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Background: Very-low-income students are a population at a high risk of perpetrating and suffering bullying at school, and at the same time the peer group at school is often one of the few sources of support for these minors. Objective: This two-wave study is aimed to disambiguate the two different roles of peer acceptance and friendship on bullying and victimization in very-low-income adolescents, exploring the possible differential role of immigrant background. Method: An online survey was administered to 249 early to late adolescents living below the poverty threshold (M[subscript age] = 12.76; SD[subscript age] = 2.34; 41.8% girls; 19.3% immigrants). A multivariate regression model with multi-group analyses was applied. Results: Our results indicated that peer friendship was a protective factor against bullying as well as victimization, whilst peer acceptance was not protective. Only for natives (but not for immigrants), a high level of peer acceptance was a risk factor for bullying, and low school achievement was a risk factor for victimization. The persistence of victimization over time was significantly stronger for immigrants than for natives. Conclusions: The study provides new insights for the unique protective role of classmates' friendship in natives and immigrants, while acceptance appeared to be less relevant. Research and applied implications are discussed.

Simple Summary: In Italy, buffalo milk is mainly transformed into 'Mozzarella di Bufala Campana', a Protected Designation of Origin (PDO) cheese. A quick method for predicting the coagulation properties of the milk before cheese production could enhance the efficiency of the industry. Therefore, the aim of this paper was to evaluate the potential use of mid-infrared spectroscopy to predict milk coagulation traits in bulk milk from Mediterranean Italian buffaloes. A total of 1736 bulk milk samples from 55 farms in central Italy were analyzed. Prediction models using mid-infrared spectroscopy were built with a modified partial least-squares regression using an external validation dataset. The best prediction model was obtained for curd firmness, but it was still inaccurate enough to replace traditional methods. This study evaluated the potential use of mid-infrared spectroscopy to predict milk coagulation traits in bulk milk from Mediterranean Italian buffaloes. A total of 1736 bulk milk samples from 55 farms in central Italy were collected during the official milk quality testing system. The prediction models were developed based on modified partial least-squares regression with 75% of the samples and validated with the remaining samples. All bulk milk samples coagulated between 7.37 and 29.45 min. Average values for milk coagulation traits in the calibration set were 17.71 min, 3.29 min, and 38.83 mm for rennet coagulation time, curd firming time, and curd firmness, respectively. The validation set included samples with similar mean and standard deviation for each trait. The prediction models showed the greatest coefficient of determination of external validation (0.57) and the ratio of prediction to deviation (1.52) for curd firmness. Similar fitting statistics of the prediction models were obtained for rennet coagulation time and curd firming time. In conclusion, the prediction models for all three coagulation traits were below the threshold to consider the prediction models adequate even for rough screening of the samples. [ABSTRACT FROM AUTHOR]

Simple Summary: Sinonasal cancer (SNC) is strongly associated with occupational exposure to several carcinogens involved in SNC's etiology, which vary by gender. Gender differences in SNC cases were examined through the Italian sinonasal cancer registry. Male-to-female incidence differences are neglectable in the youngest age classes but increase in older age classes, probably as a result of more men being diagnosed with SNC due to their greater occupational exposure to carcinogens (mostly wood and leather dusts) compared with women. Occupational exposures to carcinogens were the most frequent in both genders. A high percentage of women had unlikely exposures. Gender differences deserve more deep investigation, starting with a review of diagnostic processes and occupational history taking. Background: Although rare, sinonasal cancers (SNCs) have a high occupational attributable fraction. Methods: We applied gender-based approaches to descriptive analyses, incidence, and patterns of exposures using the Italian National Sinonasal Cancer Registry (ReNaTuNS: Registro Nazionale Tumori Naso-Sinusali). Results: The study included 2851 SNC patients. SNC was diagnosed more often in men (73%) than in women (27%). The most frequent morphology in men was intestinal-type adenocarcinoma (33%), whereas in women, it was squamous cell carcinoma (49%). Nasal cavities were predominant in both genders (50%), ethmoidal sinus in men (24%), and maxillary in women (24%). Incidence rates were 0.76 (per 100,000 person-years) in men and 0.24 in women and increased by age, more evidently in men, peaking over 75 years in both. Occupational exposures to wood and leather dusts were the most frequent (41% for men, 33% for women). Few exposures were extra-occupational or domestic. Unlikely exposure was relevant in women (57%). Conclusions: The surveillance of SNC cases through a registry that allows for the identification of and compensation for this occupational disease is important in Italy, where numerous workers are exposed to carcinogens for SNC, without even being aware. Considering the rarity of the disease, particularly among women, the ReNaTuNS can provide a method to analyze gender differences. [ABSTRACT FROM AUTHOR]

The Serravuda site on a hill near Acri, Calabria in Italy was discovered in 1970. The site presents a unique vitrified lithoid structure. Early theories speculated on its vitrification, ranging from forest fires to extraterrestrial impacts. The structure consists of vitrified Paleozoic rock fragments forming a 45-m-long wall, possibly once extending further. Analysis suggests that humans transported these fragments for construction, with subsequent partial vitrification occurring due to high temperatures from wood combustion. Thermoluminescence dating, using the innovative "Pre-bleached with Blue LEDs" protocol, indicates origins between the Late Bronze Age and Iron Age, aligning with settlement periods in the region. Fading studies were conducted to correct the error in the age data due to signal loss. The scenario suggests that the vitrification of the structure may have been a consequence of human utilization of timber for construction, with combustion resulting from random events such as forest fires or lightning strikes. This description has remarkable similarities with to those proposed for Iron Age vitrified forts in Northern Europe, suggesting that Serravuda could be seen as a precursor to such forts. Moreover, this prompts intriguing inquiries into the origins and evolution of Nordic engineering techniques focused on fire utilization in construction. [ABSTRACT FROM AUTHOR]

To report epidemiological and virological results of an outbreak investigation of influenza-like illness (ILI) among refugees in Northern Italy. Outbreak investigation of ILI cases observed among nearly 100 refugees in Northern Italy unvaccinated for influenza. An epidemiological investigation matched with a differential diagnosis was carried out for each sample collected from ILI cases to identify 10 viral pathogens (SARS-CoV-2, influenza virus type A and B, respiratory syncytial virus, metapneumovirus, parainfluenza viruses, rhinovirus, enterovirus, parechovirus, and adenovirus) by using specific real-time PCR assays according to the Centers for Disease Control and Prevention (CDC) protocols. In cases where the influenza virus type was identified, complete hemagglutinin (HA) gene sequencing and the related phylogenetic analysis were conducted. The outbreak was caused by influenza A(H3N2): the attack rate was 83.3% in children aged 9–14 years, 84.6% in those aged 15–24 years, and 28.6% in adults ≥25 years. Phylogenetic analyses uncovered that A(H3N2) strains were closely related since they segregated in the same cluster, showing both a high mean nucleotide identity (100%), all belonging to the genetic sub-group 3C.2a1b.2a.2, as those mainly circulating into the general population in the same period. The fact that influenza outbreak strains as well as the community strains were genetically related to the seasonal vaccine strain suggests that if an influenza prevention by vaccination strategy had been implemented, a lower attack rate of A(H3N2) and ILI cases might have been achieved. [ABSTRACT FROM AUTHOR]

Simple Summary: Allogeneic stem cell transplantation (allo-SCT) represents the only potentially curative treatment for high-risk acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS), but up to 50% of patients relapse after allo-SCT. The salvage therapy after disease recurrence is not standardized, and the outcome remains unfavorable. Therefore, there is a growing interest in determining the most effective approach to manage the post-transplant phase with the goal of promptly detecting disease recurrence or preventing it. In this context, we conducted a retrospective study to assess the overall survival (OS) of patients with relapsed AML or MDS after allo-SCT with the aim of acquiring useful information for identifying the best prospective therapeutic strategy. The OS was evaluated according to the type of therapy, whether it included donor lymphocyte infusion (DLI), the timing of administration, and whether it occurred during an overt hematological relapse or in a preemptive setting. Background: Disease relapse after allogeneic stem cell transplantation (allo-SCT) is the main challenge for curing acute myeloid leukemia (AML) and myelodysplastic syndrome (MDS). We investigated the overall survival (OS) after allo-SCT relapse according to different therapeutic approaches. Methods: We analyzed 134 patients who relapsed after allo-SCT performed between 2015 and 2021 at Saint-Antoine University Hospital, Paris and Spedali Civili di Brescia, Brescia. Of these, 103 (77%) were treated, comprising 69/103 (67%) who received therapy in overt relapse and 34/103 (33%) who were treated in a pre-emptive manner when molecular/cytogenetics recurrence or mixed chimerism occurred. The treatment was donor lymphocyte infusion (DLI)-based for 40/103 (39%) patients. Results: The 1-, 2-, and 5-year OS of patients treated with DLI (n = 40) was 67%, 34%, and 34%, respectively, for those treated preventively (n = 20) and 43%, 20%, and 20%, respectively, for those treated in overt relapse (n = 20) (p < 0.01). The 1-, 2-, and 5-year OS of patients treated without DLI (n = 63) was 54%, 40%, and 26%, respectively, for those treated preventively (n = 14) and 17%, 5%, and 0%, respectively, for those treated in overt relapse (n = 49) (p < 0.01). Conclusions: Relapse treatment with a pre-emptive strategy was associated with improved outcomes, particularly when DLI was employed. [ABSTRACT FROM AUTHOR]

