the canonical correspondence analysis of pollen types diagnostic for vegetation communities. Edaphic factors related to seasonal river activity changes and to the development of swamp forests in the riverbanks are significantly associated to the occurrences of Hippopotamus cf. antiquus, whereas finds of Mammuthus meridionalis belong to fully forested landscapes dominated by conifer or mixed forests of oceanic, warm to cool-temperate climate. Rhinoceros habitats include variable forest cover under different climate states. Distinct cool-temperate, partially open vegetation could be recognized for large deer included Cervalces cf carnutorum. A palynostratigraphic correlation between individual spectra and a reference palynostratigraphic record allowed assignment of many fossil remains to a precise stratigraphic position. This procedure also shown that the Leffe local faunas include specimens accumulated under different environmental and climate states, as a consequence of high-frequency climate changes characterizing the Late Villafranchian Early Pleistocene. [Copyright &y& Elsevier]

Abstract: An interdisciplinary investigation of the Pleistocene clay succession of Fornaci di Ranica (Italian Pre-Alps) aimed to reconstruct the palaeoenvironmental history and its chronostratigraphic position and to consider the implications for the Quaternary evolution of the southern alpine borderland near the Early/Middle Pleistocene transition. A detailed survey of Quaternary deposits in boreholes and exposed sections provided a complete record of the basin. The most complete core was analyzed for palynology and magnetic properties. Plant macrofossils were obtained by flotation. Pollen and spectrometric analysis allowed a precise stratigraphic placement of a moose antler and braincase kept in museum collections. The basin originated from fluviatile obstruction of a tributary valley cut into bedrock. The basal deposits formed as a terrestrial hydromorphic soil under a dense Tsuga-forest (zone RNC 1). The overlying palustrine gyttja shows a marked forest withdrawal with a climatic signature (zone RNC 3), followed by a re-establishment of mixed conifer forests (zones RNC 4–6). The occurrences of pollen of cold-adapted taxa (Saxifraga oppositifolia type, Saxifraga stellaris type, Larix), are the oldest so far known south of the Alps and suggest that mean summer temperature was near or even below the thermic tree limit. High herb diversity, partially represented by tall forbs, characterizes this zone. A further increase of the water table can be assumed in zones RNC 4 and RNC 5, since pollen of aquatic plants increases. The find of Larix decidua L. cones demonstrates the existence of the European larch in the Early Pleistocene of the Alps, previously not identified at the species level. After the Serio river had reached the maximum Quaternary aggradation, the lake was rapidly filled up with turbiditic sediments. The identification of Cervalces latifrons (Johnson, 1874) by Azzaroli (Palaeantogr. Italica 71(1979) 48) was confirmed. Pollen spectra obtained from clay fragments preserved in the braincase allowed us to constrain the stratigraphic position of these fossil remains in the lower palustrine portion of the sequence. Pollen and moose palaeoecology corroborate the reconstruction of a boreal landscape. The succession of Fornaci di Ranica is attributed to the late Early Pleistocene on the basis of the following elements: (i) the occurrence of an acme pollen zone of Tsuga, with Carya and Pterocarya; (ii) the low representation of Cedrus; (iii) the biochronology of Cervalces latifrons; (iv) normal fossil magnetic polarity, interpreted as part of the Jaramillo subchron on the basis of correlations with other studied sections from the same region, and, finally, (v) indications from the regional geological evolution. The basin deposits spanned the final stage of a temperate period and the subsequent transition to a cold phase during the Jaramillo subchron or the Cobb cryptochron. The basin originated by fluvioglacial aggradation, triggered by glaciation in the northern part of the Serio river catchement. The lake succession may represent an episode of marked increase of polar ice volume related to MIS (36) 30, or 28. The correlation with the Leffe sequence also suggests that cold climate conditions inferred for pollen zone RNC 3 did not occur earlier in the Early Pleistocene of this region. [Copyright &y& Elsevier]

