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The Bagno dell'Acqua lake is characterized by CO2 emissions, alkaline waters (pH = 9) and Eh values which indicate strongly oxidizing conditions. A typical feature of the lake is the presence of actively growing microbialites rich in calcium carbonates and silica precipitates. Mineralogy, petrography and morphology analyses of the microbialites were coupled with the analysis of the microbial community, combining molecular and cultivation approaches. The DNA sequencing revealed distinct patterns of microbial diversity, showing pronounced differences between emerged and submerged microbialite, with the upper layer of emerged samples exhibiting the most distinctive composition, both in terms of prokaryotes and eukaryotes. In particular, the most representative phyla in the microbial community were Proteobacteria, Actinobacteriota, and Bacteroidota, while Cyanobacteria were present only with an average of 5%, with the highest concentration in the submerged intermediate layer (12%). The role of microorganisms in carbonate mineral formation was clearly demonstrated as most of the isolates were able to precipitate calcium carbonate and five of them were characterized at molecular level. Interestingly, when microbial isolates were cultivated only in filtered water, the precipitation of hazenite was observed (up to 85%), opening new prospective in P (phosphate) recovery from P depleted environments. [ABSTRACT FROM AUTHOR]

In generalized linear models (GLMs), measures of lack of fit are typically defined as the deviance between two nested models, and a deviance-based R2 is commonly used to evaluate the fit. In this paper, we extend deviance measures to mixtures of GLMs, whose parameters are estimated by maximum likelihood (ML) via the EM algorithm. Such measures are defined both locally, i.e., at cluster-level, and globally, i.e., with reference to the whole sample. At the cluster-level, we propose a normalized two-term decomposition of the local deviance into explained, and unexplained local deviances. At the sample-level, we introduce an additive normalized decomposition of the total deviance into three terms, where each evaluates a different aspect of the fitted model: (1) the cluster separation on the dependent variable, (2) the proportion of the total deviance explained by the fitted model, and (3) the proportion of the total deviance which remains unexplained. We use both local and global decompositions to define, respectively, local and overall deviance R2 measures for mixtures of GLMs, which we illustrate—for Gaussian, Poisson and binomial responses—by means of a simulation study. The proposed fit measures are then used to assess, and interpret clusters of COVID-19 spread in Italy in two time points. [ABSTRACT FROM AUTHOR]

Evidence suggests that adolescents respond positively to simple, early interventions, including psychosocial support and educational interventions, even when offered in non-clinical settings. Cinematherapy can help manage life challenges, develop new skills, increase awareness, and offer new ways of thinking about specific problems. This pilot trial was conducted in Italy, aiming to investigate the effects of a six-week filmmaking course on the psychological well-being of adolescents (N = 52) with emotional/behavioural problems and neurodevelopmental disorders. At the end of the project, most participants showed improvements mostly in social skills, such as social cognition (p = 0.049), communication (p = 0.009), and motivation (p = 0.03), detected using the SRS Social Responsiveness Scale. In addition, social awareness (p = 0.001) increased in all patients. Statistically significant differences resulted in four sub-scales of Youth Self-Report Scale: withdrawn/depressed (p = 0.007), social problems (p = 0.003), thought problems (p < 0.001), and rule-breaking behaviour (p = 0.03); these results showed a decrease in emotional and behavioural problems. This study is an innovative therapeutic and educational approach based on the filmmaking art. This research can offer an empirical basis for the effectiveness of alternative therapeutic tools in child and adolescent psychiatric disorders. At the same time, it can be replicated in broader contexts (e.g., school and communities) to promote children's psychological well-being. [ABSTRACT FROM AUTHOR]

