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Background: Despite the worldwide increasing incidence of Group A Streptococcus (GAS) infections reported since December 2022, data on noninvasive GAS (nGAS) infections in the post COVID-19 era are limited. By a self-reported survey performed in an outpatient setting, we investigated the number and clinical features of GAS infections, the diagnostic work-up and the type of treatment utilized. In addition, the rate of influenza vaccination was evaluated. Methods: In June 2023 family pediatricians involved in the study sent the survey to parents of patients aged 0–16 years. The survey included questions on GAS infections that occurred from January 1 to May 31, 2023. Results: Among 3580 children, 20.3% had a GAS infection (0,8% < 1 year, 16,4% 1–3 years, 42,3% 3–6 years, 26,5% 6–9 years, 11,4%, 9–12 years, and 2,6% 12–16 years). Symptoms reported were sore throat (76.9%), fever (75.2%), tonsillar exudate (25.2%), lymphadenopathy (21.8%), and scarlet fever (14.7%). A single patient was hospitalized due to GAS meningitis. Twenty four percent of children had more than one GAS infection. In this group, frequencies of symptoms reported in the first and in the following infection were similar, except for fever and scarlet fever which were less frequent during relapses. GAS was identified by rapid antigen detection test in 81.0% of children. Eighty-nine per cent of children were treated with antibiotics, mostly amoxicillin/clavulanate (40.4%) and amoxicillin (39.4%). Thirty four percent of children received influenza vaccine. No difference was observed among immunized and not immunized regarding the number and characteristics of GAS infection. Conclusions: We reported a certain prevalence of nGAS infections in children, mainly those aged 3–6 years age, who were mostly characterized by a low score of symptoms, and in most of the cases diagnosed and treated using a microbiological test as confirmatory tool. In this new clinical setting, a national study would be useful to reach more significant data for the definition of a correct diagnosis and clinical management of nGAS infections in children. Moreover, it is important to improve flu vaccination campaign and coverage to protect children from coinfections that could worsen the disease and misdiagnose the etiology of pharyngitis. [ABSTRACT FROM AUTHOR]

The infrastructure sector is paying increasing attention to sustainability. In particular, certain events have proven how preventive local interventions can save both user lives and the same infrastructures, thus highlighting the importance of maintenance. The ineffectiveness of concrete repairs is one of the main issues in civil engineering. Merely 50% of restoration operations on concrete buildings is considered to be effective in Europe, although rehabilitation costs cover nearly half of the annual construction investments. This study investigates a potential strategy to improve the sustainability of infrastructure restoration solutions. A simplified examination of CO2 emissions, intervention costs, social factors, structural performances, and other factors considered relevant for this research, is followed by a comparison and ranking of the potential rehabilitation solutions. Four approaches have been selected to design retrofit interventions on a real column of the Sardinian Brabau bridge in Italy: i) complete column replacement; ii) substitution of the damaged longitudinal rebars with machined bars and the casting of a new concrete cover in ultra-high performance fibre-reinforced concrete; iii) longitudinal and transverse fibrereinforced polymer wrapping; iv) concrete jacketing at the base. Through the application of selected criteria, a methodological and procedural approach is developed. It provides a tool for assessing the sustainability of infrastructure maintenance works throughout the entire life cycle in the subsequent phases of this research. [ABSTRACT FROM AUTHOR]

Background: This study analyzed the Quality of Life (QoL) and cost-effectiveness of laparoscopic (LDP) versus robotic distal pancreatectomy (RDP). Methods: Consecutive patients submitted to LDP or RDP from 2010 to 2020 in four high-volume Italian centers were included, with a minimum of 12 months of postoperative follow-up were included. QoL was evaluated using the EORTC QLQ-C30 and EQ-5D questionnaires, self-reported by patients. After a propensity score matching, which included BMI, gender, operation time, multiorgan and vascular resections, splenic preservation, and pancreatic stump management, the mean differential cost and Quality-Adjusted Life Years (QALY) were calculated and plotted on a cost-utility plane. Results: The study population consisted of 564 patients. Among these, 271 (49%) patients were submitted to LDP, while 293 (51%) patients to RDP. After propensity score matching, the study population was composed of 159 patients in each group, with a median follow-up of 59 months. As regards the QoL analysis, global health and emotional functioning domains showed better results in the RDP group (p = 0.037 and p = 0.026, respectively), whereas the other did not differ. As expected, the median crude costs analysis confirmed that RDP was more expensive than LDP (16,041 Euros vs. 10,335 Euros, p < 0.001). However, the robotic approach had a higher probability of being more cost-effective than the laparoscopic procedure when a willingness to pay more than 5697 Euros/QALY was accepted. Conclusion: RDP was associated with better QoL as explored by specific domains. Crude costs were higher for RDP, and the cost-effectiveness threshold was set at 5697 euros/QALY. [ABSTRACT FROM AUTHOR]

A common and largely unresolved problem of national-scale landslide early warning systems is their independent evaluation. In a recent paper, Mondini et al. (Nat Commun 14:2466, 2023) proposed a deep-learning system for short-term forecasting of rain-induced shallow landslides in Italy. Here, we independently evaluate the performance of this national-scale system by demonstrating its application between 1 January and 31 May 2021. For the purpose, we use hourly rainfall measurements from the same rain gauge network and different and independent information on the timing and location of 163 rain-induced landslides obtained from the FraneItalia catalogue that occurred in Italy in a period non considered in the construction of the system (https://zenodo.org/records/7923683). Independent demonstration confirmed the good predictive performance of the forecasting system and revealed no geographical or temporal bias in the forecasts. The analysis also showed that the system was more effective at predicting multiple landslides in the same general area than single landslides. This was a good result as multiple landslides are inherently more dangerous than single failures. Analysis of the few misclassified landslides showed that approximately one-third of the landslides were rockfalls, and for approximately another third there was uncertainty about when or where the landslides occurred. We conclude that, despite the inevitable misclassifications inherent in any probabilistically based national-scale landslide forecasting system, the deep-learning system analysed is well suited for short-term operational forecasting of rain-induced shallow landslides in Italy. [ABSTRACT FROM AUTHOR]

Italy implemented two-dose universal varicella vaccination (UVV) regionally from 2003 to 2013 and nationally from 2017 onwards. Our objective was to analyze regional disparities in varicella outcomes resulting from disparities in vaccine coverage rates (VCRs) projected over a 50-year time-horizon (2020–2070). A previously published dynamic transmission model was updated to quantify the potential public health impact of the UVV program in Italy at the national and regional levels. Four 2-dose vaccine strategies utilizing monovalent (V) and quadrivalent (MMRV) vaccines were evaluated for each region: (A) MMRV-MSD/MMRV-MSD, (B) MMRV-GSK/MMRV-GSK, (C) V-MSD/MMRV-MSD, and (D) V-GSK/MMRV-GSK. Costs were reported in 2022 Euros. Costs and quality-adjusted life-years (QALYs) were discounted 3% annually. Under strategy A, the three regions with the lowest first-dose VCR reported increased varicella cases (+ 34.3%), hospitalizations (+ 20.0%), QALYs lost (+ 5.9%), payer costs (+ 22.2%), and societal costs (+ 14.6%) over the 50-year time-horizon compared to the three regions with highest first-dose VCR. Regions with low first-dose VCR were more sensitive to changes in VCR than high first-dose VCR regions. Results with respect to second-dose VCR were qualitatively similar, although smaller in magnitude. Results were similar across all vaccine strategies. [ABSTRACT FROM AUTHOR]

A longitudinal psycholinguistic study was conducted with 107 students from different Italian universities that produced daily photo-diary entries for two weeks, one at the beginning and the other at the end of the first Italian lockdown period, imposed in view of the rapid dissemination of COVID -19. The task was to take a daily photo accompanied by a short description (text). The texts accompanying the photos were analysed using Linguistic Inquiry and Word Count (LIWC) software to analyze linguistic markers representing psychological processes related to the experience of the pandemic and the lockdown, identifying potential changes in psycholinguistic variables useful for understanding the psychological impact of such harsh and extended restricted living conditions on Italian students. LIWC categories related to negation, anger, cognitive mechanisms, tentative discourse, past, and future increased statistically significantly between the two time points, while word count, prepositions, communication, leisure, and home decreased statistically significantly. While male participants used more articles at both time points, females used more words related to anxiety, social processes, past, and present at T1 and more related to insight at T2. Participants who lived with their partner showed higher scores on negative emotions, affect, positive feelings, anger, optimism, and certainty. Participants from southern Italy tended to describe their experiences from a collective and social perspective rather than an individual perspective. By identifying, discussing, and comparing these phenomena with the broader literature, a spotlight is shed for the first time on the psycholinguistic analysis of students at the national level who faced the first COVID -19 lockdown in Italy. [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]