Indoor radon surveying and remediation were implemented in a single-family home affected by high levels of indoor radon in the Celleno municipality (central Italy) with the aim of identifying the contribution of radon sources, evaluating the factors affecting radon entry into the building, and reducing radon risk. Average radon levels were relatively low at the ground floor (286 ± 202 Bq m−3) and first floor (167 ± 84 Bq m−3) in autumn when the temperature was still warm and the windows were open, but increased up to 2776 ± 1768 Bq m−3 and 970 ± 202 Bq m−3 in the first half of December, when the heating system was on and the windows were closed. The inner walls of the pilot room at the ground floor, semi buried on one side, were then treated with a waterproof product (a silane terminated polymer) and the average radon was halved (1475 ± 1092 Bq m−3) in the following month, which was still characterised by winter conditions. Radon entry in the room was identified and sealed with the same product, and a radon accumulation space behind a NE-SW oriented wall was naturally ventilated, reducing radon below the reference level in April with northerly winds conditions. [ABSTRACT FROM AUTHOR]

Introduction: Ixazomib, lenalidomide, and dexamethasone (IRd) have been approved for the treatment of relapsed/refractory multiple myeloma (RRMM) based on the results of the TOURMALINE‐MM1. Objectives and Methods: We conducted a retrospective–prospective analysis of 106 RRMM patients (pts) treated with IRd in 21 centers in Northern Italy, with the aim to evaluate the efficacy and safety of IRd in real life. Results: At IRd initiation, 34% of pts were aged ≥75 (median 72.5), 8.5% had an ECOG performance status ≥2, 54.7% of evaluable pts carried high‐risk cytogenetic abnormalities [del17p and/or t(4;14) and/or t(14;16) and/or 1 g gain/amp], 60.2% had received ≥2 prior lines of therapy (pLoT), 57.5% were lenalidomide (Len)‐exposed (including both Len‐sensitive and Len‐refractory pts), and 22% were Len‐refractory. Main G ≥3 adverse events (AEs) were thrombocytopenia (16%) and neutropenia (12.3%). G ≥3 non‐hematologic AEs included infections (9.4%) and GI toxicity (diarrhea 5.7%, hepatotoxicity 2.8%), VTE, skin rash, and peripheral neuropathy were mainly G1‐2. The overall response rate was 56.4% (≥VGPR 30%). With a median follow‐up of 38 m, median PFS (mPFS) was 16 m and the 1‐year OS rate was 73%. By subgroup analysis, an extended PFS was observed for pts achieving ≥VGPR (mPFS 21.2 m), time from diagnosis to IRd ≥5 years (26.2 m), 1 pLoT (34.4 m), Len‐naïve (NR), age ≥70 (20 m). In pts exposed to Len, non‐refractory in any prior line and immediately prior to IRd, mPFS was 16 and 18 m, respectively. An inferior PFS was seen in Len‐refractory pts (4.6 m). By multivariate analysis, independent predictors of PFS were age ≥70 (HR 0.6), time from diagnosis ≥5 years (HR 0.32), refractoriness to Len in any prior line (HR 3.33), and immediately prior (HR 4.31). Conclusion: IRd might be effective and safe in RRMM pts with an indolent disease, in early lines of treatment, and who proved Len‐sensitive, independent of age, and cytogenetic risk. [ABSTRACT FROM AUTHOR]

Aim was to investigate the propensity to switch to long-acting injectable HIV pre-exposure prophylaxis (PrEP) with cabotegravir among oral PrEP-experienced men who have sex with men. Out of 377 PrEP users, 325 (86.2%) were interested (would like = 210) or considering (would consider = 115) switch to long-acting PrEP. At multivariable analysis, the odds ratio of interest in long-acting PrEP in non-adherent vs. adherent individuals to oral PrEP was 5.03 (95%CI = 1.73–14.61,p = 0.003) and of consideration 1.63 (95%CI = 0.51–5.23,p = 0.410). We observed very high propensity to switch to long-acting PrEP, particularly among non-adherent users. Rapid availability of long-acting PrEP might address unmet needs of PrEP users in Italy. [ABSTRACT FROM AUTHOR]

Background: COVID-19 is generally milder in children than in adults, however severe infection has been described in some patients. Few data are available on use of Remdesivir (RDV) in children, as most clinical trials focused on adult patients. We report a multicenter study conducted in 10 Italian Hospitals to investigate the safety of RDV in children affected by COVID-19. Methods: We collected the clinical data of children with COVID-19 treated with RDV between March 2020 and February 2022 in 10 Italian hospitals. Clinical data were compared according to a duration of RDV therapy more or less than 5 days. Linear regression model was used to determine the association of significant variables from the bivariate analysis to the duration of RDV therapy. Results: A total of 50 patients were included, with a median age of 12.8 years. Many patients had at least one comorbidity (78%), mostly obesity. Symptoms were fever (88%), cough (74%) and dyspnea (68%). Most patients were diagnosed with pneumonia of either viral and/or bacterial etiology. Blood test showed leukopenia in 66% and increased C-reactive protein (CRP) levels in 63% of cases. Thirty-six patients received RDV for 5 days, nine patients up to 10 days. Most children who received RDV longer were admitted to the PICU (67%). Treatment with RDV was well tolerated with rare side effects: bradycardia was recorded in 6% of cases, solved in less than 24 h after discontinuation. A mild elevation of transaminases was observed in 26% of cases, however for the 8%, it was still detected before the RDV administration. Therefore, in these cases, we could not establish if it was caused by COVID-19, RDV o both. Patients who received RDV for more than 5 days waited longer for its administration after pneumonia diagnosis. The presence of comorbidities and the duration of O2 administration significantly correlated with the duration of RDV therapy at the linear regression analysis. Conclusion: Our experience indicates that RDV against SARS-CoV-2 is safe and well-tolerated in pediatric populations at high risk of developing severe COVID-19. Our data suggest that delaying RDV therapy after diagnosis of pneumonia may be associated with a longer duration of antiviral therapy, especially in patients with comorbidities. [ABSTRACT FROM AUTHOR]

Despite good vaccine coverage and careful blood donor selection policies, hepatitis B virus (HBV) is still the most frequent viral infection among blood donors (BDs) in Italy, mostly in the occult form (OBI). We studied the virological features of OBI in BDs from South Italy by serology, molecular testing for HBV-DNA, and sequencing for HBV genotypes and mutations. One hundred and two samples from 95 BDs (22.1% first time, 87.9% regular, median age 57 years) positive for HBV-DNA and negative for HBsAg were retrospectively analyzed. HBV biomarkers were detected in 96.9% (anti-HBc in 44.2%, anti-HBc plus anti-HBs in 49.5%, anti-HBs alone in 3.2%). No risk factor was declared by 45.3% of donors. HBV-DNA levels were very low (median: 7 IU/mL). All samples harbored HBV genotype D and single or multiple mutations in the S gene were found in 28/36 sequences analyzed and in 75% of donors. Mutations were unrelated to gender, donor group or serological patterns. An HBsAg assay with enhanced sensitivity was positive in samples from seven donors (7.4%), two of which negative for HBV-DNA by real-time PCR. OBI still represents a risk for HBV transmission from blood donations; screening by highly sensitive serological and molecular assays is warranted. [ABSTRACT FROM AUTHOR]

