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The assessment of test anxiety has received increasing attention in educational research due to the potential negative effects of anxiety on student performance. Traditionally, test anxiety scales have been developed for mathematics, but few studies have focused on physics. In this study, we validated two test anxiety scales for undergraduate physics courses: the Test Anxiety Inventory for Physics (TAIP) and the Abbreviated Test Anxiety Inventory for Physics scale (ATAIP), which were adapted from existing instruments. A convenience sample of 361 engineering students enrolled in a first-semester introductory physics course participated in the study. Confirmatory factor analysis and Rasch analysis were used to establish the construct validity of both scales. Convergent validity for the TAIP scale was established by examining its correlation with a scale adapted from the math anxiety scale. Criterion-related validity for both TAIP and ATAIP was established by analyzing the relationship between students' Rasch scores on the two scales and their performance on two conceptual tests. Finally, measurement invariance of TAIP and ATAIP scales was established using both multigroup and differential item functioning analyses to reliably investigate gender differences in the corresponding Rasch measures. The study confirms a robust four-factor structure of the TAIP. The four subscales, Worry, Emotionality, Interference, and Lack of Confidence, demonstrate good reliability (McDonald's [lower-case omega] ¼ 0.78; 0.86; 0.87; 87, respectively). Rash analysis also confirms that, for each subscale, the rating scale functioning was consistent with the item difficulty and person measures. The TAIP also demonstrates adequate convergent and criterion-related validity, as well as measurement invariance with respect to gender. The ATAIP also demonstrates good reliability (McDonald's [lower-case omega] ¼ 0.84), a well-functioning rating scale, and sufficient criterion-related validity. Additionally, it exhibits measurement invariance with respect to gender. Overall, the study supports that both the TAIP and ATAIP scales are reliable instruments for measuring students' test anxiety in an undergraduate physics course. Implications for physics instruction at the university introductory level are briefly discussed.

The training of professionals for a global world remains a challenge for Higher Education. From an intercultural educational approach, this study describes and analyses two educational proposals in Italy and Spain, which have helped to develop students' intercultural competences, thanks to a teaching framework based on participatory strategies. A multiple case study with a qualitative approach is elaborated to analyse the data on the situation in order to describe and recognise the relevance of examining participation, collaborative culture and social transformation in two Master's Degrees. Findings show that the synergy between participatory strategies and intercultural competences enhances dialogue and renegotiation of meanings, reconceptualisation of diversity, critical thinking and agency for change. The conclusions point to the need to generate collaborative networks to further mobilise the knowledge generated in training for intercultural professionals.

Given the growing presence of citizens with cultural differences, it is no longer appropriate to base citizenship on the individual belonging of a nation-state. It has become necessary to develop a new concept of citizenship that considers the existing multiple identities of people. This idea has gradually permeated educational policies on citizenship of international institutions such as UNESCO, which has introduced the concept of global citizenship education (GCE). This article is intended to enrich readers' reflection on GCE through the incorporation of an intercultural approach, to overcome nationalistic, Western-centric, and neoliberal conceptions, and to promote dialogue and interaction between different learners. Research on citizenship education and intercultural competence carried out by the Centre for Intercultural Studies, University of Verona, Italy, provides additional stimuli to foster reflection.

Value co-creation unfolds as a system of interactions in which the user and service provider play an active role in collaboratively creating values that go beyond economical and financial worth. Value co-creation is a growing trend in museums; however, little is known about how it can enhance educational activities, especially concerning digital technologies. This study analyzes the role of digital technology in the value co-creation process by addressing the following research questions: (1) how can museums, and schools implement actions to enhance co-creation activities? and (2) how does digital technology contribute to the generation of a value co-creation approach, engaging a young target audience in history education? The research adopts a single case study methodology, which is based on WORld Wars Toward Heritage for Youth (WORTHY), an educational European project that involves cultural and educational institutions from Germany, Poland, Croatia, England, and Italy. WORTHY creates a virtual collaborative museum through a digital platform. The paper's findings make clear that digital technologies play a role in value co-creation through two main experiences: learning and sharing. In the learning experience, digital co-creation is grounded in artifacts and contents, while during the sharing experience, digital technologies play a role relatively to people and content.

Conservation translocations are becoming common conservation practice, so there is an increasing need to understand the drivers of plant translocation performance through reviews of cases at global and regional levels. The establishment of the Italian Database of Plant Translocation (IDPlanT) provides the opportunity to review the techniques used in 186 plant translocation cases performed in the last 50 years in the heart of the Mediterranean Biodiversity Hotspot. We described techniques and information available in IDPlanT and used these data to identify drivers of translocation outcomes. We tested the effect of 15 variables on survival of translocated propagules as of the last monitoring date with binomial logistic mixed‐effect models. Eleven variables significantly affected survival of transplants: life form, site protection, material source, number of source populations, propagation methods, propagule life stage, planting methods, habitat suitability assessment, site preparation, aftercare, and costs. The integration of vegetation studies in the selection of suitable planting sites significantly increased the success of translocation efforts. Although posttranslocation watering had a generally positive effect on translocation outcome, other aftercare techniques did not always increase transplant survival. Finally, we found that how funds were spent appeared to be more important than the actual amount spent. Plant translocations in Italy and in the Mediterranean area should account for the complexity of speciation, gene flow, and plant migrations that has led to local adaptations and has important implications for the choice and constitution of source material. [ABSTRACT FROM AUTHOR]

Simple Summary: Fishery products are an important part of the Mediterranean diet and constitute a high source of nutrients for consumers, contributing to the prevention of several health diseases. This work analysed the protein, amino acids, and fatty acids of Mediterranean target species (four fish species and one crustacean species) which are mostly consumed in Sicily. The nutritional composition of the selected species together with the evaluation of nutrient indices showed the high quality of the sampled fish. The excellent profile of the fatty acid of "blue fish" species highlights the opportunity for local people to benefit from a highly nutritional product originating from local and sustainable fisheries and with an affordable commercial value. The protein, essential amino acid, and fatty acid composition of European pilchard (Sardina pilchardus), European hake (Merluccius merluccius), surmullet (Mullus surmuletus), red mullet (Mullus barbatus), and deep water rose shrimp (Parapenaeus longirostris) from the central Mediterranean Sea were investigated. All the species showed an essential amino acid content of about 50% of total amino acids, while the protein and total fatty acids content varied from 19.9 to 24.8% and from 1.4 to 5.1%, respectively. The fatty acid profile mainly followed the order SFA (39.1–52.6%) > PUFA (21.0–39.3%) > MUFA (15.6–24.3%). Palmitic and stearic acids were predominant among saturated fatty acids (38–52% and 21–25%, respectively), while palmitoleic and oleic acids were the most represented of the total monounsaturated acids (10–21% and 55–68%, respectively). All the species, as expected, showed a more significant proportion of n-3 PUFA (EPA + DHA) of about 81–93% of the total PUFA, with the highest values was found in European pilchard. Also, several fat quality index values, such as n-6/n-3 ratio, PUFA/SFA, the index of atherogenicity (IA), the index of thrombogenicity (IT), the hypocholesterolemic/hypercholesterolemic ratio (HH), and fish lipid quality/flesh lipid quality (FLQ) were calculated to assess the nutritional quality. All the obtained results, along with the fat quality indexes, indicated the excellent nutritional values of the selected species. [ABSTRACT FROM AUTHOR]

