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The Umbria-Marche region of Italy is a seismically active region that experienced a strong sequence of earthquakes during 1997-1998, with a cluster of magnitude M >5 events, during which the average event rate increased from the long-term level by several orders of magnitude. Using maximum-likelihood (ML) in-version of the epidemic-type aftershock sequences model to characterize the seismic-ity of this region over 22 years, we find, in agreement with previous studies, the event rate during the sequence is underpredicted, based on simulations with the large M >5 events fixed. However, by sampling the parameter space around the ML solution within the inversion uncertainty and comparing the simulated event rate with that of the real data, we are able to find near-maximum-likelihood parameters that provide a reasonable match to both the long-term average event rate and the rate during the sequence. We use the shape of the interevent time histogram to infer that the events in the sequence are probably mostly aftershocks of the large events, rather than an in-creased occurrence of background events. We suggest that event rate comparisons can be useful as an additional constraint on the selection of parameters from within the 95% confidence interval of the ML fit. Our results demonstrate the extra constraint can greatly improve the match between a stationary model and finite catalog data and that care is needed before adding further parameters to ascribe nonstationarity to time-dependent event rate changes. [ABSTRACT FROM AUTHOR]

The present study investigates territorial disparities in selected socioeconomic forces and environmental factors underlying soil degradation that may lead to early desertification processes in a dry Mediterranean region exposed to increasing human pressure. To verify if spatial disparities in land resources have increased over time, a standard approach based on the Environmentally Sensitive Area Index (ESAI) was adopted to evaluate sixty years of territorial transformations in Latium, Central Italy, a region prone to intense processes of land resource depletion. The ESAI provides a standard, holistic assessment of soil degradation based on the estimation of four different 'resource qualities' (climate, soil, vegetation, and land use) and their change over sufficiently long time windows; in this study, the procedure was run at three reference years (1960, 1990, and 2020). The observed divergence in soil degradation levels between coastal and inland districts arose during the study period, with a consequent reduction in the local-scale variability of the ESAI. Such differential processes observed along the elevation gradient in Central Italy are likely due to anthropogenic factors affecting land use and leveraging crop intensification in flat districts and farmland abandonment in steep areas. New findings to be achieved in the context of human impacts on land resource depletion are regarded as an original contribution to the study of early desertification processes in advanced economies. [ABSTRACT FROM AUTHOR]

The task of change detection (CD) in optical and SAR images is an ever-evolving and demanding subject within the realm of remote sensing (RS). It holds great significance to identify the target areas by using complementary information between the two. Due to the distinct imaging mechanisms employed by optical and SAR sensors, effectively and accurately identifying changing regions can be challenging. To this end, a novel heterogeneous RS images CD network (Twin-Depthwise Separable Convolution Connect Network, TDSCCNet) is proposed in this paper. Image domain transformation is a front-end task, while the back-end employs a single-branch bilayer depthwise separable convolutionconnected encoder-decoder to accomplish CD work. Specifically, first, the cycle-consistent adversarial network (CycleGAN) serves to integrate the optical and SAR visual domains, and a consistent feature expression is obtained. Second, the single-branch encoder structure of bilayer depthwise separable convolution is employed to realize change feature extraction. Finally, the multiscale connected decoder reconstructed by change map is utilized to reconstruct the original images and solve the local discontinuities and holes in the binary change map. Multiscale loss is designated for optimizing the global and local effects to alleviate the class imbalance problem. It was tested on four representative datasets from Gloucester, Shuguang Village, Italy and WV-3 datasets with an overall accuracy of 97.36%, 97.01%, 97.62%, and 98.01% respectively. By comparing the existing methods, experimental results confirmed the effectiveness of the proposed method. [ABSTRACT FROM AUTHOR]

Taking advantage of a large ensemble of Convection Permitting‐Regional Climate Models on a pan‐Alpine domain and of an object‐oriented dedicated analysis, this study aims to investigate future changes in high‐impact fall Mediterranean Heavy Precipitation Events at high warming levels. We identify a robust multi‐model agreement for an increased frequency from central Italy to the northern Balkans combined with a substantial extension of the affected areas, for a dominant influence of the driving Global Climate Models for projecting changes in the frequency, and for an increase in intensity, area, volume and severity over the French Mediterranean. However, large quantitative uncertainties persist despite the use of convection‐permitting models, with no clear agreement in frequency changes over southeastern France and a large range of plausible changes in events' properties, including for the most intense events. Model diversity and international coordination are still needed to provide policy‐relevant climate information regarding precipitation extremes. Plain Language Summary: Despite growing computational resources and multiple model developments, projecting future changes in the high‐impact Mediterranean Heavy Precipitation Events remains both a numerical and scientific challenge. The present study takes advantage of the recent availability of a relatively large ensemble of high resolution Regional Climate Models (2–3 km), which represent a step change in the simulation of precipitation extremes, and of an object‐oriented approach, allowing us to track the convective precipitating systems on an hourly basis. Looking at future changes in fall Mediterranean Heavy Precipitation Events at high warming levels, we identify a robust multi‐model agreement for an increased frequency from central Italy to the northern Balkans combined with a substantial expansion of the affected areas, and an increase in intensity, area, volume and severity over the French Mediterranean. However, considerable uncertainties remain in terms of frequency over parts of the domain arising from uncertainty in changes in large scale weather patterns, and in terms of degree of intensification for the most intense events. It suggests the need for model diversity and for more coordinated high resolution climate projections with careful selection of different driving global models in order to provide policy‐relevant climate information regarding precipitation extremes. Key Points: High‐resolution ensemble and object‐oriented approach offer a unique opportunity to study changes in Mediterranean extreme precipitationRobust agreement is found for an increase in intensity, volume and severity for future French Mediterranean Heavy Precipitation EventsEven at convection‐permitting scale, considerable uncertainty remains regarding the degree of intensification of the most extreme events [ABSTRACT FROM AUTHOR]