The class I HLA genotype has been widely recognized as a factor influencing HIV disease progression in treatment‐naïve subjects. However, little is known regarding its role in HIV disease course and how it influences the size of the viral reservoir once anti‐retroviral therapy (ART) is started. Here, leveraging on cutting‐edge bioinformatic tools, we explored the relationship between HLA class I and the HIV reservoir in a cohort of 90 people living with HIV (PLWH) undergoing ART and who achieved viral suppression. Analysis of HLA allele distribution among patients with high and low HIV reservoir allowed us to document a predominant role of HLA‐B and ‐C genes in regulating the size of HIV reservoir. We then focused on the analysis of HIV antigen (Ag) repertoire, by investigating immunogenetic parameters such as the degree of homozygosity, HLA evolutionary distance and Ag load. In particular, we used two different bioinformatic algorithms, NetMHCpan and MixMHCpred, to predict HLA presentation of immunogenic HIV‐derived peptides and identified HLA‐B*57:01 and HLA‐B*58:01 among the highest ranking HLAs in terms of total load, suggesting that their previously reported protective role against HIV disease progression might be linked to a more effective viral recognition and presentation to Cytotoxic T lymphocytes (CTLs). Further, we speculated that some peptide‐HLA complexes, including those produced by the interaction between HLA‐B*27 and the HIV Gag protein, might be particularly relevant for the efficient regulation of HIV replication and containment of the HIV reservoir. Last, we provide evidence of a possible synergistic effect between the CCR5 ∆32 mutation and Ag load in controlling HIV reservoir. [ABSTRACT FROM AUTHOR]

From the initial COVID-19 outbreak, Italy was the first Western country to be seriously affected by the pandemic. Understanding vaccine hesitancy can help efforts to achieve broad vaccination coverage. The objectives of this research were to determine the extent of vaccine hesitancy in Italy and to understand the characteristics of those segments of the population with some hesitancy. Between January and February 2021, 41,473 subjects answered the second questionnaire delivered in phase II of the web-based EPICOVID19 survey. Among the included adult volunteers living in Italy, 4653 (11.2%) reported having previously received at least one dose of the COVID-19 vaccine. In the sample of 36,820 respondents, all not vaccinated (age 51.1 ± 13.5; 59.7% female; 63.6% high level of education), the comparison between hesitant and inclined participants was accompanied by percentages and odds ratios. A total of 2449 individuals were hesitant (6.7% of the unvaccinated ones). Hesitancy was higher among women (OR = 1.48; 95%CI: 1.36–1.62); it was highest in the 50–59 and 40–49 age groups and among those with a lower educational level. A higher level of education was associated with a lower proportion of hesitancy (5.54%) compared with 9.44% among respondents with a low level of education (OR = 0.56; 95%CI: 0.46–0.68). Hesitancy was most common in subjects who did not report fear of infection (12.4%, OR = 4.0; 95%CI: 3.46–4.61). The results can guide the design of tailored information and communication campaigns through considering objective and subjective characteristics. [ABSTRACT FROM AUTHOR]

Do national and local newspapers both impact voter turnout? This paper tackles this question by employing data from a unique dataset that collects detailed national and local newspapers, politico-institutional and socio-economic information for Italy during 1980–2007. We use a Dynamic Panel Data with Instrumental Variables methodology that allows for the consideration of potential sources of endogeneity that may affect the relation between the press and voting behavior. We strengthen this methodology by considering the industry's entry and exit of newspapers – i.e. turbulence – as an external shock. Our analysis provides robust evidence that local newspaper readership affects both national and local turnout and improves political accountability. [ABSTRACT FROM AUTHOR]

Approximately 30–50% of hereditary breast and ovarian cancer (HBOC) is due to the presence of germline pathogenic variants in the BRCA1 (OMIM 113705) and BRCA2 (OMIM 600185) onco-suppressor genes, which are involved in DNA damage response. Women who carry pathogenic BRCA1 variants are particularly likely to develop breast cancer (BC) and ovarian cancer (OC), with a 45–79 percent and 39–48 percent chance, respectively. The BRCA1 c.4096+1G>A variant has been frequently ascertained in Tuscany, Italy, and it has also been detected in other Italian regions and other countries. Its pathogenetic status has been repeatedly changed from a variant of uncertain significance, to pathogenic, to likely pathogenic. In our study, 48 subjects (38 of whom are carriers) from 27 families were genotyped with the Illumina OncoArray Infinium platform (533,531 SNPs); a 20 Mb region (24.6 cM) around BRCA1, including 4130 SNPs (21 inside BRCA1) was selected for haplotype analysis. We used a phylogenetic method to estimate the time to the most recent common ancestor (MRCA) of BRCA1 c.4096+1G>A founder pathogenic variant. This analysis suggests that the MRCA lived about 155 generations ago—around 3000 years ago. [ABSTRACT FROM AUTHOR]

Livestock European diffusion followed different human migration waves from the Fertile Crescent. In sheep, at least two diffusion waves have shaped the current breeds' biodiversity generating a complex genetic pattern composed by either primitive or fine-wool selected breeds. Nowadays most of the sheep European breeds derive from the second wave which is supposed to have largely replaced oldest genetic signatures, with the exception of several primitive breeds confined on the very edge of Northern Europe. Despite this, some populations also in the Mediterranean region are characterised by the presence of phenotypic traits considered ancestral such as the policeraty, large horns in the ram, short tail, and a moulting fleece. Italy is home of a large number of local breeds, albeit some are already extinct, others are listed as critically endangered, and among these there is the Quadricorna breed which is a four-horned sheep characterised by several traits considered as ancestral. In this context we genotyped 47 individuals belonging to the Quadricorna sheep breed, a relict and endangered breed, from Central and Southern Italy. In doing so we used the Illumina OvineSNP50K array in order to explore its genetic diversity and to compare it with other 41 breeds from the Mediterranean region and Middle-East, with the specific aim to reconstruct its origin. After retaining 32,862 SNPs following data filtering, the overall genomic architecture has been explored by using genetic diversity indices, Principal Component Analysis (PCA) and admixture analysis, while the genetic relationships and migration events have been inferred using a neighbor-joining tree based on Reynolds' distances and by the maximum likelihood tree as implemented in treemix. The Quadricorna breed exhibit genetic diversity indices comparable with those of most of the other analysed breeds, however, the two populations showed opposing patterns of genetic diversity suggesting different levels of genomic inbreeding and drift (FIS and FROH). In general, all the performed genome-wide analyses returned complementary results, indicating a westward longitudinal cline compatible with human migrations from the Middle-East and several additional genetic footprints which might mirror more recent historical events. Interestingly, among the Italian breeds, the original Quadricorna (QUAD_SA) first separated showing its own ancestral component. In addition, the admixture analysis does not suggest any signal of recent gene exchange with other Italian local breeds, highlighting a rather ancestral purity of this population. On the other hand, both the neighbor-joining tree and the treemix analysis seem to suggest a proximity of the Quadricorna populations to breeds of South-Eastern Mediterranean origin. Although our results do not support a robust link between the genetics of the first wave and the presence of primitive traits, the observed genetic uniqueness together with the inferred phylogeograpic reconstruction would suggest an ancient presence of the Quadricorna breed in the Italian Peninsula. Because of this singularity, urgent conservation actions are needed in order to keep the breed and all related cultural products alive. [ABSTRACT FROM AUTHOR]

Atopic dermatitis (AD) is one of the most common diseases worldwide. Severe AD has a major impact on the quality of life of patients. We performed a systematic literature review on the epidemiology of AD in Italian pre-school children (age 0–5 years) and we assessed the available data on the severity of AD. In August 2022, we performed a bibliographic search using PubMed/Medline and EMBASE. We identified 10 studies with Italian data on the prevalence and/or incidence of AD in pre-school children. The period (12 months) prevalence of AD varied widely across studies, ranging between 4.0% and 42.2%, with median estimates of 14.3% among all studies and 11.8% among studies from 2010 onwards. Applied to the Italian population, this leads to a prevalence of 309,000–375,000 pre-school AD cases. Only one study computed the incidence of AD, reporting rates of 9 cases per 100 person-years in children aged 0–1 year, and 2.5 cases per 100 person-years in children aged 1–4 years. Severity data from Italy were also reviewed, across three identified three studies. A point estimate found 8.4% of cases were considered severe in one study based on the Patient-Oriented Eczema Measure (POEM), with an overall range of 7.8–11% across different Italian studies and according to various severity score types. [ABSTRACT FROM AUTHOR]

