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International audience; Seventy four Reference Sites of the European Innovation Partnership on Active and Healthy Ageing (EIP on AHA) have been recognised by the European Commission in 2016 for their commitment to excellence in investing and scaling up innovative solutions for active and healthy ageing. The Reference Site Collaborative Network (RSCN) brings together the EIP on AHA Reference Sites awarded by the European Commission, and Candidate Reference Sites into a single forum. The overarching goals are to promote cooperation, share and transfer good practice and solutions in the development and scaling up of health and care strategies, policies and service delivery models, while at the same time supporting the action groups in their work. The RSCN aspires to be recognized by the EU Commission as the principal forum and authority representing all EIP on AHA Reference Sites. The RSCN will contribute to achieve the goals of the EIP on AHA by improving health and care outcomes for citizens across Europe, and the development of sustainable economic growth and the creation of jobs.

Both medical doctors and humanitarian operators engaged in health relief or development missions abroad, are called to respect the general principles of international law, that is to say, customary law that is legally compulsory for the International Community and rules deriving from Treaties and International Conventions. Humanitarian operators have to observe also the rules and regulations of the hosting country. They have to respect all rules applying to their humanitarian action and they have to take responsibility towards beneficiaries and donors alike.

Risk perception is due to a subjective evaluation of reality and depends on a number of factors such as: individual coherence and flexibility, the set of social values and rules that contributed to the definition of the individuals' interior world - this does not always make proper risk perception possible. Even though the way common people set-up their own judgment is based on their own interpretation tracks, surely different from expert criteria, we cannot label their approach as irrational. Over time, through an evolutionary process, people have decided what is safe and what is dangerous; this personal awareness was not based on the science but on experiences, images, feelings and emotions. Most of the time, neither social nor economical conditions can prevent people to feel an epidemic risk in the same way as it was felt during the plague of 1350. Most of the time, after a disaster, victims experience a regression so, for example, even if it is known that corpses do not always cause infections, after the tsunami disaster, most of the bodies were quickly cremated by scared survivors; this made the identification and burial of the victims impossible.

Recent studies show how in the 2004-2005 period there has been an increase in natural disasters of 18% worldwide. According to a renowned author planning for disaster response is as valid as the starting hypothesis. The study of an inductive mental process in disaster response planning is the key to avoiding the invention and re-invention of the wheel for each emergency. Research in this field however is hampered by different factors one of which is data collection that during disaster response requires specific training. Standardization of data collection models with limitation of the number of variables is required as is taking into account problems related to people migration and subsequent sampling problems and retrospective analysis. Moreover poor attention to the training of the volunteers employed on the field is an issue to be considered.

Facing the numerous humanitarian emergencies that upset the international balances, the International Organisations (IO) who intervene are: the Agencies of the United Nations (UN), the International Federation of the Red Cross (IFRC) and NGOs. In the sector of international health cooperation, the World Health Organization (WHO) has elaborated a document, the International Health Regulations (IHR), that regulates the health workers' activity during a health emergency. In this paper different International Organizations employed in international humanitarian crisis are described.

To investigate the coping strategies of a group of adolescents with somatic symptom disorder compared to non-somatic symptom disorder peers during the COVID-19 related lockdown.This cross-sectional study is the second part of a previously published study showing an improved trend in depression and anxiety in a group of patients with somatic symptom disorder compared to non-somatic symptom disorder peers. An anonymous semi-structured survey was distributed to two groups of Italian adolescents to measure the impact of quarantine on their daily life and coping strategies.We recruited 115 adolescents, 58 (50.4%) mean age 15.3, with a recent diagnosis of somatic symptom disorder and 57 (49.6%) mean age 15.8, control peers.The aim of this study was to detect differences in coping strategies and relationships with parents and peers, during the lockdown period in a group of adolescents with somatic symptom disorder and low disease burden when compared with a non-somatic symptom disorder group.The relationship with parents significantly worsened in 4 (6.9%) of adolescents with somatic symptom disorder compared to 12 (21.1%) adolescents in the non-somatic symptom disorder group (p = 0.048). The relationship with peers significantly improved in 13 (22.4%) of adolescents with symptom disorder versus 3 (5.3%) of peers of the non- somatic symptom disorder group (p = 0.013).Adolescents with somatic symptom disorder with a low burden of physical symptoms experienced less deterioration in their relationships with parents and peers than the non-somatic symptom disorder group.