The probability distribution of the interevent time between two successive earthquakes has been the subject of numerous studies for its key role in seismic hazard assessment. In recent decades, many distributions have been considered, and there has been a long debate about the possible universality of the shape of this distribution when the interevent times are properly rescaled. In this work, we aim to discover if there is a link between the different phases of a seismic cycle and the variations in the distribution that best fits the interevent times. To do this, we consider the seismic activity related to the M w 6.1 L'Aquila earthquake that occurred on 6 April 2009 in central Italy by analyzing the sequence of events recorded from April 2005 to July 2009, and then the seismic activity linked to the sequence of the Amatrice-Norcia earthquakes of M w 6 and 6.5, respectively, and recorded in the period from January 2009 to June 2018. We take into account some of the most studied distributions in the literature: q-exponential, q-generalized gamma, gamma and exponential distributions and, according to the Bayesian paradigm, we compare the value of their posterior marginal likelihood in shifting time windows with a fixed number of data. The results suggest that the distribution providing the best performance changes over time and its variations may be associated with different phases of the seismic crisis. [ABSTRACT FROM AUTHOR]

Second opinion consultation is a well-established practice in different clinical settings of diagnostic medicine. However, little is known about second opinion consultation activity in transplantation, and even less is known about it concerning donor assessment. The consultations provided by the second opinion service led to the safer and homogeneous management of donors with a history of malignancy or ongoing neoplasm by transplant centers. Indeed, two of the most important aspects are the reduction of semantic differences in cancer reporting and the standardization of procedures, which are mainly due to the different settings and logistics of different pathology services. This article aims to discuss the role and the future of the second opinion in Italy during organ procurement, highlighting the critical issues and areas for improvement. [ABSTRACT FROM AUTHOR]

Background: the deficiency of 5,10-Methylenetetrahydrofolate reductase (MTHFR) constitutes a rare and severe metabolic disease and is included in most expanded newborn screening (NBS) programs worldwide. Patients with severe MTHFR deficiency develop neurological disorders and premature vascular disease. Timely diagnosis through NBS allows early treatment, resulting in improved outcomes. Methods: we report the diagnostic yield of genetic testing for MTHFR deficiency diagnosis, in a reference Centre of Southern Italy between 2017 and 2022. MTHFR deficiency was suspected in four newborns showing hypomethioninemia and hyperhomocysteinemia; otherwise, one patient born in pre-screening era showed clinical symptoms and laboratory signs that prompted to perform genetic testing for MTHFR deficiency. Results: molecular analysis of the MTHFR gene revealed a genotype compatible with MTHFR deficiency in two NBS-positive newborns and in the symptomatic patient. This allowed for promptly beginning the adequate metabolic therapy. Conclusions: our results strongly support the need for genetic testing to quickly support the definitive diagnosis of MTHFR deficiency and start therapy. Furthermore, our study extends knowledge of the molecular epidemiology of MTHFR deficiency by identifying a novel mutation in the MTHFR gene. [ABSTRACT FROM AUTHOR]

Concentrations of 7 polychlorinated dibenzo-p-dioxins (PCDDs), 10 polychlorinated dibenzofurans (PCDFs) and 18 polychlorinated biphenyls (PCBs), including 12 dioxin-like (DL-PCBs) and 6 non-dioxin-like PCBs (NDL-PCBs) were measured in 16 ovine and caprine milk samples collected in the territory of Bussi sul Tirino, central Italy, a Site of National Interest (SNI) due to its high and widespread environmental pollution. All the analyzed samples were compliant with the maximum levels fixed by Commission Regulation (EU) 1259/2011 for the content of PCDD/Fs and the sum of PCDD/Fs and DL-PCBs. In two cases, contamination levels of the sum of PCDD/Fs and DL-PCBs were higher than the action levels fixed by EU Recommendation 663/2014. The statistical analysis, performed by Principal Component Analysis (PCA), revealed that the differences in contamination profiles of the different milk samples were independent of the distance of the farms from the Bussi illegal landfill but likely related to local emission sources influencing the exposure to POPs of studied animals. [ABSTRACT FROM AUTHOR]

