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Proctology is one of the surgical specialties that suffered the most during COVID-19 pandemic. Using data from a cross-sectional worldwide web survey, we aimed to snapshot the current status of proctologic practice in Italy with differences between three macro areas (North, Centre, South). Specialists affiliated to renowned scientific societies with an interest in coloproctology were invited to join a 27-item survey. Predictive power of respondents' and hospitals' demographics on the change of status of surgical activities was calculated. The study was registered at ClinicalTrials.gov (NCT04392245). Of 299 respondents from Italy, 94 (40%) practiced in the North, 60 (25%) in the Centrer and 82 (35%) in the South and Islands. The majority were men (79%), at consultant level (70%), with a mean age of 46.5 years, practicing in academic hospitals (39%), where a dedicated proctologist was readily available (68%). Southern respondents were more at risk of infection compared to those from the Center (OR, 3.30; 95%CI 1.46; 7.47, P = 0.004), as were males (OR, 2.64; 95%CI 1.09; 6.37, P = 0.031) and those who routinely tested patients prior to surgery (OR, 3.02; 95%CI 1.39; 6.53, P = 0.005). The likelihood of ongoing surgical practice was higher in the South (OR 1.36, 95%CI 0.75; 2.46, P = 0.304) and in centers that were not fully dedicated to COVID-19 care (OR 4.00, 95%CI 1.88; 8.50, P < 0.001). The results of this survey highlight important factors contributing to the deadlock of proctologic practice in Italy and may inform the development of future management strategies.

The present analysis assessed the efficacy of extended-release quetiapine fumarate (quetiapine XR) versus risperidone in patients with schizophrenia and depressive symptoms [Hamilton Depression Rating Scale (HAM-D) score≥20 and a HAM-D item 1 score≥2]. This was a subanalysis of patients with schizophrenia from a randomized, open-label, parallel-group, flexible-dose study (NCT00640562) that also enrolled patients with schizoaffective disorder. The primary endpoint of this noninferiority study was change from baseline to week 12 in Calgary Depression Scale for Schizophrenia score (per protocol population). Overall, 114 patients received quetiapine XR (n=60; 400-800 mg/day) or risperidone (n=54; 4-6 mg/day). Change in Calgary Depression Scale for Schizophrenia score was greater for quetiapine XR than for risperidone [least squares means: -7.2 vs. -4.8; treatment difference 2.4 (95% confidence interval 0.3-4.6; P<0.05)]. Adverse events (≥3%) among patients receiving quetiapine XR were sedation, somnolence, and dry mouth, and among those receiving risperidone were anxiety, insomnia, asthenia, hyperprolactinemia, and somnolence. Abnormally high prolactin levels were reported for 57.6 and 8.1% of patients receiving risperidone and quetiapine XR, respectively. Quetiapine XR was superior to risperidone at reducing depressive symptoms in patients with schizophrenia.

The SCOFF is a quick and simple screening tool for eating disorders (EDs), intended for use by those who are not specialists in the field. The purpose of the present study is to explore the psychometric properties of an Italian version of the instrument. An Italian translation of the SCOFF was administered, together with a part of the Italian version of the Eating Disorders Inventory-3, to the following: (i) a sample of psychiatric patients diagnosed with ED according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition; (ii) a sample of female psychiatric controls with no ED symptoms; and (iii) a sample of female normal controls without EDs from the general population. Results suggest that the Italian version of the SCOFF provides a reliable and valid tool for screening EDs., (Copyright © 2011 John Wiley & Sons, Ltd and Eating Disorders Association.)

The known presence of RHD blood group alleles in apparently D– individuals who are positive for C or E antigens leads to an appropriate investigation for the RHD gene on the red blood cells (RBCs) of D– blood donors, thus preventing their RBCs from immunizing D– recipients. Ready-to-use polymerase chain reaction–sequence-specific primer (PCR-SSP) typing kits are available and allow single-sample results. The need to perform this testing on a large number of donors affiliated with the Transfusion Department of Udine (Northern Italy) led to the use of molecular genetic RH blood group typing with PCR-SSP test kits and DNA samples mixed in pools. From a population of 35,000 blood donors screened for D antigen by serologic typing, a total of 235 samples, distributed in pools of 5 DNA samples, were investigated. Positive results were reevaluated by opening the pools and retesting single samples. Validation of DNA-pool typing with commercial kits was done. Among 235 genotyped samples, 12 were found to be PCR positive (5.1%), exhibiting DEL genotype and RHD-CE-D hybrid alleles. Our data demonstrate that the use of a PCR-SSP commercial test kit with pooled samples is a helpful and valid method to correctly detect RHD alleles. As a consequence, we reclassified our donors as carriers of potentially immunogenic alleles.