Background: In the treatment of Non-Small Cell Lung Cancer (NSCLC) the combination of Immuno- Oncotherapy (IO) and chemotherapy (CT) has been found to be superior to IO or CT alone for patients' survival. Patients and clinicians are confronted with a preference sensitive choice between a more aggressive treatment with a greater negative effect on quality of life versus alternatives that are less effective but have fewer side effects. Objectives: The aims of this study were to: (a) quantify patients' preferences for relevant attributes related to Immuno-Oncotherapy treatment alternatives, and (b) evaluate the maximum acceptable risk (MAR)/Minimum acceptable benefit (MAB) that patients would accept for treatment alternatives. Methods: An online preference survey using discrete-choice experiment (DCE) was completed by NSCLC patients from two hospitals in Italy and Belgium. The survey asked patients' preferences for five patient- relevant treatment attributes. The DCE was developed using a Bayesian D-efficient design. DCE analyses were performed using mixed logit models. Information regarding patient demographics, health literacy, locus of control, and quality of life was also collected. Results: 307 patients (158 Italian, 149 Belgian), stage I to IV, completed the survey. Patients preferred treatments with a higher 5-year survival chance as the most important attribute over all the other attributes. Preference heterogeneity for the attribute weights depended on health literacy, patients' age and locus of control. Patients were willing to accept a substantially increased risks of developing side effects in exchange for the slightest increase (1%) in the chance of surviving at least 5 years from the diagnosis of cancer. Similarly, patients were willing to accept a switch in the mode of administration or complete loss of hair to obtain an increase in survival. Conclusion: In this study, the proportion of respondents who systematically preferred survival over all other treatment attributes was particularly high. Age, objective health literacy and locus of control accounted for heterogeneity in patients' preferences. Evidence on how NSCLC patients trade between survival and other NSCLC attributes can support regulators and other stakeholders on assessing clinical trial evidence and protocols, based on patients' conditions and socio-demographic parameters. [ABSTRACT FROM AUTHOR]

In this contribution, new data concerning algae, bryophytes, fungi and lichens of the Italian flora are presented. It includes new records and confirmations for the algal genera Acetabularia, Nitella, and Nitellopsis for the bryophyte genera Drepanocladus, Fissidens, Hookeria, and Weissia, the fungal genera Alnicola, Arthonia, Cortinarius, Inocybe, Leucoagaricus, Neohygrocybe, and Puccinia and the lichen genera Bacidina, Chaenotheca, Flavoplaca, Gyalecta, Heterodermia, Rinodina, Scytinium, and Squamarina. [ABSTRACT FROM AUTHOR]

This paper presents the results obtained for the mural paintings (XV century CE) in the church of San Panfilo in Villagrande di Tornimparte (AQ, Italy) by means of noninvasive spectroscopic techniques; this research is a part of the project on the Saturnino Gatti pictorial cycle, promoted and coordinated by the AIAr (the Italian Archaeometry Association). Digital optical microscopy (OM), X-ray fluorescence spectroscopy (XRF), fiber optics reflectance spectroscopy in the UV–Vis–NIR range (FORS), Fourier transform infrared spectroscopy in the external reflection mode (ER-FTIR), and Raman spectroscopy were performed on the points selected based on the image analysis results and the few available records on previous intervention, with the aim of characterizing both the original and restoration organic and inorganic materials. The synergic application of complementary techniques allowed us to obtain a complete picture of the palette and the main alteration products and organic substances (of rather ubiquitous lipid materials and less widespread resin and proteinaceous materials in specific points). The identification of modern compounds permitted the individuation of restoration areas; this was confirmed by the comparison with multiband imaging results, as in the case of specific green and blue pigments, strictly related to the presence of high signals of zinc. This analytical protocol left only very few ambiguities and allowed to minimizing the number of samples taken to clarifying, by sample laboratory analyses, the few doubts still open. [ABSTRACT FROM AUTHOR]

Introduction: The aim of this case series was to evaluate the necrosis of teeth adjacent to the site of mandibulotomy or mandibulectomy in a cohort of patients suffering from head and neck cancers. Methods: Fourteen patients who underwent segmental mandibulectomy or paramedian mandibulotomy for oral, oropharynx or major salivary gland cancer and a total of 23 teeth were included in this case series. Twelve patients underwent adjuvant head and neck radiotherapy. Cold sensitivity pulp testing and/or electric pulp testing were performed on teeth at the margin of mandibulectomy and on teeth adjacent to mandibulotomy after surgery. A "positive" response was considered the healthy state, and "negative" was considered the diseased state of the tooth. Results: The 10 patients who underwent mandibulotomy had 12 teeth with a negative response. The 4 patients treated by mandibulectomy had two positive and three negative responses to cold and electric pulp tests. Fifteen out of 23 teeth (65.2%) showed a negative response to sensitivity testing. Conclusions: Tooth necrosis seems to be a common event after mandibulectomy and mandibulotomy. Clinical Relevance: To avoid post-surgery complications, performing root canal therapy before surgery on the teeth adjacent to the surgical site could be an appropriate strategy. [ABSTRACT FROM AUTHOR]

Copyright of Italian Journal of Nursing (IJN) / Giornale Italiano di Infermieristica is the property of Collegio IPASVI MI-LO-MB - Ordine Professioni Infermieristiche MI-LO-MB and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Objectives: To evaluate the prevalence of carotid intima‐media thickness (IMT) and plaques in a cohort of people living with HIV (PLWH), the role of cardiovascular risk factors, the impact of the antiretroviral regimens and the difference between naïve and experienced patients in the onset of carotid lesions. Methods: This project was initiated in 2019 and involves eight Italian centres. Carotid changes were detected using a power colour‐Doppler ultrasonography with 7.5 MHz probes. The following parameters were evaluated: IMT of both the right and left common and internal carotids, data regarding risk factors for cardiovascular disease, HIV viral load, CD4 cell counts, serum lipids, glycaemia and body mass index. The associations between pathological findings and potential risk factors were evaluated by logistical regression, with odds ratios (ORs) and 95% confidence intervals (95% CI)s. Results: Among 1147 evaluated PLWH, with a mean age of 52 years, 347 (30.2%) had pathological findings (15.8% plaques and 14.5% IMT). Besides the usual risk factors, such as older age, male sex and dyslipidaemia, CD4 cell nadir < 200 cells/mL (adjusted OR = 1.51, 95% CI: 1.14–1.99) and current use of raltegravir (adjusted OR = 1.54, 95% CI: 1.01–2.36) were associated with higher prevalence of pathological findings. Conclusions: Our data show that the current overall percentage of carotid impairments remains high. Colour‐Doppler ultrasonography could play a pivotal role in identifying and quantifying atherosclerotic lesions among PLWH, even at a very premature stage, and should be included in the algorithms of comorbidity management of these patients. [ABSTRACT FROM AUTHOR]

Antimicrobial lock solutions (ALT) in combination with systemic antibiotics can represent a valid option to attempt central venous catheter (CVC) salvage in the case of catheter-related and central-line-associated bloodstream infections (CRBSI and CLABSI). However, data concerning the effectiveness and safety of ALT in children are limited. We aimed to share our center's experience in order to contribute to investigations into the causes of ALT failure in the pediatric population. All children consecutively admitted to Meyer Children's Hospital, University of Florence, Italy, from 1 April 2016 to 30 April 2022, who received salvage ALT to treat an episode of CRBSI/CLABSI, were reviewed. According to ALT failure or success, children were compared with the aim of identifying the risk factors for unsuccessful ALT outcome. Data from 28 children, 37 CLABSI/CRBSI episodes, were included. ALT was associated with clinical and microbiologic success in 67.6% (25/37) of children. No statistically significant differences were observed between the two groups, successes and failures, considering age, gender, reason for use, duration, insertion, type and presence of insertion site infection of the CVC, laboratory data and number of CRBSI episodes. Nevertheless, a trend towards a higher success rate was observed for a dwell time of 24 h for the entire duration of ALT (88%; 22/25 vs. 66.7%; 8/12; p = 0.1827), while the use of taurolidine and the infections sustained by MDR bacteria were associated with a tendency toward greater failure (25%; 3/12 vs. 4%; 1/25; p = 0.1394; 60%; 6/10 vs. 33.3%; 8/24; p = 0.2522). No adverse events, except one CVC occlusion, were observed. ALT combined with systemic antibiotics appears to be an effective and safe strategy for treating children with CLABSI/CRBSI episodes. [ABSTRACT FROM AUTHOR]

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

Cyberbullying may sometimes be an extension of traditional bullying. However, some particular features of cyberbullying suggest that it may have a distinct causal pathway, due to the social context of a virtual environment within which peer social processes occur. Moreover, boys and girls may perceive and respond differentially to their social context, which may heighten the risk for victimisation. This study aimed to describe how the perceived relational context (school, peers and family) may influence the probability of becoming a victim, in both offline and virtual contexts, among boys and girls. A questionnaire, measuring school climate; global, family and peer self-esteem; loneliness in relationship with parents and peers; and victimisation in traditional direct, traditional indirect and cyberbullying, was completed by 2326 Italian adolescents (mean age 13.9 years). For traditional victimisation, significant predictors were loneliness in relations with peers and a negative perception of school climate, in both males and females, while younger age (for direct victimisation) and lower global self-esteem (for indirect victimisation) were predictors for males only. For cybervictimisation, involvement as either a direct or an indirect victim was a very strong predictor for both males and females, but with an element of distinction compared to traditional victimisation, as lower self-esteem in family relationships was a predictor of cybervictimisation for males, while parent loneliness was a predictor for females. Implications for understanding the continuity/discontinuity between traditional bullying and cyberbullying, and for the development of intervention strategies, taking into account some differences by gender, are discussed. (Contains 3 tables.)