Controlling sediment to reduce debris-flow hazard is generally approached using retention basins that can be closed or have an outlet structure, generally an open check dam. They are usually placed in mild slope zones that allow minimal works for the excavation and the foundation of the outlet structure if present. Recently, it has been shown that the detention of sediments can also be achieved in the high-sloping reaches of debris-flow channels using deposition areas, basins that are open on the downstream side. In this work, we propose an approach for controlling the sediment volume transported by debris flows consisting of a cascade of deposition areas and retention basins. We also include a framework for planning, sizing, and checking the works. Two scenarios are considered, corresponding to the maximum values of the debris-flow peak discharge and volume, respectively. Moreover, the presence or absence of boulders is also considered. For this purpose, a method that evaluates the clogging of a single open check dam as a function of the coarse fraction of the sediment volume is simply extended to the case of multiple dams and implemented in a routing model. The proposed approach is applied along Ru Secco Creek in northeast Italy to defend a resort area and a village hit by a high- magnitude debris flow in 2015. After a careful survey and study, a solution with a combination of deposition areas and retention basins is planned and sized. The validity and performance of the proposed solution are analyzed using debris- flow modeling for two scenarios, considering both the absence and presence of boulders. Most of the sediment volume transported by debris flows is trapped, and a small solid discharge flows downstream of the works. [ABSTRACT FROM AUTHOR]

Background: In the region of Piedmont, in Northern Italy, formal monitoring of antimicrobial stewardship (AMS) programs has been in place since 2012. The objective of our study was to provide an updated assessment of AMS programs operating in our region, and to assess the impact of the COVID-19 pandemic on stewardship activities. Methods: A retrospective observational study was conducted to investigate AMS programs implemented in acute-care trusts participating in a broader healthcare-associated infections and antimicrobial resistance (AMR) prevention and control program, promoted by the regional health department. Within this program, structure, process, and outcome indicators of AMS programs were investigated, using a previously developed scoring system. Differences between scores prior to (2019) and during the pandemic (2021) were assessed. Linear regression was used to assess whether the 5-year trends (2017–2021) in outcome measures in relation to structure and process scores were statistically significant. Compound annual growth rates (CAGR) for each outcome were calculated to illustrate changes in outcome rates over time. Results: All public trusts in the Region (20) and a small number of private institutions (3) provided data for this study. A modest, non-significant improvement was found for 2021 structure, process, and total scores compared to respective 2019 scores. A significant improvement was found concerning the definition of a formal mission statement, whereas significantly less trusts included monitoring adherence to antimicrobial policy or treatment guidelines in their programs. Overall consumption of antibiotics for systemic use saw an increase in 2021, with 2021 recording the highest median overall consumption compared to all previous years considered in this study. Methicillin-resistant Staphylococcus aureus (MRSA) and carbapenem-resistant enterobacteria (CRE) rates decreased over the 5-year period. Significant downwards trends in MRSA rates were identified for high-outlier structure and process groups. Conclusions: Results of this study suggest AMS programs in Piedmont were not set back following the pandemic. This outcome was possible thanks to well-established programs, coordinated within a regional framework. Continued efforts should be dedicated to supporting AMS programs and contrasting AMR, even when the focus is shifted towards other public health emergencies. [ABSTRACT FROM AUTHOR]

Background: Atopic dermatitis, also known as atopic eczema, is a chronic, relapsing inflammatory, and eczematous skin disease. The clinical presentation of atopic dermatitis is characterized by erythematous, pruritic, dry, scaly, and often lichenified skin. The epidemiology of atopic dermatitis can vary greatly among countries, and across different age groups. Currently, atopic dermatitis doesn’t have a resolving treatment. Consequently, the purpose of management is to improve symptoms and achieve long-term disease control. Atopic dermatitis generates a considerable consumption of resources, developing significant economic consequences for patients, healthcare systems, and society. This study aimed to estimate the economic and social burden for atopic dermatitis patients in the Italian context. Methods: A Cost of Illness analysis was developed. Two perspectives of analysis were established for the study: the National Health System perspective and the societal perspective. Therefore, direct healthcare and non-healthcare costs, and indirect costs were included in the analysis. Data were identified and measured through the administration of a survey to patients affected by atopic dermatitis. Results: The annual total cost of a patient for the management of atopic dermatitis is equal to € 7,041.12. Within the overall cost per patient, direct health care costs (€ 3,290.69) accounting for 46.74% of the total expenditure, indirect costs (€ 1,924.92) accounting for 25.93% of the expenditure, and finally out-of-pocket expenses accounting for 27.34% of the expenditure being valued at € 1,825.52. Conclusion: The Cost of Illness analysis carried out underlines how atopic dermatitis places a significant financial burden on the healthcare system, but even more so on patients affected by this condition. Indirect costs and out-of-pocket expenditures, such as those related to the purchase of drugs, non-pharmacological treatment, and lost working days, represent the most important items of the atopic dermatitis economic and social burden. [ABSTRACT FROM AUTHOR]

Air conditioning systems can play a positive or negative role in the spread of COVID-19 infection. The importance of sufficient outdoor air changes in buildings was highlighted by the World Health Organization, therefore these should be guaranteed by mechanical ventilation systems or adequate air conditioning systems. The proposed case study concerns the optimal number of outdoor air changes to limit COVID-19 contagion for a school building in Central Italy. The Wells–Riley model is used to assess the risk of airborne infection, while energy consumption is calculated by a dynamic energy simulation software. The scope of the paper offers an innovative method to define the optimal ventilation strategy for the building's HVAC system design to reduce the risk of infection with limited increases in energy consumption and greenhouse gas emissions. Results show that the desirable approach is the one in which the same low value of contagion risk is set in all rooms. This new approach results in significant energy savings, compared to the most common ones (setting the same high outdoor air rates for all rooms) to counteract the risk of infection. Finally, the zero-emission building target is verified by introducing a suitable photovoltaic system to offset pollutant emissions. [ABSTRACT FROM AUTHOR]

In patients with cancer, tumor- and treatment-induced immunosuppression are responsible for a four-fold increase in morbidity and mortality caused by influenza and invasive Streptococcus pneumoniae infections compared to the general population. The main oncology societies strongly recommend vaccination in patients with cancer to prevent these infections. However, vaccine hesitancy is a main concern in this population. The aim of this study was to assess the feasibility of in-hospital vaccination for patients under anticancer treatment and their family members (FMs) against influenza and pneumococcal infections during the COVID-19 pandemic in order to increase vaccine coverage. This was a single-center, prospective, observational study conducted at the Department of Oncology of Luigi Sacco University Hospital (Milan, Italy) between October 2020 and April 2021. The main primary outcome was the incidence of influenza-like illness (ILI) and pneumococcal infections. The main secondary outcome was safety. A total of 341 subjects were enrolled, including 194 patients with cancer and 147 FMs. The incidence of ILI was higher among patients than among FMs (9% vs. 2.7%, OR 3.92, p = 0.02). Moreover, two subjects were diagnosed with pneumococcal pneumonia. The most frequent vaccine-related AEs were pain in the injection site (31%) and fatigue (8.7%). In conclusion, this hospital-based vaccination strategy was feasible during the COVID-19 pandemic, representing a potential model to maximize vaccine coverage during a public health emergency. [ABSTRACT FROM AUTHOR]

Aim: The study was designed to generate real‐world evidence on IDegLira in the Italian clinical practice in two groups of patients with type 2 diabetes (T2D), switching to IDegLira either from a basal only (basal group) or basal‐bolus insulin regimen (BB group). Materials and Methods: This was a non‐interventional, multicentre, single‐cohort, prospective study assessing the long‐term glycaemic control in patients with T2D, who switched to IDegLira from a basal insulin ± glucose‐lowering medication regimen with or without a bolus insulin component for approximately 18 months, conducted in 28 Italian diabetes centres. The primary endpoint was the change in glycated haemoglobin (HbA1c) levels from baseline to 6 months after IDegLira initiation. Results: The study included 358 patients with a mean age 67.2 years and diabetes duration of 15.7 years. HbA1c significantly decreased from IDegLira start to all study time points in the overall population (basal group −1.19%; BB group −0.60% at the end of observation). Patients achieving HbA1c <7% levels increased from 12.9% (n = 43) to 40.3% (n = 110) at 18 months. Fasting blood glucose and body weight also significantly decreased in both groups, although more in the BB group. Overall, 14.3% of completed patients had an intensification of treatment (mainly in the basal group) and 48.6% had a simplification of treatment (mainly in the BB group). Conclusions: Switching to IDegLira in a real‐world clinical setting is a valid therapeutic option for patients with T2D with inadequate glycaemic control on basal or BB insulin regimen and/or need to simplify their insulin therapy, with specific reasons and therapeutic goals according to different T2D management trajectories. [ABSTRACT FROM AUTHOR]