Background: There is good evidence that radiotherapy is beneficial in advanced rectal cancer, but its application in Italy has not been investigated., Methods: We conducted a nationwide survey among members of the Italian Society of Colo-Rectal Surgery (SICCR) on the use of radiation therapy for rectal cancer in the year 2005. Demographic, clinical and pathologic data were retrospectively collected with an online database. Italy was geographically divided into 3 regions: north, center and south which included the islands. Hospitals performing 30 or more surgeries per year were considered high volume. Factors related to radiotherapy delivery were identified with multivariate analysis., Results: Of 108 centers, 44 (41%) responded to the audit. We collected data on 682 rectal cancer patients corresponding to 58% of rectal cancers operated by SICCR members in 2005. Radiotherapy was used in 307/682 (45.0%) patients. Preoperative radiotherapy was used in 236/682 (34.6%), postoperative radiotherapy in 71/682 (10.4%) cases and no radiotherapy in 375 (55.0%) cases. Of the 236 patients who underwent preoperative radiotherapy, only 24 (10.2%) received short-course radiotherapy, while 212 (89.8%) received long-course radiotherapy. Of the 339 stage II-III patients, 159 (47%) did not receive any radiotherapy. Radiotherapy was more frequently used in younger patients (P < 0.0001), in patients undergoing abdominoperineal resection (APR) (P < 0.01) and in the north and center of Italy (P < 0.001). Preoperative radiotherapy was more frequently used in younger patients (P < 0.001), in large volume centers (P < 0.05), in patients undergoing APR (P < 0.005) and in the north-center of Italy (P < 0.05)., Conclusion: Our study first identified a treatment disparity among different geographic Italian regions. A more systematic audit is needed to confirm these results and plan adequate interventions.

In the last few decades, hydropower production has been moving toward a new paradigm of low and diffused power density production of energy with small and mini-hydro plants, which usually do not require significant water storage. In the case of nominal power lower than 20 kW and ultra-low head H (H < 5 m), Archimedes screw or Kaplan type turbines are usually chosen due to their efficiency, which is higher than 0.85. A new cross-flow type turbine called Ultra-low Power Recovery System (UL-PRS) is proposed and its geometry and design criteria are validated in a wide range of operating conditions through 2D numerical analysis computed using the ANSYS Fluent solver. The new proposed solution is much simpler than the previously mentioned competitors; its outlet flow has a horizontal direction and attains similar efficiency. The costs of the UL-PRS turbine are compared with the costs of one Kaplan and one cross-flow turbine (CFT) in the case study of the main water treatment plant of the city of Palermo in Italy. In this case, the UL-PRS efficiency is estimated using a URANS 3D numerical analysis computed with the CFX solver. [ABSTRACT FROM AUTHOR]

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ABSTRACT: During the last few decades, weather circulation type classifications (CTCs) have been widely used to gain insight into processes at the synoptic scale, but also for studying the relationship between atmospheric circulation and surface climate variability. This study aims to evaluate the best performing CTCs based on COST733 software for the stratification of daily ground‐level precipitation and surface air temperature across Italy by means of four statistical metrics. Six classification methods belonging to the four COST733 groups (threshold‐based, PCA‐based, leader algorithms and optimization algorithms) were investigated on 32 and 26 data time series derived from Italian weather stations for daily mean temperature and daily mean precipitation, respectively. CTCs were computed using gridded mean sea level pressure and geopotential height at 500 hPa derived from the NCEP Reanalysis 2 dataset between 1979 and 2015 and tested on three different numbers of classes (8/9, 11/12 and 18 circulation types). Evaluation metrics showed an evident seasonal variability and high‐spatial heterogeneity reflecting the geographical complexity of the Italian territory. The study points out that the best classification, both for temperature and precipitation, is strongly dependent on the classification variable (mean sea level pressure and geopotential height at 500 hPa) showing relevant differences between surface temperature and precipitation. A low number of circulation types (8/9) resulted as the most appropriate grouping for the Italian domain and the Principal Component Transversal and Simulated Annealing were the best performing classification procedures for ground‐level precipitation and temperature stratification, respectively. [ABSTRACT FROM AUTHOR]