This paper explores multilevel governance (MLG) in the context of state aid programmes for the diffusion of broadband in the European Union. By comparing three EU Member States (Italy, Spain and the UK), the qualitative analysis illustrates how MLG affects both the implementation of public interventions and the reduction of regional inequalities in the access to broadband. The analysis suggests that a distributed and shared governance is potentially beneficial for the implementation of state aid programmes, but its application is constrained by idiosyncrasies in the structure of the public and private sector. [ABSTRACT FROM AUTHOR]

This study aimed to assess the capability of supercritical fluid extraction (SFE) as an alternative and green technique compared to Soxhlet extraction for the production of oils from Opuntia ficus-indica (OFI) seeds originating from Yemen and Italy and Opuntia dillenii (OD) seeds from Yemen. The following parameters were used for SFE extraction: a pressure of 300 bar, a CO2 flow rate of 1 L/h, and temperatures of 40 and 60 °C. The chemical composition, including the fatty acids and tocopherols (vitamin E) of the oils, was determined using chromatographic methods. The highest yield was achieved with Soxhlet extraction. The oils obtained with the different extraction procedures were all characterized by a high level of unsaturated fatty acids. Linoleic acid (≤62% in all samples) was the most abundant one, followed by oleic and vaccenic acid. Thirty triacylglycerols (TAGs) were identified in both OFI and OD seed oils, with trilinolein being the most abundant (29–35%). Vanillin, 4-hydroxybenzaldehyde, vanillic acid, and hydroxytyrosol were phenols detected in both OFI and OD oils. The highest γ-tocopherol content (177 ± 0.23 mg/100 g) was obtained through the SFE of OFI seeds from Yemen. Overall, the results highlighted the potential of SFE as green technology to obtain oils suitable for functional food and nutraceutical products. [ABSTRACT FROM AUTHOR]

3D recording methodologies have been successfully integrated into the archaeological fieldwork practice, resulting in a widely accepted series of advantages for the documentation of the excavation. However, post-processing analysis is often neglected and recording protocols do not consider possible developments for exploiting the potential of 3D data. At the excavation of Vetricella, in Italy, the ERC nEU-Med project developed a digital documentation protocol aimed at reconstructing the volumetric physical space occupied by each stratigraphic unit, generating more than a thousand contexts over the course of four archaeological seasons. In this contribution we are going to present how the volumetric approach has influenced the whole methodology of documentation since the recording stage, introducing a standardized workflow aimed at reconstructing solid geometries from 3D surfaces. In this protocol a great attention is paid to the strategies, timings and needs of the fieldwork practice, without overlooking important archaeological aspects such as data accuracy and the chance to generate data for more quick on-field interpretation. The final outcome is a new visualization and analysis of the space with the use of volumetric models, which results in greater accuracy in displaying physical and stratigraphic relationships, as well as generating volumetric quantitative data. In the end, some examples drawn from Vetricella will be employed to show how solid 3D geometries and volumetric quantities can be used in support of the archaeological interpretation of the site. [ABSTRACT FROM AUTHOR]

Simple Summary: Klebsiella pneumoniae is an opportunistic bacterium known as a nosocomial pathogen, but it is able to colonize a multitude of ecological niches, both free-living and host-associated. For this reason, the presence of antimicrobial resistance genes in wildlife is an indicator that resistant bacteria of human- or livestock-origin are widespread in the environment. Wild animals can act as efficient reservoirs and epidemiological links between humans, livestock, and natural environments. Despite the renewal of interest in epidemiology, there is a critical lack of an unbiased ecological approaches to defining reservoirs and sources of infections. The aims of the present study were to investigate the occurrence of K. pneumoniae in wildlife, to characterize antimicrobial features through phenotypic and whole genome sequencing approaches, and to identify similar available sequences that could suggest a transmission event. Despite Klebsiella pneumoniae being widely recognized as a nosocomial pathogen, there is a critical lack in defining its reservoirs and sources of infections. Most studies on risk factors have focused on multidrug-resistant (MDR) isolates and clinically-oriented questions. Over a two-year period, we sampled 131 wild animals including mammal and bird species from three regions of Central Italy. All typical colonies isolated from the analytical portions were confirmed by real-time PCR and identified by MALDI-TOF mass spectrometry (MALDI-TOF MS). All confirmed K. pneumoniae isolates were tested for antimicrobial susceptibility to 29 antimicrobials and subjected to whole genome sequencing. Typical colonies were detected in 17 samples (13%), which were identified as K. pneumoniae (n = 16) and as K. quasipneumoniae (n = 1) by MALDI-TOF MS. The antimicrobial susceptibility profile showed that all the isolates were resistant to β-lactams (ceftobiprole, cloxacillin, cefazolin) and tetracycline; resistance to ertapenem and trimethoprim was observed and nine out of 16 K. pneumoniae isolates (56.2%) were classified as MDR. Genomic characterization allowed the detection of fluoroquinolone resistance-associated efflux pumps, fosfomycin and β-lactamase resistance genes, and virulence genes in the overall dataset. The cluster analysis of two isolates detected from wild boar with available clinical genomes showed the closest similarity. This study highlights the link between humans, domestic animals, and wildlife, showing that the current knowledge on this ecological context is lacking and that the potential health risks are underestimated. [ABSTRACT FROM AUTHOR]