Background Epithelial sinonasal cancers (SNC) are rare tumours with recognized associations with known/suspected occupational carcinogens (wood/leather dust, nickel/chromium compounds and formaldehyde). In Italy, a national SNC registry organized as a network of regional registries was established by law in 2008. Aims To describe SNC time trends, occupational exposures and geographical distribution in Lombardy, North-West Italy, based on population registry data (2008–20). Methods The Lombardy SNC Registry records epithelial SNCs using various sources. Interviews to collect occupational history are performed using a standardized questionnaire. Using several standard populations, we calculated yearly crude and age-standardized rates (ASRs per 100,000 person-years). Standardized incidence ratios (SIR) at municipality level were calculated, and Bayesian models were fitted to produce smoothed SIR maps. Results We recorded 827 cases (553 men, 274 women). Crude (world standardized) ASRs were 0.9 (0.4) in men and 0.4 (0.2) in women, with no time trends. Interviews were obtained for 485 (88%) men and 223 (81%) women. Among men, 217 (45%) had been exposed to occupational carcinogens (wood/leather dust: 150/65 cases, 31%/13%), while only 36 women (16%) were exposed. Among 201 men with adenocarcinoma, exposure to wood/leather dust occurred in 103/50 cases (75%/50%). Areas with elevated SIRs associated with leather dust were found in the Western areas. Exposure to wood dust was more widespread. Conclusions This study found a high frequency of occupational exposures (wood and leather dust), particularly in men with SNC. Employment in shoe industries clustered in the Western part, while work in furniture industries was less spatially structured. [ABSTRACT FROM AUTHOR]

The replacement of deteriorated pipe segments in aging water distribution networks often results in hybrid pipelines, consisting of segments of different materials of comparable length. The fact that short segments of polymeric material have a strong effect on the transient response of metallic pipelines authorizes to consider it important to examine the transient behavior of hybrid pipelines. To this end, transient tests were carried out on a high-density polyethylene (HDPE)+ cast iron (CI) hybrid pipeline at the Water Engineering Laboratory (WEL) of the University of Perugia, Italy. As a reference, tests were also carried out on a homogeneous HDPE pipeline with the same total length. The results of the laboratory tests showed that the value of the pressure local extremes (i.e., pressure peaks) was much higher in the homogeneous pipeline than in the hybrid one. On the contrary, the number of pressure peaks is much smaller in the homogeneous pipeline than in the hybrid one. Such features have been explained by analyzing the mechanisms of interaction of pressure waves at the in-series junction between the two different materials. [ABSTRACT FROM AUTHOR]

Objective: To describe the clinical and ultrasound characteristics of recurrent granulosa cell and Sertoli–Leydig cell tumors. Methods: This was a retrospective observational study performed at Fondazione Policlinico Universitario A. Gemelli, Istituto di Ricovero e Cura a Carattere Scientifico, IRCCS, Rome (Gemelli center), Italy. Patients with a histological diagnosis of recurrent granulosa cell tumor or Sertoli–Leydig cell tumor were identified from the database of the Department of Gynecological Oncology. Those who had undergone a preoperative ultrasound examination at the Gemelli center between 2012 and 2020 were included, and the data retrieved from the original ultrasound reports. In all of these reports, the recurrent tumors were described using International Ovarian Tumor Analysis (IOTA) terminology. If a patient had more than one episode of relapse, information from all episodes was collected. If there was more than one recurrent tumor at the same ultrasound examination, all tumors were included. One expert sonographer also reviewed all available ultrasound images to identify typical ultrasound patterns using pattern recognition. Results: We identified 30 patients with a histological diagnosis of recurrent granulosa cell tumor (25 patients, 55 tumors) or Sertoli–Leydig cell tumor (five patients, seven tumors). All 30 had undergone at least one preoperative ultrasound examination at the Gemelli center and were included. These women had a total of 66 episodes of relapse, of which a preoperative ultrasound examination had been performed at the Gemelli center in 34, revealing 62 recurrent lesions: one in 22/34 (64.7%) episodes of relapse, two in 4/34 (11.8%) episodes and three or more in 8/34 (23.5%) episodes. Most recurrent granulosa cell tumors (38/55, 69.1%) and recurrent Sertoli–Leydig tumors (6/7, 85.7%) were classified as solid or multilocular‐solid tumors, while 8/55 (14.5%) recurrent granulosa cell tumors and 1/7 (14.3%) recurrent Sertoli–Leydig cell tumors were unilocular cysts and 9/55 (16.4%) recurrent granulosa cell tumors were multilocular cysts. The nine unilocular cysts had contents that were anechoic (n = 2) or had low‐level echogenicity (n = 7), had either smooth (n = 4) or irregular (n = 5) internal cyst walls, and ranged in largest diameter from 8 to 38 mm, with three being < 20 mm and five being 20–30 mm. On retrospective review of the images, two typical ultrasound patterns were described: small solid tumor measuring < 2 cm (15/62, 24.2%) and tumor with vascularized echogenic ground‐glass‐like content (12/62, 19.4%). Conclusions: Some granulosa cell and Sertoli–Leydig cell recurrences manifest one of two typical ultrasound patterns, while some appear as unilocular cysts. These are usually classified as benign, but in patients being followed up for a granulosa cell tumor or Sertoli–Leydig cell tumor, a unilocular cyst should be considered suspicious of recurrence. © 2023 The Authors. Ultrasound in Obstetrics & Gynecology published by John Wiley & Sons Ltd on behalf of International Society of Ultrasound in Obstetrics and Gynecology. [ABSTRACT FROM AUTHOR]

Background: This study aimed to investigate the cognitive and affective factors associated with cross-cultural differences in arithmetic tasks. Methods: A total of 404 third- and fourth- graders were recruited from China and Italy to complete exact arithmetic, arithmetic estimation and cognitive tasks (i.e., short-term memory, executive functions, and fluid reasoning). Their mathematical anxiety was also measured. Results: The results showed that Chinese children performed better than Italian children in both arithmetic tasks and in shifting task. Italian children performed better in visuospatial updating task and reported higher levels of mathematical anxiety than their Chinese peers. Multi-group path analyses showed that the patterns of relations among cognitive factors (i.e., short-term memory, inhibition and shifting), mathematical anxiety, and arithmetic performance were similar across groups. The only exception was that visuospatial updating uniquely predicted arithmetic estimation for Chinese but not for Italian children. Conclusions: Chinese children outperformed their Italian peers in the exact arithmetic task, likely due to the greater emphasis on arithmetic fluency in Chinese mathematics education, both in schools and at home. They also had a slight advantage than Italian peers in the arithmetic estimation task. The unique link between updating and arithmetic estimation found in Chinese children but not Italian children suggests that, although arithmetic estimation is not emphasized in the curricula of either country, instruction and practice in exact arithmetic may enhance Chinese children's efficiency in solving arithmetic estimation problems. [ABSTRACT FROM AUTHOR]

Background and Aim: Pelvic inflammatory disease (PID) is usually managed by conservative treatment, but in selected cases, especially in the presence of a tubo‐ovarian abscess (TOA), surgical management is a recognized treatment option. We compared the trends in managing PID and short‐term outcomes before and during the SARS‐CoV‐2 pandemic. Methods: This is a retrospective study performed in three Italian gynecological centers. We included patients admitted to hospital with a diagnosis of PID. Demographic characteristics, management, time to diagnosis, and time to treatment were compared before versus during the SARS‐CoV‐2 pandemic. Results: One hundred nineteen PID patients were screened, eighty‐one before the SARS‐CoV‐2 pandemic, and thirty‐eight after the onset. At admission, leukocytosis (median 19.73 vs. 13.99 WBC/mm3, p‐value = 0.02) was significantly higher in patients who underwent surgery after the onset of the pandemic. TOA incidence was higher in patients who underwent surgery during the SARS‐CoV‐2 pandemic, but the difference did not reach statistically significance (p = 0.06). The proportion of patients treated with surgery dropped to 26.3% after the onset from 46% of patients before the onset of pandemic (p = 0.03). Furthermore, a higher percentage of emergency surgical procedures on day 0 of hospital admission were performed after the onset of the pandemic (50% vs. 13.1%, p = 0.01). Conclusions: In this retrospective cohort study, we found that the SARS‐CoV‐2 pandemic influenced the clinical presentation and management of PID in favor of conservative treatment. Patients who underwent surgery during the SARS‐CoV‐2 pandemic had higher inflammatory markers. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the impact of the timing of MRI on the prediction of survival and morbidity in patients with CDH, and whether serial measurements have a beneficial value. Methods: This retrospective cohort study was conducted in two perinatal centers, in Germany and Italy. It included 354 patients with isolated CDH having at least one fetal MRI. The severity was assessed with the observed-to-expected total fetal lung volume (o/e TFLV) measured by two experienced double-blinded operators. The cohort was divided into three groups according to the gestational age (GA) at which the MRI was performed (< 27, 27–32, and > 32 weeks' gestation [WG]). The accuracy for the prediction of survival at discharge and morbidity was analyzed with receiver operating characteristic (ROC) curves. Multiple logistic regression analyses and propensity score matching examined the population for balance. The effect of repeated MRI was evaluated in ninety-seven cases. Results: There were no significant differences in the prediction of survival when the o/e TFLV was measured before 27, between 27 and 32, and after 32 WG (area under the curve [AUC]: 0.77, 0.79, and 0.77, respectively). After adjustment for confounding factors, it was seen, that GA at MRI was not associated with survival at discharge, but the risk of mortality was higher with an intrathoracic liver position (adjusted odds ratio [aOR]: 0.30, 95% confidence interval [95%CI] 0.12–0.78), lower GA at birth (aOR 1.48, 95%CI 1.24–1.78) and lower o/e TFLV (aOR 1.13, 95%CI 1.06–1.20). ROC curves showed comparable prediction accuracy for the different timepoints in pregnancy for pulmonary hypertension, the need of extracorporeal membrane oxygenation, and feeding aids. Serial measurements revealed no difference in change rate of the o/e TFLV according to survival. Conclusion: The timing of MRI does not affect the prediction of survival rate or morbidity as the o/e TFLV does not change during pregnancy. Clinicians could choose any gestational age starting mid second trimester for the assessment of severity and counseling. [ABSTRACT FROM AUTHOR]