In the last years the quality of Higher Education (HE) system and its evaluation have been key issues of the political and scientific debate on education policies all over Europe. In the wide landscape that involves the entire HE system we draw attention on the third level of its organization, i.e. the Ph.D. In particular, this paper discusses the necessity of monitoring the recruitment process of Ph.D. system because it represents a fundamental aspect of the Ph.D. system as a whole. We introduce a set of concepts related to the recruitment process and then we make them computable with synthetic indicators. The study provides an empirical analysis based on doctoral schools of four academic years at the University of Siena. Proposed indicators are finally used for detecting weakness and strength of each Ph.D. school. (Contains 5 tables and 9 endnotes.)

Background: In November 2022, Italy participated in the third edition of the European Centre for disease prevention and control (ECDC) point prevalence survey (PPS) of healthcare-associated infections (HAIs) in acute-care hospitals. A questionnaire based on the WHO infection prevention and control assessment framework (IPCAF) was included, which aims to investigate multimodal strategies for the implementation of IPC interventions. Methods: A PPS was conducted using the ECDC PPS protocol version 6.0. The Regional health authority of the region of Piedmont, in north-western Italy, chose to enlist all public acute-care hospitals. Data were collected within one day per each ward, within 3 weeks in each hospital, at hospital, ward and patient level. A score between 0–1 or 0–2 was assigned to each of the 9 items in the IPCAF questionnaire, with 14 points representing the best possible score. HAI prevalence was calculated at the hospital-level as the percentage of patients with at least one HAI over all included patients. Relations between HAI prevalence, IPCAF score, and other hospital-level variables were assessed using Spearman's Rho coefficient. Results: In total, 42 acute-care hospitals of the region of Piedmont were involved, with a total of 6865 included patients. All participant hospitals reported they employed multimodal strategies to implement IPC interventions. The median IPCAF overall score was 11/14 (interquartile range, IQR: 9.25–12). The multimodal strategy with the highest level of adherence was education and training, followed by communication and reminders. Strategies with the lowest level of adherence were safety climate and culture of change, and system change. Overall HAI prevalence was 8.06%. A weak to moderate inverse relation was found between IPCAF score and HAI prevalence (Spearman's Rho -0.340, p 0.034). No other significant correlation was found. Conclusions: This study found a high self-reported overall level of implementation of multimodal strategies for IPC in the region. Results of this study suggest the relevance of the multimodal approach and the validity of the IPCAF score in measuring IPC programs, in terms of effectiveness of preventing HAI transmission. [ABSTRACT FROM AUTHOR]

Previous research has highlighted the positive impact of greater health-related quality of life (Hr-QoL) and subjective well-being (SWB) on chronic diseases' severity and progression. There is a paucity of studies investigating the long-term trajectories of these variables among hypertensive patients. The present study aims to investigate the relationships between psychological variables (Type A and D personality, locus of control—LoC, self-esteem, and trait anxiety) with SWB and Hr-QoL in patients with hypertension and comorbid metabolic syndrome. A total of 185 volunteer patients (130 males, 70.3%; mean age 54 ± 10.93) were enrolled. Patients filled out measures of Hr-QoL and SWB, LoC, and self-esteem at three time points—Type A and D behaviors and anxiety measures only at baseline. Analyses were run through two-level hierarchical mixed models with repeated measures (Level 1) nested within participants (Level 2), controlling for sociodemographic and clinical confounders. Neither Hr-QoL nor SWB changed over time. Patients with greater self-esteem and internal LoC (and lower external LoC) increased their SWB and Hr-QoL up to 1-year follow-up. A greater Type A behavior and trait anxiety at baseline predicted a longitudinal increase in most of the dependent variables. Results suggest that it could be useful to tailor interventions targeting specific variables to increase Hr-QoL and SWB among hypertensive patients. [ABSTRACT FROM AUTHOR]

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

Aims The aims of this study were to: (i) test if there are clusters of stroke survivors who experience distinct trajectories of quality of life (QOL) from hospital rehabilitation discharge to 12-month follow-up; (ii) test if any sociodemographic or clinical variables predict this class membership; and (iii) examine the associations between the clusters of stroke survivors' and their caregivers' trajectories of anxiety, depression, and burden over time. Methods and results A total of 415 stroke survivors and their caregivers were recruited in Italy for this 1-year, longitudinal, multicentre prospective study, filling out a survey at five time points. We found two distinct trajectories of change in stroke survivors' psychological QOL (i.e. Memory, Communication, Emotion, and Participation). The first trajectory (86% of the survivors) included those who started with greater levels of QOL and improved slightly to markedly in all psychological domains, while the second trajectory (14% of the survivors) comprised those who started with lower overall levels of psychological QOL and experienced a worsening or no changes at all in these dimensions up to 12-month follow-up. Very few clinical and sociodemographic variables at baseline predicted class membership. Finally, caregivers of those patients who experienced no change or a worsening in psychological QOL reported greater distress and burden over time. Conclusion Our results highlight the need for more tailored interventions to improve patients' psychological QOL and consequently their caregivers' well-being. This requires a shift from a stroke survivor–centred approach to a stroke survivor– and caregiver-centred one. [ABSTRACT FROM AUTHOR]

Rhabditis (Rhabditella) axei is a free-living, pseudoparasitic, necromenic, and parasitic nematode, depending on the host. This species feeds mainly on bacteria present in decaying organic matter, soil, and other substrates; however, in its parasitic form, it can colonize some species of snails. Moreover, the presence of R. axei has also been detected in birds and mammals, including humans. In 2021–2023, during monitoring of the palm borer Paysandisia archon in Central Italy, R. axei emerged from dead larvae of this alien invasive moth and was extracted from palm fibres of Trachycarpus fortunei in three independent sites. The nematode was identified by morphological and morphometric analyses. Molecular analyses using SSU and LSU gene fragments were used to confirm the identification and to perform Bayesian reconstruction of the phylogeny. Each sampling site showed a unique haplotype. Concerning the pathogenicity of this nematode against insects, the test performed on Galleria mellonella larvae did not show any entomopathogenic effect. This is the first time that R. axei was found associated with P. archon, and this recurrent association was discussed. [ABSTRACT FROM AUTHOR]

Background: While oral laxatives represent the first-line treatment of fecal impaction, enemas are frequently used in clinical practice in pediatric emergency departments (PEDs) and by family pediatricians (FPs). Objectives: Phosphate-containing enemas (PcEs) are commonly employed, even causing the risk of rare but lethal toxicity. We investigated pediatricians' awareness of PcE risks. Methods: We conducted an online survey by sending a multiple-choice questionnaire to the referents of 51 PEDs and 101 FPs. We collected and compared the answers with recommendations reported by the Italian Drug Agency (AIFA) and the available literature about PcE administration. Results: Of the institutions and pediatricians receiving the questionnaire, 23 PEDs (45%) and 63 FP (62.3%) participated in the survey. Of PEDs, 95% and 33.0% of FPs treated fecal impaction with PcE. Moreover, 54% of PEDs and 86.0% of FPs did not provide treatment according to the AIFA recommendations for the daily dose. Conclusions: This study shows limited pediatricians' awareness of the potential risks related to PcE. [ABSTRACT FROM AUTHOR]