Background: Klebsiella pneumoniae ST101 is an emerging high-risk clone which exhibits extensive drug resistance. Bacterial strains residing in multiple hosts show unique signatures related to host adaptation. In this study, we assess the genetic relationship of K. pneumoniae ST101 isolated from hospital samples, the environment, community, and livestock using whole genome sequencing (WGS). Materials and Methods: We selected ten K. pneumoniae ST101 strains from hospitalized patients in Italy (n = 3) (2014) and Spain (n = 5) (2015–2016) as well as Belgian livestock animals (n = 2) (2017–2018). WGS was performed with 2 × 250 bp paired-end sequencing (Nextera XT) sample preparation kit and MiSeq (Illumina Inc.). Long-read sequencing (Pacbio Sequel I) was used to sequence the two livestock strains and three Italian hospital-associated strains. Furthermore, a public ST101 sequence collection of 586 strains (566 hospital-associated strains, 12 environmental strains, six strains from healthy individuals, one food-associated strain and one pig strain) was obtained. BacPipe and Kleborate were used to conduct genome analysis. ISFinder was used to find IS elements, and PHASTER was utilized to identify prophages. A phylogenetic tree was constructed to illustrate genetic relatedness. Results: Hospital-associated K. pneumoniae ST101 showed higher resistance scores than non-clinical isolates from healthy individuals, the environment, food and livestock (1.85 ± 0.72 in hospital-associated isolates vs. 1.14 ± 1.13 in non-clinical isolates, p < 0.01). Importantly, the lack of integrative conjugative elements ICE Kp bearing iron-scavenging yersiniabactin siderophores (ybt) in livestock-associated strains suggests a lower pathogenicity potential than hospital-associated strains. Mobile genetic elements (MGE) appear to be an important source of diversity in K. pneumoniae ST101 strains from different origins, with a highly stable genome and few recombination events outside the prophage-containing regions. Core genome MLST based analysis revealed a distinct genetic clustering between human and livestock-associated isolates. Conclusion: The study of K. pneumoniae ST101 hospital-associated and strains from healthy individuals and animals revealed a genetic diversity between these two groups, allowing us to identify the presence of yersiniabactin siderophores in hospital-associated isolates. Resistance and virulence levels in livestock-associated strains were considerably lower than hospital-associated strains, implying that the public health risk remains low. The introduction of an ICE Kp into animal strains, on the other hand, might pose a public threat over time. [ABSTRACT FROM AUTHOR]

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

Public, and particularly museum-based, collections provide invaluable opportunities for analysis. The objects in these collections typically offer relatively complete examples which often become reference points for newly excavated material or analyses. However, aside from issues of provenance and occasionally authenticity, one of the biggest challenges with the analysis of objects in museum collections is, perhaps ironically, their public and collection-based context. Objects on display are often only directly analysed immediately following their initial discovery and are then increasingly restricted for direct analysis (e.g. placed behind glass, displayed in such a way that their removal is difficult, etc.). Although visible to millions, once in a collection the level of analysis possible is often limited and superficial. In this paper we discuss the analysis of three collections of ancient Italian armour now housed in collections, both public and private. We examine some of the ethical considerations when looking at such collections. We also discuss the issues faced when analysing and making digital models of objects, which are used to explore the nature and importance of military equipment in Italy during the first millennium BCE. In addition, we argue that, although famous, many of the pieces held in collections are currently being underutilized in studies of the ancient world. We suggest digitization, even when conducted quickly, can help to unlock more information from previously excavated and analysed items and we highlight the pros and cons of various techniques when working in museum-based contexts. [ABSTRACT FROM AUTHOR]