MED13-related disorder is a new neurodevelopmental disorder recently described in literature, which belongs to the group of CDK8-kinase module genes-associated conditions. It is characterized by variable intellectual disability and/or developmental delays, especially in language. Autism spectrum disorder (ASD), attention deficit hyperactivity disorder (ADHD), eye or vision problems, hypotonia, mild congenital hearth abnormalities and dysmorphisms have been described among individuals with MED13 mutations. We report the case of a 13-year-old girl who received a previous clinical diagnosis of Kabuki syndrome (KS) without mutations in classic KS genes. After a whole exome sequencing (WES) analysis a de novo missense mutation in MED13 (c.C979T; p.Pro327Ser) was found. This variant has been once described in literature as accountable for a novel neurodevelopmental disorder. The aim of this report is to improve clinical delineation of MED13-related condition and to explore differences and similarities between KS spectrum and MED13-related disorders.

A 13-year-old boy was admitted for a 4-day history of fever, malaise, sore throat and cough, treated with amoxicillin for 2 days. Physical examination revealed sparse targetoid cutaneous lesions, stomatitis with vesicles, blisters and mild conjunctival hyperaemia (figure 1). Blood tests showed an increase in erythrocyte sedimentation rate (92 mm/hour; normal value

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The feasibility and design of the CultCube 12U CubeSat hosting a small Environmental Control and Life Support Systems (ECLSS) for the autonomous cultivation of a small plant in orbit is described. The satellite is aimed at running experiments in fruit plants growing for applications in crewed vehicles for long-term missions in space. CultCube is mainly composed of a pressurized vessel, constituting the outer shell of the ECLSS, and by various environmental controls (water, nutrients, air composition and pressure, light, etc.) aimed at maintaining a survivable habitat for the fruit plants to grow. The plant health status and growth performances is monitored using hyperspectral cameras installed within the vessel, able to sense leaves' chlorophyll content and temperature, and allowing the estimation of plant volume in all its life cycle phases. The paper study case is addressed to the in-orbit experimental cultivation of a dwarf tomato plant (MicroTom), which was modified for enhancing the anti-oxidants production and for growing in stressful environments. While simulated microgravity tests have been passed by the MicroTom plant, the organism behaviour in a real microgravity environment for a full seed-to-seed cycle needs to be tested. The CultCube 12U CubeSat mission presents no particular requirements on the kind of orbit, whereas its minimum significative duration corresponds to one seed-to-seed cycle for the plant, which is 90 days for the paper study case. In the paper, after an introduction on the importance of an autonomous testbed for plant cultivation, in the perspective of the implementation of bioregenerative systems on-board future manned long-term missions, the satellite design and the MicroTom engineered plant for in-orbit growth are described. In addition to the description of the whole set of subsystems, with focus on the payload and its controllers and instrumentation, the system budgets are presented. Finally, the first tests conducted by the authors are briefly reported.

The purpose of this study is to investigate the current status of contamination due to the heavy metal and organic substances (PAHs, HC >12, organotin compounds, PCB, DDD, DDE, DDT) pollution of the sediments from the coastal area of the Bagnoli brownfield (Naples, Italy) and draw some hypotheses on the origin and trends of industrial and also geogenic contamination. Surface sediments and cores were collected and analysed. The results showed remarkable concentrations of heavy metals, PAHs, and other substances that are significantly higher than the national guideline values of sea sediment quality. Correlation analyses and spatial distribution analyses showed that generally the inorganic and organic pollutants have similar patterns, confirming the common origin from the industrial activity, but also that some of the studied metals have some natural contribution originated from the geologic setting of the area. The distribution of most of the heavy metals (especially Cd, Hg, Pb, Cu, Zn, partially Cr and Ni) and PAHs are similar, and the highest concentrations were recognised between and just off the piers, but a diffuse contamination is widespread up to the external areas of the site perimeter, rising concern on the diffusion of contaminants to the whole Gulf of Pozzuoli.

