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Abstract: SuperB is a super-flavor factory that will be built in Tor Vergata (Italy). The project, recently approved by the Italian Government, and classified as the flagship project of the Italian INFN, foresees the construction of a high intensity asymmetric electron-positron collider and of the related detector. The expected luminosity of 2x1036cm−2 s−1, a factor 100 higher than the last generation of B-factories, will allow the high statistic study of rare decays and, possibly, will allow a deeper insight in the field of new physics. Part of the SuperB apparatus is the Instrumented Flux Return (IFR). This detector exploits the flux return iron structure of the superconducting solenoid as absorber for the identification of muons and neutral hadrons. In more details, It consists of ≃ 92 cm of iron interleaved by 9 layers of highly segmented scintillators. The detection technique is based on relatively inexpensive extruded plastic scintillator bars produced at the FNAL-NICADD facility. The scintillation light is collected through Wave Length Shifting fibers and guided to recently developed devices called Silicon Photon Multipliers used as photodetectors. The use of plastic scintillator as active material ensures reliability, robustness and long term stability while the high granularity and the fast response guarantee a good space-time resolution, extremely important to cope with the expected high particles flux. The readout scheme under evaluation is this manuscript is the double coordinate readout (“BIRO readout”) where two layers of orthogonal scintillator bars provide both, the polar and azimuthal coordinate. In order to deeply understand the performances and possible drawbacks of the above technique, a full depth prototype has been designed and built in Ferrara and Padova, and tested at the Fermilab Test Beam Facility (FBTF) in December 2010. In this paper a comprehensive description of the IFR related R&D studies will be presented. In particular, we will focus on the results of the Fermilab beam test, issues and future activities will also be outlined. [Copyright &y& Elsevier]

Introduction: Cardiovascular disease (CVD) is the first cause of death in Europe and over the world. This study analyses health-related behaviours in adults referring doctor-diagnosed CVDs., Materials and Methods: We used data from the Italian cross-sectional Behavioural Risk Factor Surveillance System PASSI gathered in 2015-2018. Complex survey design analyses included the Taylor series method for variance estimation and Poisson regression for associations between socio-demographic characteristics and CVD., Results: Among 132,598 respondents, the prevalence of doctor-diagnosed CVD was 5%. Higher percentages are observed among: men, older individuals, socioeconomically disadvantaged people. Compared to the general population, people with CVD have greater risk and aggravating factors, and a worse health status overall. All protective behaviors and lifestyles shall be improved., Discussion and Conclusions: In Italy, adults with CVD are more likely to be exposed to aggravating modifiable risk factors: it represents a valuable information for increased preventive interventions, even more in the light of the COVID-19 pandemic scenario.

Objective: Direct oral anticoagulants (DOACs) were developed to avoid the limitations of vitamin K antagonists (VKAs). DOACs are associated with a greater incidence of gastrointestinal bleeding and a smaller number of intracranial haemorrhages than VKAs. Therefore, it is important to deepen our knowledge of their safety profiles. The aim of this study was thus to analyse adverse drug reaction (ADR) reports on DOACs and VKAs using the Sicilian Spontaneous Reporting System (SRS) database., Methods: All ADR reports with DOACs and VKAs as suspected drugs that were entered into the Sicilian SRS database during the period 2001-2019 were selected. In detail, all reports with the following single active substances were included: dabigatran etexilate, rivaroxaban, apixaban and edoxaban; acenocoumarol and warfarin were included as a comparator group. Descriptive statistical methodology was used to evaluate characteristics of the reported cases with a case-by-case assessment., Results and Discussion: Out of 521 reports related to anticoagulants, 444 (85.2%) and 77 (14.8%) involved DOACs and VKAs, respectively. DOAC-related reports were mainly of gastrointestinal disorders. In contrast, VKAs were mostly associated with blood and lymphatic system disorders, injury, investigations and vascular disorders. Many more cases of ADRs in the form of gastrointestinal disorders concerned dabigatran etexilate (n = 179, 73.7%) than the other DOACs, while ADRs in the form of blood disorders were mainly associated with acenocoumarol (n = 27, 57.4%). The most commonly reported Preferred Terms for DOACs were dyspepsia (n = 89, 17.1%), upper abdominal pain (n = 41, 9.2%) and pruritus (n = 26, 5.8%), whereas for VKAs, they were anaemia (n = 21, 27.3%) and hypocoagulable state (n = 18, 3.5%). Potentially interacting concomitant medications particularly included antithrombotic agents (n = 19, 4.3%) for DOACs and proton-pump inhibitors (PPIs) (n = 37, 48.1%) and antithrombotic agents (n = 13, 16.9%) for VKAs., Conclusion: The ADRs most commonly associated with DOACs, especially dabigatran, were gastrointestinal disorders, particularly gastrointestinal bleeding. Our study also highlights the potential role of drug-drug interactions in the ADRs. The cases of gastrointestinal bleeding highlight the need for careful prescribing of DOACs and use of potentially interacting concomitant drugs., (© 2021 John Wiley & Sons Ltd.)