Background: Although elderly patients (≥70 years) represent 30% of new diagnoses of soft tissue sarcoma (STS), they are underrepresented in clinical trials and are often unfit to receive standard anthracycline-based chemotherapy. Trabectedin is registered as a second-line treatment for advanced STS and is characterized by a favorable safety profile.Methods: The aim of this single-arm, phase 2 study was to investigate trabectedin (scheduled dose, 1.3-1.5 mg/m2 ) as a first-line treatment in elderly patients with advanced stage STS who are inoperable and are unfit to receive standard anthracycline-based chemotherapy. The coprimary endpoints were progression-free survival at 3 months (PFS3) and the rate of clinically limiting toxicities (CLTs). We also conducted an ancillary study on pharmacokinetics.Results: Twenty-four patients (12 men and 12 women) with a median age of 79 years (interquartile range [IQR], 74-83 years) were enrolled. The histological subtype was leiomyosarcoma in 46%, liposarcoma in 33%, and other histotypes in 21%. The median number of trabectedin courses was 4 (IQR, 3-6), with 7 patients (29%) receiving ≥6 cycles. Eight patients (33%) required dose reductions. The most frequent grade 3/4 adverse events were neutropenia in 9 patients (38%), fatigue in 5 patients (21%), and aminotransferase elevation in 5 patients (21%). PFS3, median PFS, and overall survival were 71% (80% CI, 57%-81%), 4 months, and 12 months, respectively. Ten patients (42% [80% CI, 28%-57%]) experienced CLTs. Trabectedin Cmax , half-life, clearance, and distribution volume were 1.28 ng/mL (standard deviation [SD], 0.58 ng/mL), 26.70 hours (SD, 9.09 hours), 39.98 L/h/m2 (SD, 14.08 L/h/m2 ), and 1460 L/m2 (SD, 561 L/m2 ), respectively.Conclusion: Trabectedin can be administered safely to elderly patients with STS who are unfit to receive anthracyclines. Pharmacokinetics in the elderly population was superimposable to historical data. [ABSTRACT FROM AUTHOR]

Purpose: Carbapenemases-producing Klebsiella pneumoniae are challenging antimicrobial therapy of hospitalised patients, which is further complicated by colistin resistance. This study describes molecular epidemiological insights into colistin-resistant and carbapenemases-producing clinical K. pneumoniae. Patients and methods: Cultures collected from 26 hospitalised patients during 2014–2017 in the main hospital in Molise Region, central Italy, were characterized. The minimum inhibitory concentration for 19 antibiotics was determined, including carbapenems and colistin. Prevalence of resistance-associated genes was investigated through PCR, detecting blaKPC, blaGES, blaVIM, blaIMP, blaNDM, blaOXA-48, blaCTX-M, blaTEM, blaSHV, and mcr-1,2,3,4,5,6,7,8. The mgrB gene was also analysed in colistin-resistant strains by PCR and sequencing assays. K. pneumoniae were typed by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST). Results: Twenty out of 26 K. pneumoniae were phenotypically resistant to carbapenems and 19 were resistant to colistin. All isolates harbored blaKPC, and blaSHV,blaTEM and blaVIM were further the most common resistance-associated genes. In colistin-resistant strains, mcr-1,2,3,4,5,6,7,8 variants were not detected, while mutations and insertion elements in mgrB were observed in 68.4% (n=13) in 31.6% (n=6) isolates, respectively. PFGE revealed 12 clusters and 18 pulsotypes at 85% and 95% cut-off, while the Sequence Types ST512 (n=13, 50%), ST101 (n=10, 38.5%), ST307 (n=2, 7.7%) plus a novel ST were detected using MLST. Conclusion: All K. pneumoniae showed a multidrug-resistant phenotype, particularly to carbapenems and colistin. According to national data, blaKPC was the prevailing carbapenemase, followed by blaVIM, while blaTEM and blaSHV were among the most frequent beta-lactamases. Consistent with previous reports in Italy, ST512 was the most common clone, particularly during 2014–15, whilst ST101 became dominant in 2016–17. Colistin resistance was mainly associated with deleterious mutations and transposon in the mgrB gene. Improvements of surveillance, compliance with infection prevention procedures and antimicrobial stewardship are essential to limit the spread of resistant K. pneumoniae. [ABSTRACT FROM AUTHOR]

Purpose: Immediate loading has become an emerging technique because it has been shown to be asuccessful, time-saving procedure. Recently, immediate loading has been performed simultaneously with implant placement into fresh extraction sockets; excellent results have been achieved, but few reports are available with a long-term follow-up. The aim of the present study was to evaluate the difference in success rates in the maxilla between postextraction implants and implants placed in healed sites, both of which were immediately loaded, after a long-term follow-up. Materials and Methods: Between October 2001 and February 2003, 239 implants were inserted in 81 consecutively operated patients and immediately loaded; 138 implants were placed in fresh postextraction sites (57.7%) and 101 implants were placed in healed sites (42.3%). Two different implant systems were used in this study. Each implant was loaded within 72 hours of placement (60.3% at the time of surgery, 6.3% after 24 hours, 30.1% after 48 hours, and 3.3% after 72 hours). Preestablished success criteria were used to evaluate the success rate of the implants. Results: The mean follow-up was 6.7 years (range: 6.0 to 7.3 years). Only 8 of the 239 implants failed, for an overall success rate of 96.6%. Six of the failed implants were inserted in postextraction sites, and 2 had been placed in healed sites; the success rates were 95.7% and 98.0%, respectively. Statistical analysis revealed no significant differences between postextraction and healed sites. Conclusions: Immediate loading of immediate postextraction sites results in an implant success rate that is broadly comparable to that seen for implants placed in healed sites. Moreover, this procedure can provide predictable and favorable results in many different clinical conditions and for a long term. [ABSTRACT FROM AUTHOR]