Warm mix asphalt (WMA) technologies allow the production, lay-down and compaction of asphalt mixtures at reduced temperatures and the use of higher amounts of reclaimed asphalt pavement (RAP) with respect to conventional hot mix asphalt (HMA), leading to significant environmental benefits and energy savings. However, limited data is available on the long-term performance of such pavements. The objective of this study was to predict the long-term performance of an existing warm recycled motorway pavement (made with WMA mixtures containing RAP) constructed in 2016 in central Italy, along with the corresponding hot recycled pavement (made with HMA mixtures containing RAP). For this purpose, cores were taken from the pavements in 2022 to investigate the binder and base courses through dynamic modulus and cyclic fatigue tests, according to the simplified viscoelastic continuum damage (S-VECD) testing approach. The results of the tests were used to predict the service life of the pavements using two pieces of software, KENPAVE and FlexPAVE, based respectively on the elastic design method and the viscoelastic design method in the presence of damage. The FlexPAVE results indicated that the expected service life of the WMA pavement is much longer than that of the HMA pavement, mainly because the WMA mixtures have better damage properties than the HMA mixtures. Conversely, the KENPAVE simulations predicted a similar service life for the two pavements, highlighting the impossibility of the elastic method to catch the actual contribution of high-performance non-standard materials. The promising outcomes of the FlexPAVE simulations further encourage the application of warm recycled pavements. [ABSTRACT FROM AUTHOR]

We present a very high-resolution bathy-morphological map of the offshore sector around the Scoglio d’Affrica islet (northern Tyrrhenian Sea, Italy). The study area covers a sector of 45 km2, between 3 and 85 m depth. Its central part, i.e. the apex of the Ridge, is characterised by a flat or gently sloping seafloor, where three mud volcanoes, and 250 pockmarks are recognised. Differently, the western and eastern Ridge flanks are steeper and characterised by 60 quasi-rectilinear escarpments and small ridges, more than 20 morphological highs, and elongated channels occasionally floored by bedforms. The seafloor shallower than 40 m is covered by Posidonia oceanica, forming compact and continuous or fragmented meadows intermingled with sandy patches. The main map represents the bathy-morphological setting of the area, which is largely affected by fluid seepage, providing insights for habitat mapping and preliminary marine geohazard assessment due to the violent gas outburst from mud volcanoes. [ABSTRACT FROM AUTHOR]

In other words, the COVID-19 pandemic has highlighted the need for a medicine based on proximity (i.e. a closer relationship between the patient and the GP in their common space) and proactivity (i.e. the GP's self-initiated behavior that aims at facing a clinical issue earlier, or even before it has occurred). Keywords: artificial intelligence; chronic disease; digital healthcare; OPeNet platform EN artificial intelligence chronic disease digital healthcare OPeNet platform 511 514 4 11/15/22 20221101 NES 221101 To the Editor, In October 2020, we reported in this journal the description of the Embrace project as an enabler to help General Practitioners (GPs) in their virtuous path of co-management of the chronic patient in the context of the Italian National Healthcare Service (NHS) [[1]]. [Extracted from the article]

The choice of influencer marketing as an endorser for promoting products and services is becoming a more and more effective communication strategy of open innovation. Their use of social media platforms, such as Instagram, allows them to be reached by millions of followers all over the world. As a response to the economic crisis that affected Italy after the first wave of the COVID-19 pandemic, Chiara Ferragni, one of the most endorsed influencers worldwide, started a communication campaign with the aim to promote Italian food and tourist destinations (cities of art, seaside, ski and countryside locations, thermal baths, museums, galleries, hotels, etc.). This study analyses Chiara Ferragni's activity and the dynamic of communication she used via her Instagram (IG) profile to enhance Italian tourist destinations and "local food & wine". Specifically, it measured the contribution of local food used as an evocative factor in the appreciation of a tourist destination and its power in different contexts. Hundreds of posts on the influencer's IG profile were observed using the netnographic analysis. Subsequently, the AGIL model (Adaption, Goal Attainment, Integration, and Latent pattern maintenance) was applied to measure the main dimensions of this communication campaign and its effectiveness to relaunch touristic catering sectors. The study offers a new model of open innovation for advertising and promoting food and catering businesses. [ABSTRACT FROM AUTHOR]

