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Background: This study explores the impact of the pandemic on children's mental health. It examined the understanding of parents regarding their children's mental condition and their ability to identify issues, 2 years post the outbreak of the COVID-19 pandemic. Methods: Using a cross-sectional design, 507 Italian parents reported on their youngest child aged between 2 and 17, totaling 507 children. The outcomes focused on were parental perception of children's mental health deterioration, scores on the Strengths and Difficulties Questionnaire (SDQ) above the clinical cut-off, and parental under-recognition of mental health issues. Descriptive analyses and multivariable logistic regression models were executed (significance at p < 0.05). Results: Parents were 88.1% women (median age 41 years, interquartile range [IQR] = 36-47). Their children were 50.3% female [median age 6 years (IQR = 4-11)]. The data revealed 21.1% of parents perceived a deterioration in their children's mental health, while 44.2% had SDQ scores above the cut-off. Parental under-recognition of mental issues was found in 20.1% of cases. Significant correlations were found between parental perception of deterioration, SDQ scores, and factors like parental mental distress and children's sleep issues. Implications: The findings suggest that schools and verified websites can serve as critical conduits for providing parents with reliable information. By promoting early identification and intervention, such mechanisms can help ensure mental health equity for children. Conclusions: The research highlights the effect of the pandemic on children's mental health and the issue of parental under-recognition. The results underscore the importance of public health initiatives that enhance mental health information accessibility and reliability for parents.

The collaboration between university and industry under the institutional arrangement of the University Third Mission has been widely investigated by scholars and, more recently, with an increasing focus on the importance of trust. In this line of research, based on the study of six cases of collaboration in one of the more economically developed regions of Italy, this article aims at analysing how trust is produced -- or constructed -- by actors involved in the collaborative relationships to identify different processes, factors, dynamics by which such a construction takes place, shape and content, and to discuss its contribution to the rise and maintenance of such collaborations.

We report a research-based proposal on electromagnetic induction within the theoretical framework of the Model of Educational Reconstruction. The proposal is based on a sequence of inquiry-based experimental activities centered on hands-on materials and "Real-Time" quantitative experiments, through which students explore the phenomenology of electromagnetic induction. The sequence was planned to address Faraday-Neumann-Lenz law analyzing the involved physics quantities and constructing quantitative relationships between them. Our hypothesis was based on the idea that phenomenological explorations performed through online sensors promote a functional understanding of electromagnetic induction and help students to face the conceptual knots highlighted by international literature about these phenomena. The educational sequence was proposed to a sample of 87 high school students with the aim of analyzing the evolution of the educational processes employing a set of inquiry-based tutorials. The qualitative analysis of students' answers demonstrates that students increased their knowledges in the analysis of electromagnetic induction phenomena recognizing the fundamental role of time-variation of the magnetic field flux in the Faraday-Neumann-Lenz law.

Burnout is psychological, physical, and emotional suffering that may affect students with low or inadequate resources to face stressful events at school. Although the existing instruments are used worldwide to assess school burnout risk, they show several flaws and mainly focus on the emotional facets of the syndrome. No previous studies have developed a multi-component tool to reveal students' burnout by simultaneously analyzing cognitive, behavioral, and emotional problems. The central core of the current study is to adapt the Burnout Assessment Tool-Core symptoms (BAT-C; Schaufeli et al., 2020), comprising four subscales, exhaustion, mental distance, cognitive impairment, and emotional impairment, for a sample of Italian students. The factor structure, the reliability, and the validity of the scale are investigated. The participants are 745 middle school students (male, 52.2%; aged 9-13, M = 11.84, and SD = 1.21). Confirmatory factor analyses confirmed the best fit of the second-order model (four first-order factors and one second-order factor). Specifically, four factors were loaded onto a main high-order factor, which constitutes the BAT-C. Our findings support the Italian adaptation of the BAT-C for students' samples as a valid instrument for measuring the core symptoms of school burnout.

The diffusion of evaluation systems based on research excellence has been confronting scholars with the dilemma of how to combine the different activities and roles characterizing the academic profession. Besides research, other types of knowledge transfer and academic citizenship, i.e., the service activities and roles carried out on behalf of the university within and outside organizational boundaries, are in fact cornerstones of universities' functioning that allow for their thriving and need to be valued. This study investigates the complementarity, substitution, and independence effects between the various types of knowledge transfer and academic citizenship in a sample of 752 Italian academics working in business schools. We collected data combining different sources including CVs, publication records, and national datasets. Multivariate path analysis was employed to measure covariances between knowledge transfer and academic citizenship. We contribute to the debate on academic citizenship by showing that public and discipline-based service are complementary to knowledge transfer activities, while institutional service is independent from knowledge transfer. Remarkably, journal papers are research outcomes complementary to most academic activities, and the same holds true for dissemination at workshops and conferences. Running counter dominant rhetoric, this study testifies to the likelihood of faculty being "all-round" professionals. We disclose that activities and roles are influenced by academics' previous pathways and research grants and discuss the need to value academic citizenship in performance measurement systems.

A class of 18 students attending the last year of an Italian high school was divided into groups and performed the extraction of pigments contained in hibiscus tea. Each group worked at a different temperature and carried out multiple extractions using distilled water as a solvent. By means of UV-vis spectroscopy it was possible to determine the yield of each individual extraction and then to study the effect of temperature on the extraction itself. The method is easy to implement, it does not require the use of hazardous reagents or special safety precautions, and it is very cheap. The laboratory part was carried out in 3 h time, while the analysis and data processing took about 4 h. On an educational level, the students learned to process and analyze large amounts of data, and they became familiar with the UV-vis spectrophotometer and eventually had to solve the problems independently.

School visits to research laboratories or facilities represent a unique way to bring students closer to science and Science, Technology, Engineering and Mathematics careers. However, such visits can be very expensive for students and teachers, in terms of both time and money. In this paper, we present a possible alternative to on-site visits consisting in an activity addressed to high school students that makes use of a Virtual Reality application to make them 'enter' into a particle physics experiment. This proposal can represent a valid way of guaranteeing a visit to a research centre for all schools, regardless of their social or geographical origin. We describe the tests we carried out with a focus group of teachers and their students, and the obtained results.

The role of virtual simulations in the evolution of primary school students' mental models about electrostatics is investigated by analysing the answers of two groups of 9-10 years old pupils inside instructional sequences that combine two hands-on activities using balloons and jackets with the same activities using PhET simulations: one group followed a sequence where the real experiments were conducted before the virtual simulations, the other group followed a sequence where the virtual simulations where proposed before the real experiments. Students' answers were categorized into a descriptive dimension (accordance with the phenomena) and into an explanatory dimension (level of adequacy with the microscopic model based on elementary charges). Our results show that, although virtual simulations improve the level of adequacy of students' answers to the target model, this improvement is not transferred to new phenomena, so that the capability of relating the developed model to the real world is the same in both sequences. Moreover, about 40% of pupils remained at their starting non-explanatory level in both teaching sequences. We conclude that simulations per se do not help students in evaluating and refining their models, indicating the need for teachers' support in modelling-based instruction involving not visible physical entities.