The extent in which voters from different ideological viewpoints support state interventions to curb crises remains an outstanding conundrum, marred by conflicting evidence. In this article, we test two possible ways out from such puzzle. The role of ideology to explain support for state interventions, we argue, could be (i) conditional upon the ideological nature of the crisis itself (e.g., whether the crisis relates to conservation vs. post-materialist values), or (ii) unfolding indirectly, by moderating the role played by political trust. We present evidence from a conjoint experiment fielded in 2022 on a representative sample of 1,000 Italian citizens, in which respondents were asked whether they support specific governmental interventions to curb a crisis, described under different conditions (e.g., type of crisis, severity). Our results show that the type of crisis matters marginally – right-wing respondents were more likely to support state interventions only in the case of terrorism. More fundamentally, political trust affects the probability to support state interventions, but only for right-wing citizens. [ABSTRACT FROM AUTHOR]

This study aimed to assess the impact of the COVID-19 pandemic on national surveillance of viral hepatitis in Italy. Interrupted time series analysis. Using an interrupted time series analysis with a customised AutoRegressive Integrated Moving Average model on hepatitis cases reported to the Integrated Epidemiological System of Acute Viral Hepatitis from 2006 to 2022, we examined trends in incidence, time to diagnosis and time to epidemiological investigations for hepatitis A, hepatitis B and hepatitis C. The quarterly incidence of hepatitis B (−0.251, P = 0.05) and hepatitis C (−0.243, P = 0.003) significantly decreased with the onset of the pandemic. Surveillance times for hepatitis B (5.496, P < 0.001) and hepatitis C (35.723, P < 0.001), measured as days lost per quarter, significantly increased 12 and 24 months after the pandemic's start. This aligns with a notable rise in quarterly incidence at 36 months for both (0.032, P = 0.030 for hepatitis B; 0.040, P < 0.001 for hepatitis C). The decrease in reported cases could be due to an increase in infection prevention control and containment measures put in place in a pandemic context. However, a delay in the initiation of epidemiological investigations was observed, which could lead to a further increase in incidence in the future. [ABSTRACT FROM AUTHOR]

This study aimed to explore the association between prestige norms of moral disengagement and ethnic bullying among Italian early adolescents. Prestige norms of moral disengagement were also examined as possible moderator of the association between individual prejudice and ethnic bullying. Participants were 742 sixth to eighth graders attending multiethnic schools in Italy (49.7% girls), all of Italian heritage, who answered peer and self-report measures. In multilevel models, individual levels of moral disengagement were associated with ethnic bullying, and prestige norms of moral disengagement (classroom level) moderated (cross-level interaction) the association between xenophobic prejudice and ethnic bullying was significant only for high levels of prestige norms. Results highlight the importance of individual prejudices in ethnic bullying and suggest that the processes of socialization of cognitive distortions within peer groups are complex, providing useful insights for interventions. [ABSTRACT FROM AUTHOR]

Non-cholera Vibrio spp. includes ubiquitous organisms living in aquatic environments. Their occurrence is associated with global warming and meteorological disasters. In May 2023 the Romagna region, Italy, was affected by severe floods. In the following 15 weeks we observed 5 patients with invasive infections caused by V. vulnificus (3/5) and V. harveyi (2/5). All patients (median age 77 years) had medical comorbidities and shared exposure to seawater. Two patients needed surgery; 2 died. In conclusion, we observed an increased burden of Vibrio spp. invasive infections after May 2023 floods, affecting old patients with predisposing medical conditions. [ABSTRACT FROM AUTHOR]

Purpose: The current study evaluated the in vitro activities of ceftolozane/tazobactam (C/T), imipenem/relebactam (IMI/REL), and comparators against recent (2017–2021) clinical isolates of gram-negative bacilli from two countries in southern Europe. Methods: Nine clinical laboratories (two in Greece; seven in Italy) each collected up to 250 consecutive gram-negative isolates per year from lower respiratory tract, intraabdominal, urinary tract, and bloodstream infection samples. MICs were determined by the CLSI broth microdilution method and interpreted using 2022 EUCAST breakpoints. β-lactamase genes were identified in select β-lactam-nonsusceptible isolate subsets. Results: C/T inhibited the growth of 85–87% of Enterobacterales and 94–96% of ESBL-positive non-CRE NME (non-Morganellaceae Enterobacterales) isolates from both countries. IMI/REL inhibited 95–98% of NME, 100% of ESBL-positive non-CRE NME, and 98–99% of KPC-positive NME isolates from both countries. Country-specific differences in percent susceptible values for C/T, IMI/REL, meropenem, piperacillin/tazobactam, levofloxacin, and amikacin were more pronounced for Pseudomonas aeruginosa than Enterobacterales. C/T and IMI/REL both inhibited 84% of P. aeruginosa isolates from Greece and 91–92% of isolates from Italy. MBL rates were estimated as 4% of Enterobacterales and 10% of P. aeruginosa isolates from Greece compared to 1% of Enterobacterales and 3% of P. aeruginosa isolates from Italy. KPC rates among Enterobacterales isolates were similar in both countries (7–8%). OXA-48-like enzymes were only identified in Enterobacterales isolates from Italy (1%) while GES carbapenemase genes were only identified in P. aeruginosa isolates from Italy (2%). Conclusion: We conclude that C/T and IMI/REL may provide viable treatment options for many patients from Greece and Italy. [ABSTRACT FROM AUTHOR]

The accurate prediction of intense precipitation events is one of the main objectives of operational weather services. This task is even more relevant nowadays, with the rapid progression of global warming which intensifies these events. Numerical weather prediction models have improved continuously over time, providing uncertainty estimation with dynamical ensembles. However, direct precipitation forecasting is still challenging. Greater availability of machine‐learning tools paves the way to a hybrid forecasting approach, with the optimal combination of physical models, event statistics, and user‐oriented postprocessing. Here we describe a specific chain, based on a random‐forest (RF) pipeline, specialised in recognising favourable synoptic conditions leading to precipitation extremes and subsequently classifying extremes into predefined types. The application focuses on northern and central Italy, taken as a testbed region, but is seamlessly extensible to other regions and time‐scales. The system is called MaLCoX (Machine Learning model predicting Conditions for eXtreme precipitation) and is running daily at the Italian regional weather service of ARPAE Emilia‐Romagna. MalCoX has been trained with the ARCIS gridded high‐resolution precipitation dataset as the target truth, using the last 20 years of the European Centre for Medium‐Range Weather Forecasts (ECMWF) reforecast dataset as input predictors. We show that, with a long enough training period, the optimal blend of larger‐scale information with direct model output improves the probabilistic forecast accuracy of extremes in the medium range. In addition, with specific methods, we provide a useful diagnostic to convey to forecasters the underlying physical storyline which makes a meteorological event extreme. [ABSTRACT FROM AUTHOR]