In this article we want to show the potential of an evolutionary algorithm called Topological Weighted Centroid (TWC). This algorithm can obtain new and relevant information from extremely limited and poor datasets. In a world dominated by the concept of big (fat?) data we want to show that it is possible, by necessity or choice, to work profitably even on small data. This peculiarity of the algorithm means that even in the early stages of an epidemic process, when the data are too few to have sufficient statistics, it is possible to obtain important information. To prove our theory, we addressed one of the most central issues at the moment: the COVID-19 epidemic. In particular, the cases recorded in Italy have been selected. Italy seems to have a central role in this epidemic because of the high number of measured infections. Through this innovative artificial intelligence algorithm, we have tried to analyze the evolution of the phenomenon and to predict its future steps using a dataset that contained only geospatial coordinates (longitude and latitude) of the first recorded cases. Once the coordinates of the places where at least one case of contagion had been officially diagnosed until February 26th, 2020 had been collected, research and analysis was carried out on: outbreak point and related heat map (TWC alpha); probability distribution of the contagion on February 26th (TWC beta); possible spread of the phenomenon in the immediate future and then in the future of the future (TWC gamma and TWC theta); how this passage occurred in terms of paths and mutual influence (Theta paths and Markov Machine). Finally, a heat map of the possible situation towards the end of the epidemic in terms of infectiousness of the areas was drawn up. The analyses with TWC confirm the assumptions made at the beginning. • In this article the potential of an evolutionary algorithm called TWC is shown. • TWC can obtain new and relevant information from extremely limited and poor data. • TWC has been applied to the COVID-19 epidemic data. • TWC correctly identifies the location of the official Italian outbreak. • TWC correctly identifies the trend in the geographical expansion of the epidemic. [ABSTRACT FROM AUTHOR]

Background: Little evidence-based information is available to guide the treatment of oligoarticular juvenile idiopathic arthritis. We aimed to investigate whether oral methotrexate increases the efficacy of intra-articular corticosteroid therapy.Methods: We did this prospective, open-label, randomised trial at ten hospitals in Italy. Using a concealed computer-generated list, children younger than 18 years with oligoarticular-onset disease were randomly assigned (1:1) to intra-articular corticosteroids alone or in combination with oral methotrexate (15 mg/m2; maximum 20 mg). Corticosteroids used were triamcinolone hexacetonide (shoulder, elbow, wrist, knee, and tibiotalar joints) or methylprednisolone acetate (ie, subtalar and tarsal joints). We did not mask patients or investigators to treatment assignments. Our primary outcome was the proportion of patients in the intention-to-treat population who had remission of arthritis in all injected joints at 12 months. This trial is registered with European Union Clinical Trials Register, EudraCT number 2008-006741-70.Findings: Between July 7, 2009, and March 31, 2013, we screened 226 participants and randomly assigned 102 to intra-articular corticosteroids alone and 105 to intra-articular corticosteroids plus methotrexate. 33 (32%) patients assigned to intra-articular corticosteroids alone and 39 (37%) assigned to intra-articular corticosteroids and methotrexate therapy had remission of arthritis in all injected joints (p=0·48). Adverse events were recorded for 20 (17%) patients who received methotrexate, which led to permanent treatment discontinuation in two patients (one due to increased liver transaminases and one due to gastrointestinal discomfort). No patient had a serious adverse event.Interpretation: Concomitant administration of methotrexate did not augment the effectiveness of intra-articular corticosteroid therapy. Future studies are needed to define the optimal therapeutic strategies for oligoarticular juvenile idiopathic arthritis.Funding: Italian Agency of Drug Evaluation. [ABSTRACT FROM AUTHOR]

Abstract: The ITER Heating Neutral Beam injectors will be implemented in three steps: development of the ion source prototype, development of the full injector prototype, and, finally, construction of up to three ITER injectors. The first two steps will be carried out in the ITER neutral beam test facility under construction in Italy. The ion source prototype, referred to as SPIDER, which is currently in the development phase, is a complex experiment involving more than 20 plant units and operating with beam-on pulses lasting up to 1h. As for control and data acquisition it requires fast and slow control (cycle time around 0.1ms and 10ms, respectively), synchronization (10ns resolution), and data acquisition for about 1000 channels (analogue and images) with sampling frequencies up to tens of MS/s, data throughput up to 200MB/s, and data storage volume of up to tens of TB/year. The paper describes the architecture of the SPIDER control and data acquisition system, discussing the SPIDER requirements and the ITER CODAC interfaces and specifications for plant system instrumentation and control. [Copyright &y& Elsevier]