Given that basic mathematical ability is a requirement to succeed in "non-mathematical" majors, e.g. degrees for Psychology, Education, and Health Sciences with compulsory introductory stats courses, assessing this ability can be useful to promote achievement. The aim of the present study was to develop a scale to measure the mathematical ability deemed necessary to successfully complete introductory statistics courses. The Item Response Theory was applied to construct a scale for accurately measuring low levels of ability, i.e. levels under which examination attainment should be prevented. Mathematical basics were identified and a pool of items was created. Items were calibrated under the 2PL model and the test information function was investigated. The equivalence of the developed scale across national (Italy) and international (Spain) contexts was assessed analyzing Differential Item Functioning (DIF). Finally, the validity was studied for both the Italian and the Spanish versions of the scale. Advantages of the scale for international research and teaching are discussed. (Contains 6 tables and 2 figures.)

Thirty‐two tephra layers were identified in the time‐interval 313–366 ka (Marine Isotope Stages 9–10) of the Quaternary lacustrine succession of the Fucino Basin, central Italy. Twenty‐seven of these tephra layers yielded suitable geochemical material to explore their volcanic origins. Investigations also included the acquisition of geochemical data of some relevant, chronologically compatible proximal units from Italian volcanoes. The record contains tephra from some well‐known eruptions and eruptive sequences of Roman and Roccamonfina volcanoes, such as the Magliano Romano Plinian Fall, the Orvieto–Bagnoregio Ignimbrite, the Lower White Trachytic Tuff and the Brown Leucitic Tuff. In addition, the record documents eruptions currently undescribed in proximal (i.e. near‐vent) sections, suggesting a more complex history of the major eruptions of the Colli Albani, Sabatini, Vulsini and Roccamonfina volcanoes between 313 and 366 ka. Six of the investigated tephra layers were directly dated by single‐crystal‐fusion 40Ar/39Ar dating, providing the basis for a Bayesian age–depth model and a reassessment of the chronologies for both already known and dated eruptive units and for so far undated eruptions. The results provide a significant contribution for improving knowledge on the peri‐Tyrrhenian explosive activity as well as for extending the Mediterranean tephrostratigraphical framework, which was previously based on limited proximal and distal archives for that time interval. [ABSTRACT FROM AUTHOR]

Some memories of a summer vacation in Aosta Valley, Italy, in August 1952 are recalled, in which, among other things, references are made to certain aspects of the history of academic psychiatry in Milan of the 1950s and 1960s. [ABSTRACT FROM AUTHOR]

Background: US Food and Drug Administration has issued Emergency Use Authorizations for hundreds of serological assays to support Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) diagnosis. The aim of this study is to evaluate, for the first time in children, the performance of three widely utilized SARS-CoV-2 serology commercial assays, Diesse Diagnostics (IgG, IgA, IgM) and Roche Diagnostics, both Roche Nucleocapsid (N) IgG and Roche Spike (S) IgG assays. Methods: Sensitivity and 95% confidence intervals (CIs) were estimated for each of the three different serological tests and mixed and direct comparison were performed. Univariate and multivariate Poisson regression models were fitted to calculate incidence rate ratios and 95% CIs as estimate of the effects of age, gender, time on the serology title. A p-value < 0.05 indicated statistical significance. Results: Overall, 149 children were enrolled in the study. A low sensitivity was found for Diesse IgA, IgM and IgG. Compare to Diesse, Roche S had a higher sensitivity at 15–28 days from infection (0.94, 95%CI: 0.73–1.0) and Roche N at 28–84 days (0.78, 95%CI: 0.58–0.91). When a direct comparison of IgG tests sensitivity was feasible for patients with pairwise information, Roche S and Roche N showed a statistically significant higher sensitivity compared to Diesse in all the study periods, whereas there was no difference between the two Roche tests. Conclusion: Roche S and Roche N serology tests seem to better perform in children. Large prospective studies are needed to better define the characteristics of those tests. [ABSTRACT FROM AUTHOR]

Livestock European diffusion followed different human migration waves from the Fertile Crescent. In sheep, at least two diffusion waves have shaped the current breeds' biodiversity generating a complex genetic pattern composed by either primitive or fine-wool selected breeds. Among primitive breeds, aside from sharing common ancestral genomic components, they also show several traits such as the policeraty, large horns in the ram, short tail, and a moulting fleece, considered as ancestral. Although most of the primitive breeds characterized by these traits are confined on the very edge of Northern Europe, several residual populations are also scattered in the Mediterranean region. In fact, although in Italy a large number of local breeds are already extinct, others are listed as critically endangered, and among these there is the Quadricorna breed which is a four-horned sheep characterized by several ancestral traits. In this context we genotyped 47 individuals belonging to the Quadricorna sheep breed, a relict and endangered breed, from Central and Southern Italy. In doing so we used the Illumina OvineSNP50K array in order to explore its genetic diversity and to compare it with other 33 primitive traits-related, Mediterranean and Middle-East breeds, with the specific aim to reconstruct its origin. After retaining 35,680 SNPs following data filtering, the overall genomic architecture has been explored by using genetic diversity indices, Principal Component Analysis (PCA) and admixture analysis, while the genetic relationships and migration events have been inferred using a neighbor-joining tree based on Reynolds' distances and by the maximum likelihood tree as implemented in treemix. Multiple convergent evidence from all our population genetics analyses, indicated that the two Quadricorna populations differ from all the other Italian breeds, while they resulted to be very close to the Middle Eastern and primitive European breeds. In addition, the genetic diversity indices highlighted values comparable with those of most of the other analyzed breeds, despite the two populations exhibit slightly different genetic indices suggesting different levels of genomic inbreeding and drift (FIS and FROH). The admixture analysis does not suggest any signal of recent gene exchange with other Italian local breeds, highlighting a rather ancestral purity of the two populations, while on the other hand the treemix analysis seems to suggest an ancient admixture with other primitive European breeds. Finally, all these evidences seem to trace back the residual Quadricorna sheep to an early Neolithic spread, probably following a Mediterranean route and that urgent conservation actions are needed in order to keep the breed and all related cultural products alive. [ABSTRACT FROM AUTHOR]

The Italian government has started the regulatory process of osteopathy to include it among the healthcare professions mentioning terms, such as "perceptual palpation" and "somatic dysfunction" within the professional profile. 'Palpatory findings' are one of the multidimensional aspects that can inform osteopathic clinical reasoning. The non-regulated educational system has led to heterogenic professionals working in Italy, thus, the aim of this study was to investigate how Italian experts use palpatory findings in their clinical practice. A total of 12 experts were selected to participate in four virtual focus groups. A qualitative inductive approach with a constructivist paradigm was chosen to describe the results. The themes that emerged were: osteopathic identity; evaluation; osteopathic diagnosis; and sharing with different recipients. Participants agreed on the peculiarity and distinctiveness of osteopathic palpation, but there was some disagreement on the clinical significance of the findings, highlighting a complex multidimensional approach to diagnosis and treatment. The results seem to reflect the history of the profession in Italy, which has evolved quickly, leading professionals to seek new paradigms blending tradition and scientific evidence. The authors suggest further investigation to verify the state of art among osteopaths not involved in research or a broader consensus of the results. [ABSTRACT FROM AUTHOR]