Background: Lung cancer is one of the most lethal cancers worldwide and patient clinical outcomes seem influenced by their socioeconomic position (SEP). Since little has been investigated on this topic in the Italian context, our aim was to investigate the role of SEP in the care pathway of lung cancer patients in terms of diagnosis, treatment and mortality. Methods: This observational retrospective cohort study included patients discharged in the Lazio Region with a lung cancer diagnosis between 2014 and 2017. In the main analysis, educational level was used as SEP measure. Multivariate models, adjusted for demographic and clinical variables, were applied to evaluate the association between SEP and study outcomes, stratified for metastatic (M) and non-metastatic (NM) cancer. We defined a diagnosis as 'delayed' when patients received their initial cancer diagnosis after an emergency department admission. Access to advanced lung cancer treatments (high-cost, novel and innovative treatments) and mortality were investigated within the 24-month period post-diagnosis. Moreover, two additional indicators of SEP were examined in the sensitivity analysis: one focusing on area deprivation and the other on income-based exemption. Results: A total of 13,251 patients were identified (37.3% with metastasis). The majority were males (> 60%) and over half were older than 70 years. The distribution of SEP levels among patients was as follow: 31% low, 29% medium–low, 32% medium–high and 7% high. As SEP increased, the risks of receiving a delayed diagnosis ((high vs low: M: OR = 0.29 (0.23–0.38), NM: OR = 0.20 (0.16–0.25)) and of mortality ((high vs low M: OR = 0.77 (0.68–0.88) and NM: 0.61 (0.54–0.69)) decreased. Access to advanced lung cancer treatments increased in accordance with SEP only in the M cohort (high vs low: M: OR = 1.57 (1.18–2.09)). The primary findings were corroborated by sensitivity analysis. Conclusions: Our study highlighted the need of public health preventive and educational programs in Italy, a country where the care pathway of lung cancer patients, especially in terms of diagnosis and mortality, appears to be negatively affected by SEP level. [ABSTRACT FROM AUTHOR]

Background: In primarily unresectable liver tumors, ALPPS (Associating Liver Partition and Portal Vein Ligation for Staged hepatectomy) may offer curative two-stage hepatectomy trough a fast and extensive hypertrophy. However, concerns have been raised about the invasiveness of the procedure. Full robotic ALPPS has the potential to reduce the postoperative morbidity trough a less invasive access. The aim of this study was to compare the perioperative outcomes of open and full robotic ALPPS. Methods: The bicentric study included open ALPPS cases from the University Hospital Zurich, Switzerland and robotic ALPPS cases from the University of Modena and Reggio Emilia, Italy from 01/2015 to 07/2022. Main outcomes were intraoperative parameters and overall complications. Results: Open and full robotic ALPPS were performed in 36 and 7 cases. Robotic ALPPS was associated with less blood loss after both stages (418 ± 237 ml vs. 319 ± 197 ml; P = 0.04 and 631 ± 354 ml vs. 258 ± 53 ml; P = 0.01) as well as a higher rate of interstage discharge (86% vs. 37%; P = 0.02). OT was longer with robotic ALPPS after both stages (371 ± 70 min vs. 449 ± 81 min; P = 0.01 and 282 ± 87 min vs. 373 ± 90 min; P = 0.02). After ALPPS stage 2, there was no difference for overall complications (86% vs. 86%; P = 1.00) and major complications (43% vs. 39%; P = 0.86). The total length of hospital stay was similar (23 ± 17 days vs. 26 ± 13; P = 0.56). Conclusion: Robotic ALPPS was safely implemented and showed potential for improved perioperative outcomes compared to open ALPPS in an experienced robotic center. The robotic approach might bring the perioperative risk profile of ALPPS closer to interventional techniques of portal vein embolization/liver venous deprivation. [ABSTRACT FROM AUTHOR]

This paper is divided into two parts: the first presents a summary of the history of macroseismic collection data in Italy, from an initial experience in the mid-19th century, to the beginning of the use of macroseismic postcards and their evolution in the first decades of the 20th century; the second part analyses a number of specific aspects of the content of macroseismic postcards. An example of the reading difficulties that these postcards pose is illustrated together with a brief comparison between the Mercalli and Mercalli-Cancani-Sieberg scales, which serve to interpret macroseismic postcards. Both the historical and analytical parts of the paper, aim to improve the comprehension of the sources and, consequently, the knowledge on Italian seismicity. [ABSTRACT FROM AUTHOR]

The genus Vipera encompasses most species of medically significant venomous snakes of Europe, with Italy harbouring four of them. Envenomation by European vipers can result in severe consequences, but underreporting and the absence of standardised clinical protocols hinder effective snakebite management. This study provides an updated, detailed set of guidelines for the management and treatment of Vipera snakebite tailored for Italian clinicians. It includes taxonomic keys for snake identification, insights into viper venom composition, and recommendations for clinical management. Emphasis is placed on quick and reliable identification of medically relevant snake species, along with appropriate first aid measures. Criteria for antivenom administration are outlined, as well as indications on managing potential side effects. While the protocol is specific to Italy, its methodology can potentially be adapted for other European countries, depending on local resources. The promotion of comprehensive data collection and collaboration among Poison Control Centres is advocated to optimise envenomation management protocols and improve the reporting of epidemiological data concerning snakebite at the country level. [ABSTRACT FROM AUTHOR]

This study investigates parents' perceptions of the impact of cultural diversity on their children and their role in facilitating their children's navigation through diverse cultural landscapes. A questionnaire, part of the Erasmus+ REACT project (the reciprocal maieutic approach), was distributed among 243 parents of secondary school children in Bulgaria, Italy, Greece, and Spain. It aimed to shed light on the effects of cultural diversity on young individuals and the influence of parents in fostering intercultural competences and critical thinking. The findings reveal a strong positive perception among parents regarding cultural diversity, with a significant majority acknowledging its beneficial impact on their children's development. Parents identify themselves as crucial educators and role models, emphasizing the importance of open dialogue, positive exemplification, and the teaching of tolerance and respect. Despite recognizing the general adeptness of their children in interacting with cultural diversity, parents perceive challenges, particularly related to differences in beliefs, religions, and social classes. Parents favor experiential and participatory activities over traditional academic methods for fostering intercultural competence, suggesting a shift toward more inclusive educational practices that involve family and community. This study calls for educational initiatives that promote active participation, connection with the community, critical thinking, and empathy toward cultural differences. [ABSTRACT FROM AUTHOR]

Plutonium zwierleini is a large plutoniumid centipede of great evolutionary interest, occurring with isolated populations along the western Mediterranean area, from Spain to Italy. Due to its rarity and the extreme paucity of available records, P. zwierleini is among the least known Mediterranean chilopods, and scarce information is currently available on its ecology and natural history. Based on an extensive sampling effort carried out in Sicily between 2022 and 2023, we here provide additional occurrence localities for the species across Sicily, and new insights into its ecology. Overall, 29 novel Sicilian records of P. zwierleini, scattered across 21 localities, were collected thus increasing its known Sicilian distribution area by 117%, and the number of localities by 110%. The species was found in a wide range of habitats such as open areas, woods, buildings, and caves, characterizing Plutonium zwierleini as a habitat generalist, whose fine ecological preferenda need to be further explored. Moreover, to explore the diet and behaviour of the species, some specimens were kept in captivity. The captive individuals fed mostly on dead or poorly mobile soft-bodied prey and inert food, without ever displaying predatory behaviour; this suggests that, contrarily to what is currently assumed, P. zwierleini might be a scavenger rather than a predator. The potential distribution of Plutonium zwierleini in Sicily was inferred based on georeferenced occurrence records and climatic variables. The implemented MaxEnt model forecasts the possible occurrence of P. zwierleini on the whole island, with the single exception of its south-easternmost part, possibly due to the local pattern of precipitation seasonality. We hope that the present work might pave the way for further surveys aimed at a better understanding of the ecology of Plutonium zwierleini and the collection of new data in the other regions inhabited by this secretive species. [ABSTRACT FROM AUTHOR]

Background: Music Therapy (MT) is a non-pharmacological, art-based intervention that employs music experiences within a therapeutic alliance to attend to clients' physical, emotional, cognitive, and social requirements. This is the first study aiming at investigating the impact of MT on the psychological facets of children suffering from cancer. Methods: The study, combining the AQR and m-YPAS assessment tools, evaluated behavioral, sound–musical, and interactive parameters in pediatric oncology patients undergoing MT sessions during hospitalization. Fifty patients admitted to the Paediatric Oncology and Haematology Unit at Policlinico S. Orsola Hospital in Bologna, Italy, were enrolled, irrespective of their treatment regimen. Data collection occurred on the first day of the MT session between 3 p.m. and 5 p.m., with observations conducted by independent observers. In addition to traditional statistical analysis, network analysis was used to explore the combined interactions of all parameters, effectively discerning the distinctive roles played by each one during therapy sessions and their influence on all others. Results: Network analysis highlighted distinct patterns of interactions among parameters during the various sessions, emphasizing the role of positive emotions and a calm setting, the child's ability to take the initiative in sessions, their sense of agency, and the parent's role in guiding them. Significant differences were recorded at each time point between all variables considered. Conclusions: The results of this innovative study may pave the way for future multicenter studies aimed at further exploring the role of MT in children undergoing both curative and palliative treatments for cancer. [ABSTRACT FROM AUTHOR]