Cognitive abilities are essential to children's overall growth; thus, the implementation of early and effective training interventions is a major challenge for developmental psychologists and teachers. This study explores whether an intervention simultaneously operating on fluid reasoning (FR), visuospatial, narrative, and motor abilities could boost these competencies in a group of Italian preschoolers (N = 108, 54 males 54 females, Age[subscript mean] = 4.04). FR and visuospatial abilities showed training-related increases at the end of the training and 1-year follow-up (moderate effect size). Interestingly, positive correlations with working memory and mathematical abilities were found. Beyond their scientific relevance, the short- and long-term effects provide fundamental indications for designing and implementing educational programs dedicated to preschoolers.

Academics all over the world are feeling the increasing pressure to attain satisfactory research performance. Since research is not the only activity required of academics, though, the debate on how it may be coupled with other knowledge transfer activities like teaching, patenting, and dissemination has been captivating scholars interested in higher education. The literature is surprisingly silent about the interplay between research performance and other roles and tasks that faculty are expected to carry out, namely academic citizenship, intended as the service that they provide to their institution, to the scientific community, and to the larger society. Through a negative binomial regression conducted on 692 Italian academics in management, this paper investigates both the direct and moderating effect exerted by academic citizenship on the relationship between research performance in two subsequent evaluation exercises, thus advancing our knowledge of the relationship between research and service. Findings show that institutional service acts as a pure moderator, discipline-based service is a quasi-moderator, while public service exerts only a direct negative effect on research performance. In light of the emergent interplay between research and service, the necessity to boost reflection on academic citizenship is discussed and suggestions for its acknowledgement and advancement are formulated.

We report the results of a study on high school student difficulties in drawing the magnetic field lines for two magnets facing each other. Student difficulties were investigated by means of a predict-observe-explain activity. Our data confirm some of the previous results from the educational research literature on student difficulties in drawing and interpreting field lines and shed some new light on students' reasoning patterns. Specific difficulties for the case of two magnets with opposite poles facing each other are also identified.

Introduction: Postoperative delirium (POD) has a major impact on patient recovery after cardiac surgery. Although its pathophysiology remains unclear, there could be a correlation between cerebral blood flow (CBF) variations during cardio-pulmonary bypass (CPB) and POD. Our study aimed to evaluate whether variations in on-pump CBF, compared to pre-anesthesia and pre-CPB values, are associated with POD following coronary artery bypass grafting (CABG) surgery. Methods: This prospective observational cohort study included 95 adult patients undergoing elective on-pump CABG surgery. Right middle cerebral artery blood flow velocity (MCAV) was assessed using Transcranial Doppler before anesthesia induction, before CPB and every fifteen minutes during CPB. Pre-anesthesia and pre-CPB values were chosen as baselines. Individual values, measured during CPB, were converted as percentage changes relative to these baselines and named as %MCAV0 and %MCAV1, respectively. POD was assessed using the Confusion Assessment Method for ICU (CAM-ICU) during the first 48 post-operative hours and with the 3-Minute Diagnostic Interview for Confusion Assessment Method (3D-CAM) on the fifth post-surgical day. Results: Overall POD incidence was 17.9%. At 30 minutes of CPB, %MCAV0 was higher in POD group than in no-POD group (p =.05). %MCAV0 at 45 minutes of CPB was significantly higher in POD group (87 (±17) %) than in no-POD group (68 (±24) %), p =.04. %MCAV1 at 30 and 45 minutes of CPB were higher in POD group than in no-POD group, at the limit of statistical significance. We found %MCAV1 > 100% in POD group, but not in no-POD group. Conclusions: Significant differences in %MCAV0 became evident after 30 minutes of CPB, whereas differences in %MCAV1 at 45 minutes of CPB were at limit of statistical significance. In POD group %MCAV1 was higher than 100% at 30 and 45 minutes of CPB, which is supposed to be a sign of cerebral hyperperfusion. Monitoring CBF during CPB could have prognostic value for POD. [ABSTRACT FROM AUTHOR]

Purpose: Non-tuberculous mycobacteria (NTM) account for high clinical burden, and treatment can be challenging. Moreover, accessibility of NTM medications varies across centers. These challenges may lead to unplanned therapeutic changes, discontinuations, potentially affecting patient outcomes. Aim of this survey was to evaluate the accessibility of NTM-targeting drugs in Italy (with a particular focus on clofazimine) in centers associated with the IRENE Registry, a collaborative network of healthcare professionals. Methods: A cross-sectional, internet-based, questionnaire-survey on the use and availability of clofazimineand other NTM-targeting drugs was sent to 88 principal investigators of the IRENE network in Italyin 2020. The questionnaires were designed with closed-ended and open-ended questions and distributed using the SurveyMonkey® platform. Results: The surveys underscore the more frequent involvement of pulmonologists (42%) and infectious disease specialists (34%) in NTM treating strategies. Respondents were distributed across 18 out of20 Italian regions, with a significant concentration in the north, encompassing university hospitalsand outpatient clinics. Molecular testing is available in 40% of the involved centers, while phenotypic in 30% of the centers. Centers have a multidisciplinary team and an appointed pharmacy service for NTM drugs distribution in 10 and 75% of the cases, respectively. Substantial variability was observed in drug availability and accessibility, drug regimen composition, and drug dosage, particularly for medications like clofazimine. Conclusions: This study shows the high heterogeneity of anti-NTM drug availability in Italy and prompts toward a harmonization in antibiotic prescription and access; it also emphasizes the challenges in determining the optimal therapeutic strategies for treating NTM-infections. [ABSTRACT FROM AUTHOR]

Introduction: Vascular Ehlers-Danlos syndrome (vEDS) is an inherited connective tissue disorder characterized by arterial fragility. Celiprolol is a β1-adrenoceptor antagonist with partial β2 agonist activity that has been shown to reduce rates of vascular events in this setting, though the underlying mechanisms are not yet fully understood. Moreover, very few echocardiographic data are available in patients with vEDS. Aim: To perform a comprehensive echocardiographic assessment of a cohort of patients with vEDS with or without celiprolol therapy compared with healthy subjects. Methods: Twenty patients with genetically confirmed diagnosis of vEDS followed at our Institution (University Hospital of Brescia, Italy) were divided into two groups according to whether or not they were on celiprolol therapy at the maximum recommended dose (400 mg daily) for at least 12 months. Both groups were compared to 10 healthy individuals matched for sex, age, body mass index (BMI), and office blood pressure (BP) values. Each participant underwent transthoracic echocardiography with tissue Doppler analysis (TDI) for a comprehensive evaluation of cardiac structure and function. Results: Mean age was 35 years and mean BMI was 21.6 kg/m2. Female sex was prevalent (60%). Left ventricular (LV) internal diameter values tended to be lower in patients with untreated vEDS than in healthy controls (4.33 vs 4.74 cm, respectively), though this difference was not statistically significant. Similar data were observed for LV mass index (56.9 vs 68.6 g/m2), stroke volume (56.6 vs 71.6 mL), and E/A ratio (1.26 vs 1.66), whereas an opposite trend was observed for e' lateral (13.2 vs 12.2 cm/s). No statistically significant difference was found between groups in terms of other parameters of LV mass, systolic and diastolic function. A normal LV geometry was found in all the cases. Indices of mechano-energetic efficiency and ventricular-arterial coupling were also similar between groups. No patient presented with aortic root dilation, mitral valve prolapse, valve insufficiency of more than mild degree, or valve stenosis of any degree. Conclusion: Our study suggests that patients with vEDS have normal cardiac mass and geometry, as well as normal systolic and diastolic function. Celiprolol therapy does not seem to significantly influence such aspects. Compared with vascular imaging, less stringent follow-up with echocardiography seems reasonable in this setting. Future studies with prospective design should confirm these aspects. [ABSTRACT FROM AUTHOR]