Background: Physician professionalism, including anaesthesiologists and intensive care doctors, should be continuously assessed during training and subsequent clinical practice. Multi-source feedback (MSF) is an assessment system in which healthcare professionals are assessed on several constructs (e.g., communication, professionalism, etc.) by multiple people (medical colleagues, coworkers, patients, self) in their sphere of influence. MSF has gained widespread acceptance for both formative and summative assessment of professionalism for reflecting on how to improve clinical practice. Methods: Instrument development and psychometric analysis (feasibility, reliability, construct validity via exploratory factor analysis) for MSF questionnaires in a postgraduate specialty training in Anaesthesiology and intensive care in Italy. Sixty-four residents at the Università del Piemonte Orientale (Italy) Anesthesiology Residency Program. Main outcomes assessed were: development and psychometric testing of 4 questionnaires: self, medical colleague, coworker and patient assessment. Results: Overall 605 medical colleague questionnaires (mean of 9.3 ±1.9) and 543 coworker surveys (mean 8.4 ±1.4) were collected providing high mean ratings for all items (> 4.0 /5.0). The self-assessment item mean score ranged from 3.1 to 4.3. Patient questionnaires (n = 308) were returned from 31 residents (40%; mean 9.9 ± 6.2). Three items had high percentages of "unable to assess" (> 15%) in coworker questionnaires. Factor analyses resulted in a two-factor solution: clinical management with leadership and accountability accounting for at least 75% of the total variance for the medical colleague and coworker's survey with high internal consistency reliability (Cronbach's α > 0.9). Patient's questionnaires had a low return rate, a limited exploratory analysis was performed. Conclusions: We provide a feasible and reliable Italian language MSF instrument with evidence of construct validity for the self, coworkers and medical colleague. Patient feedback was difficult to collect in our setting. [ABSTRACT FROM AUTHOR]

Background: After-action reports analyze events and improve knowledge about how to prevent and react to unexpected situations. Anyway, there is no consensus among the templates developed for disaster events reporting, and there is not a specific model for reporting hospital disaster response. Objective: The study was aimed to pilot the use of a new assessment tool for hospital response to natural disasters. Methods: A data collection tool, focused on hospital disaster response to natural disasters, was created modifying the "Utstein-Style Template for Uniform Data Reporting of Acute Medical Response in Disasters" and tested the reaction of the nearest hospitals to the epicenter after the August 24, 2016, Central Italy earthquake. Results: Four hospitals were included. The completion rate of the tool was 97.10%. A total of 613 patients accessed the 4 emergency departments, most of them in Rieti Hospital (178; 29.04%). Three hundred thirty-six (54.81%) patients were classified as earthquake-related, most with trauma injuries (260; 77.38%). Conclusions: This template seemed to be a valid instrument for hospital disaster management reporting and could be used for better comprehension of hospital disaster reaction, debriefing activities, and hospital disaster plan revisions. [ABSTRACT FROM AUTHOR]

Objective measurement of simulation performance requires a validated and reliable tool. However, no published Italian language assessment tool is available. Translation of a published English language tool, the Ottawa Crisis Resource Management Global Rating Scale (GRS), may lead to a validated and reliable tool. After developing an Italian language translation of the English language tool, the study measured the reliability of the new tool by comparison with the English language tool used independently in the same simulation scenarios. In addition, the validity of the Italian language tool was measured by comparison to a skills score also applied independently. The correlation coefficient between the Italian language overall GRS and the English language overall GRS was 0.82 (adjusted 95 % confidence interval: 0.62-0.92). The correlation coefficient between the Italian language overall GRS and the skill score was 0.85 (adjusted 95 % confidence interval 0.68-0.94). This study demonstrated that the Italian language GRS has acceptable reliability when compared with the English language tool, suggesting that it can be used reliably to evaluate the performance during simulated emergencies. The study also suggests that the tool has acceptable validity for assessing the simulation performance. The study suggests that the Italian language GRS translation has reasonable reliability when compared with the English language GRS and reasonable validity when compared with the assessment of the skills scores. Data suggest that the instrument is adequately reliable for informal and formative type of examinations, but may require further confirmation before use for high-stake examinations such as licensing. [ABSTRACT FROM AUTHOR]