This paper proposes a new multi-step approach for sensitivity assessment of surface runoff parameters. The procedure has been tested on a peri-urban basin in southern Italy, interested by intense urbanization. The basin has limited data about land characteristics, and nearby precipitation measurements are not available. Accordingly, rainfall events are defined based on depth-duration-frequency curve valid for the area. The main novelties of the work are to provide a general framework for assessing the influence of runoff parameters (i.e. depression storage and surface roughness) for a basin model in SWMM in relation to rain events of various intensity/duration, and to provide a ranking of crucial parameters significantly affecting peak discharge and total volume of the hydrograph, for an ungauged basin, by means the Fourier Amplitude Sensitivity Test (FAST). Results indicate the dependence on rainfall characteristics of the relative importance of the parameters describing the pervious and impervious areas. Notably, the peak discharge of the shortest considered event is influenced only by the two parameters of the impervious area, while the opposite holds for the longest rain event. The total runoff volume is mostly influenced by the depression storage of impervious areas, with the parameters of pervious areas becoming more influential for longer rain events. Results allow a clear interpretation of the modelled physical processes variability within the basin and their relationship with rainfall/areas features, thus providing useful insights for key parameter definition in other contexts and for other models. [ABSTRACT FROM AUTHOR]

Microbial diversity of caves is largely understudied and its possible applications are still unknown. Autochthonous fungi, in particular, may have the potential to biomineralize metals and may be used as promising agents for bioremediation of polluted sites; thus, unearthing the fungal diversity in hypogean ecosystems is nowadays of utmost importance. To start addressing this knowledge gap, the cultivable mycobiota of two neighbouring caves—one natural and one exploited for touristic purposes—were characterised and compared by studying fungi isolated from sediments collected at increasing distances from the entrance. Overall, 250 fungal isolates ascribable to 69 taxa (mainly Ascomycota) were found, a high percentage of which was reported in caves for the first time. The sediments of the touristic cave displayed a richer and more diversified community in comparison with the natural one, possibly due to visitors carrying propagules or organic material. Considering that these environments are still poorly explored, chances to detect new fungal lineages are not negligible. [ABSTRACT FROM AUTHOR]

The cancer hazard associated with lifetime exposure to radiofrequency radiation (RFR) was examined in Sprague Dawley (SD) rats at the Ramazzini Institute (RI), Italy. There were increased incidences of gliomas and cardiac schwannomas. The translational relevance of these rare rat tumors for human disease is poorly understood. We examined the genetic alterations in RFR-derived rat tumors through molecular characterization of important cancer genes relevant for human gliomagenesis. A targeted next-generation sequencing (NGS) panel was designed for rats based on the top 23 orthologous human glioma-related genes. Single-nucleotide variants (SNVs) and small insertion and deletions (indels) were characterized in the rat gliomas and cardiac schwannomas. Translational relevance of these genetic alterations in rat tumors to human disease was determined through comparison with the Catalogue of Somatic Mutations in Cancer (COSMIC) database. These data suggest that rat gliomas resulting from life-time exposure to RFR histologically resemble low grade human gliomas but surprisingly no mutations were detected in rat gliomas that had homology to the human IDH1 p.R132 or IDH2 p.R172 suggesting that rat gliomas are primarily wild-type for IDH hotspot mutations implicated in human gliomas. The rat gliomas appear to share some genetic alterations with IDH1 wildtype human gliomas and rat cardiac schwannomas also harbor mutations in some of the queried cancer genes. These data demonstrate that targeted NGS panels based on tumor specific orthologous human cancer driver genes are an important tool to examine the translational relevance of rodent tumors resulting from chronic/life-time rodent bioassays. [ABSTRACT FROM AUTHOR]

Current approach to identify BRCA 1/2 carriers in the general population is ineffective as most of the carriers remain undiagnosed. Radiomics is an emerging tool for large scale quantitative analysis of features from standard diagnostic imaging and has been applied also to identify gene mutational status. The objective of this study was to evaluate the clinical and economic impact of integrating a radiogenomics model with clinical and family history data in identifying BRCA mutation carriers in the general population. This cost-effective analysis compares three different approaches to women selection for BRCA testing: established clinical criteria/family history (model 1); established clinical criteria/family history and the currently available radiogenomic model (49% sensitivity and 87% specificity) based on ultrasound images (model 2); same approach used in model 2 but simulating an improvement of the performances of the radiogenomic model (80% sensitivity and 95% specificity) (model 3). All models were trained with literature data. Direct costs were calculated according to the rates currently used in Italy. The analysis was performed simulating different scenarios on the generation of 18-year-old girls in Italy (274,000 people). The main outcome was to identify the most effective model comparing the number of years of BRCA-cancer healthy life expectancy (HLYs). An incremental cost-effectiveness ratio (ICER) was also derived to determine the cost in order to increase BRCA carriers-healthy life span by 1 year. Compared to model 1, model 2 increases the detection rate of BRCA carriers by 41.8%, reduces the rate of BRCA-related cancers by 23.7%, generating over a 62-year observation period a cost increase by 2.51 €/Year/Person. Moreover, model 3 further increases BRCA carriers detection (+ 68.3%) and decrease in BRCA-related cancers (− 38.4%) is observed compared to model 1. Model 3 increases costs by 0.7 €/Year/Person. After one generation, the estimated ICER in the general population amounts to about 3800€ and 653€ in model 2 and model 3 respectively. Model 2 has a massive effect after only one generation in detecting carriers in the general population with only a small cost increment. The clinical impact is limited mainly due to the current low acceptance rate of risk-reducing surgeries. Further multicentric studies are required before implementing the integrated clinical-radiogenomic model in clinical practice. [ABSTRACT FROM AUTHOR]

In-line valves are devices typically used for isolation or flow regulation in pipe systems, playing a key role in the operational management of transmission mains (TM). However, there is no fast and expeditious procedure available for checking the efficacy of the sealing mechanism, and its ability to prevent leakage, unwanted flow or partial blockages, which is a crucial action for any maintenance operation. Due to the different values of the conveyed discharge, the diameter changes along the TM at a series junctions which therefore makes diameter changes a very common singularity. This paper has two aims. The first one is to evaluate the feasibility of Inverse Transient Analysis (ITA) for checking the sealing of in-line valves. In particular, the primary objective of the numerical model is to identify the distinctive features of the measured pressure signals that correspond to the status of an in-line valve, discerning whether it is fully sealed or partially closed. The second objective is to use Direct Analysis (DA) of the pressure signals to appropriately capture the transient response of the series junctions. To address these issues, safe transients have been generated in a real TM by means of a Portable Pressure Wave Maker (PPWM) device, refined at the Water Engineering Laboratory (WEL) of the University of Perugia, Italy. The results of the field tests and numerical model point out that the positive pressure wave reflected by the in-line valve is smaller than the one expected if it were perfectly sealed. Moreover, the transient response of the series junction has been properly captured by the DA of the pressure signal. Accordingly, the proposed procedures have been demonstrated to be suitable tools for the management of long transmission pipelines. [ABSTRACT FROM AUTHOR]

Objectives: We explored temporal variations In disease burden of ambient particulate matter 2.5 pm or less in diameter (PM2.5) and ozone in Italy using estimates from the Global Burden of Disease Study 2019. Methods: We compared temporal changes and percent variations (95% Uncertainty Intervals [95% UI]) in rates of disability adjusted life years (DALYs), years of life lost, years lived with disability and mortality from 1990 to 2019, and variations in pollutant-attributable burden with those in the overall burden of each PM2.5- and ozone-related disease. Results: In 2019, 467,000 DALYs (95% UI: 371,000, 570,000) were attributable to PM2.5 and 39,600 (95% UI: 18,300, 61,500) to ozone. The crude DALY rate attributable to PM2.5 decreased by 47.9% (95% UI: 10.3, 65.4) from 1990 to 2019. For ozone, it declined by 37.0% (95% UI: 28.9, 44.5) during 1990-2010, but it increased by 44.8% (95% UI: 35.5, 56.3) during 2010-2019. Age-standardized rates declined more than crude ones. Conclusion: In Italy, the burden of ambient PM2.5 (but not of ozone) significantly decreased, even in concurrence with population ageing. Results suggest a positive impact of air quality regulations, fostering further regulatory efforts. [ABSTRACT FROM AUTHOR]

To develop and validate a 3D simulation model to calculate laser ablation (LA) zone size and estimate the volume of treated tissue for thyroid applications, a model was developed, taking into account dynamic optical and thermal properties of tissue change. For validation, ten Yorkshire swines were equally divided into two cohorts and underwent thyroid LA at 3 W/1,400 J and 3 W/1,800 J respectively with a 1064-nm multi-source laser (Echolaser X4 with Orblaze™ technology; ElEn SpA, Calenzano, Italy). The dataset was analyzed employing key statistical measures such as mean and standard deviation (SD). Model simulation data were compared with animal gross histology. Experimental data for longitudinal length, width (transverse length), ablation volume and sphericity were 11.0 mm, 10.0 mm, 0.6 mL and 0.91, respectively at 1,400 J and 14.6 mm, 12.4 mm, 1.12 mL and 0.83, respectively at 1,800 J. Gross histology data showed excellent reproducibility of the ablation zone among same laser settings; for both 1,400 J and 1,800 J, the SD of the in vivo parameters was ≤ 0.7 mm, except for width at 1,800 J, for which the SD was 1.1 mm. Simulated data for longitudinal length, width, ablation volume and sphericity were 11.6 mm, 10.0 mm, 0.62 mL and 0.88, respectively at 1,400 J and 14.2 mm, 12.0 mm, 1.06 mL and 0.84, respectively at 1,800 J. Experimental data for ablation volume, sphericity coefficient, and longitudinal and transverse lengths of thermal damaged area showed good agreement with the simulation data. Simulation datasets were successfully incorporated into proprietary planning software (Echolaser Smart Interface, Elesta SpA, Calenzano, Italy) to provide guidance for LA of papillary thyroid microcarcinomas. Our mathematical model showed good predictability of coagulative necrosis when compared with data from in vivo animal experiments. [ABSTRACT FROM AUTHOR]