This paper aims to evaluate the impact of a policy that targets criminal infiltration in local governments on the provision of local public goods in Italian municipalities. Building on the theoretical framework proposed by Dal Bò (American Political Science Review 100:41–53, 2006), we use a sufficient statistic approach to describe the dynamic behaviour of local public goods when stricter law enforcement weakens criminal pressure groups. Utilizing data on the local public finances of Italian municipalities spanning from 2004 to 2015, our findings reveal that, after the dismissal of infiltrated governments, the targeted municipalities devote a larger share of resources to public goods, with an estimated increase of approximately 3.9 percentage points. Notably, this effect seems to be driven by an increase in investment of approximately 3 percentage points. Overall, our results suggest that policies targeting the problem of criminal infiltration in local governments can improve socioeconomic conditions and the well-being of local communities, by increasing investments in economically and socially relevant public goods. [ABSTRACT FROM AUTHOR]

Before the COVID-19 pandemic, ventilation in buildings was not always given its due importance. The World Health Organization has highlighted the important role of air exchange with the outdoors in improving the air quality in buildings; buildings should, therefore, be equipped with mechanical ventilation or adequate air conditioning systems. This paper aims to investigate different retrofit solutions for air conditioning, evaluating them in terms of energy consumption and cost and the impact of increased outdoor air exchange rates on countering the propagation of COVID-19; the latter is the main novelty of the paper. As a case study, we take an existing office building located in Central Italy that was previously not equipped with a mechanical ventilation system (a system with primary air was introduced during the study). The energy analysis was conducted using dynamic simulation software after validation through energy bills; energy and economic analyses were conducted considering different external-air exchange rates. An optimal number of outdoor air changes was found to mitigate the risk of COVID-19 infection, a finding in line with the international literature. The increase in air changes with outdoor air leads to a rise in energy consumption and costs. These values were evaluated for different air conditioning systems and operational schedules. These drawbacks can be made less significant by combining interventions in the system with energy-efficiency measures applied to the building envelope. [ABSTRACT FROM AUTHOR]

Background: Limited evidence exists regarding the association between COVID-19 and Long COVID manifestations in children, particularly concerning variants of concern (VOCs). We aimed to characterize a cohort of pediatric patients hospitalized with confirmed acute SARS-CoV-2 and monitor them for Long COVID symptoms. Additionally, it seeks to explore any potential correlations between VOCs and clinical symptoms. Methods: We conducted a prospective study involving children hospitalized from November 2021 to March 2023, with confirmed acute SARS-CoV-2 infection. A telephone survey was conducted at 3-6-12 months after discharge. Results: We included 167 patients (77 F/90 M). Upon hospital admission, 95.5% of patients presented as symptomatic. Regarding patients for whom it was feasible to determine the SARS-CoV-2 variant (n = 51), the Delta variant was identified in 11 children (21.6%) and Omicron variant in the remaining 40 patients (78.4%: 27.5% BA.1 variant; 15% BA.2 variant; 57.5% BA.5 variant). 19 patients (16.5%) reported experiencing at least one symptom indicative of Long COVID (weight loss 31.6%, inappetence 26.3%, chronic cough 21.1%, fatigue 21.1%, and sleep disturbances, wheezing, abdominal pain and mood disorders 15.8%). In only 4 patients with Long COVID we could identified a specific SARS-CoV-2 variant (3 Omicron: 2 BA.1 and 1 BA.2; 1 Delta). Conclusions: this study underscores that long COVID is a significant concern in the pediatric population. Our data reinforce the importance of continuously monitoring the impact of long-COVID in infants, children, and adolescents. A follow-up following SARS-CoV-2 infection is therefore advisable, with symptom investigation tailored to the patient's age. [ABSTRACT FROM AUTHOR]

Plants have always represented a key element in landscape delineation. Indeed, plant diversity, whose distribution is influenced by geographic/climatic variability, has affected both environmental and human ecology. The present contribution represents a multi‐proxy study focused on the detection of starch, pollen and non‐pollen palynomorphs in ancient dental calculus collected from pre‐historical individuals buried at La Sassa and Pila archaeological sites (Central Italy). The collected record suggested the potential use of plant taxa by the people living in Central Italy during the Copper‐Middle Bronze Age and expanded the body of evidence reported by previous palynological and palaeoecological studies. The application of a microscopic approach provided information about domesticated crops and/or gathered wild plants and inferred considerations on ancient environments, water sources, and past health and diseases. Moreover, the research supplied data to define the natural resources (e.g., C4‐plant intake) and the social use of the space during that period. Another important aspect was the finding of plant clues referable to woody habitats, characterised by broad‐leaved deciduous taxa and generally indicative of a warm‐temperate climate and grassy vegetation. Other unusual records (e.g., diatoms, brachysclereids) participated in defining the prehistoric ecological framework. Thus, this work provides an overview on the potential of the human dental calculus analysis to delineate some features of the ancient plant ecology and biodiversity. [ABSTRACT FROM AUTHOR]

The easy implementation of a nature-based solution (NBS) to address a prompt stabilisation of burnt areas may be crucial in the Mediterranean forest environment. A plot scale hydrological and ecological survey was conducted in a pine forest of the Aspromonte Massif (southern Italy) affected by a high fire severity in summer 2021. The hydrological response to 30 rainfall event groups is analysed by monitoring nine sloping plots distributed into three plot blocks (forested according to the pre-fire situation, burnt with randomly directed felled logs and burnt with manually felled logs redirected along contour lines). The hydrological response of bare soil is mitigated by about 30% through the combined effects of the NBS and the vegetation cover by pioneer species. Although the regeneration of Pinus radiata is scarcer in the arranged plots, the spontaneous vegetation, once gone, prepares better edaphic conditions for the triggering of forest dynamics assured by the auto-succession of Pinus radiata. In terms of woody mechanical resistance, NBS durability is compatible with the time required for seedlings to regenerate the forest ecosystem. The results achieved so far encourage further research on higher slopes and complementary aspects (vegetal and animal biodiversity, economic factors, etc.). [ABSTRACT FROM AUTHOR]

Aims: To describe the health literacy (HL) levels of hospitalised patients and their relationship with nursing diagnoses (NDs), nursing interventions and nursing measures for clinical risks. Design: Retrospective study. Methods: The study was conducted from December 2020 to December 2021 in an Italian university hospital. From 146 wards, 1067 electronic nursing records were randomly selected. The Single‐Item Literacy Screener was used to measure HL. Measures for clinical risks were systematically assessed by nurses using Conley Index score, the Blaylock Risk Assessment Screening Score, Braden score, and the Barthel Index. A univariable linear regression model was used to assess the associations of HL with NDs. Results: Patients with low HL reported a higher number of NDs, interventions and higher clinical risks. HL can be considered a predictor of complexity of care. Conclusions: The inclusion of standardised terms in nursing records can describe the complexity of care and facilitate the predictive ability on hospital outcomes. Implications for the profession and/or patient care: HL evaluation during the first 24 h. From hospital admission could help to intercept patients at risk of higher complexity of care. These results can guide the development of interventions to minimise needs after discharge. Patient or Public Contribution: No patient or public contribution was required to design or undertake this research. Patients contributed only to the data collection. [ABSTRACT FROM AUTHOR]