ObjectiveThis study aims to explore the attitude of adolescents with chronic diseases toward social media exposure, focusing in particular on Facebook.DesignCross-sectional study.SettingAn anonymous semistructured survey was distributed to an Italian hospital-based cohort of adolescents with chronic disease to explore the role of Facebook in their daily life.PatientsWe recruited 212 adolescents (aged between 13 and 24 years) with a diagnosis of inflammatory bowel disease, coeliac disease, diabetes mellitus type 1 and cystic fibrosis.ResultsTwo hundred and seven of the 212 (97.6%) expressed the need of sharing their illness experience with friends, 201 out of 212 (94.8%) usually searched information on the internet to find new therapies and to discover their prognosis. One hundred and forty-nine out of 212 adolescents (70.3%) perceived dependence on their parents as the most negative aspect of having a chronic disease, and 200 out of 212 (94.3%) were looking for friends with the same disease on Facebook. Two hundred and ten out of 212 (99.1%) did not want their doctors or nurse on their social media platforms. During the active disease periods, the time spent with social media increased from an average of 5 to 11 hours.ConclusionsThis descriptive analysis focused on the Facebook impact on chronic disease perception among affected adolescents. It showed that they used to spend an increased amount of time on this platform during disease flare-up and highlighted their wish of keeping doctors and nurses away from their social dimension.

Plant cultivation on spacecraft or planetary outposts is a promising and actual perspective both for food and bioactive molecules production. To this aim, plant response to ionizing radiations, as an important component of space radiation, must be assessed through on-ground experiments due to the potentially fatal effects on living systems. Hereby, we investigated the effects of X-rays and γ-rays exposure on tomato “hairy root” cultures (HRCs), which represent a solid platform for the production of pharmaceutically relevant molecules, including metabolites and recombinant proteins. In a space application perspective, we used an HRC system previously fortified through the accumulation of anthocyanins, which are known for their anti-oxidant properties. Roots were independently exposed to different photon radiations, namely X-rays (250 kV) and γ-rays (Co60, 1.25 MeV), both at the absorbed dose levels of 0.5, 5, and 10 Gy. Molecular changes induced in the proteome of HRCs were investigated by a comparative approach based on two-dimensional difference in-gel electrophoresis (2D-DIGE) technology, which allowed to highlight dynamic processes activated by these environmental stresses. Results revealed a comparable response to both photon treatments. In particular, the presence of differentially represented proteins were observed only when roots were exposed to 5 or 10 Gy of X-rays or γ-rays, while no variations were appreciated at 0.5 Gy of both radiations, when compared with unexposed control. Differentially represented proteins were identified by mass spectrometry procedures and their functional interactions were analyzed, revealing variations in the activation of stress response integrated mechanisms as well as in carbon/energy and protein metabolism. Specific results from above-mentioned procedures were validated by immunoblotting. Finally, a morphometric analysis verified the absence of significant alterations in the development of HRCs, allowing to ascribe the observed variations of protein expression to processes of acclimation to ionizing radiations. Overall results contribute to a meaningful risk evaluation for biological systems exposed to extra-terrestrial environments, in the perspective of manned interplanetary missions planned for the near future.

This paper is aimed at demonstrating the possibility of growing a tomato ideotype, fortified in anti-oxidant content (derived from Micro-Tom, a model cultivar for tomato research overexpressing anthocyanins) and specifically developed for spatial environment, in a seed-to-seed cycle (70-90 days) on a CubeSat. To reach this goal, a dedicated micro satellite equivalent to 12 U will be developed to be sent into low-orbit. Growing plants in space is a prerequisite to sustain long-term human exploration of the solar system. Plants can increase the independence of a space mission providing astronauts with food, oxygen, waste recycling, water purification increasing quality of life. Preliminary experimental results to simulate the low orbit conditions are here described, together with all the devices used during the test activities. © 2018 IEEE.