In this study we assessed the prevalence and predictors of pharyngeal infections due to Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) in a cohort of patients attending an STI Clinic. From January 2016 to September 2018, 893 patients attending the STI Clinic of St Orsola-Malpighi Hospital (Bologna, Italy) and reporting unprotected oral sex were enrolled. A pharyngeal swab for the molecular detection of CT and NG was collected from each patient. Positive CT samples were further genotyped by an omp1 gene PCR. A total of 134 cases of gonorrhea (15%) and 34 chlamydial infections (3.8%) were detected in the pharyngeal site, with no significant differences between males (all men who have sex with men [MSM]) and females. More than 90% of the infections were completely asymptomatic, suggesting that symptoms were not predictors of a pharyngeal infection (P = 0.7). On the contrary, a history of sexual contacts with a partner positive for CT and/or NG (P < 0.0001), HIV positivity (P = 0.01), and the presence of concurrent genital and/or rectal infections (P < 0.0001) were significantly associated with CT/NG pharyngeal infections. Pharyngeal lymphogranuloma venereum cases were rare (prevalence: 0.4%), asymptomatic, and only found in MSM. Better knowledge about pharyngeal CT/NG infections could help to set up effective strategies for their prevention. [ABSTRACT FROM AUTHOR]

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The use of azithromycin for the treatment of Mycoplasma genitalium infections has led to resistance to macrolides. From July 2014 to July 2020, 7150 samples were analysed for the detection of sexually transmitted infections at the Policlinico of Bari. A total of 67/7150 samples (0.93%) were positive for MG DNA and 47 samples were analysed for the evaluation of six azithromycin resistance-associated mutations. In 5/47 samples, the A2058G mutation was detected (10.63%). Although the cases of positive MG samples and mutations are low in our reality, diagnostic tests to detect azithromycin resistant-associated genes may provide a convenient way to monitor resistance rate.

In Italy, educational programs for cancer patients are currently provided by the national government, scientific societies, and patient advocate organizations. Several gaps limit their effectiveness, including the lack of coordinated efforts, poor involvement of patient feedback in the planning of programs, as well as a lack of resources on innovative cancer-related topics. This process is parallel to a strong shift in the attitude of patients towards health in general and taking charge of their own health conditions in particular. The National Cancer Institute in the USA and the Organization of European Cancer Institutes encourage comprehensive cancer centers in providing educational programs conceived to overcome these gaps. The goal of this paper is to identify and describe the key elements necessary to develop a global patient education program and provide recommendations for strategies with practical examples for implementation in the daily activities of cancer institutes. A multidisciplinary committee was established for patient education, including patient representatives as equal partners, to define, implement, verify, and evaluate the fundamental steps for establishing a comprehensive education program. Six essential topics were identified for the program: appropriate communication of cancer epidemiology, clinical trial information, new therapeutic technologies, support in the use of medicines, psycho-oncological interventions, age-personalized approaches, and training programs for healthcare providers. Integration of these topics along with patient feedback is the key to a successful model for educational programs. An integrated educational program can transform a comprehensive cancer center to an institution that provides research and care for and with patients. [ABSTRACT FROM AUTHOR]

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This paper discusses the authors' approach to designing an interface for the Gabii Project's digital volumes that attempts to fuse elements of traditional synthetic publications and site reports with rich digital datasets. Archaeology, and classical archaeology in particular, has long engaged with questions of the formation and lived experience of towns and cities. Such studies might draw on evidence of local topography, the arrangement of the built environment, and the placement of architectural details, monuments and inscriptions (e.g. Johnson and Millett 2012). Fundamental to the continued development of these studies is the growing body of evidence emerging from new excavations. Digital techniques for recording evidence 'on the ground,' notably SFM (structure from motion aka close range photogrammetry) for the creation of detailed 3D models and for scene-level modeling in 3D have advanced rapidly in recent years. These parallel developments have opened the door for approaches to the study of the creation and experience of urban space driven by a combination of scene-level reconstruction models (van Roode et al. 2012, Paliou et al. 2011, Paliou 2013) explicitly combined with detailed SFM or scanning based 3D models representing stratigraphic evidence. It is essential to understand the subtle but crucial impact of the design of the user interface on the interpretation of these models. In this paper we focus on the impact of design choices for the user interface, and make connections between design choices and the broader discourse in archaeological theory surrounding the practice of the creation and consumption of archaeological knowledge. As a case in point we take the prototype interface being developed within the Gabii Project for the publication of the Tincu House. In discussing our own evolving practices in engagement with the archaeological record created at Gabii, we highlight some of the challenges of undertaking theoretically-situated user interface design, and their implications for the publication and study of archaeological materials. [ABSTRACT FROM AUTHOR]