Simple Summary: In the evolving landscape of breast cancer care, recognizing HER2-low expression as a target for anti-HER2 therapies has revolutionized treatment approaches. This retrospective, observational, multicenter study, focusing on male breast cancer (MBC), aimed to characterize the HER2-low subtype. Of the 144 MBCs analyzed, 54.9% were HER2-0, 27.1% HER2-low, and 18% HER2-positive. Specifically, among hormone receptor-positive MBCs, 34.8% were HER2-low. Notably, the prevalence of HER2-low in MBC appears slightly lower than in females. HER2-low MBCs showed a higher likelihood of positive lymph node involvement. About 13% of HER2-low MBCs carried germline BRCA1/2 pathogenic variants, predominantly in BRCA2. Overall, our data derived from the largest MBC series to our knowledge, also characterized for germline pathogenic variants, support the recognition of the emerging category of HER2-low breast cancer. This study emphasizes the need for tailored understanding of HER2-low expression in MBC and underscores potential implications for refining therapeutic approaches based on distinct molecular profiles. In the field of breast cancer care, a significant breakthrough has occurred with the recognition of HER2-low expression as a target for novel anti-HER2 antibody–drug conjugates (ADC). This discovery is reshaping the treatment landscape, challenging previous perceptions that considered HER2-low as clinically insignificant. The ability to target HER2-low expression is expected to have substantial clinical implications, irrespective of gender, including in cases of male breast cancer (MBC). However, an estimate of the prevalence of the HER2-low subtype in MBC is missing. This retrospective, observational, multicenter study was aimed at characterizing the HER2-low subtype in MBC. For the purpose of this study, the three-tiered categorization of HER2 (HER2-0, HER2-low, and HER2-positive) was used to reclassify the HER2-negative group into HER-0 or HER2-low subtypes. In the whole series of 144 invasive MBCs, 79 (54.9%) were HER2-0 (IHC scores of 0), 39 (27.1%) HER2-low (IHC scores of 1+/2+ with negative ISH), and 26 (18.0%) HER2-positive (IHC scores of 3+/2+ with positive ISH). Specifically, among hormone receptor-positive (HR+) HER2-negative invasive MBCs, 34.8% were HER2-low and 65.2% HER2-0. Compared with HER2-0, HER2-low subtype was associated with a positive lymph node involvement (p = 0.01). Other pathologic characteristics including histology, staging, and grading did not show notable variations between the two subtypes. The presence of germline BRCA1/2 pathogenic variants (PVs) did not significantly differ between HER2-0 and HER2-low MBCs. However, about 13% of HER2-low MBCs had germline PVs in BRCA1/2 genes, mainly BRCA2, a clinically relevant observation in the context of combined target therapy. Overall, our data, which focused on the largest gender-specific breast cancer series, to our knowledge, confirm that the emerging three-tiered categorization of HER2 (HER2-0, HER2-low, and HER2-positive) can also be considered in MBC, to mitigate both the gender gap and the underrepresentation of males in clinical trials. [ABSTRACT FROM AUTHOR]

Aims: The current European Society of Cardiology (ESC) guidelines provide clear indications for the treatment of acute and chronic heart failure (HF). Nevertheless, there is a constant need for real‐world evidence regarding the effectiveness, adherence, and persistence of drug therapy. We investigated the use of sacubitril/valsartan for the treatment of HF with reduced ejection fraction in real‐world clinical practice in Italy. Methods and results: An observational, retrospective, non‐interventional cohort study based on electronic medical records from nine specialized hospital HF centres in Italy was carried out on patients with prescription of sacubitril/valsartan. Overall, 948 patients had a prescription of sacubitril/valsartan, with 924 characterized over 6 months and followed up for 12 months. Pharmacoutilization data at 1 year of follow‐up were available for 225 patients {mean age 69.7 years [standard deviation (SD) = 10.8], 81.8% male}. Of those, 398 (45.2%) reached the target dose of sacubitril/valsartan of 97/103 mg in a mean time of 6.9 (SD = 6.2) weeks. Blood pressure and hypotension in 61 patients (65%) and worsening of chronic kidney disease in 10 patients (10.6%) were the main reasons for not reaching the target dose. Approximatively 50% of patients had a change in sacubitril/valsartan dose during follow‐up, and 158 (70.2%) were persistent with the treatment during the last 3 months of follow‐up. A sensitivity analysis (persistence during the last 4 months of follow‐up) showed persistence for 162 patients (72.0%). Adherence data, available for 387 patients, showed full adherence for 205 (53%). Discontinuation (102/717 patients, 14.2%) was mainly due to hypotension and occurred after a mean time of 34.3 (SD = 28.7) weeks. During follow‐up, out of 606 patients with available data, 434 patients (71.6%) had an HF add‐on drug or drugs concomitant with sacubitril/valsartan. HF‐related hospitalization during follow‐up was numerically higher in non‐persistent (16/67 patients, 23.9%) vs. patients persistent to sacubitril/valsartan (30/158, 19%) (P = 0.405). Conclusions: Real‐world data on the use of sacubitril/valsartan in clinical practice in Italy show a rapid titration to the target dose, high therapeutic adherence enabling a good level of therapeutic management in line with ESC guidelines for patients with reduced ejection fraction. [ABSTRACT FROM AUTHOR]

In this work, a flower-shaped shading system with integrated tracking photovoltaic, suitable for sustainable extensive urban coverages, is designed. Detailed photovoltaic energy yield simulations with a single-diode model approach are performed to disclose the potential of the proposed tracking photovoltaic shading device (PVSD). Simulations are performed with reference to a case study. A double-layer space truss is used to house the innovative modular photovoltaic tracking system, and the first application is envisaged for the coverage of a public market area of a sunny municipality in Southern Italy. By comparing it with the traditional photovoltaic fixed system, the results of the simulations show a steadier energy generation of the new PVSD, and it also provides better coverage with renewable energy during the hours of the day when the traditional system produces low electric energy. Lastly, an early interactive prototype of the PVSD system is presented. The tracking mechanism is carefully designed, 3D-printed at a small scale and tested with a motorized dynamic system controlled by a microcontroller board. The realization of the physical prototype and the engineering of the movement mechanism confirmed the feasibility and the correct functioning of the conceived system opening to real-scale applications. [ABSTRACT FROM AUTHOR]

The metabolite fingerprinting of four Italian commercial bean seed cultivars, i.e., Phaseolus Cannellino (PCANN), Controne (PCON), Vellutina (PVEL), and Occhio Nero (PON), were investigated by Nuclear Magnetic Resonance (NMR) spectroscopy and multivariate data analysis. The hydroalcoholic and organic extract analysis disclosed more than 32 metabolites from various classes, i.e., carbohydrates, amino acids, organic acids, nucleosides, alkaloids, and fatty acids. PVEL, PCON, and PCANN varieties displayed similar chemical profiles, albeit with somewhat different quantitative results. The PON metabolite composition was slightly different from the others; it lacked GABA and pipecolic acid, featured a higher percentage of malic acid than the other samples, and showed quantitative variations of several metabolites. The lipophilic extracts from all four cultivars demonstrated the presence of omega-3 and omega-6 unsaturated fatty acids. After the determination of the total phenolic, flavonoids, and condensed tannins content, in vitro antioxidant activity was then assessed using the DPPH scavenging activity, the ABTS scavenging assay, and ferric-reducing antioxidant power (FRAP). Compared to non-dark seeds (PCON, PCANN), brown seeds (PVEL, PON) featured a higher antioxidant capacity. Lastly, only PON extract showed in vitro antifungal activity against the sclerotia growth of S. rolfsii, by inhibiting halo growth by 75%. [ABSTRACT FROM AUTHOR]

