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Marked changes in human dispersal and development during the Middle to Upper Paleolithic transition have been attributed to massive volcanic eruption and/or severe climatic deterioration. We test this concept using records of volcanic ash layers of the Campanian Ignimbrite eruption dated to ca. 40,000 y ago (40 ka B.P.). The distribution of the Campanian Ignimbrite has been enhanced by the discovery of cryptotephra deposits (volcanic ash layers that are not visible to the naked eye) in archaeological cave sequences. They enable us to synchronize archaeological and paleoclimatic records through the period of transition from Neanderthal to the earliest anatomically modern human populations in Europe. Our results confirm that the combined effects of a major volcanic eruption and severe climatic cooling failed to have lasting impacts on Neanderthals or early modern humans in Europe. We infer that modern humans proved a greater competitive threat to indigenous populations than natural disasters.

In many nosocomial Legionella outbreaks water distribution systems are the most frequent source of infection.Considering the hospital waterline old age, an investigation on colonization by Legionella spp was carried out in order to evaluate the pipeline system weaknesses and to implement environmental preventive measures.From 2004 to 2010, overall 97 samples from the water line were collected. The samples were analyzed according to the italian Legionella spp standard methods; water temperature, pH and residual free chlorine were determined at the time of collection. X2 test, exact-test and t-test were used to compare proportions and means.Overall 28 samples (23.7%) were positive for Legionella spp, and five of them (17.9%) exceeded the threshold level104 cfu/L. The number of positive samples varied along the years, showing a significant increasing trend (X2 for trend = 11.5; p0.01), but most occurred in 2008 (53,6%), when the hospital underwent major building reconstruction. Samples positive for Legionella spp by comparison to negative ones showed a lower free chlorine concentration (0.08 mg/L vs 0.15 mg/L) and a higher water temperature (46.1° vs 42.7°). Actually the percentage of positive samples decreased significantly with the increasing in free chlorine in the water (X2 for trend = 8.53; p0.01). The samples collected at the connection between public water line with the hospital supply network were always free from Legionella. All hospital buildings were colonized by Legionella spp, although 80% of samples104 cfu/L occurred in the C-building. No cases of nosocomial legionellosis were reported during the study period.Hospital water system showed a diffuse colonization by Legionella spp, although the degree of contamination reached the threshold level (104 cfu/L) only in a small percentage of samples, showing a substantial effectiveness of the control measures applied.

In patients with wounds admitted to Emergency Departments (ED) acquiring tetanus vaccination history by interview is very unreliable. Protected patients may receive unnecessary prophylaxis and unprotected nothing. Aim of the study was to evaluate tetanus immunity status comparing the traditional anamnestic method with the Tetanus Quick Stick (TQS), a rapid immunochromatographic test.A double-blind prospective study was carried out in the ED of the 1,000 bed teaching hospital Umberto I in Rome. Adult patients (≥18) with wounds attending at the ED were randomly included. Tetanus immunity status was evaluated by healthcare workers (HCWs) comparing the TQS test with the anamnesis. TQS test was performed by a trained HCW and afterwards the anamnesis about tetanus immunity status was collected by another HCW unaware of the TQS result. Also cost analysis was carried out.Overall 400 patients (242 males and 158 females) were included, mean age was 46.7 ± 20.2 years (median 44 range 18 - 109), 304 (76.0%) were italians and 96 foreigners (24.0%). Overall, 209 (52.2%) resulted TQS +, and protective immunity level was associated to lower mean age (40.1 ± 16.8 vs 53.8 ± 21,1; p0,01). Using the anamnestic method 336 (84.0%) patients resulted "unprotected", 52 (13.0%) "partially unprotected" and 12 (3.0%) "completely protected". TQS test results showed that 154 (45.8%) out of 336 "unprotected" and 45 (86.5%) out of 52 "partially unprotected" actually had a protective antibody level. Finally two (16.7%) out of 12 "completely protected" group presented a non protective antibody level. Following only the anamnestic method 201 (50.0%) patients would have received some inappropriate treatment. Adopting TQS test in all patients would also be cost-effective saving € 1.95/patient. As tetanus immunity is inversely related to age, for51 years old patients unnecessary treatment would have been avoided in 57.1% of patients, with a mean reduction per patient of € 7.50/patient with the TQS vs. € 12.69/patient without.The study showed that tetanus protective immunity prevalence among adult patients attending our ED is about 50% and is mainly influenced by class age. TQS use allowed to reduce drastically inappropriate tetanus vaccine and immunoglobulins booster treatment. Also TQS use reduced costs.