Abstract: Background: Elderly patients with ovarian carcinoma have a poorer prognosis compared with their younger counterpart, and this depends in most cases on undertreatment. The aim of this study was to evaluate, retrospectively, the pattern of care and the prognosis of elderly patients with platinum-sensitive recurrent ovarian cancer. The SOCRATES study retrospectively assessed the pattern of care of a cohort of patients with recurrent platinum-sensitive ovarian cancer observed in the years 2000–2002 in 37 Italian centres. Data were collected between April and September 2005. Patients and methods: Patients with recurrent ovarian cancer with >6 months of platinum free interval were considered eligible. Four-hundred-ninety-three patient files were collected and 425 were considered eligible and analyzed. Ninety-four patients with age ≥70 years and 331 patients with age <70 years were analyzed. Results: Recurrence free interval (RFI), PS, and number of disease sites were similar among the two groups. A lower proportion of elderly patients underwent secondary cytoreduction (8.9% compared to 23.9%; p =0.0018). The mean number of chemotherapy lines received for recurrence was 2.7 and 2.5 in young and aged patients, respectively. Elderly patients received more frequently at second line single agent platinum than platinum-combination therapy or other non-platinum chemotherapy. The response rate to the second line chemotherapy was higher in younger patients than in the elderly population (CR+PR, younger: 67.2%; elderly: 46.5%; p =0.0004). Median overall survival from recurrence was 30.7 months in the younger patients and 23.6 months in the elderly group (p =0.0037). At multivariate analysis, number of disease sites (>1 vs. 1), performance status at recurrence (2–3 vs. 0–1), RFI (6–12 months vs. >12 months), age at recurrence, were independently associated with survival. Conclusion: Elderly patients with platinum-sensitive recurrent ovarian cancer receive less surgery and chemotherapy. Response to chemotherapy is better in younger patients. Age is an unfavourable factor independently associated to a worst prognosis. [Copyright &y& Elsevier]

The coronavirus has challenged all medical systems worldwide. Herein both waves of COVID-19 (coronavirus disease 2019) in spring and autumn 2020 differ principally. Whereas Europe was hit by the first wave more or less unprepared, which was aggravated by the high virulence of COVID-19, the second wave is characterized by a much higher contagiosity of the virus with very high incidences. On the other hand the virus has attenuated, which is reflected by the significantly lower incidence-related mortality rate. However, the overall increasing number of infected patients represents again a great challenge for the medical management of the disease. France and Spain are doing better in comparison to Germany and Italy this time. The absolute number of deaths per week is higher than during the peak of the first wave. However, urologists in these countries have also experienced greater restrictions in their activities in the second shutdown than in Germany, where there is only a reduction of beds to between 75 and 90%. Mostly all levels are operated. Of importance for Germany, however, is the plateau on a high level for several weeks probably due to the reduced efficacy of a light lock-down. This finally resulted in a total lock-down in mid-December 2020. Subsequently in Germany some hospitals are also reaching their limits with similar consequences for the departments of urology facing a 50% reduction of beds and operating only level III and IV indications. Nevertheless, the management of urologic patients during the COVID-19 pandemic is carried out in Europa on a high standard. Therefor the risk of secondary harm to our patients is expected to be rather minimal in the long run.

Mosquitoes of the Aedes genus transmit arboviruses of great importance to human health as dengue, chikungunya, Zika and yellow fever. The tiger mosquito Aedes albopictus can play an important role as arboviral vector, especially when Aedes aegypti is absent or present at low levels. Remarkably, the rapid worldwide spreading of the tiger mosquito is expanding the risk of arboviral transmission also to temperate areas, and the autochthonous cases of chikungunya, dengue and Zika in Europe emphasize the need for improved monitoring and control. Proteomic and transcriptomic studies on blood feeding arthropod salivary proteins paved the way toward the exploitation of genus-specific mosquito salivary proteins for the development of novel tools to evaluate human exposure to mosquito bites. We previously found that the culicine-specific 34k2 salivary protein from Ae. albopictus (al34k2) evokes specific IgG responses in experimentally exposed mice, and provided preliminary evidence of its immunogenicity to humans. In this study we measured IgG responses to al34k2 and to Ae. albopictus salivary gland protein extracts (SGE) in individuals naturally exposed to the tiger mosquito. Sera were collected in two areas of Northeast Italy (Padova and Belluno) during two different time periods: at the end of the low- and shortly after the high-density mosquito seasons. Anti-SGE and anti-al34k2 IgG levels increased after the summer period of exposure to mosquito bites and were higher in Padova as compared to Belluno. An age-dependent decrease of anti-saliva IgG responses was found especially in Padova, an area with at least 25 years history of Ae. albopictus colonization. Moreover, a weak correlation between anti-saliva IgG levels and individual perception of mosquito bites by study participants was found. Finally, determination of anti-al34k2 IgG1 and IgG4 levels indicated a large predominance of IgG1 antibodies. Overall, this study provides a convincing indication that antibody responses to al34k2 may be regarded as a reliable candidate marker to detect temporal and/or spatial variation of human exposure to Ae. albopictus ; a serological tool of this kind may prove useful both for epidemiological studies and to estimate the effectiveness of anti-vectorial measures., (Copyright © 2020 Buezo Montero, Gabrieli, Montarsi, Borean, Capelli, De Silvestro, Forneris, Pombi, Breda, Capelli and Arcà.)