Ammi L. is a small genus of economically important plants belonging to Apiaceae family that includes only six taxa. In the present study the chemical composition of the essential oil from aerial parts of Ammi crinitum Guss., a very rare plant, endemic of Sicily, was analyzed by GC–MS. No previously paper has been published on this species. The results showed the presence of large quantity of monoterpene hydrocarbons with sabinene (63.9%), as the most abundant component. Other metabolites present in good quantity were γ-terpinene (8.0%), and 4-terpineol (3.7%). Based on the composition of the essential oil of all the other Ammi taxa, several considerations have been carried out. [ABSTRACT FROM AUTHOR]

Objective: Systemic sclerosis (SSc) is an orphan disease that can lead to severe involvement of the gastrointestinal tract with a significant impact on patients' quality of life (QoL). The Mediterranean diet (MD) was consistently demonstrated to have beneficial effects on chronic diseases based on biological bases. We aimed to evaluate the adherence to the MD of Italian patients with SSc to preliminarily assess its association with gastrointestinal symptoms and other disease features, mood, and QoL. Methods: In this cross‐sectional study, adherence to the MD was measured in 387 patients from four SSc Italian referral centers through the 14‐item Mediterranean Diet Adherence Screener (14‐MEDAS) questionnaire. We also registered patients' reported outcomes related to the QoL and mood. Results: Overall, an optimal adherence to MD was observed in 14.7% of patients with SSc, a moderate adherence in 71.3%, and a low adherence in 14.0%. In univariate analysis, poor adherence to the MD was associated with a more prominent depressive mood, time missed at work, and perception of more severe Raynaud's phenomenon and digital ulcers, whereas the 14‐MEDAS score inversely correlated with depression score and reflux. Conclusion: In our cohort of patients with SSc, overall adherence to MD was moderate. Patients with lower adherence to MD also reported worse outcomes related to QoL and mood. Administration of the 14‐MEDAS could be a reasonable choice to assess adherence to the MD in patients with SSc. Future initiatives to study the role of MD in the management of patients with SSc are warranted. [ABSTRACT FROM AUTHOR]

This study seeks to measure teachers' readiness to use ICT in Italy by exploiting the data collected by the National Institute for the evaluation of education and training system (INVALSI) in 2018–2019. We propose a fuzzy set approach to provide a multidimensional picture of how much teachers were ready to integrate ICTs into educational practice. In addition, we use empirical bootstrap intervals to test whether significant differences exist in teacher readiness over several personal and socioeconomic characteristics. The study reveals that teachers' readiness for ICT is composed of three dimensions and varies by teachers' characteristics and regions. These results are a useful tool for understanding the relationship between teachers and ICTs so as to develop more appropriate educational policies. [ABSTRACT FROM AUTHOR]

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Implementing the circular economy (CE) through the design of a restorative industrial system is a major challenge. This study investigates the capabilities that underpin the circular competitive advantages of firms in the textile and clothing industry in Italy, which is one of the country's most polluting sectors. We have developed a framework of dynamic capabilities needed for circular transition, using the theoretical lenses of a natural‐resource‐based view. Using a multiple‐case study, the strategies of pollution prevention, product stewardship, and sustainable development and the associated capabilities of sensing, seizing, and reconfiguring are investigated. Internal practices, the role of the downstream actors in the supply chain, co‐creation dynamics with external actors, and the social potential of the CE emerge as key factors. Managers may also benefit from our recommendations aimed at increasing the environmental performance of their firms and scaling up their born‐circular businesses. [ABSTRACT FROM AUTHOR]

Purpose: The purpose of this paper is to explore the coherence between sustainability conceptualization (the "what") and its implementation (the "how") in terms of implemented actions and stakeholders' interactions. The paper proposes a grid approach for the simultaneous evaluation of sustainability conceptualization and implementation. Design/methodology/approach: This research is based on a multiple case study conducted in ten Italian Universities. In-depth interviews with general directors and administrative staff responsible for sustainable activities have been conducted together with documents and websites analysis. Findings: The coherence between sustainability conceptualization and its implementation showed heterogeneity of practice. Results propose a grid approach, which highlights six different approaches to explain the connection between the "what" and the "how" of sustainability. Research limitations/implications: The research is focused on Italian universities and may have overlooked approaches to campus sustainability specific of other countries. Practical implications: Understanding the coherence between the "what" and the "how" of sustainability can provide university managers with a practical tool of analysis when approaching and evaluating the sustainable campus. Originality/value: While higher education scholars are widely exploring the conceptualization of a sustainable campus and its implementation, little is known about the coherence between these two realms, despite their importance to facilitate the transition of sustainability vision into real practice. This study contributes to this area by proposing a grid approach to evaluate the coherence between sustainability conceptualization and implementation.

Sexual reproduction has contributed to a significant degree of variability in cultivated grapevine populations. However, the additional influence of spontaneous somatic mutations has played a pivotal role in shaping the diverse landscape of grapevine agrobiodiversity. These naturally occurring selections, termed 'clones,' represent a vast reservoir of potentially valuable traits and alleles that hold promise for enhancing grape quality and bolstering plant resilience against environmental and biotic challenges. Despite their potential, many of these clones remain largely untapped. In light of this context, this study aims to delve into the population structure, genetic diversity, and distinctive genetic loci within a collection of 138 clones derived from six Campanian and Apulian grapevine varieties, known for their desirable attributes in viticulture and winemaking. Employing two reduced representation sequencing methods, we extracted Single-Nucleotide Polymorphism (SNP) markers. Population structure analysis and fixation index (FST) calculations were conducted both between populations and at individual loci. Notably, varieties originating from the same geographical region exhibited pronounced genetic similarity. The resulting SNP dataset facilitated the identification of approximately two hundred loci featuring divergent markers (FST ≥ 0.80) within annotated exons. Several of these loci exhibited associations with essential traits like phenotypic adaptability and environmental responsiveness, offering compelling opportunities for grapevine breeding initiatives. By shedding light on the genetic variability inherent in these treasured traditional grapevines, our study contributes to the broader understanding of their potential. Importantly, it underscores the urgency of preserving and characterizing these valuable genetic resources to safeguard their intra-varietal diversity and foster future advancements in grapevine cultivation. [ABSTRACT FROM AUTHOR]

The ongoing COVID-19 pandemic caused by SARS-CoV-2 has affected millions of people worldwide and has significant implications for public health. Host transcriptomics profiling provides comprehensive understanding of how the virus interacts with host cells and how the host responds to the virus. COVID-19 disease alters the host transcriptome, affecting cellular pathways and key molecular functions. To contribute to the global effort to understand the virus's effect on host cell transcriptome, we have generated a dataset from nasopharyngeal swabs of 35 individuals infected with SARS-CoV-2 from the Campania region in Italy during the three outbreaks, with different clinical conditions. This dataset will help to elucidate the complex interactions among genes and can be useful in the development of effective therapeutic pathways. [ABSTRACT FROM AUTHOR]

• In non-middle eastern patients FMF manifests in mild form. • Chromosomes bearing the R202Q variant might not be completely neutral. • The sensitivity of FMF scores is diminished in a homogenous italian population. Familial Mediterranean Fever (FMF) is linked with the MEFV gene and is the commonest among monogenic autoinflammatory diseases, with high prevalence in the Mediterranean basin. Although the clinical presentation of FMF has a major role in diagnosis, genotype/phenotype correlations and the role of "benign" gene variants (as R202Q) appear highly variable and incompletely clear, making difficult to select the most effective strategy in the management of patients. Aim of the present study was to investigate the clinical presentation and the genetic background in a homogenous cohort of patients from Apulia (south eastern Italy). We investigated 217 patients with a clinical suspect of autoinflammatory diseases, who were characterized for the occurrence of specific symptoms and with next generation sequencing by a 4-gene panel including MEFV, MVK, NLRP3 and TNFRSF1A. A genetic change was identified in 122 (53.7%) patients, with 161 different MEFV variants recorded in 100 individuals, 10 variants in NLRP3 , and 6 each in TNFRSF1A and MVK. The benign variant R202Q was largely prevalent (41.6% of all MEFV variants). When patients were selected according the number of pathogenic MEFV variants (0, 1, or 2 pathogenic variants), results failed to show significant links between the frequency of symptoms and the number of pathogenic variants. Only family history and Pras score (indicative for severity of disease) predicted the presence of pathogenic variants, as compared with carriers of variants considered of uncertain significance or benign. Fever >38 °C and arthralgias appeared more frequently in R202Q-positive patients than in non-R202Q carriers. These two subgroups showed comparable duration of fever, occurrence of myalgia, abdominal and chest pain, Pras, and IFFS scores. In conclusion, results confirm that FMF manifests in mild form in non-middle eastern patients. This possibility partly affects the reliability of clinical criteria/scores. Furthermore, the presence of the R202Q variant might not be completely neutral in selected groups of patients. [ABSTRACT FROM AUTHOR]