Age estimation is a crucial matter in several forensic and legal instances. The literature recommends carrying out hand and wrist radiograph to assess skeletal age. Much research has been conducted to examine the application of various methods in different categories. Our study aims to evaluate the reliability of Greulich and Pyle, Tanner-Whitehouse 2, and FELS methods in Beninese and Italian samples, with a total of 204 subjects, 102 (51 were male and 51 were female) from Benin and 102 (51 were male and 51 were female) from Italy, aged between 4 and 19 years. Hand-wrist radiographs were carried out at Saint Luc Hospital in Cotonou for the African sample and in 2 hospitals in Southern Italy for Italian sample. Skeletal maturity was obtained, applying the 3 methodologies. The arithmetic mean of the 3 ages obtained was calculated, as well as the possible difference between the known chronological age and the estimated mean skeletal age. Data were analyzed statistically using the χ test, Student t test, and Bland-Altman plots. There are no significant statistical differences between real age and skeletal age calculated using the Greulich and Pyle and FELS methods. Comparison between Tanner-Whitehouse 2 and the average of the methods used results in statistically significant, but clinically insignificant, differences.

In Italy, the National Plan for the Elimination of Measles and Congenital Rubella 2010-15 suggests offering Measles, Mumps and Rubella (MMR) vaccination to susceptible women who underwent voluntary termination of pregnancy (VTP) In Rome, S. Eugenio Hospital is one of the structures where VTP is practised in an Operative Unit called "Family Planning" The primary goal of this study was to estimate the prevalence of susceptibility to rubella, using IgG and IgM immunoassays, among women accessing VTP and to offering MMR vaccination to susceptible women. Secondarily, this study evaluated acceptance of the vaccination offer From 2013 to 2015, data were collected from 1513 voluntary termination of pregnancy (VTP) cases The results show a significant increase of 5 percent in susceptibility prevalence in the target group from 13.6% in 2013 and 2014 to 18.4% in 2015 The association between rubella susceptibility and age was statistically significant (p<0.01) Throughout the entire period, acceptance of the vaccine proposal was 19% (45/232) among susceptible women; 58% (135/232) refused the vaccine and 23% (52/232) took time to think about it This study shows an increase of 5 percent in the prevalence of rubella susceptibility over two years. This result is worrying, even considering the short span of the data collection The rate of acceptance of vaccination is unsatisfactory considering the possibility of future pregnancies This issue deserves continued action, which, going forward, might transform a "project" into a shared strategy as part of a wider network with the goal of aligning Italy with international recommendations.

Rubella is a contagious disease that can be very serious, especially in unvaccinated pregnant women. The best way to be protected is getting vaccinated: MMR vaccine is very effective at protecting people against measles, mumps, and rubella, and preventing the complications caused by these diseases. According to PASSI 2012-2015 (the Italian behavioral risk factor surveillance system) in the territory of ex ASL Roma C only 56% of women between 18 and 49 years were immunized against rubella, thanks to vaccination (34%) or past infection detected by rubeotest (22%); 2% was susceptible and 42% of respondents did not know their immune status against rubella. The Italian National Plan for the Elimination of Measles and Congenital Rubella (PNEMoRc) 2010-15 had the aim to reduce the prevalence of rubella susceptibility in young women (&lt;5%), to reduce the prevalence of congenital rubella and to increase MMR vaccination coverage. This plan suggested to promote actions to spread correct information about MMR vaccine in the general population and healthcare workers and to offer this vaccine to susceptible women during every appropriate contact with the Family planning clinics. In order to ensure and monitor these recommendations, a recovery procedure for MMR vaccine was activated in 2015 for women who contacted the health facilities for their first child vaccination. A form was developed in order to collect information about women's immune status against rubella and measles. According to this tool all women who stated they had never been vaccinated for rubella or MMR and/or did not remember vaccination and/or had never had a rubeotest were considered susceptible to rubella. Women susceptible to rubella were invited to undergo vaccination. Data collected during one year activity were recorded and analyzed with Epinfo 7.0 software. We collected 1801 correctly filled forms; 88.6% (1595) of women were evaluated immune to rubella and 11.4% susceptible. The prevalence of susceptibility seems to be influenced by age, from 16% in the youngest age group to 9% in the &gt;35 years. Among 206 women susceptible to rubella: 38% were vaccinated, 31% preferred to wait, 11% refused vaccination and for 20% data is missing. The protocol of MMR vaccine recovery was effective, and allowed to reach a good number of women who had a contact with the health facilities and we hope this number to be bigger, adding a part of those women who preferred to wait. However, data of a year activity indicate that vaccine recovery initiatives should be proposed and implemented, in consideration of the proportion of rubella susceptibility in women who were recently pregnant.