The priority objectives of the Italian Transfusion System are self-sufficiency for blood components and for plasma-derived products. Currently the collection activity guarantees self-sufficiency of blood components, including plasma for clinical use, but not for plasma-derived drugs, ie albumin and immunoglobulins in particular. The National Plasma Program of 2016-2020, issued a Ministerial Decree on December, 2, 2016, aims to achieve this goal, both by increasing the collection of plasma and therefore its transfer to plasma derivation companies, and by increasing the appropriateness of the requests. Currently, the companies Grifols SpA, Kedrion SpA, CSL Behring, and Baxter-Baxalta Srl are present on the Italian market, individually or in business associations, with which the various Italian regions have established an agreement based on the national legislation., (Copyright © 2019. Published by Elsevier Ltd.)

Following reports of West Nile neuroinvasive disease in the north-eastern area of Italy in 2009, all blood donations dating from the period between 1 August and 31 October 2009 in the Rovigo province of the Veneto region were routinely checked to exclude those with a positive nucleic acid test for West Nile virus (WNV). Only one of 5,726 blood donations was positive (17.5 per 100,000 donations; 95% confidence interval (CI): 0.4–97.3). In addition, a selection of 2,507 blood donations collected during the period from 20 July to 15 November 2009 were screened by ELISA for IgG and IgM antibodies against WNV. A positive result was received for 94 of them. The positive sera were further evaluated using immunofluorescence and plaque reduction neutralisation test (PRNT), in which only 17 sera were confirmed positive. This corresponds to a prevalence of 6.8 per 1,000 sera (95% CI: 4.0–10.9). In a case-control study that matched each of the 17 PRNT-positive sera with four negative sera with the same date of donation and same donation centre, we did not find a significant association with age and sex of the donor; donors who worked mainly outdoors were significantly more at risk to have a positive PRNT for WNV.

Background: This study was aimed at obtaining significant information on the quality of whole-blood plasma (WBP) delivered to a private pharmaceutical company by the blood transfusion centers (BTCs) of 10 Italian regions., Study Design and Methods: A statistical sampling plan of plasma units took into account the contribution each selected blood transfusion center, belonging to the 10 regions, made to the plasma pool annually delivered to the pharmaceutical company. A total of 1787 plasma units were selected for coagulation Factor VIII (FVIII:C) and Factor VIII antigen (FVIII:Ag) analysis., Results: The FVIII:C mean value was 0.99 IU per mL; it was significantly lower in O units (0.86 IU/mL) than in non-O units (1.08 IU/mL). The mean value of FVIII:Ag was 0.90 IU per mL; it was significantly lower in O units (0.78 IU/mL) than in non-O units (0.99 IU/mL). In units with a FVIII:C level of less than 0.70 IU per mL, the FVIII:Ag mean value (0.62 IU/mL) was higher in comparison to the FVIII:C mean value (0.57 IU/mL). Instead, in the units with a FVIII:C level of at least 0.70 IU per mL, the mean level of FVIII:C (1.08 IU/mL) was higher than that of FVIII:Ag (0.96 IU/mL)., Conclusions: The mean value of FVIII:C (0.99 IU/mL) in whole-blood plasma produced by the 10 Italian regions is higher than that reported in other studies. A total of 83.1 percent of units have a FVIII:C level of at least 0.70 IU per mL. The mean level of FVIII:Ag is lower than that of FVIII:C. FVIII:Ag is higher in those units with a FVIII:C level of less than 0.70 IU per mL, while it gradually decreases as FVIII:C exceeds 0.70 IU per mL, thus showing a greater resistance to handling of plasma in the production steps mostly affecting FVIII:C stability.

Sixty patients, recognized as chronic alcoholics on the grounds of the case history and with a score above 11 of the Munich Alcoholism Test (MALT) have been treated with metadoxine or placebo for thirty days according to a double blind randomized design. In the group treated with active drug there has been a significant reduction higher than in the controls of the scores relating to the abstinence symptomatology, in particular regarding the neuropsychic residual symptomatology (anxiety, depression, insomnia) after the first week of treatment, a reduced requirement of benzodiazepines and/or neuroleptics, and a significant decrement higher than in the controls of the score of MALT at the end of treatment. Furthermore, metadoxine seems to make easy the maintenance of abstinence, at least at short term.