Nowadays, wild grapevine populations are quite limited and sporadic mainly due to habitat destruction, land-use change, and the spread of pathogens that have reduced their distribution range. Palaeoecological, archaeobotanical, and genetic studies indicate that modern cultivars of Vitis vinifera are the results of the domestication of the dioecious, and sometimes hermaphrodite, wild species standing in riparian zones and wet environments. Wild grapevine populations have declined as a consequence of various forms of anthropogenic disturbance and were assigned by the IUCN Red List of Threatened Species to the Least Concern category. The River Crati Natural Reserve (Riserva Naturale Foce del Crati), located in southern Italy, hosts a population of Vitis vinifera subsp. sylvestris in a rewilding wet forest close to the Ionian Sea. These protected areas are of high scientific, biogeographic, and conservation interest in terms of Mediterranean biodiversity. Dendroecological and pollen morpho-biometric analyses of the wild grapevine are presented in this study. Palaeoecological perspectives for a landscape management strategy aimed at conserving and restoring the relic grapevine population are discussed. [ABSTRACT FROM AUTHOR]

In this paper, the evaluation of the Rn-222 radioactivity content in drinking water samples from the Calabria region, southern Italy, is reported as a case study. The Rn-222-specific activity in the analyzed groundwater samples for human use was evaluated by using the PerkinElmer Tricarb 4910 TR setup and compared with the parameter value (100 Bq L−1) reported in the reference Italian legislation, i.e., D.Lgs. 28/2016, derived from the European Directive 2013/51/Euratom. The radiological health risk for the population of the investigated area, due to the ingestion and inhalation of Rn-222 dissolved in water, was then evaluated by calculating the total annual effective dose, only in those cases where the parameter value was exceeded. The obtained results represent a main reference for the investigated area and are useful for determining any possible radiological health risk for human beings related to the ingestion of the investigated radionuclide. Moreover, they can also be used as a baseline for future investigations regarding background radioactivity levels. [ABSTRACT FROM AUTHOR]

Introduction: Hypophosphatasia (HPP) is a rare genetic disease caused by inactivating variants of the ALPL gene. Few data are available on the clinical presentation in Italy and/or on Italian HPP surveys. Methods: There were 30 suspected HPP patients recruited from different Italian tertiary cares. Biological samples and related clinical, biochemical, and anamnestic data were collected and the ALPL gene sequenced. Search for large genomic deletions at the ALPL locus (1p36) was done. Phylogenetic conservation and modeling were applied to infer the effect of the variants on the protein structure. Results: There were 21 ALPL variants and one large genomic deletion found in 20 out of 30 patients. Unexpectedly, NGS-driven differential diagnosis allowed uncovering three hidden additional HPP cases, for a total of 33 HPP subjects. Eight out of 24 coding variants were novel and classified as "pathogenic", "likely pathogenic", and "variants of uncertain significance". Bioinformatic analysis confirmed that all the variants strongly destabilize the homodimer structure. There were 10 cases with low ALP and high VitB6 that resulted negative to genetic testing, whereas two positive cases have an unexpected normal ALP value. No association was evident with other biochemical/clinical parameters. Discussion: We present the survey of HPP Italian patients with the highest ALPL mutation rate so far reported and confirm the complexity of a prompt recognition of the syndrome, mostly for HPP in adults. Low ALP and high VitB6 values are mandatory for the genetic screening, this latter remaining the gold standard not only to confirm the clinical diagnosis but also to make differential diagnosis, to identify carriers, to avoid likely dangerous therapy in unrecognized cases. [ABSTRACT FROM AUTHOR]

Simple Summary: Leptospirosis is a zoonosis caused by Leptospira, helical-shaped pathogenic spirochetes. Leptospira can affect both domestic and wild animals and humans, with clinical manifestations ranging from severe conditions to mild feverish symptoms or asymptomatic conditions. Leptospirosis is an occupational disease often overlooked in humans, possibly due to underdiagnosis, particularly in the absence of specific clinical signs. Its transmission can occur by direct contact with contaminated urine or organs. Dogs are reservoirs of pathogenic Leptospira, in particular L. interrogans serogroup Canicola, capable of infecting humans and other mammals. We report a case of acute leptospirosis in a puppy dog housed in a municipal kennel and the subsequent diagnostic investigations carried out on all the dogs housed in the kennel. The puppy tested positive for Leptospira interrogans serogroup Icterohaemorrhagiae in both serological and molecular tests. All of the other 66 dogs in the kennel underwent clinical and laboratory tests twice, 15 days apart. At the first sampling, eight dogs (12%) showed antibodies against Leptospira interrogans serogroup Icterohaemorragiae serovar Copenhageni and in one of them Leptospira spp. DNA was detected. Dogs, and kennel dogs in particular, are sentinels for many zoonotic diseases, likely due to high population densities, stress, and exposure to rodents and other disease vectors. Leptospirosis is a worldwide widespread zoonosis caused by Leptospira genus. We report an acute leptospirosis case in a puppy housed at a municipal kennel and the subsequent diagnostic investigations carried out on all dogs housed in the kennel. Laboratory investigation included mainly a microagglutination test, real-time PCR, and multi-locus sequence typing (MLST) for Leptospira genus. Other agents of infection were excluded. The puppy resulted positive for Leptospira interrogans Icterohaemorrhagiae both with serological and molecular assays. All of the other 66 dogs in the kennel underwent clinical and laboratory investigations twice, 15 days apart. No other dog showed leptospirosis clinical signs. At the first sampling, eight dogs (12%) showed antibodies against Leptospira interrogans serogroup Icterohaemorragiae serovar Copenhageni. Real-time PCR on urine samples of seropositive dogs detected Leptospira spp. DNA in one sample, then identified as Leptospira interrogans serogroup Icterohaemorragiae by MLST. Fifteen days after, four of the previous seropositive dogs still showed antibodies against Leptospira spp. All urine samples collected from seropositive dogs were negative at real-time PCR. The study allowed the early confirmation of a Leptospirosis case and the identification of at least one asymptomatic carrier of pathogenic Leptospira spp. The prompt activation of all appropriate management measures allowed limiting and extinguishing the infection. [ABSTRACT FROM AUTHOR]

The present era of globalization, interdependence and multicultural societies has brought about both opportunities and crises in educational institutions. Especially schools and families seem to be unable to cope with such revolutionary changes. The crises also concern all fields involved in maintaining social welfare, including counselling and psychotherapy. Within these fields, there is a growing need for Intercultural Competences at the cognitive, emotional and relational levels which endow teachers and counsellors with the ability to operate in linguistically and culturally complex contexts. However, despite the vast amount of international scholarship, the concept of "Intercultural Education" and the term "Intercultural Competences" are often misunderstood and require more precise definition. The present contribution intends to give further impulse to the discussion of Intercultural Competences and to offer concrete definitions that are applicable to the fields of education, counselling and psychotherapy. The article is based on a comprehensive review of literature on Intercultural Competence and an extensive empirical study carried out by the Centre for Intercultural Studies at the University of Verona. The study relies upon focus groups and semi-structured interviews in order to develop a theoretical model of Intercultural Competences with implications at the practical-operative, methodological and vocational levels.