We present an improved density model and a new structural map of the Neapolitan Yellow Tuff caldera, the active portion of the nested Campi Flegrei caldera. The model was built using a new 3-D inversion of the available high-precision gravity data, and a new digital terrain and marine model. The inversion procedure, based on a variable-depth lumped assembling of the subsurface gravity distribution via cell aggregation, gives better defined insights into the internal caldera architecture, that well agree with the available geological, geophysical, and geochemical data. The adopted 3-D gravity method is highly efficient for characterizing the shallow caldera structure (down to 3 km depth) and defining features related to regional or volcano tectonic lineaments and dynamics. In particular, the resulting density distribution highlights a pronounced density low in correspondence of the central portion of the caldera with a detail not available till now. The joint interpretation of the available data suggests a subsurface structural setting that supports a piecemeal collapse of the caldera, and allows the identification of its headwall. Positive gravity anomalies localize dense intrusions (presently covered by late volcanic deposits) along the caldera marginal faults, and the main structural lineaments both bordering the resurgent block and cutting the caldera floor. These results allow us to both refine the current geological-structural framework and propose a new structural map that highlights the caldera boundary and its internal setting. This map is useful to interpret the phenomena occurring during unrest, and to improve both short-term and long-term volcanic hazards assessment.

È necessario che gli approcci puramente probabilistici, fondamentali nel decidere le soglie caratteristiche del fenomeno di unrest siano accompagnati da valutazioni deterministiche d’insieme delle variazioni osservate nei segnali geofisici e geochimici all’interno di un unica ipotesi di riferimento compatibile con la dinamica degli ultimi 5.000 anni dei Campi Flegrei nota su base vulcanologica oltreché storica.

The e-cigarette, also known as e-cig, represents an emerging issue of great concern for public health. The aim of the present report was to explore the scientific literature about the use of electronic cigarette (e-cig), with a particular reference to the features of "toxicological safety", "effectiveness in overcoming the addiction to smoking the traditional cigarette" and "necessary research agenda". The efficacy of e-cig for smoking cessation is uncertain: some authors found that it can be a valid support, but long-term cessation rate has not be assessed. Other studies evidenced that e-cig is often used not for quitting smoking but to avoid smoking ban for traditional cigarettes and, even, some researches evidenced that it appears to contribute to nicotine addiction. E-cig smoking seems to be less dangerous of conventional cigarettes, but its use is not risk-free. Besides, cases of accidental or intentional poisoning with liquid solutions of e-cig have been reported. Also, the smoke of e-cig decreases indoor air quality, releasing particulate matter and other toxics that can persist on surfaces for days and generating passive exposure. These phenomena are similar to environmental tobacco smoke produced by conventional smoking, that is the sum of second- and third-hand smoke. We propose to call them "environmental electronic smoke", "electronic-second- hand smoke" and "electronic-third-hand smoke", respectively. Uncertainties relating to e-cig features determined the sequence, in the short term, of warnings and regulations approved and then replaced. In conclusion, although in recent years many researches were performed, evidences is limited and there is a need to study in deep all these issues.