Benign paroxysmal positional vertigo (BPPV) usually has a favorable course, although it is possible to observe BPPV with a high recurrence rate. Previous studies suggested that vitamin D deficiency might affect BPPV recurrences, and oxidative stress might play a complementary role in BPPV pathogenesis. This multicentric trial aimed to evaluate the effectiveness of oral nutritional supplementation with a compound of alpha-lipoic acid, Carnosine, and Zinc (LICA® (Difass International, Coriano (RN), Italy)), vitamins of group B and vitamin D in preventing BPPV recurrences. A total of 128 patients with high recurrence-BPPV were randomized in three arms: Arm 1 consisted of subjects with "insufficient" or "deficient" vitamin D blood levels, treated with daily oral supplementation of LICA®, vitamins of group B and vitamin D3 (800 UI), Arm 2 included BPPV subjects with "sufficient" vitamin D who did not receive any nutritional support, and Arm 3 included subjects with a "sufficient" serum concentration of vitamin D who received supplementation with a compound of LICA® and Curcumin. After six months of follow-up, a significant reduction of BPPV relapses compared to the baseline was found only in Arm 1 (−2.32, 95% CI: 3.41–1.62, p-value < 0.0001). Study results suggested that oral nutritional supplementation with vitamin D3 plus antioxidants can prevent relapses in patients suffering from high recurrence-BPPV. [ABSTRACT FROM AUTHOR]

Background: Little is known about the perceived impact of the COVID-19 pandemic and subsequent lockdown measures on young patients with tic disorders. Previous studies focused on clinician and parent ratings of tic severity, whereas the only international self-report data are available for adult populations. We present the first findings from a case–control study on children and adolescents with tics during lockdown in Italy. Methods: We surveyed 49 patients aged 6–18 years and 245 matched controls with a newly developed questionnaire covering socio-demographic and clinical data, as well as lockdown-related changes to daily life activities. Results: About half (53.2%) of the Italian school-age patients who took part in our survey experienced changes in tic severity during lockdown. Perceived increases in tic severity (29.8%) were reported more often than decreases (23.4%). Analogous trends were reported for perceived restlessness and, more significantly, irritability, whereas changes in pain symptoms were less common and were similar in both directions. The presence of tics was associated with increased difficulties with remote learning (p = 0.01), but decreased feelings of missing out on social interactions with schoolmates (p = 0.03). Conclusions: Self-reported data on the impact of COVID-19 lockdown in school-age patients with tic disorders indicate perceived changes in tic severity, as well as restlessness and irritability, in about half of the cases. These findings could guide both clinicians and teachers in the implementation of targeted adjustments in the delivery of care and educational strategies, respectively. [ABSTRACT FROM AUTHOR]

Introduction: Several countries imposed nationwide or partial lockdowns to limit the spread of COVID-19 and avoid overwhelming hospitals and intensive care units. Lockdown may involve restriction of movement, stay-at-home orders and self-isolation, which may have dramatic consequences on mental health. Recent studies demonstrated that the negative impact of lockdown restrictions depends on a wide range of psychological and socio-demographic factors. Aims: This longitudinal study aimed to understand how internal factors such as personality and mindfulness traits, and external factors, such as daily habits and house features, affect anxiety, depression and general wellbeing indicators, as well as cognitive functions, during the course of a lockdown. Methods: To address these questions, 96 participants in Italy and the United Kingdom filled out a survey, once a week for 4 weeks, during the first-wave lockdowns. The survey included questions related to their habits and features of the house, as well as validated questionnaires to measure personality traits, mindful attitude and post-traumatic symptoms. Indicators of wellbeing were the affective state, anxiety, stress and psychopathological indices. We also measured the emotional impact of the pandemic on cognitive ability by using two online behavioral tasks [emotional Stroop task (EST) and visual search]. Results: We found that internal factors influenced participants' wellbeing during the first week of the study, while external factors affected participants in the last weeks. In the first week, internal variables such as openness, conscientiousness and being non-judgmental toward one's own thoughts and emotions were positively associated with wellbeing; instead, neuroticism and the tendency to observe and describe one's own thoughts and emotions had detrimental effects on wellbeing. Toward the end of the study, external variables such as watching television and movies, browsing the internet, walking the dog, and having a balcony showed a protective value, while social networking and engaging in video calls predicted lower values of wellbeing. We did not find any effects of wellbeing on cognitive functioning. Conclusion: Recognizing specific traits and habits affecting individuals' wellbeing (in both short and long terms) during social isolation is crucial to identify people at risk of developing psychological distress and help refine current guidelines to alleviate the psychological consequences of prolonged lockdowns. [ABSTRACT FROM AUTHOR]

• Laboratory-based enterovirus surveillance detected an outbreak of echovirus 11. • Echovirus 11 only infected children; neonates were the most severely affected. • Echovirus 11 strains belonged to the D5 genogroup. • Echovirus 11 strains were related to the lineage circulating in Europe in 2022-23. Following the alert of echovirus 11 (E-11) infection in neonates in EU/EEA Member States, we conducted an investigation of E-11 circulation by gathering data from community and hospital surveillance of enterovirus (EV) in northern Italy from 01 August 2021 to 30 June 2023. Virological results of EVs were obtained from the regional sentinel surveillance database for influenza-like illness (ILI) in outpatients, and from the laboratory database of ten hospitals for inpatients with either respiratory or neurological symptoms. Molecular characterization of EVs was performed by sequence analysis of the VP1 gene. In our ILI series, the rate of EV-positive specimens showed an upward trend from the end of May 2023, culminating at the end of June, coinciding with an increase in EV-positive hospital cases. The E-11 identified belonged to the D5 genogroup and the majority (83%) were closely associated with the novel E-11 variant, first identified in severe neonatal infections in France since 2022. E-11 was identified sporadically in community cases until February 2023, when it was also found in hospitalized cases with a range of clinical manifestations. All E-11 cases were children, with 14 out of 24 cases identified through hospital surveillance. Of these cases, 60% were neonates, and 71% had severe clinical manifestations. Baseline epidemiological data collected since 2021 through EV laboratory-based surveillance have rapidly tracked the E-11 variant since November 2022, alongside its transmission during the late spring of 2023. [ABSTRACT FROM AUTHOR]

Objective: To identify patients with VEXAS syndrome (vacuoles, E1 enzyme, X‐linked, autoinflammatory, somatic syndrome) from a single‐center cohort of Italian patients with vasculitis, using a clinically oriented phenotype‐first approach. Methods: We retrospectively reviewed the clinical records of 147 consecutive male patients followed up in our vasculitis clinic from 2013 to date. All patients with a diagnosis of vasculitis and treatment‐resistant manifestations of inflammation, persistently elevated inflammation markers, and hematologic abnormalities were identified. Bone marrow aspirates were examined for the presence of vacuoles. Sequencing of ubiquitin‐activating enzyme E1 (UBA‐1) was performed using genomic DNA from peripheral blood leukocytes or bone marrow tissue. Results: Seven patients with vasculitis and concomitant features of VEXAS syndrome were identified. A final diagnosis of VEXAS syndrome was made in 3 of the 5 patients who underwent sequencing of UBA‐1 (diagnosis was made postmortem for 1 patient). In all 3 patients, examination of the bone marrow aspirate revealed vacuoles characteristic of VEXAS syndrome, and all 3 patients met the definitive World Health Organization criteria for myelodysplastic syndrome. Cytogenetic analysis showed normal karyotypes in all 3 patients. Conclusion: To our knowledge, this is the first report of VEXAS syndrome associated with antineutrophil cytoplasmic antibody (ANCA)–associated vasculitis. Our data emphasize the need to consider VEXAS syndrome when evaluating patients with various forms of systemic vasculitis. The novel association between VEXAS syndrome and ANCA‐associated vasculitis reported herein warrants further investigation. [ABSTRACT FROM AUTHOR]

Action Observation Treatment is a novel rehabilitation approach exploiting a neurophysiological mechanism that allows one to recruit the neural structures sub-serving action execution during the mere observation of those same actions. Action Observation Treatment is effective in the rehabilitation of several neurological diseases. In this pilot study, we used Action Observation Treatment in a telerehabilitation setting in children with Cerebral Palsy. Ten children with Cerebral Palsy, aged 5–12 years, entered the study. They followed the Action Observation Treatment rehabilitation program at home with remote supervision by a child neurologist located at the hospital. Outcome measures were the scores at the Melbourne Assessment of Unilateral Upper Limb Function Scale and the Assisting Hand Assessment. Scores obtained after treatment and at a two months' follow-up significantly differed from baseline and overlapped those obtained in randomized controlled studies carried out in a conventional setting. Action Observation Treatment is therefore a promising approach that can be used on a large scale in a telerehabilitation setting. Tele-rehabilitation has the potential to enhance early intervention service provision for children with Cerebral Palsy. Action Observation Treatment has the potential to become a routine approach in a telerehabilitation setting. [ABSTRACT FROM AUTHOR]