Germline pathogenic variants (PVs) in BRCA1/2 genes are associated with breast cancer (BC) risk in both women and men. Multigene panel testing is being increasingly used for BC risk assessment, allowing the identification of PVs in genes other than BRCA1/2. While data on actionable PVs in other cancer susceptibility genes are now available in female BC, reliable data are still lacking in male BC (MBC). This study aimed to provide the patterns, prevalence and risk estimates associated with PVs in non- BRCA1/2 genes for MBC in order to improve BC prevention for male patients. We performed a large case-control study in the Italian population, including 767 BRCA1/ 2-negative MBCs and 1349 male controls, all screened using a custom 50 cancer gene panel. PVs in genes other than BRCA1/2 were significantly more frequent in MBCs compared with controls (4.8% vs 1.8%, respectively) and associated with a threefold increased MBC risk (OR: 3.48, 95% CI: 1.88–6.44; p < 0.0001). PV carriers were more likely to have personal (p = 0.03) and family (p = 0.02) history of cancers, not limited to BC. PALB2 PVs were associated with a sevenfold increased MBC risk (OR: 7.28, 95% CI: 1.17–45.52; p = 0.034), and ATM PVs with a fivefold increased MBC risk (OR: 4.79, 95% CI: 1.12–20.56; p = 0.035). This study highlights the role of PALB2 and ATM PVs in MBC susceptibility and provides risk estimates at population level. These data may help in the implementation of multigene panel testing in MBC patients and inform gender-specific BC risk management and decision making for patients and their families. • About 5% of MBC cases are carriers of pathogenic variants in genes other than BRCA1/2 • PALB2 and ATM are associated with increased MBC risk • CHEK2 is not associated with MBC risk in the Italian population • Multigene panel test should be implemented in MBC patients [ABSTRACT FROM AUTHOR]

We developed a new Italian short version of the Geriatric Anxiety Scale (GAS-12) and evaluated its psychometric properties. The GAS-12 specifically screens for anxiety symptoms in the Italian older adult population by identifying items that best discriminate anxiety in this population. In Study 1, we administered the full-length Italian translation of the GAS to 517 older adults and used item response theory to identify the most discriminating items and to develop the short form used in Study 2. In Study 2, we evaluated the functioning of the new short form of the questionnaire in a new sample of 427 older adults using Confirmatory factor analysis. Analyses indicated 12 items that discriminated well between anxious and non-anxious participants and distributed along the latent continuum of each trait. The GAS-12 fits a three-factor structure. There was also evidence for convergent and divergent validity. The Italian GAS-12 appears to be a useful instrument for the quantitative screening of anxiety in Italian older adults. Anxiety imposes significant impairment thus making imperative the screening and assessment of anxiety symptoms. The GAS-12 is particularly indicated with limited time and many scales in a clinical assessment or research protocols. [ABSTRACT FROM AUTHOR]

Background: During the COVID-19 pandemic, studies report that in the first few months of the lockdown there was a decrease in requests for mandatory psychiatric treatment, while, in contrast, following the second wave, the number of cases increased. This study investigates the use of compulsory psychiatric treatments internationally in the first and subsequent phases of the pandemic. Methods: Sixteen key people were interviewed: eight mental health care professionals and eight scholars in Italy, Greece, China and Chile. Participants were asked to discuss their experience of the motivations, diagnoses and management of patients undergoing an involuntary psychiatric hospitalization. Results: The analysis through Grounded Theory highlighted four themes: (a) the culture of psychiatric care services, (b) the effect of the pandemic on involuntary hospitalizations, (c) exceptional management of hospitalization, and (d) policies and suggestions for more inclusive mental health treatments. Conclusion: During the first wave, respondents reported a decrease in the use of involuntary treatments, while a gradual increase was seen in the following months. Italy extended compulsory psychiatric treatment to a group of new users, including young people and adolescents with acute crises; in other contexts, the main users are chronic psychiatric patients. [ABSTRACT FROM AUTHOR]

In this study, we aimed to identify the current trend of novel psychoactive substance (NPS) consumption in Italy and the level of knowledge about NPS in the general population and to explore the presence of risk factors for a lifetime NPS misuse. We conducted an anonymous online survey, administered to a large sample of people of any age living in Italy, asking for their knowledge about NPS as well as their history of drug use. Descriptive statistics were reported, and regression analyses were performed to identify risk factors for lifetime use of NPS. A total of 1097 individuals gave a valid response to the survey. A lifetime use of NPS was reported by 13.5%. Multivariate regression analysis showed that male gender (OR 2.33, 95% CI 1.52–3.55), homosexual sexual orientation (OR 2.52, 95% CI 1.21–5.27), a use of emergency services due to alcohol (OR 3.38, 95% CI 2.23–5.12) and previous contact with mental health services (OR 1.58, 95% CI 1.04–2.41) were risk factors for a lifetime use of NPS (p < 0.05). An improvement of preventive strategies and simplified access to information on NPS, especially tailored to individuals at increased risk of misuse, could slow diffusion of NPS and avert the consequences of substance use. [ABSTRACT FROM AUTHOR]

The relationship with bike infrastructure is missing in the current examination of user perception, which places a great deal of emphasis on visual aesthetic quality or surveys. Italy is experiencing the great development of cycling infrastructures, and the related plans, in line with sustainability objectives, have the task of examining users in various aspects. The purpose of this study is to examine users' criteria based on perceptions of the landscape in the presence of cycling infrastructures and to analyze the current infrastructures and understand their alignment with sustainable plans. One of the multiple-criteria decision analysis (MCDA) methods based on fuzzy comprehensive evaluation (FCE) was utilized, and it entails identifying the factors that constitute an index and assessing the priority of these factors in relation to other components. The findings demonstrate that the primary variables are distinct aspects of the landscape that are objective. We discovered that these components perform better for urban than metropolitan sectors in this study, as we divided the scenarios into metropolitan and general (urban, suburban, and coastal urban) scenarios. [ABSTRACT FROM AUTHOR]

We used hydrological and geodetic observations to characterize the effects of hydrological forcing on the displacements observed by GPS (Global Positioning System) measurements collected by stations located in the karst area of the Matese massif (Apennines, central-southern Italy). The latter is one of the main karst massifs of the central-southern Apennines, characterized by steep slopes, high mountain peaks (up to 2050 m a.s.l.), and wide endorheic areas, playing a fundamental role in recharging the large groundwater resource of the massif. Integrated statistical analysis of rainfall and spring discharge time series provided insight into timescales characterizing the hydrological dynamic of the Matese massif, highlighting how hydraulic conditions of the water table at a specific time mainly depend on long antecedent periods of rainfall. Nevertheless, the intense daily rainfall occurring during the wet season is responsible for the abrupt increase of the discharge of the Matese's springs, which show a typical karst behavior. Statistical analyses of time series show robust correlations between hydrological conditions of the karst aquifer and GPS displacements observed at stations placed over and around the massif. We find that the observed outward and inward deformations of the massif (horizontal dilatation and contraction) are controlled by the water table variations, which are in turn controlled by the temporal variations of the groundwater recharge due to rainfall. The detected deformation patterns are intimately related to the seasonal and multi-year characteristics of the recharge/discharge processes and allowed us to track with geodetic measurements the different phases of the water cycle in the karst aquifer of the Matese massif. [ABSTRACT FROM AUTHOR]