The use of performance and image enhancing drugs (PIEDs) is not uncommon in athletes and appears to be associated with several psychopathological disorders of unclear prevalence. In this multicenter, cross-sectional study, we aimed to evaluate the prevalence of body image disorders (BIDs) and eating disorders (EDs) in PIED-using athletes vs. PIED nonusers. We enrolled 84 consecutive professional and amateur athletes training in sport centers in Italy, who underwent semi-structured interviews (SCID-I, SCID-II) and completed the Body Image Concern Inventory (BICI) and the Sick, Control, One, Fat, Food Eating Disorder Screening Test (SCOFF). PIEDs were searched for in participants’ blood, urine, and hair. Of these, 18 (21.4%) used PIEDs, the most common being anabolic androgenic steroids, amphetamine-like substances, coffee and caffeine derivatives, synthetic cathinones, and ephedrine. PIED users and nonusers did not differ in socio-demographic characteristics, but differed in clinical and psychopathological features, with PIED users being characterized by higher physical activity levels, higher daily coffee and psychotropic medication use (e.g., benzodiazepines), more SCID diagnoses of psychiatric disorders, especially substance use disorder, body dysmorphic disorder (BDD), EDs, and general anxiety disorder, higher BICI scores (indicating higher risk of BDD), and higher SCOFF scores (suggesting higher risks for BIDs and EDs). [ABSTRACT FROM PUBLISHER]

ABSTRACT This study presents the results of dynamically downscaled climate simulations over Italy produced with the COSMO-CLM model. Three simulations forced by ERA-Interim Reanalysis were conducted respectively at a spatial resolution of 0.22°, 0.125° and 0.0715° over the period 1979-2011. The results were analysed in terms of 2-m temperature and precipitation with the aim of assessing the model's ability to reproduce these important features of the Italian climate. The results were validated by comparing model output with different independent observational datasets. Values of temperature and precipitation show a general good agreement with observations, with a fair reduction of errors in all seasons as the resolution is increased. Two simulations at a spatial resolution of 0.0715°, driven by the global model CMCC-CM, were performed over the period 1971-2100, employing the IPCC RCP4.5 and RCP8.5 scenarios. Climate projections show a significant warming expected in Italy at the end of the 21st century, along with a general reduction in precipitation, particularly evident in spring and summer. [ABSTRACT FROM AUTHOR]

A statistical calibration scheme is applied to multi-model global seasonal ensemble reforecasts in order to predict the interannual variability of summer averaged surface maximum temperature over Italy. In some cases, this technique is shown to be able to improve the skill scores of the seasonal predictions during the last 35 years, with respect to the direct model output (DMO), using seasonal predictions initialised 1 month before the beginning of the season. It is shown that the presence of some skill in the DMO multi-model predictions is mostly due to the correct prediction of the observed secular trends in maximum temperature, and, partly, to the correct prediction of outliers, in particular, of the summer of 2003. At the same time, while the removal of trends produces a small reduction of skill in both the raw and calibrated predictions, the removal of outliers improves the performance of the calibration scheme. Once all trends and outliers are removed, the DMO predictions have no skill, while the calibrated predictions still present a detectable skill. The improvement introduced by the calibration are shown to be statistically significant by applying resampling techniques. It is shown that the reason of this partial success is linked to the fact that although the models present several shortcomings, some models can capture the existence of a weak large-scale signal, possibly linked with the presence of a summer teleconnection between the equatorial Pacific and Europe, with a spatial pattern substantially different from that associated with the temperature secular trend. The teleconnection is associated with a modulation of the quasi-stationary barotropic eddies in the Northern Hemisphere extra-tropics. [ABSTRACT FROM AUTHOR]

Results show that the year-to-year quality variation of wines produced in North and Central Italy depends on the large-scale climate variability, and that the wine quality improvement in the last four decades is partially due to an increase of temperature and to a decrease of precipitation in West and Central Mediterranean Europe (WME; CME). In addition, wine quality is positively correlated with air temperature throughout the entire active period of the grapevine, weakly negatively correlated with precipitation in spring, and well negatively correlated in summer and fall. The month-to-month composites of the NAO anomaly show that, in years of good quality wine, this anomaly is negative in late spring, oscillates around zero in summer, and is positive in early fall; while, in years of bad quality wine, it is positive in late spring and summer, and negative in early fall, i.e. its polarity has an opposite sign in spring and fall in good versus bad years. The composite seasonal maps show that good wines are produced when the spring jet stream over the Atlantic diverts most of the weather perturbations towards North Europe, still providing a sufficient amount of rainwater to CME; when summer warming induced by southerly winds is balanced by the cooling induced by westerly winds; and when a positive geopotential anomaly over WME shelters CME from fall Atlantic storms. Bad quality wines are produced when the jet stream favors the intrusion of the Atlantic weather perturbations into the Mediterranean. Results suggest that atmospheric pattern persistencies can be used as precursors for wine quality forecast. [ABSTRACT FROM AUTHOR]