L'articolo esamina il contributo del giurista Claude-Marie Raudot , deputato della Droite durante la Seconda Repubblica, al dibattuto sul decentramento, da lui condotto nelle pagine della rivista "Correspondant" con la competenza del giurista, ma anche con l’esperienza maturata come sindaco d’Avallon, nel cuore della Borgogna, durante gli anni della monarchia orleanista.

Summary Objectives The diagnosis of bloodstream infections (BSIs) in immunocompromised patients, such as patients with cancer, is challenging. Although blood culture (BC) is considered the standard diagnostic tool for BSIs, it takes several days to yield results and has low sensitivity in these patients. Here, we tested a novel method for diagnosing BSIs in a large cohort of immunodepressed patients. Methods Real-time PCR (LightCycler ® Septi Fast Test M GRADE , Roche Diagnostics) was compared with BC for its ability to detect bacteria and fungi in blood samples from 100 immunocompromised patients (98 with cancer) in whom sepsis was suspected. Results In concordant samples (79.2% of total cases), real-time PCR identified the presence or absence of microbes significantly faster than BC ( p =3.7×10 −49 , t -test). Furthermore, in 6 cases, Septi Fast distinguished contamination of BCs by coagulase-negative staphylococci. Septi Fast , however, failed to detect 5 cases of clinically relevant BSI that tested positive by BC. Conclusions Septi Fast rapidly diagnosed BSIs in our cohort of immunosuppressed patients. The results of this study suggest that Septi Fast can be used in conjunction with, but cannot replace, BC to better identify the etiology of fever in immunocompromised patients.

Nardi L, Zucchini S, D’Alberton F, Salardi S, Maltoni G, Bisacchi N,Elleri D, Cicognani A. Quality of life, psychological adjustment andmetabolic control in youths with type 1 diabetes: a study with self- andparent-report questionnaires.Pediatric Diabetes 2008: 9: 496–503.Objective: To evaluate self and parent reports on quality of life (QoL)and psychological adjustment of youths with type 1 diabetes, incomparison to a general paediatric population, and identify relationshipsbetween disease duration, metabolic control and psychologicalparameters.Research design and methods: Participants included 70 youths with type1 diabetes and their parents. They were compared with 70 non-diabeticsubjects. Data were analyzed in the whole group and in subgroups aged6–10, 11–13 and 14–18 yr. All cases performed pediatric QoL, ChildBehaviour Checklist, filled in by parents, and Youth Self-Report, filled inby youths. Data were compared with haemoglobin A1c (HbA1c) valuesand disease duration.Results: Self-reports showed a psychological adjustment of youths withtype 1 diabetes similar to that of controls. Parent reports showed thatparents of children with type 1 diabetes were more worried than those ofcontrols (p , 0.01). Adolescents showed a worse QoL and more frequentpsychological disturbances. In this group, for youth and parent reports,HbA1c levels correlated positively with psychological problems(p , 0.05) and negatively with QoL (p , 0.05). Only for parent reports,in the whole group and in subgroups aged 6–10 and 11–13 yr, diseaseduration correlated positively with psychological adjustment (p , 0.05).Conclusions: Before adolescence, youths with type 1 diabetes showedonly slight problems in psychological adjustment and QoL, with anassociation with disease duration reported by parents. In adolescence,both youths and their parents reported more emotional and behaviouralproblems, independent of disease duration. Better metabolic control andpsychological well-being seemed directly related.