The occurrence of multiple precipitation events not‐independent in time, that is, a temporal clustering, is an example of a temporal compounding event. This type of forcing is of great relevance for the occurrence of different natural hazards, like floods and deep‐seated landslides, for which previous soil saturation plays an important role in shaping the associated hazard. Using ERA5‐Land data set and E‐OBS, we firstly investigate the spatial and temporal characteristics of temporal clustering of precipitation over the Italian territory, and we relate it with two oscillation patterns, namely North Atlantic Oscillation (NAO) and Mediterranean Oscillation Index (MOI), and with common synoptic conditions. Then, we explore the role of temporal compounding of precipitation in the generation of different movement types (complex, debris flow, fall, flow, and sliding) using the database of landslides from the Aree Vulnerate Italiane project (in Italian AVI, meaning Areas Affected by Landslides or Floods). From this study it emerges that below average values of NAO and MOI increase the probability of having clustered precipitation events. For all types of landslides, except rock falls, we observed that the majority of the events are preceded by a temporal clustering of precipitation, over longer time windows for complex events, shorter for debris flows. For rock falls, we found also a link with low minimum temperature and freeze‐thaw cycles for winter events and high maximum temperature for summer events. This work contributes to the investigation of temporal clustering of precipitation in connection with natural hazards characterized by a mechanism of saturation. Plain Language Summary: Most natural catastrophic events are caused by a sequence in time of multiple not‐independent precipitation events, also called temporal clustering of precipitation. This is related to the process of saturation of the soil that in most cases is not saturated by a single precipitation event. For example, soil moisture is important in the occurrence of landslides, since it causes instability of the slope, or in floods, since it prevents water from infiltrating. When an extreme event is caused or amplified by the occurrence of multiple meteorological events in time or space we talk about climate‐related compound events. In this work we look at the characteristics of temporal clustering of precipitation in Italy, where and when it occurs and its relation with large scale circulations. Then, we investigate its role, together with the role of single intense precipitation events and temperature, as a trigger of different landslide types (complex, debris flow, fall, flow, and sliding). In this work we bring a clearer understanding of the trigger of landslides in Italy, and we highlight the role of temporal clustering of precipitation for hazards related with a saturation process. Key Points: We introduced a statistical method to detect temporal clustering of events, for example, precipitationNegative dependence between some teleconnection indices and temporal clustering of precipitation in winter in ItalyTemporal clustering of precipitation is a significant trigger of landslides in Italy. Temperature is also relevant for rock falls [ABSTRACT FROM AUTHOR]

Aluto volcano (Central Ethiopia) displays a complex, hybrid topography, combining elements typical of caldera systems (e.g., a central, flat caldera floor) and stratovolcanoes (e.g., relatively high and steep, radial flanks, related to eruptions occurring clustered in space). The most recent known eruptions at Aluto have commonly generated column‐collapse pyroclastic density currents (PDCs), a hazardous phenomenon that can pose a significant risk to inhabited areas on and around the volcano. In order to analyze and quantify the role that Aluto's complex topography has on PDC hazard, we apply a versatile probabilistic strategy, which merges the TITAN2D model for PDCs with a novel zero‐censored Gaussian Process (zGP) emulator, enabling robust uncertainty quantification at tractable computational costs. Results from our analyses indicate a critical role of the eruptive vent location, but also highlight a complex interplay between the topography and PDC volume and mobility. The relative importance of each factor reciprocally depends on the other factors. Thus, large PDCs (≥0.1–0.5 km3) can diminish the influence of topography over proximal regions of flow propagation, but PDCs respond to large‐ and small‐scale topographic features over medial to distal areas, and the zGP captures processes like PDC channelization and overbanking. The novel zGP can be applied to other PDC models and can enable specific investigations of PDC dynamics, topographic interactions, and PDC hazard at many volcanic systems worldwide. Potentially, it could also be used during volcanic crises, when time constraints usually only permit computation of scenario‐based hazard assessments. Plain Language Summary: Aluto (Central Ethiopia) is a volcano whose morphology combines features of volcanic calderas (e.g., Campi Flegrei, Italy): flat, sunken areas in the center of the volcano; and stratovolcanoes (e.g., Pinatubo, Philippines): radial slopes, relatively long and steep, reminding of a cone shape. Topography crucially controls the propagation of complex and very dangerous flows, composed of volcanic gas and particles, known as pyroclastic density currents (PDCs). We apply a novel approach to quantify the role of topography on conditioning which areas might be impacted by PDCs during a given eruption. We use two models for this purpose: a physics‐based computational model that simulates PDC propagation over the Earth's surface, and a statistical model whose goal is to "emulate" the former to save computation time. Using the emulator as a substitute simulator enables exploration of a vast number of eruptive scenarios, something unfeasible using the simulator alone. Our results highlight that the starting location of the flows is critical, while other flow characteristics (e.g., volume) have complex interactions with topography at different distances from the starting location. Our approach has great potential as it can fit different purposes (e.g., hazard assessment) and can be applied to many other volcanoes and/or computer models. Key Points: A novel zero‐censored Gaussian Process emulator is systematically applied to explore pyroclastic density current hazard at Aluto (Ethiopia)A complex, multi‐scale interplay between flow volume, flow mobility and Aluto's varied topography arises from our quantitative analysesVent location is the primary control on hazard but flow‐source forcing and flow mobility can also outweigh the other controlling factors [ABSTRACT FROM AUTHOR]

Prolonged media exposure after collective crises is widely shown to have adverse effects on people's mental health. Do these effects show variation across different countries? In the present study, we compared the link between media exposure related to COVID-19 and mental health-related outcomes in the United States and Italy, two countries with high levels of early COVID-19 prevalence. Participants matched on age and gender in the United States (n = 415) and Italy (n = 442) completed assessments of media exposure, stress, anxiety, COVID-19 worry, and other variables shortly after the first wave of infections in 2020. COVID-19 related media exposure predicted higher levels of stress, anxiety, and COVID-19 worry, net of the effects of neuroticism, political identification, and demographics. Moreover, COVID-19 related media exposure interacted with country to predict more stress and COVID-19 worry in the United States than in Italy. Findings are among the first to document cross-national differences in the association of media exposure with mental health outcomes. [ABSTRACT FROM AUTHOR]

Aims of the present study were to prospectively assess psychosocial functioning trajectories during the COVID pandemic and the possible impact of sociodemographic variables, as well as of COVID-19 pandemic-related factors, on these trajectories, in a sample of patients with pre-existing severe mental disorders. Moreover, we aimed at identifying predictors of impairment in psychosocial functioning over a period of 9 months of COVID-19 pandemic. Patients were recruited during the 3rd wave of the COVID-19 pandemic (T0, March–April 2021) while strict containment measures were applied in Italy, and reassessed after 3 months (T1, June–July 2021), and after 6 months from T1 (T2- November–December 2021), during the 4th wave of COVID pandemic. A sample of 300 subject (out of the 527 subjects recruited at baseline) completed the T2 evaluation. Patients were assessed by: Work and Social Adjustment Scale (WSAS) for psychosocial functioning, Generalized Anxiety Disorder 7-Item (GAD-7) for anxiety symptoms, Patient Health Questionnaire-9 (PHQ-9) for depressive symptoms and the Impact of Events Scale-Revised, for post-traumatic symptoms. Cluster analyses identified 4 trajectories of functioning: the High, Stable Functioning group (N = 77), the Improvement Functioning group (N = 62), the Progressive Impairment group (N = 83) and the Persistent Severe Impairment group (N = 78) respectively. We found that predictors of higher WSAS score at T2 were higher WSAS score at T0 (B = 0.43, p <.001), PHQ scores at baseline >10 (B = 2.89, p <.05), while not living alone was found to be a protective factor (B = −2.5, p <.05). Results of the present study provides insights into the vulnerability of individuals with psychiatric disorders during times of crisis. Study findings can contribute to a better understanding of the specific needs of this population and inform interventions and support strategies. [ABSTRACT FROM AUTHOR]