This paper introduces the aims and scope of the RESET project (. RESponse of humans to abrupt Environmental Transitions), a programme of research funded by the Natural Environment Research Council (UK) between 2008 and 2013; it also provides the context and rationale for papers included in a special volume of Quaternary Science Reviews that report some of the project's findings. RESET examined the chronological and correlation methods employed to establish causal links between the timing of abrupt environmental transitions (AETs) on the one hand, and of human dispersal and development on the other, with a focus on the Middle and Upper Palaeolithic periods. The period of interest is the Last Glacial cycle and the early Holocene (c. 100-8 ka), during which time a number of pronounced AETs occurred. A long-running topic of debate is the degree to which human history in Europe and the Mediterranean region during the Palaeolithic was shaped by these AETs, but this has proved difficult to assess because of poor dating control. In an attempt to move the science forward, RESET examined the potential that tephra isochrons, and in particular non-visible ash layers (cryptotephras), might offer for synchronising palaeo-records with a greater degree of finesse. New tephrostratigraphical data generated by the project augment previously-established tephra frameworks for the region, and underpin a more evolved tephra 'lattice' that links palaeo-records between Greenland, the European mainland, sub-marine sequences in the Mediterranean and North Africa. The paper also outlines the significance of other contributions to this special volume: collectively, these illustrate how the lattice was constructed, how it links with cognate tephra research in Europe and elsewhere, and how the evidence of tephra isochrons is beginning to challenge long-held views about the impacts of environmental change on humans during the Palaeolithic. © 2015 Elsevier Ltd., RESET was funded through Consortium Grants awarded by the Natural Environment Research Council, UK, to a collaborating team drawn from four institutions: Royal Holloway University of London (grant reference NE/E015905/1), the Natural History Museum, London (NE/E015913/1), Oxford University (NE/E015670/1) and the University of Southampton, including the National Oceanography Centre (NE/01531X/1). The authors also wish to record their deep gratitude to four members of the scientific community who formed a consultative advisory panel during the lifetime of the RESET project: Professor Barbara Wohlfarth (Stockholm University), Professor Jørgen Peder Steffensen (Niels Bohr Institute, Copenhagen), Dr. Martin Street (Romisch-Germanisches Zentralmuseum, Neuwied) and Professor Clive Oppenheimer (Cambridge University). They provided excellent advice at key stages of the work, which we greatly valued. We also thank Jenny Kynaston (Geography Department, Royal Holloway) for construction of several of the figures in this paper, and Debbie Barrett (Elsevier) and Colin Murray Wallace (Editor-in-Chief, QSR) for their considerable assistance in the production of this special volume.

L’isola di Pantelleria è la parte emersa di un vulcano attivo che si innalza per più di 1000 m dal fondo del mare nel Canale di Sicilia. Questo vulcanismo è la conseguenza della tettonica trans-tensionale del Rift del Canale di Sicilia, iniziata nel Miocene Superiore. L’attività vulcanica sull’isola, iniziata da almeno 324 ka, è direttamente correlata alle deformazioni prodotte sia dalla tettonica regionale che dalla vulcano-tettonica, ed è stata caratterizzata da eruzioni esplosive ed effusive che mostrano un ampio spettro di magnitudo, intensità, e stili. Essa è stata alimentata da magmi composizionalmente variabili da basalti debolmente alcalini a trachiti e rioliti peralcaline. Alcune delle grosse eruzioni esplosive sono state accompagnate da collassi calderici. Il più recente di questi collassi è avvenuto a seguito dell’eruzione del Tufo Verde (50 ka) e ha generato una caldera il cui fondo è stato interessato da un intenso fenomeno di risorgenza negli ultimi 30 ka. La storia vulcanica degli ultimi 50 ka è stata suddivisa in sei cicli di attività caratterizzati da eruzioni alimentate da magmi silicici peralcalini, occasionalmente intercalati da eruzioni di magmi basici. La genesi dei magmi basici è dovuta a fusione parziale del mantello superiore, mentre quella dei magmi evoluti è stata attribuita o a processi di cristallizzazione frazionata dai magmi basici o ad anatessi di gabbri cumulitici. Benché il persistente stato di attività del vulcano e l’urbanizzazione dell’isola determinano un significativo rischio, le caratteristiche dei magmi eruttati e delle dinamiche delle eruzioni hanno fatto di Pantelleria un ecosistema unico nel Mediterraneo che va pertanto salvaguardato e valorizzato.