Simple Summary: Patient-derived organoids are 3D models useful to study cancer biology and may be implemented as predictive tools in therapeutic decisions. We set up a two-step protocol that allows for establishing both short-term and long-term organoid cultures from lung cancer patients. We set up an optimal medium formulation and implemented rigorous quality controls, leading to a substantial improvement in organoid establishment success rate. Our 3D models are suitable for drug screening and co-culture experiments. This protocol represents a key advance for the employment of lung cancer organoids both as models for research and as predictive tools in clinical practice. Background/Objectives: Despite the introduction of innovative therapeutics, lung cancer is still the leading cause of cancer-related death. For this reason, lung cancer still requires deep characterization to identify cellular and molecular targets that can be used to develop novel therapeutic strategies. Three-dimensional cellular models, including patient-derived organoids (PDOs), represent useful tools to study lung cancer biology and may be employed in the future as predictive tools in therapeutic decisions. However, the successful establishment of lung cancer organoids cultures that faithfully represent the respective patient tissues is still challenging due to low success rate and/or overgrowth of normal airway epithelial cells. Methods: We set up a two-step protocol that allows for establishing both short-term and long-term 3D cultures, with different characteristics and success rates. Results: Cancer tissue-originated spheroids (CTOSs) show a 100% success rate and allow for the concomitant isolation of autologous tumor infiltrating leukocytes (TILs). On the contrary, PDOs can be expanded for a medium-long term and bio-banked but retain a lower success rate and the possibility of contamination with normal airway epithelial cells. To overcome these problems, we set up an optimal medium formulation and we implemented rigorous quality controls, leading to a substantial improvement in the success rate of tumoral PDO establishment. Conclusions: Overall, this protocol guarantees flexibility and reliability, also providing useful guidelines for quality control checks to support different experimental settings. The setting up of a robust protocol for lung cancer PDO culture establishment and expansion is a key requirement for their employment both in cancer research and as predictive tools in clinical practice. [ABSTRACT FROM AUTHOR]

Difficulties in mathematics have been described in very preterm children, but their origins are not well understood and may differ from other populations with specific learning disability. Very preterm children, children with learning disability, and typically developing children were compared in mathematics skills, using standardized tools, experimental tasks, and eye-tracker measures. We assessed symbolic and nonsymbolic magnitude comparisons, number knowledge, calculation, as well as cognitive skills of 103 Italian-speaking fourth and fifth graders. Compared to typically developing peers, very preterm children showed delays in number knowledge, slower reaction times in nonsymbolic magnitude comparisons, and an atypical gaze exploration characterized by more and shorter fixations that lacked a target preference. The profile of mathematics skills of very preterm children appeared different from that of children with learning disability. Although both populations showed mainly preserved cognitive skills and slower reaction times in nonsymbolic magnitude comparisons, children with specific learning disability showed more severe impairments in calculation and were slower in symbolic magnitude comparisons, compared to very preterm children. Including eye-tracking measures in preterm follow-up programs and planning tailored interventions are recommended.

Academics have always been endowed with the privilege of autonomy, but the diffusion of evaluation systems based on publication outcomes potentially jeopardizes the benefits deriving from behaviors that address other pillars of higher education. Besides research and teaching, academic citizenship, i.e., the service behaviors carried out within and outside organizational boundaries, are in fact cornerstones of university functioning. We investigate the relationship between academic citizenship and research after the introduction of an evaluation system that moves research performance to center stage on a dataset collecting publication records and service activities of 353 Italian scholars in the accounting discipline in the 2004-2013 period. A cluster analysis reveals different academics' orientations towards research and academic citizenship. We contribute to the debate on academic choices by showing that a large number of university members tend to focus on a single type of academic citizenship or to adopt a research orientation, while a significant part remains stuck in the middle without achieving satisfying performance in any domains according to international standards, and discuss implications for the design of behavioral incentives.

Objective: This study aimed to investigate the interest in online and in‐person psychological support services in Italy during the COVID‐19 pandemic, stimulated by the implementation of the government‐issued 'bonus psicologo' for psychotherapy sessions. Methods and Measures: Public interest was measured using data from Google Trends, a resource that offers open access to actual search requests, within the time frame of 2 July 2017 to 13 November 2022. These data were stratified for Italian regions to explore regional differences. We conducted interrupted time series analyses to assess changes in interest before, during and after the lockdown. Results: Results indicated a significant increase in interest in online psychological support during the lockdown, which was sustained over time and was positively correlated with the implementation of the 'bonus psicologo' (p <.001). Interest in in‐person support decreased during the lockdown but began to rise post‐lockdown (p =.028), with no notable impact from the economic incentive. High interest in online support continued in certain regions even 1 year post‐lockdown, warranting further analysis. Conclusion: The study underscores a heightened post‐pandemic interest in psychological support, both online and in person, in comparison with pre‐pandemic levels. Google Trends emerges as a valuable tool for monitoring public interest during specific events, though the findings must be interpreted with care, given the study's time frame and reliance on relative search volume as a measure. Future research is needed to validate these findings and to compare them against epidemiological data. [ABSTRACT FROM AUTHOR]

Smoking is a major public health issue worldwide. The prevalence of smoking among healthcare workers is particularly concerning as they serve as role models for their patients and play a crucial role in combating the tobacco epidemic. Our survey analyzes the smoking habits, second-hand smoke exposure, attitude and support towards smoking cessation among healthcare workers in a hospital in Southern Italy. An anonymous questionnaire was completed by 179 healthcare workers. Among the participants, 36.9% were current smokers, 22.3% were ex-smokers, 8.4% were abstinent smokers, and 32.4% were never smokers. Additionally, 43.0% of smokers reported being exposed to second-hand smoke for 7 days per week, compared to 17.9% of never-smokers. Only 29.2% of current smokers are attempting to quit, while 58.5% have shown no interest in quitting. Most smokers reported not receiving any advice to quit, and only 4.9% received advice from health professionals. Our results align with previous research indicating high smoking rates; however, our findings are even more critical compared to pre-2020 studies in other regions of Europe and Italy. This could be strictly due to the known relation between burnout and COVID-19: the high levels of burnout among health workers caused by the pandemic may have contributed to the increase in smoking behavior. The smoking habits among healthcare workers highlight the urgent need to enhance anti-smoking programs also within healthcare settings. [ABSTRACT FROM AUTHOR]