High ambient temperatures have been associated with increased mortality across the world. Several studies suggest that timely preventive measures may reduce heat-related excess mortality. The main aim of this study was to detect the temporal modification of heat-related mortality, in older adults (aged 65-74) and in elderly ≥75 years old, in the Florentine area by comparing previous (1999-2002) and subsequent (2004-2007) periods to the summer of 2003, when a regional Heat-Health Warning System (HHWS) was set up. Mortality data from 1999 to 2007 (May-September) were provided by the Mortality Registry of the Tuscany Region ( n = 21,092). Weather data were used to assess daily apparent temperatures (AT). Case-crossover time-stratified designs and constrained segmented distributed lag models were applied. No significant heat-related mortality odds ratio (OR) variations were observed among the sub-periods. Nevertheless, a general OR decrease dating from 1999-2002 (OR 1.23; lack of HHWS) to 2004-2005 (OR 1.21; experimental HHWS running only for Florence) and to 2006-2007 (OR 1.12; official HHWS extended to the whole Florentine area) was observed when the maximum AT was considered. This modification was only evident in subjects ≥75 years old. The heat effect was higher and sustained for more days (until lag 9) during the period 1999-2002 than 2004-2007. The decrease of the excessive heat effect on mortality between periods with the absence and existence of a HHWS is also probably due to the mitigation of preventive measures and the implementation of a HHWS with specific interventions for safeguarding the health of the 'frail elderly'. [ABSTRACT FROM AUTHOR]

We describe the Henetus wave forecast system in the Adriatic Sea. Operational since 1996, the system is continuously upgraded, especially through the correction of the input ECMWF wind fields. As these fields are of progressively improved quality with the increasing resolution of the meteorological model, the correction needs to be correspondingly updated. This ensures a practically constant quality of the Henetus results in the Adriatic Sea since 1996. After suitable and extended validation of the quality of the results at different forecast ranges, the operational range has been recently extended to five days. The Henetus results are used also to improve the tidal forecast on the Venetian coasts and the Venice lagoon, particularly during the most severe events. Extensive statistics on the model performance are provided, both as analysis and forecast, by comparing the model results versus both satellite and buoy data. [ABSTRACT FROM AUTHOR]

The study is a statistical analysis of sea states timeseries derived using the wave modelWAM forced by the ERA-40 dataset in selected areas near the Italian coasts. For the period 1 January 1958 to 31 December 1999 the analysis yields: (i) the existence of a negative trend in the annualand winter-averaged sea state heights; (ii) the existence of a turning-point in late 80's in the annual-averaged trend of sea state heights at a site in the Northern Adriatic Sea; (iii) the overall absence of a significant trend in the annual-averaged mean durations of sea states over thresholds; (iv) the assessment of the extreme values on a time-scale of thousand years. The analysis uses two methods to obtain samples of extremes from the independent sea states: the r-largest annual maxima and the peak-over-threshold. The two methods show statistical differences in retrieving the return values and more generally in describing the significant wave field. The r-largest annual maxima method provides more reliable predictions of the extreme values especially for small return periods (<100 years). Finally, the study statistically proves the existence of decadal negative trends in the significant wave heights and by this it conveys useful information on the wave climatology of the Italian seas during the second half of the 20th century. [ABSTRACT FROM AUTHOR]

The study is a statistical analysis of sea states timeseries derived using the wave model WAM forced by the ERA-40 dataset in selected areas near the Italian coasts. For the period 1 January 1958 to 31 December 1999 the analysis yields: (i) the existence of a negative trend in the annual- and winter-averaged sea state heights; (ii) the existence of a turning-point in late 70's in the annual-averaged trend of sea state heights at a site in the Northern Adriatic Sea; (iii) the overall absence of a significant trend in the annual-averaged mean durations of sea states over thresholds; (iv) the assessment of the extreme values on a time-scale of thousand years. The analysis uses two methods to obtain samples of extremes from the independent sea states: the r-largest annual maxima and the peak-over-threshold. The two methods show statistical differences in retrieving the return values and more generally in describing the significant wave field. The study shows the existence of decadal negative trends in the significant wave heights and by this it conveys useful information on the wave climatology of the Italian 15 seas during the second half of the 20th century. [ABSTRACT FROM AUTHOR]

Nowadays, the Mediterranean region is generally recognized as a climate change hot spot given its strong response to global warming, with relevant impacts on rainfall amount and distribution. Within this context, in this work the temporal variability of rainfall at annual, seasonal and monthly scale was analyzed in Italy using rainfall data extracted from the reanalysis dataset ERA5-Land during the period 1950–2020. In particular, rainfall trend magnitude and significance have been estimated by means of non-parametric tests applied to 3215 grid points falling within the Italian territory. The main results of this analysis evidenced only a few relevant trends at the annual scale, mostly involving northern Italy (positive trend) and the Sardinia region (negative trend). At seasonal scale, the results showed a marked negative trend in winter, characterizing almost all the Italian territory, while in the other seasons a positive trend was identified in the majority of grid points, especially in the Alps. Finally, at the monthly scale, September was identified as the month of the year with the highest percentage of grid points with positive trends mainly located in central, southern, and north-eastern Italy. [ABSTRACT FROM AUTHOR]