Vancomycin-resistant enterococci (VRE) are among the most common healthcare associated multidrug-resistant organisms. Purpose of the article was to review recent data regarding the epidemiology, clinical issues and infection control of this organisms.A PubMed-MEDLINE search was carried out.The European Antimicrobial Resistance Surveillance System (EARSS) highlights a large variability between the various european countries, with VRE ranging from2% (Finland, Holland) to20% (Ireland, Greece, Portugal). Italy shows a low rate level (4.2%). In USA according to the National Healthcare Safety Network (NHSN) in 2006-2007 overall 33% of enterococci were resistant to vancomycin, whereas in Canada VRE prevalence showed to be much lower10%. Although with some methodological limits, several studies showed that infections caused by VRE are more serious and associated to a higher mortality rate and economic burden compared to those caused by vancomycin susceptible enterococci (VSE). The average increased associated mortality was over two-fold. Resistance to newer antimicrobial agents as daptomycin and linezolid has been described, complicating treatment options for infections caused by these organisms.Control measures aimed at reducing the incidence of VRE colonization and infection in healthcare settings should include: hand washing with an antiseptic or a waterless antiseptic agent, routine screening for vancomycin resistance among clinical isolates, rectal surveillance cultures, contact isolation for patients with VRE and antimicrobial stewardship.

The effect of exposure to some air pollutants during pregnancy on embryonic and fetal development has been evaluated by several studies, but it has not been well defined. The main objective of this study was to use a systematic review to evaluate the relationship between air benzene exposure in pregnant women and possible negative effects on intrauterine development and negative outcomes at birth.After a systematic literature search, we identified five peer-reviewed studies with quantitative results regarding the association between benzene exposure during pregnancy and adverse outcomes on intrauterine development and at birth. The characteristics of the study design and population of each selected article were summarised.There was evidence for the association between an increase in preterm birth or a decrease in biparietal diameter growth with maternal exposure to benzene or early exposure to aromatic solvents, while the evaluation of the relationship between benzene exposure during pregnancy and other parameters (i.e., birthweight, fetal weight, birth length, head circumference growth, fetal femur length, and abdominal circumference) returned no clear conclusions.Further studies are required to confirm and clarify the possible adverse outcomes of benzene exposure during pregnancy. Recommendations for future studies are related to the most appropriate strategies for outcomes and exposure assessment and the evaluation of "individual genetic susceptibility", which is a possible confounding factor in this kind of studies.

New geochronological, geochemical, and Sr-isotopic data on volcanics erupted before the Campanian Ignimbrite (CI, 37 ka) and the Neapolitan Yellow Tuff (NYT, 12 ka) caldera-forming eruptions at Campi Flegrei (CF) have allowed us to investigate the behavior and temporal evolution of the Phlegraean magmatic system. The most prominent feature of the CF magmatic system was the existence of a large, trachytic magma chamber, episodically recharged, which fed eruptions for tens of thousands years before the CI and NYT eruptions. During the pre-CI caldera activity, magmas were episodically erupted from vents located outside the present caldera structure. These magmas ranged in composition from trachyte to alkali-trachyte, with Sr-isotope ratios increasing through time, and becoming identical to that of the CI magma, at about 44 ka ago. This suggests that the Phlegraean magmatic system before the CI eruption was acting as an open system. It was being progressively replenished by new batches of magma that mixed with the resident less radiogenic, fractionating trachytic magmas and was periodically tapped. The magma chamber evolution culminated in the catastrophic eruption of the voluminous (150 km3 DRE), chemically and isotopically zoned CI trachytic magmas, and in the resultant CI caldera formation. Subsequent to the CI eruption, during a period of moderate subaereal volcanic activity of about 20 ka duration, magmas predominantly trachytic to alkali-trachytic in composition and isotopically similar to the last emitted CI magma were erupted from vents located inside the CI caldera. The temporal trend shown by Sr-isotope ratios provides evidence for a new input of alkali-trachytic magma, at ca. 15 ka, with 87Sr/86Sr ratio identical to that of the alkali-trachytic magma feeding the first phase of the NYT eruption. These data testify to the arrival in a short time span of a new trachytic to alkali-trachytic magma in the system, isotopically distinct from the CI magma, that gave rise about 3 ka later to eruption of the NYT (40 km3 DRE).