Background/Objectives: Autism Spectrum Disorder (ASD) is a lifelong neurodevelopmental condition characterized by social communication impairments and repetitive behaviors. Recent reports show that one in thirty-six 8-year-old children are autistic, signifying a considerable public health concern. According to previous studies, emotional dysregulation (ED) affects 50–60% of individuals with ASD and includes symptoms such as poor emotional control, heightened reactivity, and a low frustration tolerance. The main aims of the current study are to investigate the prevalence of ED among autistic preschoolers (below 6 years of age) and to assess the impacts of gender and intellectual disability on their emotional dysregulation profile. Methods: Data have been collected from three children's research hospitals in Italy (IRCCS Stella Maris Foundation, Stella Maris Mediterraneo Foundation, and IRCCS Bambino Gesù). Parents of 825 autistic pre-schooled children (mean age: 39.68 months, SD: 10.51 months) completed a general questionnaire and the Child Behaviour Checklist (CBCL), a reliable caregiver-reported assessment tool which provides a dysregulation profile. Results: A total of 30% of the children displayed a severe-to-moderate ED (emotional dysregulation) profile, with these children exhibiting significantly higher emotional–behavioral problems compared to those without ED. Males with ED exhibited greater emotional reactivity than females with ED. However, no significant relationships were found between ED and age, autism severity (ADOS-2), or intellectual disability. Conclusions: The results underline the importance of early, tailored interventions to face emotional challenges in young children with ASD, potentially improving long-term outcomes for this population. [ABSTRACT FROM AUTHOR]

Italy has long experienced a significant developmental gap between its northern and southern regions, with the latter being less developed. The 2007–2008 financial crisis accentuated this gap, leading to distinct patterns of interregional migration. This paper aims to investigate the effects of past migration flows and income inequality on interregional mobility in Italy, using a gravity model with bidirectional dyads and three different measures of inequality as dependent variables: Gini Index, Relative Poverty, and Income Ratio. Previous research has shown that living in highly unequal regions is associated with increased mistrust and anxiety about social status, contributing to unhappiness among residents. Using bilateral gross migration flows for the period 2007–2018, the study aims to control for the potential endogeneity between interregional mobility and inequality. The results indicate a positive relationship between high levels of inequality and interregional out-mobility, underscoring the need for policies aimed at reducing both horizontal and vertical inequality within and among Italian regions. [ABSTRACT FROM AUTHOR]

Images broadcast on television, radio analyses, and long articles printed in newspapers and, today, the content of digital platforms have become an overwhelming part of our daily lives. The history of the State of Israel, which has been debated since its foundation, is very complex and not exempt from the reverberations that the policies of the opposing blocs have had over time on the conflicts that followed. Given the attention of the European public to international events concerning Israel and the role of the media in conveying information about them, the aim of this research was to investigate how Israel is talked about in the current media environment in Italy, particularly the digital one, within the Facebook platform between the years 2019 and 2021. This is the period before the outbreak of the war on 7 October 2023; this is to try to understand whether Israel has always been narrated according to specific media frames in Italy, such as those we see emerging with the current conflict against Hamas, or is it possible to highlight different aspects in previous years within the same context of crisis, but a global health crisis: before and after COVID-19. [ABSTRACT FROM AUTHOR]

Background/Objectives: Adolescence is an important period of psychophysical development. In this phase of life people acquire greater self-awareness and adopt behaviors that will later shape their lifestyle in adulthood. This study aimed to assess whether family structure can influence adolescents' eating habits. Methods: Data were acquired from a survey titled 'Italian Health Behaviour in School-aged Children' (HBSC) given to a representative sample of Tuscan adolescents aged 11, 13, 15 and 17 years of age. Participants (3210) filled out a validated questionnaire answering questions about their eating habits and family structure. After adjusting for covariates, some interesting trends were highlighted in the survey results. Results: Adolescents living in single-mother families reported a lower intake of fruits (OR 0.68, 95% CI = 0.55–0.83) and vegetables (OR 0.66, 95% CI = 0.53–0.81) and a higher intake of sugar-added soft drinks (OR 1.33, 95% CI = 1.08–1.64). Living in a mother and stepfather family was associated with a higher intake of sugar-added soft drinks (OR 1.53, 95% CI = 1.02–2.28), whereas living in a father and stepmother family was associated only with a lower intake of fruits (OR 0.48, 95% CI = 0.26–0.87). Participants living with other family types reported a lower intake of vegetables (OR 0.68, 95% CI = 0.47–0.98). Conclusions: The results of this study show a correlation between family structure and adolescents' eating habits. [ABSTRACT FROM AUTHOR]

Background: Malignant Distal Biliary Obstruction (MBDO) is a common event occurring along the natural history of both pancreatic cancer and cholangiocarcinoma. Epidemiological and biological features make MBDO one of the key elements of the clinical management of patients suffering for of pancreatic cancer or cholangiocarcinoma. The development of dedicated biliary lumen-apposing metal stents (LAMS) is changing the clinical work up of patients with MBDO. i-EUS is an Italian network of clinicians and scientists with a special interest in biliopancreatic endoscopy, EUS in particular. Methods: The scientific methodology was chosen in line with international guidance and in a fashion similar to those applied by broader scientific associations. PICO questions were elaborated and subsequently voted by a broad panel of experts within a simplified Delphi process. Results and conclusions: The manuscripts describes the results of a consensus conference organized by i-EUS with the aim of providing an evidence based-guidance for the appropriate use of the techniques in patients with MBDO. [ABSTRACT FROM AUTHOR]

Objectives: To investigate the potential efficacy of a commercial continuous positive airway pressure (CPAP) ventilator to provide effective respiratory support in a simulated scenario of out-of-hospital cardiac arrest (OHCA). Methods: The study was conducted on a high-fidelity manikin (SimMan 3 GTM, Laerdal, NOR) connected to the ASL 5000TM Lung Simulator (IngMar Medical, USA). To simulate OHCA, we set no spontaneous respiratory acts and physiological respiratory system resistance (13 cmH2O/L.sec) and compliance (50 mL/cmH2O). The Respironics BiPAP A40 ventilatorI (Philips, NL) was used to provide ventilatory support while operating in CPAP mode. Tests were performed at different values of positive pressure of the CPAP ventilator (PCPAP: 5, 7.5, 10, 12.5 and 15 cmH2O) and the intrapulmonary volume (tidal volume, Vt) measured via the simulator software computer interface. A trained physician performed the tests. Our primary outcome was a VT of ≈500-600 mL with an intermittent maneuver simulating cardiopulmonary resuscitation (CPR)-like ventilatory support practice according to international guideline-based target (1-sec ventilation followed by 1-sec pause). Results: In intermittent ventilatory support tests, PCPAP levels of 12.5, and 15 cmH2O resulted in a VT equal to 508 ± 13 mL, and 557 ± 44 mL respectively (p = 0.04), thus approaching the VT target. Conclusions: We provide preliminary evidence of the potential efficacy of CPAP ventilators designed for home use to provide effective respiratory support to a simulated respiratory arrest patient. [ABSTRACT FROM AUTHOR]