Background: A prompt start to an appropriate neonatal and paediatric resuscitation is critical to reduce mortality and morbidity. However, residents are rarely exposed to real emergency situations. Simulation-based medical training (SBMT) offers the opportunity to improve medical and non-technical skills in a controlled setting. This survey describes the availability and current use of SBMT by paediatric residents in Italy with the purpose of understanding residents' expectations regarding neonatal and paediatric emergency training, and identifying gaps and potential areas for future implementation. Methods: A survey was developed and distributed to Italian residents. SBMT was defined as any kind of training with a mannequin in a contextualised clinically realistic scenario. Results: The response rate was 14.4%, covering the 71% of Italian paediatric residency programmes. Among them, 88% stated that Out of the 274 residents, 88% stated that they received less than 5 h of SBMT during the past training year, with 66% not participating in any kind of simulation activity. In 62% of the programmes no simulation training facility was available to residents. Among those who received SBMT, 46% used it for procedures and skills, 30% for clinical scenarios, but only 24% of them reported a regular use for debriefing. Of the overall respondents, 93% were interested in receiving SBMT to improve decision-making abilities in complex medical situations, to improve technical/procedural skills, and to improve overall competency in neonatal and paediatric emergencies, including non-technical skills. The main barriers to the implementation of SBMT programmes in Italian paediatric residencies were: the lack of experts (57%), the lack of support from the school director (56%), the lack of organisation in planning simulation centre courses (42%) and the lack of teaching materials (42%). Conclusions: This survey shows the scarce use of SBMT during paediatric training programmes in Italy and points out the main limitations to its diffusion. This is a call to action to develop organised SBMT during paediatric residency programs, to train qualified personnel, and to improve the quality of education and care in this field. [ABSTRACT FROM AUTHOR]

Background Autosomal recessive hypercholesterolemia (ARH) is a rare inherited lipid disorder. In Sardinia, differently from other world regions, the mutated allele frequency is high. It is caused by mutations in the low-density lipoprotein receptor adaptor protein 1 gene. Fourteen different mutations have been reported so far; in Sardinia, 2 alleles (ARH1 and ARH2) explain most of the cases. Four ARH patients, all carriers of the ARH1 mutation, have been identified in mainland Italy and 2 in Sicily. Objective The objectives of the study were to improve the molecular diagnosis of familial hypercholesterolemia (FH) and to estimate the frequency of the ARH1 allele in 2 free-living Sicilian populations. Methods We sequenced by targeted next-generation sequencing 20 genes related to low-density lipoprotein metabolism in 50 hypercholesterolemic subjects. Subjects from 2 free-living populations from Northern (Ventimiglia Heart Study, 848 individuals) and Southern Sicily (Zabut Zabùt Aging Project, 1717 individuals) were genotyped for ARH1 allele. Results We identified 1 homozygous carrier of the ARH1 mutation among the 50 hypercholesterolemic outpatients. Population-based genotyping of ARH1 in 2565 subjects allowed the identification of 1 heterozygous carrier. The overall estimated allele frequency of ARH1 in Sicily was 0.0002 (0.02%). Conclusions The identification of a new case of ARH in Sicily among 50 clinically diagnosed FH highlights the importance of next-generation sequencing analysis as tool to improve the FH diagnosis. Our results also indicate that ARH1 carrier status is present in ∼1:2500 of Sicilian inhabitants, confirming that ARH is extremely rare outside Sardinia. [ABSTRACT FROM AUTHOR]

The market of berries is a niche of high value in Italy. Small fruit’s healthy properties are well known in the international market, but little is known about the reason for a low commercialization rate of fresh small fruit in Italy. The objective of this study was to assess consumer preferences in Italy for selected berry species. Moreover, the study aims to identify the relevant attributes of berries that affect the demand for this produce according to consumers and to compare these attributes. We assessed relevant attributes affecting the demand for fresh berries for different consumers’ profiles and compared berries’ attributes rankings. The results reveal high concordance between blackberries and raspberries; price is the attribute that constrains more purchases because it is deemed too high. Consumers prefer small fruit because of the rising interest in their nutraceutical value, and they have a higher willingness to pay because of this important attribute. [ABSTRACT FROM PUBLISHER]