The Agnano–Monte Spina tephra (AMST), dated at 4100 years BP by 40Ar/39Ar and 14C AMS techniques, is the product of the highest-magnitude eruption in the Campi Flegrei caldera (CFc) during its last epoch of activity (4800–3800 years BP). The sequence alternates magmatic and phreatomagmatic pyroclastic-fallout, -flow and -surge beds and bedsets. Two main pumice-fallout deposits with variable easterly-to-northeasterly dispersal axes are about 10 cm thick at 42 km from the vent area. High particle concentration pyroclastic currents were confined to the caldera depression; lower concentration flows overtopped the morphological boundary of the caldera and traveled at least 15 km over the surrounding plain. The unit is subdivided into six members, named A through F in stratigraphic sequence, based upon their sedimentological characteristics. Isopachs and isopleths maps suggest a vent location in the Agnano plain. A volcano-tectonic collapse begun during the course of the eruption, took place along the faults of the northeastern sector of the resurgent block within the CFc, and generated the Agnano plain. The early erupted trachytic magma had a homogeneous alkali–trachytic composition, whereas later-erupted magma shows small-scale hetereogeneities. Trace elements and Sr-isotope compositions, indicate that two isotopically distinct magmas, one alkali–trachytic and the other trachytic, were tapped and partially mixed during the eruption. The small volume (1.2 km3 DRE) of erupted magma and the structural position of the vent suggest that the eruption was fed by a dyke intruded along a normal fault in the sector of the resurgent block under a tensional stress regime.

In this chapter, we present results of a detailed investigation of the Campanian Ignimbrite (CI) eruption that took place c 40,000 BP. We endeavour to show that the potential impacts of this underrated eruption, in cambination with other environmental factors, demand e reconsideration of the processes and rythms that took place in western Eurasia at a crucial point in time represented by the so-called Middle to Upper Palaeolithic 'transition'. The source of the CI eruption was in the Phlegraean Fields Caldera, north-west of Naples in southern Italy (Figure 2.1). Petrologically identified CI ash layers have been reported from inland and marine sequences throughout south-eastern Europe from the Tyrrhenian Sea to the Volga River in Russia. The extensive CI deposits can be recognised as the product of the largest volcanic eruption during the past 200,000 years in the Greater Mediterranean area, defined here as including the Balkans, Anatolia, and the Pontic (Black Sea) regions. The eruption was large in both intensity and magnitude. The CI sulphate signal has been recognised in the GISP2 ice core, Greenland (Fedele et al 2003). This eruption can be dated to c 40,000 BP by means of argon-argon measurements supported by correlations with the Greenland ice record. This temporal placement draws attention to the climatic context of a time period centred on 40,000 BP, midway through the Weichselian (Last Glacial) Interpleniglacial, which corresponds to stage of Late Pleistocene environmental straitgraphy (MIS 3 ; Figures 2.2 and 3). The volcanic catastrophe precisely overlapped with the culmination of the penultimate Bond cycle of Stage 3, a cooling trend that began ~45,000 BP. We therefore propose that a positivefeedback triggered by an exceptional concurrence of factors - climatic change, glaciation, ocean-ice exchange, and latitude - is likely to have had hemispheric or wider effects. The most pronounced of these was the abrupt cooling coeval with the Heinrich Event 4 (HE4) about 40,000 BP. The scenario of a 'volcanic winter' should therefore be considered. The archaeological changes immediately following the CI are a sign of conspicuous interference with human populations. The coincidenceof a volcanic eruption and Palaeolithic phases had been noted previously (eg, Mussi 2001), but has not been effectively addressed in spite of abundant archaeological evidence in southern Italy and elsewhere. Furthermore, we surmise that the hiatus in human occupation must have has a causal relationship not only with the impact from the blast but with the ecological disruption it generated. It could be argued that only when humans are examined as ecosystem components can the effects of the CI on social and cultural processes - including the Middle to Upper Palaeolithic 'transition' - be understood.