Come è noto, la definizione di 'Grande Tribunale' fa riferimento al tribunale supremo di ogni organizzazione statuale di età moderna; un tribunale regio - o principesco - composto solo da giuristi, designati personalmente dal sovrano, e fra i più illustri, con competenze esclusive in alcune materie - i reati di lesa maestà, su tutti - e con competenze d'appello su tutte le sentenze emanate dai tribunali di grado inferiore. Gli studi su questi organismi apicali nell’organizzazione della giustizia di ciascun ordinamento hanno registrato negli ultimi decenni un notevole incremento. Appare oramai assodato nel panorama della storiografia giuridica il riconoscimento del ruolo centrale svolto da tali corti nella formazione stessa del diritto effettivamente applicato. Assoluta protagonista, in tale fenomeno, è la dottrina giuridica. Nel passaggio all’età Moderna si delinea, infatti, un progressivo spostamento del centro di elaborazione della scienza del diritto dalle università ai tribunali, i giuristi eleggono la prassi giudiziaria a centro quanto mai vitale delle loro speculazioni. Si assiste dunque alla creazione ed allo sviluppo di un diritto sub specie interpretationis che tra il XVI e il XIX secolo, in tutta Europa, trova la sua “culla” nei Supremi Tribunali di ciascun ordinamento territoriale; i suoi interpreti principali sono i giudici di tali Corti, rappresentanti di una vera e propria casta di giuristi, legata alla pratica forense i quali affiancano ed in certi casi surrogano, nella funzione creatrice ed innovatrice del diritto, i professori delle università. Nel mio contributo cercherò di analizzare la fusione profonda avvenuta nel Regnum Siciliae tra prassi giudiziaria e scienza giuridica. Quest’ultima, infatti, tra il XVI ed il XVII secolo, elegge il processo a campo privilegiato per le sue speculazioni, vedendo altresì fiorire i generi letterari ad esso dedicati quali i trattati ma soprattutto le raccolte di Decisiones dei Supremi Tribunali dell’isola. Artefici di tale fusione sono quei giudici-giuristi che allo stesso tempo ricoprono il ruolo di alti magistrati oltre che di esponenti di spicco della dottrina siciliana.

Objectives Brain damage following a perinatal hypoxic–ischemic (HI) insult has been documented by different diagnostic techniques. The aim of the present study was to relate a-EEG time course during the first 24h of life to brain metabolic changes detected by proton MR spectroscopy ( 1 H-MRS) at 7–10days of life and to evaluate their correlation with outcome. Methods Thirty-two patients with any grade HI encephalopathy were studied. Thirty-one out of 32 patients survived and underwent 1 H-MRS examination at 7–10days of life; a-EEG was recorded during the first 24h of life in 27/32 newborns; 26 patients underwent both examinations. Griffiths test, evaluation of motor skills, visual and hearing function were performed at regular intervals until the age of 2years. Results a-EEG at 6, 12 and 24h of life showed a significant correlation with outcome. N -acetyl-aspartate/creatine (Cr), Lactate/Cr and myo-inositol differed significantly between patients with normal or poor outcome. a-EEG time course during the first 24h of life showed improvement in newborns with normal 1 H-MRS and good outcome and a deterioration in those with abnormal 1 H-MRS and poor outcome. Conclusions a-EEG time course may be able to document the severity and the evolution of the cerebral damage following an HI event. a-EEG is related to the severity of cerebral injury as defined by 1 H-MRS and both examinations showed a good correlation with outcome. These data, obtained in non-cooled infants, may represent reference data for future investigations in cooled infants.

Cinta Senese is a white belted pig breed native of Central Italy. Market prices of Cinta Senese (CS) of fresh and cured products are very high and this is due to the quality of the raw material. Assurance that products are made using only CS individuals is what consumers want. Therefore the institution of a protocol for a DNA-based traceability of Cinta Senese products is desirable. Coat colour genes could allow to distinguish this belted breed from the most widespread breeds reared in Italy. Four polymorphisms at locus MC1R and one at locus KIT were analyzed in 180 Cinta Senese (CS) purebred, 18 F1 Large White x CS and 15 F1 Duroc x CS individuals. Cinta Senese is homozygous i/i at locus KIT, whereas it shows two allelic forms at locus MC1R: MC1R*6 and MC1R*3. The results confirm that it is possible to distinguish Cinta Senese from both white and red pig breeds and even from crossbred animals. The suggested protocol might consist in a PCR test genotyping KIT locus combined with at least one of the RFLPs test at the MC1R locus. Furthermore, sequencing of the PCR products were performed in order to validate the protocol.