Background: Abdominal surgery carries significant morbidity and mortality, which is in turn associated with an enormous use of healthcare resources. We describe the clinical course of 30 Intensive Care Unit (ICU) patients who underwent abdominal surgery and showed severe infections caused by Klebsiella pneumoniae sequence type (ST) 258 producing K. pneumoniae carbapenemase (KPC-Kp). The aim was to evaluate risk factors for mortality and the impact of a combination therapy of colistin plus recommended regimen or higher dosage of tigecycline. Methods: A prospective assessment of severe monomicrobial KPC-Kp infections occurring after open abdominal surgery carried out from August 2011 to August 2012 in the same hospital by different surgical teams is presented. Clinical and surgical characteristics, microbiological and surveillance data, factors associated with mortality and treatment regimens were analyzed. A combination regimen of colistin with tigecycline was used. A high dose of tigecycline was administered according to intra-abdominal abscess severity and MICs for tigecycline. Results: The mean age of the patients was 56.6 ± 15 and their APACHE score on admission averaged 22.72. Twenty out of 30 patients came from the surgical emergency unit. Fifteen patients showed intra-abdominal abscess, eight anastomotic leakage, four surgical site infection (SSI) and three peritonitis. The overall crude ICU mortality rate was 40% (12 out of 30 patients). Twelve of the 30 patients were started on a combination treatment of high-dose tigecycline and intravenous colistin. A significantly lower mortality rate was observed among those patients compared to patients treated with approved dose of tigecycline plus colistin. No adverse events were reported with high doses of tigecycline. Conclusions: Critically-ill surgical patients are prone to severe post-surgical infectious complications caused by KPC-Kp. Timely microbiological diagnosis and optimizing antibiotic dosing regimens are essential to prevent worse outcomes. Further studies and well-controlled clinical trials are needed to define the optimal treatment of infections by KPC-Kp and, more generally, carbapenem-resistant bacteria. [ABSTRACT FROM AUTHOR]

Objectives: The study aimed at prospectively evaluating the evolution of asthma control in Italy, to evaluate the reasons for lack of asthma control, perceived quality of life (QoL) and association with level of asthma control, the impact of pharmacological treatment, the number of exacerbations and the healthcare resource consumption. Methods: PRISMA (PRospectIve Study on asthMA control) was an observational study performed in asthmatic patients including a cross-sectional phase and a 12-month prospective phase. Asthma control was assessed with the Asthma Control Test™ (ACT) and QoL was evaluated with EuroQoL-5D questionnaire filled in and collected during 5 clinic visits together with all the other data. Results: The prospective phase included 1017 patients with uncontrolled (55.7%) or partly controlled asthma (44.3%). Out of the 739 patients evaluable after 12 months, 22.2% achieved full asthma control (ACT score = 25) and 58.7% reached a good control (ACT score: 20-24). The improvement in asthma control was associated with improved QoL and reduced hospital visits. The main reasons for lack of asthma control were comorbidities, continued exposure to irritants/triggers and poor adherence to therapy. The frequency of exacerbations was lower in patients with controlled asthma. A fixed combination therapy with an inhaled corticosteroid and a long-acting β2 agonist was reported by 77.0% of patients. A better asthma control and improved QoL were achieved with extrafine beclomethasone/formoterol compared to either budesonide/formoterol or fluticasone/salmeterol. Conclusions: An improvement in asthma control and QoL can be achieved during a 1-year monitoring in a real life setting. Extrafine beclomethasone/formoterol was associated with significant benefit in terms of asthma control and QoL compared to large-particles combinations. ClinicalTrials.gov number NCT01110460. [ABSTRACT FROM AUTHOR]

Antipatharian corals are important structural and complex members of benthic communities inhabiting the Italian seafloor. In this study, the distribution of black corals in Italy is reported and mapped for the first time. This review has permitted the identification of occurrences of such vulnerable marine ecosystems along the Italian coasts in a bathymetric range of 42 m to 790 m. Black corals appear to be most conspicuous and widely distributed in the mesophotic zone (from around 60 to 300 m depth), with a major occurrence on the rocky bottom and shoals. This review also highlights that these communities suffer direct damage from anthropogenic impacts (fishing activity and lost garbage). Finally, this study provides evidence that the reported Italian submarine sites associated with the occurrence of black corals probably represent only a small portion of their real distribution. This finding urges the need to increase monitoring efforts to support the protection and the conservation of these pristine species assemblages. [ABSTRACT FROM AUTHOR]