We aimed to explore attitudes and training experiences of medical students toward gender medicine (GM). A cross-sectional study with convenience sampling was conducted (sample size = 430). To assess predictors of high GM consideration in patient management, a multivariable logistic regression was performed. A total of 82% considered sex and gender important; 61% stated that they would use GM skills in their careers. A total of 76% had never discussed GM with their tutors, with differences between male and female students (p =.002). Predictors of high GM consideration were: age (adjOR = 1.4, 95%CI = 1.1–1.8) and the impression that tutors considered patients' sex and gender during practice (adjOR = 3.9, 95%CI = 2.0–7.6). Thus, participants considered GM important, but some students were unsure whether it could be useful in practice. The strongest predictor of high GM consideration was the tutors' good example during training. It would be advisable to implement the teaching of this topic during both courses and traineeships. [ABSTRACT FROM AUTHOR]

Thromboprophylaxis/anticoagulation treatment is often required in hospitalized COVID-19 patients. We aimed to estimate the prevalence of major bleeding events in hospitalized COVID-19 patients. This was a retrospective observational study including all COVID-19 hospitalized patients ≥18 years of age at one reference center in northern Italy. The crude prevalence (between February 2020–2022) of major bleeding events was estimated as the number of major bleeding episodes divided by patients at risk. Uni- and multivariable Cox models were built to assess factors potentially associated with major bleeding events. Twenty-nine (0.98%) out of 2,945 COVID-19 patients experienced a major bleeding event [prevalence of 0.55% (95%CI 0.37–0.79)], of which five were fatal. Patients who experienced a major bleeding event were older [78 years (72–84 IQR) vs. 67 years (55–78 IQR), p-value < 0.001] and more frequently exposed to anti-aggregating therapy (44.8% vs. 20.0%, p-value 0.002) when compared to those who did not. In the multivariable Cox model, age [per 1 year more AHR 1.05 (CI95% 1.02–1.09)] was independently associated with an increased risk of major bleeding events. A strict monitoring of older hospitalized COVID-19 patients is warranted due to the risk of major bleeding events. [ABSTRACT FROM AUTHOR]

Research excellence has been the main thrust of higher education reforms in several countries, but its translation into coherent policies has proved to be controversial. Literature has delved into the role exerted by contextual factors and individual characteristics in the adoption of behaviours inspired by social values. Our study aims at investigating the effect of individual and contextual features and their interplay in the quest for research excellence. We formulate and test hypotheses on a dataset collecting the publication records of the population of 4510 Italian academics in business and management and in architecture in the 2004-2013 period. Findings disclose that, alongside previous achievements, research-oriented settings favour research excellence. In addition, we show that a research-oriented context enhances the publication record of academics without highly ranked publications, whereas it slightly reduces the productivity of outstanding academics. Implications for public policy, especially in terms of performance measurement systems, are presented.

Notwithstanding the large consensus on the idea that justice should be favoured in school contexts to promote student well-being, there is still a lack of research that has investigated how the experience of justice at school spreads impact on global adolescent psychological health. The aim of this study is to investigate the degree to which the experience of teacher (in)justice is possibly related to some of the indicators of adolescent global psychological health, namely individual and social functioning, psychological problems, and somatic symptoms. We also test the role of two components of school-specific well-being, i.e., emotional engagement and classroom connectedness, here considered as potential mediators between teacher justice and psychological health. Structural equation modelling indicated that teacher justice is positively associated with emotional engagement, classroom connectedness and individual functioning, and negatively related to psychological problems. The relation from teacher justice to individual functioning was partially mediated by emotional engagement and classroom connectedness. The relation from teacher justice to social functioning and somatic symptoms was fully mediated by classroom connectedness, while a partial mediation was found between teacher justice and psychological problems via classroom connectedness. These results are commented at the light of their implications for teacher practices.

The present study examined maternal responses to infants' spontaneous communicative behaviors in a sample of 20 extremely-low-gestational-age (ELGA) infants and 20 full-term (FT) infants during 30 minutes of play interaction when infants were 12 months of age. Relations between maternal responses and infants' communication skills at 12 and 24 months were investigated. Maternal responses were coded according to their contingency and degree of relevance to the infant's communicative signal. Despite the less advanced gestural abilities of ELGA infants, their mothers produced high percentages of contingent and relevant responses, as did mothers of their FT peers. Maternal contingent and highly relevant responses (i.e., those with a repeated label) were associated with ELGA infants' receptive and expressive communication skills at 12 months and predicted expressive communication skills at 24 months. Results suggest that contingent maternal responses with a repeated label following infants' spontaneous communicative behaviors support communicative development, particularly among ELGA infants.

The future of cave surveying is a full 3D scan, as automatic as possible, capturing all morphologically relevant details. However, the vast majority of cavers are still using tools designed more than 15 years ago. The advancements in tools for architects, Computer-Aided Design (CAD) designers, programmers of Virtual Reality (VR) and robotics could be helpful also for the caving community. That's why Charlotte, a cheap DIY 2.5D scanner designed for cave surveying, was developed and built. To demonstrate its capabilities, a new survey of Grotta Regina del Carso Cave (Cadaster Nr. 2328/4760VG), the largest cave in the Gorizia Karst, has been realized and published. The new scanner is based on the same traditional cave surveying techniques, familiar to all cavers, and features a LiDAR to capture the exact cave morphology. The results are so realistic they can be used for 3D animations, physics simulations, or even 3D printing. The prototype of the new tool costs less than 400€ (EURO; as of December 2022). All the source code and schematics are released as Free and Open Source. Cavers are encouraged to fork the project on Github and provide new functionalities, to keep up with new technology available and the needs of caving scientific research all around the world. [ABSTRACT FROM AUTHOR]

Bacterial infections are a common complication in patients with decompensated liver cirrhosis. The complex landscape of cirrhosis, characterized by immune paralysis and an exhausted response to exogenous triggers, explains the higher prevalence of such infections, particularly in advanced disease stages. In clinical practice, the onset of a bacterial infection can lead to further deterioration of hepatic and extra-hepatic function, potentially resulting in acute decompensation or acute-on-chronic liver failure. This has significant clinical implications, particularly for patients awaiting a transplant. In this review, we will discuss the latest evidence on the diagnosis and therapy of bacterial infections in patients with decompensated cirrhosis. Additionally, we will analyze the impact of bacterial infections in the context of liver transplantation, discussing debated topics such as the timing of transplantation in patients with infections, potential implications for prioritization, effects on post-operative recovery, grafts, and patient survival. [ABSTRACT FROM AUTHOR]

Twenty-four-hour ambulatory blood pressure monitoring (ABPM) is recognized as a reference tool for accurately diagnosing hypertension. Until a few years ago, this technique was restricted to use by specialists. Recently, however, due to the need for wider availability and thanks to technological innovation, simplification of analysis processes, and increasing recognition of the importance of this tool for the diagnosis of hypertension, ABPM is now also being used in non-specialist settings. In such settings, ABPM is used with a two-pronged approach: (i) independently by a general practitioner with the possibility of specialist supervision for particular and complex cases; (ii) in the non-medical setting (community pharmacies, home care services, etc.) where the healthcare provider is trained in the proper use of the technique, with the understanding a physician must be responsible for the final clinical reporting. Unfortunately, due to the increasingly wide diffusion of ABPM, there has been considerable confusion about management roles and responsibilities in recent years. To clarify competencies and roles and standardize the processes related to the technique's implementation and proper management, experts of the Blood Pressure Monitoring Working Group of the Italian Society of Hypertension have drafted this document with the aim of providing a quick and easy reference guide for training healthcare professionals in the field. [ABSTRACT FROM AUTHOR]