Background: In severe neonatal hyperammonemia, extracorporeal dialysis (ECD) provides higher ammonium clearance than peritoneal dialysis (PD). However, there are limited outcome data in relation to dialysis modality. Methods: Data from infants with hyperammonemia secondary to inborn errors of metabolism (IEM) treated with dialysis were collected in six Italian centers and retrospectively analyzed. Results: Forty-five neonates born between 1990 and 2011 were enrolled in the study. Of these, 23 were treated with PD and 22 with ECD (14 with continuous venovenous hemodialysis [CVVHD], 5 with continuous arteriovenous hemodialysis [CAVHD], 3 with hemodialysis [HD]). Patients treated with PD experienced a shorter duration of predialysis coma, while those treated with HD had a shorter ammonium decay time compared with all the other patients ( p < 0.05). No difference in ammonium reduction rate was observed between patients treated with PD, CAVHD or CVVHD. Carbamoyl phosphate synthetase deficiency (CPS) was significantly associated with increased risk of death (OR: 9.37 [1.52-57.6], p = 0.016). Predialysis ammonium levels were significantly associated with a composite end-point of death or neurological sequelae (adjusted OR: 1.13 [1.02-1.27] per 100 μmol/l, p = 0.026). No association was found between outcome and dialysis modality. Conclusions: In this study, a delayed ECD treatment was not superior to PD in improving the short-term outcome of neonates with hyperammonemia secondary to IEM. [ABSTRACT FROM AUTHOR]

Urso, the last of the great Salernitan physicians, was both an ardent defender of a theoretical, scientific medicine and the first in the medieval West to propose, in his aphorisms, a rational and naturalistic explanation of the healing power of incantations. The article explores this paradox and provides an in-depth analysis of Urso's highly original and hitherto ignored argument, as well as its intellectual and social background. According to Urso, the efficacy of incantations relies not on the power of words, but on the charismatic physician's "aura"--spirits emanating from his body--and the patient's confidence in and conformity with the physician. Urso compares medical incantations to teaching, fascination, demonic magic, sacraments, and prayer. It is argued that Urso's incursions into theology are both a tactic to defend his bold naturalism against accusations of unorthodoxy and a reflection of his ambition to create a comprehensive "science of everything." Urso's text and an English translation are provided in an appendix. [ABSTRACT FROM AUTHOR]

This article concerns itself with the references in Ibn Ḥayyān's Muqtabis, Book V, to an Amalfitan presence at the court of Cordoba in the middle of the fourth/tenth century. It will be argued that these isolated references to a precociously early, Italian, mercantile presence in Spain, taken largely at face value by the text's editor and all but neglected in Amalfitan historiography, need to be interrogated to determine whether they fit the fourth/tenth-century context of Amalfitan–Muslim relations, or should be read against their fifth/eleventh-century context as evidence for a golden age of the Caliphate which, by Ibn Ḥayyān's day, was already passing into memory and myth. Using contemporary, comparative evidence from Barcelona, the article examines the possibility of communications between Italy and Spain in the earlier period, and concludes that the conditions were probably right for an Amalfitan arrival, but rapidly changed by Ibn Ḥayyān's day to exclude them from further contacts. [ABSTRACT FROM AUTHOR]

The article presents an exploration into the interdisciplinary influence of human ethology and sociobiology upon the study of gender roles and theories of cultural constructions of marriage and sexual behavior. The author provides a social study of a village in Tuscany in the late 16th- and early 17th-century, suggesting that the mating and marriage behaviors of the society corresponded to psycho-biological demands rather than cultural constructions.