The seabed of the Pontine Archipelago (Tyrrhenian Sea) insular shelf is peculiar as it is characterized by a mixed siliciclastic–carbonate sedimentation. In order to reconstruct the Late Quaternary paleoenvironmental evolution of the Pontine Archipelago, this study investigates the succession of facies recorded by two sediment cores. For this purpose, benthic foraminifera and rhodoliths assemblages were considered. The two cores (post-Last Glacial Maximum in age) were collected at 60 (CS1) and 122 m (Caro1) depth on the insular shelf off Ponza Island. The paleontological data were compared with seismo-stratigraphic and lithological evidence. The cores show a deepening succession, with a transition from a basal rhodolith-rich biodetritic coarse sand to the surface coralline-barren silty sand. This transition is more evident along core Caro1 (from the bottom to the top), collected at a deeper water depth than CS1. In support of this evidence, along Caro1 was recorded a fairly constant increase in the amount of planktonic foraminiferal and a marked change in benthic foraminiferal assemblages (from Asterigerinata mamilla and Lobatula lobatula assemblage to Cassidulina carinata assemblage). Interestingly, the dating of the Caro1 bottom allowed us to extend to more than 13,000 years BP the rhodolith record in the Pontine Archipelago, indicating the possible presence of an active carbonate factory at that time. [ABSTRACT FROM AUTHOR]

The Zannone Giant Pockmark (ZGP) is a shallow-water (<−150 m) giant depression located on the shelf off Zannone Island (Pontine Archipelago, central Tyrrhenian Sea, Italy), hosting active hydrothermal vents. The ZGP seabed displays different fluid-venting morphologies (pockmarks, lithified pavements, mounds, and cone-shaped structures) and widespread bacterial communities. In this study, we analyzed ROV (Remote Operated Vehicle) images to gain information on seabed geology and the textural, mineralogical, and geochemical composition of authigenic crusts and gravel-sized clasts sampled close to active emissions. ROV images show authigenic dome-shaped crusts composed of native sulfur associated with barite, gypsum, amorphous silica, and secondary hydrothermal minerals (illite–montmorillonite). The gravel-sized clasts are mostly rhyolites strongly affected by hydrothermal alteration (Alteration Index > 88; depletion of some mobile elements and enrichment of some base metals), causing feldspar-destruction, silicification, formation of hydrothermal phyllosilicates, and precipitation of disseminated pyrite. More intense alteration implying the complete obliteration of the primary mineralogy or fabric is represented by quartz-pyrite samples. ZGP seabed morphology and petro-geochemical features of deposits point to the possible occurrence of a sulfide system linked to the degassing of magma similar to that feeding the Pleistocene products of Ponza Island. [ABSTRACT FROM AUTHOR]

This study measures the communication ability of wineries in two extreme territories of Southern Italy, Mount Etna and the island of Pantelleria. The evaluation of four dimensions of web communication was carried out by the AGIL Scheme (i.e., adaptation, goal-attainment, integration, latent pattern maintenance). The study provides a generalizable model to be applied in other similar studies. Additionally, focus groups of experts were carried out. The method proved to be suitable to measure the communication effectiveness of wineries through websites. Extreme territories may add value to the wine, regardless of the brand. The heroic wines may become the symbol of these territories, helping environmentally safeguard and contrast territory abandonment by rural communities. The findings highlight that effective communication of heroic viticulture may be used to reposition these wines and increase their competitive advantage in foreign markets. The study generates new ideas for reflection on new types of web communication. [ABSTRACT FROM AUTHOR]

The efficacy of allergen immunotherapy (AIT) is well supported by evidence from trials and meta-analyses. However, its actual performance in daily practice may be diminished by several pitfalls, including inappropriate patient selection, and, especially, the use of allergen extracts of insufficient quality. We performed a survey, the Allergen Immunotherapy Decision Analysis, to evaluate which criteria specialists use to choose products for sublingual immunotherapy (SLIT) in adult patients suffering from allergic respiratory disease. We surveyed a total of 169 Italian allergists randomly chosen from a database belonging to a market research company (Lexis Ricerche, Milan, Italy). The survey was performed between October and November 2012 under the aegis of the European Center for Allergy Research Foundation and consisted of a questionnaire-based electronic survey prepared by a scientific board of 12 AIT experts. The questionnaire comprised two parts, the first of which contained 14 items to be ranked by each participant according to the importance assigned to each when choosing SLIT products. The physicians' rankings assigned major importance to the level of evidence-based validation of efficacy and safety, standardization of the product, efficacy based on personal experience, and defined content(s) of the major allergen(s) in micrograms. The results of this survey show that Italian allergists rank the quality-related characteristics of allergen extracts as highly important when choosing products for AIT. The allergists' preference for high-quality products should be addressed by regulatory agencies and by producers.