Aim: Dental caries was identified as the single most common chronic childhood disease; its prevention should be a priority for dentists. With the aim of describing the correlation between early childhood caries (ECC) and the phenomenon of child neglect, a questionnaire which recorded socio-economic and dental service use data was provided to a randomly chosen sample of parents at three pediatric health service centers in Bari (Italy)., Materials and Methods: In order to evaluate the association among risk factors and ECC, contingency tables were created and the value of the Odds Ratio (OR) was calculated, indicating the confidence intervals and chi square values. A student's t-test for independent samples was performed to evaluate the differences between the averages. A value of p≤0.5 was considered to be significant for all tests used., Results: Of the 63 children examined, 61.9% (n=39; 95%CL=49.9- 73.9) presented with ECC, of which 47.6% (n=30; 95%CL=34.9-60.6) were classified as Wyne's Type I; 12.7% (n=8; 95%CL=5.6-23.5) were classified as Type II; and 1.6% (n=1; 95%CL=0-8.5) as Type III. Interestingly, the frequency of Types II and III were shown to be higher in low-income families (chi-square=8.50; p=0.03)., Conclusion: Dentists should recognize children's susceptibility to ECC and their exposure to risk factors for neglect, thus facilitating a primary prevention visit.

Age estimation in forensics is essential in cases involving both living and dead subjects. For living subjects, age estimation may be used to establish an individual's status as a minor in cases involving adoption, criminal responsibility, child pornography, and those seeking asylum. Criteria for age estimation in the living have recently been put forth by The Study Group on Forensic Age Diagnostics. The group has proposed guidelines with a three-step procedure: a physical examination and anthropometrical analysis; dental analysis by orthopantomogram (OPG); and X-ray study of the left hand and wrist. The board of FASE highlighted advantages and limits of each method, and suggested practical solutions concerning the age estimation process for adults and subadults. The aim of this study was to verify the applicability of the Greulich and Pyle, and Demirjian techniques on a sample group of Italians, whose ages were known, in determining the skeletal and dental age, in addition to evaluating the reliability of these techniques. 535 subjects between the ages of 7 and 15years were examined, each one undergoing both an orthopantomography (OPG) and radiography of the left wrist and hand. The data obtained underwent statistical analysis. The analyses have shown that a correlation exists between skeletal and dental age, and real age. Age estimation carried out using the Greulich and Pyle method has shown itself to be especially accurate on the Italian sample, particularly in the age ranges of 7-9years and 10.4-11.5years. The Greulich and Pyle method has shown itself to be reliable for the sample analyzed notwithstanding the ethnic differences between the original sample of reference and those analyzed in this study. Application of the Demirjian technique resulted in an overestimation of dental age. This difference is shown to be more highly significant in the higher age ranges. The combination of the Greulich and Pyle, and Demirjian methods have revealed a difference regarding real age, which turns out to be more modest in the younger age ranges and more significant in older subjects., (Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.)

The Apulian (South of Italy) territory saw the birth of a criminal organization called Sacra Corona Unita (SCU, United Holy Crown) which transformed the rules of traditional mafia organizations. This work examined 83 victims of the SCU between 1980 and 2000. The bodies were mainly of SCU members and in some cases, of police and law enforcement officers and other citizens caught in the crossfire. Some of these were discovered; thanks to the collaboration of "repented" SCU members who became police informers. The condition of the bodies varied in relation to the date and manner of killing. In some cases anthropometric research methods were necessary. In 73% of the cases, lesions of the head were the only marks left on the body. In conclusion, the existence of some social aspects connected with the symbolisms and membership rites that characterized the origin, evolution, and decline of the SCU is stressed.

In recent years the high number of malpractice lawsuits in dentistry has attracted closer attention of dental practitioners to its medico-legal aspects. Implantology, in particular, presents many points of medico-legal concern connected with the difficulties inherent to dental procedures and objectives (both functional and esthetic), as well as full patient collaboration as an essential part of successful treatment. An accurate assessment of each case by the clinician is fundamental, especially in circumstances where esthetic considerations are preponderant as, for instance, in the frontal sectors. In such cases, the options of implantology or of a traditional fixed prosthesis need to be carefully weighed in light of the patient's anatomic condition. The patient should therefore receive complete information and be made fully aware of the risk of treatment failure, as well as possible complications, limits to the procedures, and the fact that successful outcome will also depend on her/his scrupulous observance of the practitioner's instructions. In short, the aim is to make the patient an active ''accomplice'' in treatment. To this end, the use of an extremely detailed information leaflet is strongly advised; after careful clarification of any doubts the patient may have, the patient's written informed consent should be obtained. Nevertheless, there is the risk that excessive intrusion of bureaucracy into medical procedures in defence of the practitioner against malpractice suits may hinder the principal aim of traditional medicine, i.e. to provide the best care for the patient through mutual trust fostered within the doctor-patient relationship.

The skin armour and posterior spiracles of L1, L2 and L3 of Oestrus ovis (Diptera: Oestridae) are described and documented photographically by a scanning electron microscope. The complex and variable morphology of the attack organs of larvae of different stages makes it easier to understand better their exceeding adaptability to the host. The SEM survey has also allowed an apparently unreported anatomic particular with a probable sensory function to be detected in L1.

The authors value the distribution of some parameters such as age, sex, life habits, kind of clinical diagnosis and its relation to histological diagnosis in a population of 110 patients heterogeneous for rank and provenance. After describing the kind of casualty department aid, they explain the meaning of the word leukoplakia and underline the difficulties of clinical diagnosis: the macroscopic appearance of the white patch (according to WHO definition) is often comparable to other oral diseases either classified as precancerous lesions or not.