Simple Summary: Antimicrobial resistance is a global threat involving human, animal, and environmental health. Evidence of antibiotic resistance was found in pets, livestock, humans, in uncontaminated environments, or in animals never treated with antibiotics. In order to provide new data, this study was carried out in the protected area of the Maiella National Park (Central Italy) sampling wild and domestic ungulates that share or do not share grazing lands. The analysis was realized by combining the georeferenced data of animals and the microbiological investigations starting from fresh fecal samples. The Escherichia coli isolates were tested for antibiotics particularly relevant in human health. Even if the selected molecules are not currently used in veterinary medicine, evidence of resistant bacteria was found in sympatric wild and domestic animals, as well as in non-sympatric domestic animals. The detection of colistin resistance gene mcr-4 and carbapenems resistance genes OXA-48 was reported for the first time in wild ungulates in Italy and in Europe. More investigations are necessary, but these preliminary results highlight the importance of continuing studies for the early detection of emerging resistance patterns. The aim of this study was to determine and characterize potential resistance mechanisms against selected Critically Important Antibiotics in Escherichia coli isolates collected from wild and domestic ruminants living in the Maiella National Park, in Central Italy. A total of 38 isolates were obtained from red deer, Apennine chamois, cattle, sheep, and goats grazing in lands with different levels of anthropic pressure. Antimicrobial susceptibility was determined by Minimal Inhibitory Concentration testing, showing phenotypic resistance to colistin, meropenem, or ceftazidime in 9 isolates along with one bacterial strain being resistant to three of the tested antibiotics. In addition, the biomolecular assays allowed the amplification of the genes conferring the colistin (mcr-4), the carbapenems (OXA-48), penicillins and cephalosporins (TEM, SHV, CMY-1, CMY-2) resistance. In order to describe the potential pathogenicity of isolates under study, virulence genes related to Shiga toxin-producing (STEC) and enteropathogenic (EPEC) pathovars were identified. This study is the first report of mcr-4 and OXA-48 genes in resistant E. coli harboring virulence genes in Italian wildlife, with special regard to Apennine chamois and red deer species. The multidisciplinary approach used in this study can improve the early detection of emerging antibiotic resistance determinants in human-animal-environment interfaces by means of wildlife monitoring. [ABSTRACT FROM AUTHOR]

Antimicrobial resistance is a major public health concern restricted not only to healthcare settings but also to veterinary and environmental ones. In this study, we analyzed, by whole genome sequencing (WGS) the resistome, mobilome and virulome of 12 multidrug-resistant (MDR) marine strains belonging to Shewanellaceae and Vibrionaceae families collected at aquaculture centers in Italy. The results evidenced the presence of several resistance mechanisms including enzyme and efflux pump systems conferring resistance to beta-lactams, quinolones, tetracyclines, macrolides, polymyxins, chloramphenicol, fosfomycin, erythromycin, detergents and heavy metals. Mobilome analysis did not find circular elements but class I integrons, integrative and conjugative element (ICE) associated modules, prophages and different insertion sequence (IS) family transposases. These mobile genetic elements (MGEs) are usually present in other aquatic bacteria but also in Enterobacteriaceae suggesting their transferability among autochthonous and allochthonous bacteria of the resilient microbiota. Regarding the presence of virulence factors, hemolytic activity was detected both in the Shewanella algae and in Vibrio spp. strains. To conclude, these data indicate the role as a reservoir of resistance and virulence genes in the environment of the aquatic microbiota present in the examined Italian fish farms that potentially might be transferred to bacteria of medical interest. [ABSTRACT FROM AUTHOR]

Simple Summary: In recent years, in geographic areas such as Central Italy, the wild boar population has greatly increased. Although wildlife represents a fundamental resource for ecosystems and biodiversity, wild animals could act as reservoirs for different pathogens, representing an issue for human and domestic animal health. This investigation reports the presence and circulation of pathogenic and antimicrobial-resistant Escherichia coli in wild boar hunted in Tuscany (Italy). Different pathotypes, responsible for human and animal diseases, were detected. Furthermore, resistance to commonly used antibiotics was detected in a large percentage of isolates. Considering the possibility of contact between wild boars, domestic animals, and humans, active monitoring of pathogens is essential for epidemiological purposes. Wild boar are among the most widespread wild mammals in Europe. Although this species can act as a reservoir for different pathogens, data about its role as a carrier of pathogenic and antimicrobial-resistant Escherichia coli are still scarce. The aim of this study was to evaluate the occurrence of antimicrobial-resistant and pathogenic Escherichia coli in wild boar in the Tuscany region of Italy. During the hunting season of 2018–2019, E. coli was isolated from 175 of 200 animals and subjected to antimicrobial resistance tests and PCR for detection of resistance and virulence factor genes. The highest resistance rates were against cephalothin (94.3%), amoxicillin–clavulanic acid (87.4%), ampicillin (68.6%), and tetracycline (44.6%). The most detected resistance genes were blaCMY-2 (54.3%), sul1 (38.9%), sul2 (30.9%), and tetG (24.6%). Concerning genes encoding virulence factors, 55 of 175 isolates (31.4%) were negative for all tested genes. The most detected genes were hlyA (47.4%), astA (29.1%), stx2 (24.6%), eaeA (17.1%), and stx1 (11.4%). E. coli was classified as Shiga toxin-producing E. coli (STEC) (21.7%), enterohemorrhagic E. coli (EHEC) (6.3%), enteroaggregative E. coli (EAEC) (5.1%), and atypical enteropathogenic E. coli (aEPEC) (3.4%). Enterotoxigenic E. coli (ETEC), enteroinvasive E. coli (EIEC), and typical enteropathogenic E. coli (tEPEC) were not detected. Our results show that wild boars could carry pathogenic and antimicrobial-resistant E. coli, representing a possible reservoir of domestic animal and human pathogens. [ABSTRACT FROM AUTHOR]