Necrotizing gingivitis (NG) is an acute inflammatory process with an estimated prevalence of less than 1%. The treatment of choice is usually antibiotics in addition to periodontal treatment. This scoping review aims to detail extent and type of proof related to NG in paediatric patient; moreover, a decision tree protocol was developed to define NG management in paediatric patients based on the presence or absence of systemic compromission. In addition, we also propose the use of ozone treatment as an adjuvant therapy. Seven papers (3 case reports, 2 guidelines, and 2 reviews) were selected for evaluation by reading the full texts. This review outlines the lack of research on the treatment of NG in paediatric patients; we, however, demonstrate the efficacy of the decision tree protocol by describing two case reports in which patients were treated with antibiotics according to the presence or absence of systemic involvement through the implementation of an individualized therapeutic approach, with periodontal ozone therapy. Moreover, the supportive use of this molecule in the management of NG can be a valuable tool in the healing of gingival tissues. [ABSTRACT FROM AUTHOR]

Monitoring, management and conservation of rare and elusive species often requires early detection of individuals, especially for re-introduced and endangered taxa. Environmental DNA (eDNA) approaches can enhance the detection power of traditional biomonitoring methods for low-density, newly-established populations. In this study, we used species-specific Real Time PCR TaqMan assays to assess the presence of two endangered freshwater species, the white-clawed crayfish Austropotamobius pallipes and the Eurasian otter Lutra lutra at eight sites in four river catchments in Liguria (northwestern Italy). The Eurasian otter was considered extinct in the study area since the 1980s. However, recent, although scattered sightings indicated a recolonisation by a few individuals. The white-clawed crayfish populations declined drastically and became increasingly dispersed in the western part of Liguria. Our eDNA analysis confirmed the presence of both species in some of the selected rivers and detected Eurasian otter DNA where the species was not recorded through traditional monitoring methods. This study confirms eDNA-based monitoring approaches as valuable tools to assess the presence of rare and elusive species and help implement protection plans at a local scale. [ABSTRACT FROM AUTHOR]

Background: The growing importance of psychological recovery for patients and their families following intensive care unit (ICU) experiences in recent years cannot be overemphasized. The ICU diary is used to aid patients in reducing the prevalence of post-traumatic stress disorder, anxiety, and depression. The usefulness of maintaining a diary during the grieving process has not yet been thoroughly investigated. Aim: To investigate the role of ICU diaries in the grief process experienced by family members of a person who died in the intensive care unit. Study Design: Nine family members of seven deceased ICU patients with an ICU diary were contacted and interviewed by phone using a semi-structured interview. A qualitative data analysis was performed using thematic synthesis. Setting: Italian general intensive care unit. Findings: Interviewed family members felt that the diary helped them during the grieving process. The return of diaries was desired by family members for support and to remember one's loved one. The diary helped them process their losses in various ways, including signs of evidence of care, emotional involvement, consideration, and coping with grief. Four main themes emerged from the analysis: writing the diary, reading the diary, talking about the diary, and the diary during the grieving process. Conclusions: The overall perception of the ICU diary was positive. The diary mostly helped relatives to "give back something of what we lost". This study also affirms the positive link between ICU diaries and bereavement in Italian ICU. Further studies are required to confirm the usefulness of this tool in the grieving process. Relevance to Clinical Practice: The ICU diary can help patients' family members understand what happened to their loved one and play an important role in the grieving process. The diary served as a valuable source of information that aided in providing bereavement support to the family by helping them to gain a rational and emotional understanding of the patient's death. [ABSTRACT FROM AUTHOR]

Social identity is relevant to political attitudes. Recent studies show that perceived social positions particularly shape populist attitudes. Italy is an interesting test case that has been scarcely investigated by previous research. Thus, using original data collected in 2021, this paper analyses populist attitudes in Italy and the relationship between subjective social status, status mismatch, and social resentment. This study finds that subjective status matters more than objective conditions for populist attitudes. Those who perceive themselves as being at the bottom of the social hierarchy tend to have higher levels of populist attitudes than the rest of the population. However, low social resentment can partially absorb the effect of low status. The paper provides original data from which novel insights into the debate on populism are discernible, appearing to stem more from individual perceptions than objective positions. The results also suggest some possible remedies against rising populist attitudes. [ABSTRACT FROM AUTHOR]

Background: Collagen meniscal implant (CMI) is considered an effective procedure for reducing knee pain and improving knee function after previous meniscectomy. Nevertheless, the current knowledge regarding long-term patient reported-outcome measures after CMI is limited. Purpose: To evaluate clinical outcomes, reoperations, and failures of CMI at a minimum 10-year follow-up. Study Design: Case series; Level of evidence, 4. Methods: Consecutive patients who underwent CMI at a single institution were screened for eligibility. Inclusion criteria for the present study were (1) medial or lateral CMI; (2) isolated or combined procedure with anterior cruciate ligament reconstruction, knee osteotomy, or cartilage treatment; and (3) follow-up between 10 and 15 years. Demographics and surgical details were obtained via chart review. Patients were asked if they were satisfied with the procedure and were evaluated with the Lysholm score, Knee injury and Osteoarthritis Outcome Score (KOOS), visual analog scale for pain, and Tegner score at the final follow-up. Cases requiring partial or total scaffold removal for any reason (including scaffold breakage, infection, or surgery for osteoarthritis progression) were considered surgical failure. Survival analysis was performed with Kaplan-Meier curve, and clinical scores were analyzed based on the Patient Acceptable Symptom State (PASS). Results: A total of 92 patients (mean age, 42.2 years were included in the analysis. A significant improvement in all clinical scores was reported between the preoperative evaluation and the last follow-up. A chondropathy with Outerbridge grade ≥3 was associated with significantly overall lower clinical scores, while a timing from meniscectomy to CMI of ≥5 years determined more pain at rest and reduced Quality of Life in the KOOS subscale. No significant difference was found in terms of clinical scores between patients undergoing isolated and combined procedures. At the final follow-up, the mean Lysholm score was 76.3 points. In total, 12 cases (13%) were considered surgical failures. Sixteen patients (17%) did not reach PASS for the Lysholm score, with a total of 28 cases (30%) classified as clinical failures. Overall, 19% (KOOS Pain) and 40% (KOOS Symptoms) of patients did not achieve the PASS in the KOOS subscales. Chondropathy with Outerbridge grade ≥3 was associated with a higher risk of not achieving the PASS in all the KOOS subscales, while age at surgery of ≥45 years resulted in a lower risk of not achieving PASS in the Pain subscale. At the last follow-up, 63% of patients were still involved in sports activity, with 41% at the same or higher level. Finally, 80% of the patients were satisfied with the procedure. Conclusion: Up to 10 years after surgery, around 70% of the patients who underwent CMI reported satisfactory clinical results, with clinical subjective scores still higher compared with the preoperative evaluation. Overall, 30% of cases were considered clinical failures, with 13% considered surgical failures and 17% not meeting the PASS for the Lysholm score. In addition, cartilage status and time from meniscectomy were shown to have a negative impact on the outcomes, while an age ≥45 years was associated with less pain. There was no clinical difference between patients who underwent isolated CMI or combined procedures. [ABSTRACT FROM AUTHOR]