The increasing drug resistance of Acinetobacter (A.) baumannii is a growing concern globally. This bacterium, prevalent in hospitals, is responsible for multi-resistant infections and has been identified by the WHO as a priority pathogen for new antibiotic development. While there is extensive information on human isolates, data on animal isolates are scarce and fragmented based on limited clinical cases and genomic analyses. The impact of resistant strains on public and veterinary health is challenging to assess due to a lack of data. However, the potential impact on public health cannot be underestimated. Therefore, it is imperative to strengthen surveillance of A. baumannii in domestic animals, livestock, and wildlife. The growing presence of this pathogen in veterinary clinical samples is alarming, especially given the increasing interaction between animals and humans. Recognizing animals as potential reservoirs is crucial for understanding pathogen transmission dynamics, given their capacity for zoonotic transmission. With the rise in the number of animals testing positive for multi-resistant bacteria, monitoring A. baumannii in the animal population is vital to prevent the pathogen's spread and protect public health. A review of studies conducted in Italy on the topic underscores the role of pets, livestock, and foods of animal origin in the transmission of A. baumannii and Acinetobacter spp. Further animal research is urgently needed to gain a better understanding of the mechanisms of spread and resistance. This review underscores the need to explore this area, providing crucial insights for public health and infectious disease management within a One Health context. [ABSTRACT FROM AUTHOR]

According to the Sonotope Hypothesis, the heterogenous nature of the acoustically sensed, but not yet interpreted, environmental sounds (i.e., sonoscape) is created by the spatial and temporal conformation of sonic patches (sonotopes) as recently been described in a Mediterranean rural landscape. We investigated the Sonotope Hypothesis in a mountain beech forest of the Northern Apennines, Italy that is notoriously poor in soniferous species. Our aim was to test whether sonotopes were temporally distinct over seasonal and astronomical timeframes and spatially configured in relation to vegetation variables. We used the Acoustic Complexity Index (ACItf) to analyze the heterogeneity of sonic information gathered from an array of 11 sound recorders deployed within a lattice of eleven 4-ha hexagonal sample sites distributed throughout a 48-ha managed beech forest. We visualized and described the temporal patterns of ACItf between seasons (May-June and July-August 2021), across six astronomical periods (Night I, Morning Twilight, Morning, Afternoon, Evening Twilight, and Night II), and according to two aggregated frequency classes (<2000 and >2000 Hz). We introduced Spectral Sonic Signature (SSS) calculated from the sequence of ACItf values along frequency bins as a descriptor of the dynamic production of sounds across spatial and temporal scales. We calculated Mean Spectral Dissimilarity to compare SSS values across temporal periods and between sample sites. We identified sonotopes by grouping similar SSS for each sample site generated from cluster analyses and visualized their spatial arrangements. Frequencies <2000 Hz (mainly geophonies from wind and rain) were more prevalent than frequencies >2000 Hz (mainly biophonies from songbirds). Despite there being no strong relationship to vegetation variables and minimal biophony and anthropophony, distinct sonotopes still emerged for every astronomical and seasonal period. This suggests that the sonoscape expresses distinct spatial and temporal sonotope configurations associated with the temporal and spatial patterns of geophysical events that generate geophonies with minimal animal or anthropogenic occurrences. A new strategy based on the reintroduction of indigenous trees and shrubs in managed clearings should be considered for enhancing local biodiversity conservation along with ecoacoustic monitoring based on the Sonotope Hypothesis. [ABSTRACT FROM AUTHOR]

Summary: Acute chest syndrome (ACS) is a frequent cause of hospitalization in sickle cell disease (SCD). Despite advances in acute care, many settings still lack knowledge about ACS best practices. After the AIEOP Guidelines were published in 2012, suggesting standardized management in Italy, a retrospective study was performed to assess the diagnostic and therapeutic pathways of ACS in children. From 2013 to 2018, 208 ACS episodes were presented by 122/583 kids in 11 centres. 73 were male, mean age 10.9 years, 85% African, 92% HbSS or Sβ°. In our hub‐and‐spoke system, a good adherence to Guidelines was documented, but discrepancies between reference centres and general hospitals were noted. Improvement is needed for timely transfer to reference centres, use of incentive spirometry, oxygen therapy and pain management. [ABSTRACT FROM AUTHOR]

Background Hydrogen cyanamide is a plant growth regulator introduced in Italy as Dormex in 2000, but recalled from the market in 2008. It's currently not authorized in Europe. Inhalation/dermal contact may cause irritation/caustic burns, ingestion of severe organ damage and concomitant alcohol consumption disulfiram-like reaction due to aldehyde-dehydrogenase inhibition by hydrogen cyanamide. Aims To study all exposure cases referred to our centre, evaluating temporal and geographic distribution and analysing clinical manifestations, including the ones after alcohol consumption. Methods We retrospectively evaluated all hydrogen cyanamide exposures referred to our Poison Control Centre (January 2007–December 2021). For each case, age, sex, exposure route/year, geographical location, intent of exposure, alcohol co-ingestion, emergency department-admission Poison Severity Score, signs/symptoms and treatment were analysed. Results Thirty subjects were included. Median case/year was 1 [1; 2]: 79% occurred after market withdrawal, 92% in Sicily. All exposures were unintentional and work related; 41% of patients also co-ingested alcohol. Mean poison severity score at emergency department admission was 1.54, more severe when ingestion occurred. The most common signs/symptoms were flushing, secondary to peripheral vasodilation (41%), hyperaemia/erythema (29%), dyspnoea (25%), nausea (20%), vomiting (12%), oedema (12%), II–III degrees burns (12%) and pharyngodynia (12%). All patients were treated symptomatically and fully recovered. Conclusions Hydrogen cyanamide exposure can lead to severe clinical manifestations. Despite its withdrawal from the Italian market, hydrogen cyanamide is still used: through PCC's crucial role in monitoring exposure to agricultural products efforts should be made to contrast illegal trade and increase awareness of its potential toxicity in those countries in which it's still legal. [ABSTRACT FROM AUTHOR]

Background and Aims: Whether the HCV test‐and‐treat strategy impacted on the rate of new HCV infections among PLWH in Italy is unknown. Methods: Prospective study of PLWH in the ICONA network. At baseline, PLWH were tested for HCV‐Ab; HCV‐RNA (if HCV‐Ab positive) and, if positive, treated with DAA. SVR12 indicated eradication. Seroconversions and re‐infections were evaluated yearly in HCV‐Ab neg and HCV‐RNA neg at first screening. We estimated the following: HCV seroconversions, incidence of HCV reinfections, and access to DAA and SVR12 rates tighter with factors associated with each outcome. Data were analysed by Cox regression, Poisson regression and logistic regression models. Results: Sixteen thousand seven hundred and forty‐three PLWH were included; 27.3% HCV‐Ab positive; of these, 39.3% HCV‐RNA positive. HCV seroconversion incidence:.48/100 PYFU (95% CI:.36–.65); re‐infections incidence: 1.40/100 PYFU (95% CI:.91–2.04). The risk factor for HCV re‐infection was young age: aIRR 1.85, 95% CI: 1.17–2.95) per 10 years younger. 86.4% of HCV viremic in follow‐up started DAA. PWID vs. heterosexuals (aHR.75, 95% CI.62–.90), HIV‐RNA >50 copies/mL (aHR.70, 95% CI.56–.87), HCV genotype other than G1, G2, G3, G4 or with multiple/missing HCV genotype and post‐COVID‐19 calendar periods were associated with lower DAA access. 922/965 (95.5%) PLWH achieved SVR12. We estimated 72% reduction of chance to achieve SVR12 in PLWH with a CD4 count <200/mm3 (vs. CD4 ≥200/mm3 aOR.18, 95% CI:.07–.46). 95.5% of DAA‐treated individuals eradicated HCV, but they represent only 53.2% of HCV viremic PLWH and 66.4% of those in follow‐up. HCV‐RNA positivity by year decreased from 41.7% in 2017 to 11.7% in 2022. Conclusions: The screening‐and‐treat campaign implemented in Italy, even if only partially effective, resulted in a dramatic drop in HCV circulation in our cohort. [ABSTRACT FROM AUTHOR]

Soil water content (SWC) is a fundamental variable involved in several hydrological processes governing catchment functioning. Comparative analysis of hydrological processes in different catchments based on SWC data is therefore beneficial to infer driving factors of catchment response. Here, we explored the use of high‐temporal resolution SWC data in three forested catchments (2.4–60 ha) in different European climates to characterize hydrological responses during wet and dry conditions. The investigated systems include Ressi, Italy, with a humid temperate climate, Weierbach, Luxembourg, with a semi‐oceanic climate, and Can Vila, Spain, with a Mediterranean climate. We introduced a new SWC metric defined as the difference between seasonal mean SWC at a relatively shallow and a deep soil layer. The difference is classified in three distinct states: similar SWC between the two layers, higher SWC in the deeper layer, and higher SWC in the shallow layer. In the most humid site, Ressi, we frequently found similar SWC at the two soil depths which was associated with high runoff ratios. Despite similar precipitation amounts in Can Vila and Weierbach, SWC patterns were very different in both catchments. In Weierbach, SWC was similar across the entire soil profile during wet conditions, whereas evaporation of shallow water resulted in higher SWC in the deep soil layer during dry conditions. This led to high runoff ratios during wet conditions and low runoff ratios during dry conditions. In Can Vila, SWC was consistently higher in the deeper layer compared to the shallow layer, irrespective of the season, suggesting an important role of hydraulic redistribution and vertical water movement in this site. Our approach provides an easy and useful method to assess differences in hydrological behaviour solely based on SWC data. As similar datasets are increasingly collected and available, this opens the possibility for further analyses and comparisons in sites around the globe with contrasted physiographic and climate characteristics. [ABSTRACT FROM AUTHOR]