Introduction: The ongoing coronavirus disease 19 (COVID-19) outbreak involves the pediatric population, but to date, few reports have investigated the circulation of variants among children. Material and Methods: In this retrospective study, non-hospitalized pediatric patients with SARS-CoV-2-positive nasopharyngeal swabs (NPS) were enrolled at the Institute for Maternal and Child Health-IRCCS Burlo Garofolo, Trieste (Italy), from November 2020 to January 2022. SARS-CoV-2 variants were identified by in vitro viral isolation, amplification, automatic sequencing of the receptor binding domain (RBD) of the SARS-CoV-2 spike coding gene, and subsequent next-generation sequencing. The growth curves of the isolated strains were defined in vitro by infecting Vero-E6 cells and quantifying the viral load in the supernatants up to 72 h post-infection by qRT–PCR. The neutralization activity of sera obtained from a COVID-19 vaccinated subject, recovered (2020) patient, vaccinated and recovered (2021) patient, and seronegative subject was assessed by microneutralization assay against the different variants. Results: In total, 32 SARS-CoV-2-positive children, 16 (50%) females, with a median age of 1.4 years (range: 1 day–13 years), were enrolled. The D614G amino acid substitution was detected in all isolated and amplified viral strains. Of the 32 isolates, 4 (12.5%) carried a nonsynonymous nucleotide mutation leading to the N439K (3/4), lineage B.1.258 (∆H69/∆V70), and S477N (1/4) substitution. In 7/32 (21.8%) isolates, amino acid substitutions allowed the identification of a delta variant, lineage B.1.617.2-AY.43, and in 1/32 (3.1%), the Omicron strain (B.1.1.529.BA1) was identified. The growth curves of the B.1, B.1.258 (∆H69/∆V70), B.1.617.2-AY.43, and B.1.1.529.BA1 variants did not show any significant differences. A reduction in the serum neutralizing activity against B.1.258 (∆H69/∆V70) only in a vaccinated subject (1.7-fold difference), against B.1.617.2-AY.43 in a vaccinated subject and in recovered patients (12.7 and ≥2.5-fold differences, respectively), and against B.1.1.529.BA1 variant (57.6- and 1.4-fold differences in vaccinated and in vaccinated and recovered patients) were observed compared to the B.1 variant. Conclusions: SARS-CoV-2 variants carrying the B.1.258 (∆H69/∆V70) and S477N substitutions were reported here in a pediatric population for the first time. Although the growth rates of the isolated strains (B.1.258, B.1.617.2-AY.43, B.1.1.529.BA1) did not differ from the B.1 variant, neutralizing activity of the sera from vaccinated subjects significantly decreased against these variants. Attention should be devoted to the pediatric population to prevent the spread of new SARS-CoV-2 variants in an unvaccinated and predominantly naive population. [ABSTRACT FROM AUTHOR]

Introduction: The study investigates the emotional discomfort of cancer patients and their caregivers, who need to access the oncology day hospital to receive treatment during the COVID-19 pandemic in Italy. Methods: This is a single-institution, prospective, cross-sectional study. From May to June 2020, the points of view of both patients and caregivers were compared through 2 different multiple-choice questionnaires, enquiring demographic characteristics, changes in emotional status, interpersonal relationships with health professionals (HCPs) and self-perception of treatment outcomes. Results: Six hundred twenty-five patients and 254 caregivers were enrolled. Females were prevalent and patients were generally older than caregivers. Forty percent of patients and 25.6% of caregivers thought they were at a greater risk of contagion because lived together with a cancer patient or accessed the hospital. Both patients (86.3%) and caregivers (85.4%) considered containment measures a valid support to avoid the spread of infection. People with a lower education level were less worried about being infected with SARS-COV-2. Waiting and performing visits/treatments without caregivers had no impact on the emotional status of patients (64.4%), but generated in caregivers greater anxiety (58.8%) and fear (19.8%) of not properly managing patients at home. The majority of patients (54%) and caregivers (39.4%) thought the pandemic does not influence treatment outcomes. The relationship with HCPs was not negatively impacted for majority of patients and caregivers. Conclusions: Starting from these data, we can better understand the current psychological distress of patients and their families in order to develop potential strategies to support them in this strenuous period of crisis. [ABSTRACT FROM AUTHOR]

Serial measurements of cardiac troponin are recommended by international guidelines to diagnose myocardial infarction (MI) since 2000. However, some relevant differences exist between the three different international guidelines published between 2020 and 2021 for the management of patients with chest pain and no ST-segment elevation. In particular, there is no agreement on the cut-offs or absolute change values to diagnose non-ST-segment elevation MI (NSTEMI). Other controversial issues concern the diagnostic accuracy and cost-effectiveness of cut-off values for the most rapid algorithms (0 h/1 h or 0 h/2 h) to rule-in and rule-out NSTEMI. Finally, another important point is the possible differences between demographic and clinical characteristics of patients enrolled in multicenter trials compared to those routinely admitted to the Emergency Department in Italy. The Study Group of Cardiac Biomarkers, supported by the Italian Scientific Societies Società Italiana di Biochimica Clinica, Italian Society of the European Ligand Assay Society, and Società Italiana di Patolgia Clinica e Medicina di Laboratorio decided to revise the document previously published in 2013 about the management of patients with suspected NSTEMI, and to provide some suggestions for the use of these biomarkers in clinical practice, with a particular focus on the Italian setting. [ABSTRACT FROM AUTHOR]

Food and food security are not areas where municipalities have roles prescribed by law; nonetheless, they are responsible for a range of overlapping services and functions related to food. Competences for policymaking are divided across many different departments, local authorities, and agencies whose functions involve multiple actors, and both scholars and policymakers have called for a more integrated approach to food policies and for cities to play a prominent role in addressing food system challenges through new, place-based, and carefully crafted governance systems. In this study, we examined a unique case study and process that led to the establishment and further development of the first intermunicipal food policy (IFP) in Italy, called Piana del Cibo (literally "Plain of Food"), a governance arrangement through which five municipalities within the province of Lucca (in the Tuscany region, central Italy) reach out beyond their administrative and functional boundaries. Despite the food policy agenda in Lucca being currently underway, this research contributes to a deeper understanding of the possible pathways of policy integration and of the implications of such processes in small cities, highlighting potential enablers and obstacles to integration. The findings indicate that the governance structure currently tested is an institutional unicum in the Italian food policy landscape and is shaped as joint management of food policy functions (gestione associata) combined with an elaborate structure of participatory governance. The presented case study illustrates how a process of (food) policy integration should be understood as processes entailing different and mutually interacting dimensions. It also showcases a set of factors that can reveal potential enablers and obstacles in such processes. • The IFP represents an institutional unicum in the Italian food policy landscape. • The IFP model combines the Joint Management of functions (gestione associata) with participatory governance. • The case illustrates how a process of (food) policy integration should be understood as processes. [ABSTRACT FROM AUTHOR]

Objectives: Optimized diagnostic algorithms to detect active infections are crucial to achieving HCV elimination. We evaluated the cost effectiveness and sustainability of different algorithms for HCV active infection diagnosis, in a context of a high endemic country for HCV infection. Methods: A Markov disease progression model, simulating six diagnostic algorithms in the birth cohort 1969‐1989 over a 10‐year horizon from a healthcare perspective was used. Conventionally diagnosis of active HCV infection is through detection of antibodies (HCV‐Ab) detection followed by HCV‐RNA or HCV core antigen (HCV‐Ag) confirmatory testing either on a second sample or by same sample reflex testing. The undiagnosed and unconfirmed rates were evaluated by assays false negative estimates and each algorithm patients' drop‐off. Age, liver disease stages distribution, liver disease stage costs, treatment effectiveness and costs were used to evaluate the quality‐adjusted life‐years (QALYs) and the incremental cost‐effectiveness ratios (ICER). Results: The reference option was Rapid HCV‐Ab followed by second sample HCV‐Ag testing which produced the lowest QALYs (866,835 QALYs). The highest gains in health (QALYs=974,458) was obtained by HCV‐RNA reflex testing which produced a high cost‐effective ICER (€891/QALY). Reflex testing (same sample‐single visit) vs two patients' visits algorithms, yielded the highest QALYs and high cost‐effective ICERs (€566 and €635/QALY for HCV‐Ag and HCV‐RNA, respectively), confirmed in 99.9% of the 5,000 probabilistic simulations. Conclusions: Our data confirm, by a cost effectiveness point of view, the EASL and WHO clinical practice guidelines recommending HCV reflex testing as most cost effective diagnostic option vs other diagnostic pathways. [ABSTRACT FROM AUTHOR]