Introduction: Several observational studies have been conducted to assess the prevalence of cardiovascular risk factors in hypertensive patients; however, none has yet investigated prevalence, clustering, and current management of cardiovascular risk factors upon first referral to hypertension specialists, which is the aim of the present study. Methods: Consecutive adult outpatients with essential/secondary hypertension were included at the time of their first referral to hypertension specialists at 13 Italian centers in the period April 2022–2023 if they had at least one additional major cardiovascular risk factor among LDL-hypercholesterolemia, type 2 diabetes, and cigarette smoking. Prevalence, degree of control, and current management strategies of cardiovascular risk factors were assessed. Results: A total of 255 individuals were included, 40.2% women and 98.4% Caucasian. Mean age was 60.3±13.3 years and mean blood pressure [BP] was 140.3±17.9/84.8±12.3 mmHg). Most participants were smokers (55.3%), had a sedentary lifestyle (75.7%), suffered from overweight/obesity (51%) or high LDL-cholesterol (41.6%), had never adopted strategies to lose weight (55.7%), and were not on a low-salt diet (57.4%). Only a minority of patients reported receiving specialist counseling, and 27.9% had never received recommendations to correct unhealthy lifestyle habits. Nearly 90% of individuals with an estimated high/very high cardiovascular risk profile did not achieve recommended LDL-cholesterol targets. Conclusions: In patients with hypertension, both pharmacological and lifestyle therapeutic advice are yet to improve before referral to hypertension specialists. This should be considered in the primary care setting in order to optimize cardiovascular risk management strategies. [ABSTRACT FROM AUTHOR]

This cross-linguistic study investigated whether the native language has any influence on lexical composition among Italian (N = 125) and Finnish (N = 116) very preterm (born at <32 gestational weeks) children at 24 months (controls: 125 Italian and 146 Finnish full-term children). The investigation also covered the effect of maternal education (ME) on lexical composition. The Italian/Finnish MacArthur Communicative Development Inventory was used for gathering the data. Although the lexicons of the preterm children were smaller than those of the controls, the native language had no major effect on their lexical composition. The ME had a significant effect on preterm children's lexical composition, especially in the Finnish children. The findings indicate that lexical composition is not strongly affected by preterm birth. They also imply that lexical composition is a robust phenomenon that is connected to lexicon size and is not language-specific when analysed in broad terms, although some language-specific features were also detected.

In unreinforced masonry structures, among the most dangerous events that can occur during earthquakes are the out-of-plane mechanisms. This type of response significantly changes if the wall is restrained by a horizontal element. The collapse, in this case, could take place for slipping/failure of the diaphragm connection or for overturning of the wall, following the formation of a crack at an intermediate height between the base and the top. A specific analytical model is used to capture the complex dynamic behavior of the wall, formed by two stacked rigid bodies (free to rock) with the top one connected to a flexible diaphragm. The model is calibrated using experimental data available in the literature and it is then used to carry out a dynamic parametric analysis. The variation range of relevant parameters refers to the building features surveyed in Emilia-Romagna region, Italy, and their effect on the global response of the system is investigated. Further, the influence of ground motion is considered, using different ground accelerations. The results of the analysis highlight that, for the considered area and return period, the maximum rotations of the system are significant only for large slenderness values. Further, the investigation shows that the diaphragm plays a crucial role in the dynamic response of the system. The stiffness of the diaphragm can significantly reduce the rotations and consequently the risk of overturning. Additionally, the study on the effect of the wall size pointed out how a top spring causes a reverse scale effect. [ABSTRACT FROM AUTHOR]

• The prevalence of pSS in Italy may be consistent with the definition of rare disease. • Patients with pSS show higher rates of hospitalization, pharmacological treatment, and outpatient care needs. • Economic impact of pSS patients' health care is three-times higher than the general population. Primary Sjögren's syndrome (pSS) is a systemic autoimmune disease with significant impact on morbidity, mortality, and quality of life. This study aimed to evaluate epidemiology, healthcare needs and related costs of pSS patients from the Italian National Health Service perspective. From the Fondazione Ricerca e Salute's database (∼5 million inhabitants/year), pSS prevalence in 2018 was calculated. Demographics, mean healthcare consumptions and direct costs at one year following index date (first in-hospital diagnosis/disease waiver claim) were analysed through an individual direct matched pair case-control analysis (age, sex, residency). In Italy, 3.8/10,000 inhabitants were identified as affected by pSS (1,746 case: 1,746 controls) in 2018. In the year following index date, 53.7% of cases and 42.7% of controls received ≥1 drug (p <0.001); mean per capita cost was €501 and €161, respectively (p <0.01). At least one hospitalization occurred to 7.8% of cases and 3.9% of controls (p <0.001) with mean per capita costs of €416 and €129, respectively (p = 0.46). At least one outpatient specialist service was performed in 49.8% of cases and 30.6% of controls (p <0.001); mean per capita costs were €200 and €75, respectively (p <0.01). Overall, mean annual costs were €1,171 per case and €372 per control (p < 0.01). According to results of this population-based study, the prevalence of pSS in Italy appears to be consistent with the definition of rare disease. Patients with pSS have higher pharmacological, in-hospital and outpatient specialist care needs, leading to three-times higher overall cost for the INHS, compared to the general population. [ABSTRACT FROM AUTHOR]

Background: This study explores the impact of the pandemic on children's mental health. It examined the understanding of parents regarding their children's mental condition and their ability to identify issues, 2 years post the outbreak of the COVID‐19 pandemic. Methods: Using a cross‐sectional design, 507 Italian parents reported on their youngest child aged between 2 and 17, totaling 507 children. The outcomes focused on were parental perception of children's mental health deterioration, scores on the Strengths and Difficulties Questionnaire (SDQ) above the clinical cut‐off, and parental under‐recognition of mental health issues. Descriptive analyses and multivariable logistic regression models were executed (significance at p <.05). Results: Parents were 88.1% women (median age 41 years, interquartile range [IQR] = 36‐47). Their children were 50.3% female [median age 6 years (IQR = 4‐11)]. The data revealed 21.1% of parents perceived a deterioration in their children's mental health, while 44.2% had SDQ scores above the cut‐off. Parental under‐recognition of mental issues was found in 20.1% of cases. Significant correlations were found between parental perception of deterioration, SDQ scores, and factors like parental mental distress and children's sleep issues. Implications: The findings suggest that schools and verified websites can serve as critical conduits for providing parents with reliable information. By promoting early identification and intervention, such mechanisms can help ensure mental health equity for children. Conclusions: The research highlights the effect of the pandemic on children's mental health and the issue of parental under‐recognition. The results underscore the importance of public health initiatives that enhance mental health information accessibility and reliability for parents. [ABSTRACT FROM AUTHOR]