HBV/HCV co-infection is common in HIV-1-infected prisoners. To investigate the characteristics of HIV co-infections, and to evaluate the molecular heterogeneity of HIV, HBV and HCV in prisoners, we carried-out a multicenter cross-sectional study, including 65 HIV-1-infected inmates enrolled in 5 Italian detention centers during the period 2017–2019. HIV-1 subtyping showed that 77.1% of inmates were infected with B subtype and 22.9% with non-B subtypes. Italian nationals were all infected with subtype B (93.1%), except two individuals, one infected with the recombinant form CRF72_BF1, and the other with the HIV-1 sub-subtype A6, both previously not identified in inmates of Italian nationality. Non-Italian nationals were infected with subtype B (52.6%), CRFs (36.8%) and sub-subtypes A1 and A3 (5.2%). HIV variants carrying resistance mutations to NRTI, NNRTI, PI and InSTI were found in 7 inmates, 4 of which were never exposed to the relevant classes of drugs associated with these mutations. HBV and/or HCV co-infections markers were found in 49/65 (75.4%) inmates, while 27/65 (41.5%) showed markers of both HBV and HCV coinfection. Further, Italian nationals showed a significant higher presence of HCV markers as compared to non-Italian nationals (p = 0.0001). Finally, HCV phylogenetic analysis performed in 18 inmates revealed the presence of HCV subtypes 1a, 3a, 4d (66.6%, 16.7% and 16.7%, respectively). Our data suggest the need to monitor HIV, HBV and HCV infections in prisons in order to prevent spreading of these viruses both in jails and in the general population, and to implement effective public health programs that limit the circulation of different genetic forms as well as of viral variants with mutations conferring resistance to treatment. [ABSTRACT FROM AUTHOR]

Geochemical fingerprints of grape samples have been defined for 10 cultivars grown in two sampling areas characterized by homogeneous pedological and climate systems in the province of Treviso (northeast Italy). The choice of lithologies was based on the fact that vineyards in Italy frequently grow in both sedimentary soils with various terrigenous carbonate contents and basic volcanic soils. The latter may have high concentrations of heavy metals that are essential for a balanced human diet but can be toxic or harmful if assimilated in excess. To identify possible geochemical tracers within the soil that can be passed to the grapes and possible bioaccumulation of soil-derived elements within the grapes, major and trace elements of the soils, sampled at depths of greater root development, were determined by X-ray fluorescence, and metal concentrations in grape juice were determined by inductively coupled plasma-mass spectrometry. All samples were compared with samples collected at two other sites located in the Euganean Hills, in the southern part of the Veneto region, considering that the wines produced in these areas are exported all over the world. [ABSTRACT FROM AUTHOR]

This study sought to analyze the relationship between regional body composition, swimming performance, and aerobic and force profile determined through tethered swimming in well-trained swimmers. Eleven male and five female swimmers were involved in the study and underwent the following evaluations: (1) body composition, assessed by the dual-energy X-ray absorptiometry method (DXA); (2) swimming performance, determined for 200, 400, 800, and 1.500 m front-crawl swimming; (3) a tethered swimming force test to determine maximum and mean force (Fmax and Fmean); and (4) an incremental tethered swimming test for the aerobic profile determination of the swimmers. Oxygen uptake (VO2) was directly measured by an automatic and portable system (K4b2 Cosmed, Italy). The fat-free mass (lean mass + bone mineral content, LM+BMC) in lower and upper limbs (UL_LM+BMC: 6.74 ± 1.57 kg and LL_LM+BMC: 20.15 ± 3.84 kg) positively correlated with all indexes of aerobic conditioning level, showing higher coefficients to the indexes representing the ability to perform at high aerobic intensities (VO2max: 49.2 ± 5.9 mL·kg−1·min−1 and respiratory compensation point (RCP): 43.8 ± 6.0 mL·kg−1·min−1), which attained 0.82 and 0.81 (with VO2max), 0.81 and 0.80 (with RCP). The S200 (1.48 ± 0.13 m·s−1) was significantly correlated to Trunk_LM+BMC (r = 0.74), UL_LM+BMC (r = 0.72), Total_LM+BMC (r = 0.71), and LL_LM+BMC (r = 0.64). This study highlights that regional body composition plays an important role in swimming, and body segment analysis should be considered instead of the total body. Tethered swimming may represent a useful method for force and aerobic assessment, aiming at training control and performance enhancement. [ABSTRACT FROM AUTHOR]

Personal ornaments are widely viewed as indicators of social identity and personhood. Ornaments are ubiquitous from the Late Pleistocene to the Holocene, but they are most often found as isolated objects within archaeological assemblages without direct evidence on how they were displayed. This article presents a detailed record of the ornaments found in direct association with an Early Mesolithic buried female infant discovered in 2017 at the site of Arma Veirana (Liguria, Italy). It uses microscopic, 3D, and positional analyses of the ornaments as well as a preliminary perforation experiment to document how they were perforated, used, and what led to their deposit as part of the infant's grave goods. This study provides important information on the use of beads in the Early Mesolithic, in general, as well as the relationship between beads and young subadults, in particular. The results of the study suggest that the beads were worn by members of the infant's community for a considerable period before they were sewn onto a sling, possibly used to keep the infant close to the parents while allowing their mobility, as seen in some modern forager groups. The baby was then likely buried in this sling to avoid reusing the beads that had failed to protect her or simply to create a lasting connection between the deceased infant and her community. [ABSTRACT FROM AUTHOR]

The aim of this study was to elucidate the taxonomy of the common but overlooked epiphytic coralline algae species from shallow reefs and seagrass meadows of the Abrolhos Archipelago, Brazil. Two thin (two vegetative cells thick) epiphytic coralline species were recorded: Lithophyllum epiphyticum sp. nov. and Hydrolithon farinosum. Molecular analysis from psbA genetic marker confirmed the position of L. epiphyticum into Lithophylloideae and revealed a phylogenetic relationship with an undescribed Lithophyllum from Italy. Thin thallus (2–3 cells thick) and cells lining the pore of tetrasporangial conceptacles protruding laterally occluding the canal, either partially or totally, are its main diagnostic characteristics. Hydrolithon farinosum is herein described in detail for Brazil, and its worldwide distribution is then discussed. [ABSTRACT FROM AUTHOR]

Background: The most common intestinal operation in Crohn's disease (CD) is an ileocolic resection. Despite optimal surgical and medical management, recurrent disease after surgery is common. Different types of anastomoses with respect to configuration and construction can be made after resection for example, handsewn (end-to-end and Kono-S) and stapled (side-to-side). The various types of anastomoses might affect endoscopic recurrence and its assessment, the functional outcome, and costs. The objective of the present study is to compare the three types of anastomoses with respect to endoscopic recurrence at 6 months, gastrointestinal function, and health care consumption. Methods: This is a randomized controlled multicentre superiority trial, allocating patients either to side-to-side stapled anastomosis as advised in current guidelines or a handsewn anastomoses (an end-to-end or Kono-S). It is hypothesized that handsewn anastomoses do better than stapled, and end-to-end perform better than the saccular Kono-S. Two international studies with a similar setup will be conducted mainly in the Netherlands (End2End) and Italy (HAND2END). Patients diagnosed with CD, aged over 16 years in the Netherlands and 18 years in Italy requiring (re)resection of the (neo)terminal ileum are eligible. The first part of the study compares the two handsewn anastomoses with the stapled anastomosis. To detect a clinically relevant difference of 25% in endoscopic recurrence, a total of 165 patients will be needed in the Netherlands and 189 patients in Italy. Primary outcome is postoperative endoscopic recurrence (defined as Rutgeerts score ≥ i2b) at 6 months. Secondary outcomes are postoperative morbidity, gastrointestinal function, quality of life (QoL) and costs. Discussion: The research question addresses a knowledge gap within the general practice elucidating which type of anastomosis is superior in terms of endoscopic and clinical recurrence, functionality, QoL and health care consumption. The results of the proposed study might change current practice in contrast to what is advised by the guidelines. Trial registration: NCT05246917 for HAND2END and NCT05578235 for End2End (http://www.clinicaltrials.gov/). [ABSTRACT FROM AUTHOR]