New data about the Mediterranean pycnogonids are given. For this contribution, we analysed 315 samples that until now had remained unidentified, collected in 1979–1980 in the Tyrrhenian Sea close to Torrevaldaliga, Italy. We found six species: Ammothella appendiculata, Anoplodactylus californicus, Endeis biseriata, Endeis spinosa, Nymphon gracile and Tanystylum conirostre. Two of them are the subject of taxonomical and faunal remarks: morphological features of Anoplodactylus californicus specimens are reported and discussed, and the first record of Endeis biseriata for the Mediterranean Sea is reported. [ABSTRACT FROM AUTHOR]

Background: Very-low-income students are a population at a high risk of perpetrating and suffering bullying at school, and at the same time the peer group at school is often one of the few sources of support for these minors. Objective: This two-wave study is aimed to disambiguate the two different roles of peer acceptance and friendship on bullying and victimization in very-low-income adolescents, exploring the possible differential role of immigrant background. Method: An online survey was administered to 249 early to late adolescents living below the poverty threshold (Mage = 12.76; SDage = 2.34; 41.8% girls; 19.3% immigrants). A multivariate regression model with multi-group analyses was applied. Results: Our results indicated that peer friendship was a protective factor against bullying as well as victimization, whilst peer acceptance was not protective. Only for natives (but not for immigrants), a high level of peer acceptance was a risk factor for bullying, and low school achievement was a risk factor for victimization. The persistence of victimization over time was significantly stronger for immigrants than for natives. Conclusions: The study provides new insights for the unique protective role of classmates' friendship in natives and immigrants, while acceptance appeared to be less relevant. Research and applied implications are discussed. [ABSTRACT FROM AUTHOR]

Background: Thyroid hormone impairment, represented as an alteration in levels of thyroid hormones and a lower fT3/fT4 ratio, has been correlated with a worse prognosis for both cancer and non-cancer patients. The role of baseline thyroid function in patients with metastatic renal cell carcinoma (mRCC) however, has not been studied yet. Materials and Methods: We recorded clinical data, baseline biochemical results, and oncological outcomes from 10 Oncology Units in Italy. We stratified patients into three groups according to the fT3/fT4 ratio value and subsequently analyzed differences in progression-free survival (PFS) and overall survival (OS) in the three groups. We also performed univariate and multivariate analyses to find prognostic factors for PFS and OS. Results: We analyzed 134 patients treated with systemic treatment for mRCC. Median PFS in the low, intermediate, and high fT3/fT4 ratio group were 7.5, 12.1, and 21.7 months respectively (p<0.001); median OS in the three groups were 36.5, 48.6, and 70.5 months respectively (p =0.006). The low fT3/fT4 ratio maintained its prognostic role at the multivariate analysis independently from IMDC and other well-established prognostic factors. The development of iatrogenic hypothyroidism was not associated with a better outcome. Conclusion: We found that baseline thyroid hormone impairment, represented by a low fT3/fT4 ratio, is a strong prognostic factor in patients treated for mRCC in first line setting and is independent of other parameters currently used in clinical practice. [ABSTRACT FROM AUTHOR]

Background: Adult body fatness is a convincing risk factor for postmenopausal breast cancer. With the aim to compare the different breast cancer (BC) features in Northern and Southern Italy, we investigated the relationship between BMI and BC characteristic in two groups of patients referred in the Modena and Lecce breast units. Materials and Methods: A retrospective analysis of a continuous series of BC patients referred to the Città di Lecce Hospital and the Modena Cancer Center, from January 2019 to December 2020 was performed. We identified four groups of BMI at BC diagnosis: underweight, BMI <18.5 kg/m2; normal weight, BMI ≥ 18.5–24.9 kg/m2; overweight, BMI ≥ 25.0–29.9 kg/m2; obese, BMI ≥30.0 kg/m2. BC characteristics and clinical outcomes were analyzed by the Kolmogorov-Smirnov test and Mann-Whitney U test; categorical data were compared using Pearson's chi-square test, and dicotomic data were compared by odds ratio. Results: Nine hundred seventy-seven BC patients were included in the analysis. Overall, 470 were from Modena and 507 from Lecce. No differences were observed in the mean age of BC patients of Modena (61,42) and Lecce (62,08). No statistical differences between the two populations were shown in terms of tumor characteristics and pathological stage. Conversely, a statistical difference of BMI between the BC patients coming from Modena and Lecce (25.87 and 27.81, respectively; p = 0.000001) was found. BC patients diagnosed in Lecce at age ≥70 years had higher median BMI compared with the ones from Modena (p = 0.000002). The increased BMI in this aged population was also associated to larger tumor size (p = 0.040). Conclusion: The rate of overweight and obesity was higher in BC women living in Southern Italy, despite the presumed nutrition according to the so-called Mediterranean type dietary pattern. Unexpectedly, an increased BMI rate and a relationship with larger tumor size were found in Southern BC patients aged ≥70 years. Our findings strongly support the need for promoting a healthier lifestyle model in Italy, with the aim of reducing the rate of the obesity and, consequently, the increased risk of BC. [ABSTRACT FROM AUTHOR]

The growth and evolution of crustal-scale magmatic systems play a key role in the generation of the continental crust, the largest eruptions on Earth, and the formation of metal resources vital to our society. However, such systems are rarely exposed on the Earth's surface, limiting our knowledge about the magmatic processes occurring throughout the crust to indirect geochemical and petrographic data obtained from the shallowest part of the system. The Hf isotopic composition of accessory zircon is widely used to quantify crust-mantle evolution and mass transfers to and within the crust. Here we combine single-grain zircon Hf isotopic analysis by LA-MC-ICP-MS with thermal modelling to one of the best-studied crustal-scale igneous systems (Sesia Magmatic System, northern Italy), to quantify the relative contribution of crustal- and mantle-derived magmas in the entire system. Zircons from the deep gabbroic units define a tight range of εHf (−2.5 ± 1.5). Granites and rhyolites overlap with this range but tail towards significantly more negative values (down to −9.5). This confirms that the entire system consists of hybrid magmas that stem from both differentiation of mantle-derived magmas and melting of the crust. Thermal modelling suggests that crustal melting and assimilation predominantly occurs during emplacement and evolution of magmas in the lower crust, although melt production is heterogeneous within the bodies both spatially and temporally. The spatial and temporal heterogeneity resolved by the thermal model is consistent with the observed Hf isotope variations within and between samples, and in agreement with published bulk-rock Sr–Nd isotopic data. On average, the crustal contribution to the entire system determined by mixing calculations based on Hf isotopic data range between 10 and 40%, even with conservative assumptions, whereas the thermal model suggests that this space- and time-averaged contribution does not exceed 20%. However, spatial and temporal variations in the crustal melt proportion (from 0 up to 80% as observed in the thermal model) may impart significant isotopic variability to different batches of magma observed on the outcrop scale, emphasizing the need to consider a magmatic system as a whole, i.e., by integrating all spatial and temporal scales, to more precisely quantify crustal growth vs. reworking. [ABSTRACT FROM AUTHOR]

Background: While evidence-based practice (EBP) is widely accepted across healthcare professions, research investigating its implementation in manual therapy professions such as osteopathy is limited. The primary aim of this study was to investigate Italian osteopaths' attitudes, skills, and use of EBP. A secondary purpose was to understand the obstacles and enablers to EBP adoption in the Italian osteopathic context. Methods: A cross-sectional national survey was conducted (April to June 2020) among a sample of Italian osteopaths. Eligible participants were invited to complete the Italian-translated Evidence-Based practice Attitude and Utilization Survey (EBASE) anonymously online using various recruitment strategies, including email and social media campaigns. In addition to the three EBASE sub-scores (attitudes, skills and use), the demographic characteristics of the sample were considered. Results: A total of 473 osteopaths responded to the survey. The sample appeared to represent the Italian osteopathic profession. The majority of participants had a favorable attitude toward EBP. Eighty-eight percent of respondents agreed that EBP was necessary for osteopathy practice and that scientific literature and research findings were beneficial to their clinical scenario (95%). Perceived skill levels in EBP were rated as moderate, with the lowest scores for items relating to clinical research and systematic review conduct. Apart from reading/reviewing scientific literature and using online search engines to locate relevant research papers, participant engagement in all other EBP-related activities was generally low. Clinical practice was perceived to be based on a very small proportion of clinical research evidence. The primary obstacles to EBP implementation were a dearth of clinical evidence in osteopathy, and poor skills in applying research findings. The primary enablers of EBP adoption were access to full-text articles, internet connectivity at work, and access to online databases. Conclusions: Italian osteopaths were largely supportive of evidence-based practice but lacked basic skills in EBP and rarely engaged in EBP activities. The updating of osteopathic training curriculum and professional formal regulation in Italy could provide a suitable framework to improve EBP skills and use. [ABSTRACT FROM AUTHOR]