The public housing stock, called social housing, in Italy was developed between the 1950s and the 1980s. As of today, the first residential developments are almost nearing their end-of-life age and are in need of urgent and intensive renovation. The European Commission, with the Renovation Wave, has set a goal of doubling the rate of building renovation over the next 10 years, reducing emissions, improving energy performance, and promoting decarburization. Renovation interventions, including structural, functional, energy, and plant upgrading interventions, etc., are to be preferred over integral demolition and reconstruction interventions, which have significant repercussions in terms of managerial and social discomfort. The case studies examined concern renovation interventions aimed at energy efficiency, functional adaptation of housing, as well as façade restyling. The design variants analyzed were evaluated in terms of CO2e emissions, according to life cycle inventory (LCI) and Environmental Product Declaration (EPD) approaches. This approach has a twofold purpose: to propose design guidelines, with low CO2e emissions, through hypotheses of variants in the case studies, and to propose, to the economic operators, economically advantageous bidding scenarios in the procurement process. [ABSTRACT FROM AUTHOR]

Neonates face heightened susceptibility to drug toxicity, often exposed to off-label medications with dosages extrapolated from adult or pediatric studies. Premature infants in Neonatal Intensive Care Units (NICUs) are particularly at risk due to underdeveloped pharmacokinetics and exposure to multiple drugs. The study aimed to survey commonly used medications with a higher risk of ototoxicity and nephrotoxicity in Spanish and Italian neonatal units. A prospective cross-sectional study was conducted in Italian and Spanish neonatal units using a web-based survey with 43 questions. A modified Delphi method involved experts refining the survey through online consensus. Ethical approval was obtained, and responses were collected from January to July 2023. The survey covered various aspects, including drug-related ototoxic and nephrotoxic management, hearing screening, and therapeutic drug monitoring. Responses from 131 participants (35.9% from Spain and 64.1% from Italy) revealed awareness of drug toxicity risks. Varied practices were observed in hearing screening protocols, and a high prevalence of ototoxic and nephrotoxic drug use, including aminoglycosides (100%), vancomycin (70.2%), loop diuretics (63.4%), and ibuprofen (62.6%). Discrepancies existed in guideline availability and adherence, with differences between Italy and Spain in therapeutic drug monitoring practices. Conclusions:The study underscores the need for clinical guidelines and uniform practices in managing ototoxic and nephrotoxic drugs in neonatal units. Awareness is high, but inconsistencies in practices indicate a necessity for standardization, including the implementation of therapeutic drug monitoring and the involvement of clinical pharmacologists. Addressing these issues is crucial for optimizing neonatal care in Southern Europe. What is Known: • Neonates in intensive care face a high risk of nephrotoxicity and ototoxicity from drugs like aminoglycosides, vancomycin, loop diuretics, and ibuprofen. • Therapeutic drug monitoring is key for managing these risks, optimizing dosing for efficacy and minimizing side effects. What is New: • NICUs in Spain and Italy show high drug toxicity awareness but differ in ototoxic/nephrotoxic drug management. • Urgent need for standard guidelines and practices to address nephrotoxic risks from aminoglycosides, vancomycin, loop diuretics, and ibuprofen. [ABSTRACT FROM AUTHOR]

Starting on 2 November 2023, some territories in the Region of Tuscany in Italy were hit by exceptionally intense meteorological and calamitous events. The Region of Tuscany's government was immediately at the forefront of relief, assisting the population, and aiding restoration. On 3 November, a national state of emergency was declared due to flooding. Journalistic communication is an essential aspect of disaster mitigation, preparedness, response and recovery. In terms of protecting people and reducing damage, journalists and the media have an important role to play. This article reports an Italian case study analysing the behaviour of local media in cases of natural disaster. Nine focus groups were conducted with local journalists covering the flood emergency. The results highlight the role of social and institutional mediation, rather than mere dissemination, played by the local press in emergency situations, a central element in the construction of a community bond, precisely in moments of insecurity and disorientation. The narration of a disaster from the inside seems to have allowed the emergence and representation of hitherto unknown social realities in Tuscany. The goal of the news coverage was widened, making it possible to respond better to the diverse interests of the reading public and to satisfy in a short time and exhaustively the information needs of individual communities in difficulty. [ABSTRACT FROM AUTHOR]

Background: This study aimed to gather data on physical activity (PA), bleeding, health-related quality of life, and health status, using a wearable device and an electronic patient-reported outcome (ePRO) app, in individuals with moderate or severe hemophilia A (HA) without inhibitors receiving treatment according to the clinical practice. Methods: This is a 12-month multicenter cohort study conducted in Italy. The primary outcomes included the description of PA by type and intensity, adherence to World Health Organization guidelines, bleeding, and health-related quality of life by EQ-5D questionnaire. PA data were collected continuously through a fitness tracker worn by the patient; all the other variables were collected through ePRO questionnaires. Results: Only 54 of the 103 enrolled subjects (52.4%) used their fitness tracker for the defined valid period; adolescents were the least compliant age group. PA was performed at low rates and intensity. Approximately 52% of the subjects had sedentary behavior. The mean EQ-5D values did not change over time. At least one bleeding was reported in 43.7% of the subjects, mostly with sedentary behavior. The PA in the 2 days preceding the bleeding was comparable to the one observed in the overall observational period. Conclusions: The systematic recording of data through a fitness tracker and ePRO app shows that subjects with HA without inhibitors have lower-than-expected PA and that they still experience issues related to bleeding. [ABSTRACT FROM AUTHOR]

Objective: Epilepsy surgery can be proposed as a treatment option in people with focal epilepsy, however satisfaction with epilepsy surgery in Italy remains unknown. We aimed to validate in Italy an instrument to measure patient satisfaction with epilepsy surgery, the 19-item Epilepsy Surgery Satisfaction Questionnaire (ESSQ-19). Methods: Consecutive patients with epilepsy who received epilepsy surgery between the years 2018–2021 at Modena Academic Hospital were recruited and provided clinical and demographic data. The Italian version of the ESSQ-19 and other three questionnaires were completed to assess construct validity. To evaluate the validity and reliability of the tool Spearman's rank correlation, and internal consistency analysis were performed. Results: 66 out of 79 eligible patients participated in the study (22 females; median age 37 years). The mean values of satisfaction for each domain of the IT-ESSQ-19 were: seizure control 83.4; (SD 16.7), psychosocial functioning 79.3 (SD 17.1), surgical complications 90.8 (SD 14.9), and recovery from surgery 81.4 (SD 16.9). The mean summary score was 83.7 (SD 13.3). The questionnaire was shown to have high internal consistency in the four domains (Cronbach's alpha = 0.82–0.93), and no significant floor/ceiling effects of the summary score. The ESSQ-19 scores significantly correlated with other instruments to support construct validity. It also demonstrated good discriminant validity for being seizure free [AUC 0.72; 95% CI = 0.56–0.88], and to endorse depression [AUC 0.76, 95% CI = 0.56–0.96]. Significance: The Italian version of the ESSQ-19 is a reliable and valid self-reported questionnaire for assessing patient satisfaction with epilepsy surgery. [ABSTRACT FROM AUTHOR]