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Innovation is fundamental for all agri-food companies to increase competitiveness. Being extra-virgin olive oil (EVOO) a traditional food product (TFP), the main obstacle to innovation is its traditional nature. This study evaluated consumers’ acceptance for an EVOO with a naturally increased content of poliphenols, as it has been extracted through ultrasounds. This product has been compared with a set of emerging innovations that may be introduced in the next future. To this end, a choice experiment was carried out bent on the estimation of a Latent Class Model (LCM). A nationally-representative sample of EVOO consumers were involved in a web-based interview. The LCM analysis highlighted three segments of consumers: (1) innovative; (2) traditionalist; (3) cautious. Results showed that there is cluster of consumers willing to accept this innovation, therefore its introduction on the market appears to be possibly successful.

Chronic pelvic pain is a hidden issue which needs to involve many different usually uncoordinated specialists. For this reason there is a risk that treatments, in the absence of well-defined pathways, common goals, and terminology, may be poorly effective. The aim of the present paper is to summarize the evidence on anorectal pelvic pain, offering useful evidence-based practice parameters for colorectal surgeons' daily activity. Analysis of chronic anorectal and pelvic pain syndromes, the diagnostic and clinical optimal needs for evaluation, and the innumerable low evidence treatments and therapeutic options currently available suggests that a multimodal individualized management of pain may be the most promising approach. The limited availability of dedicated centers still negatively affects the applicability of these principles., (© 2024. Springer Nature Switzerland AG.)

Italy is the world leader in the production of pasta and the Italian market is characterized by strong price competition among large industrial producers. Thus, recently, many small and medium firms have started to differentiate their products as a way to achieve higher margins and escape from price competition. Using data on the prices and characteristics of dried pasta sold online in the Italian market and a hedonic price model, we estimated the implicit prices associated with several attributes that are currently available for dried pasta. We find that the "artisanal" statement on pasta labeling is associated with the highest price premium. Also, results show that protected geographical indication, Halal and Kosher certifications, and the use of ancient wheat varieties are valuable features of dried pasta sold in the Italian market. Instead, a positive, albeit limited in magnitude, price premium is associated with dried pasta made using 100% Italian durum wheat semolina, the organic method, enriched with additional ingredients. Findings suggest that producers can differentiate their products by mostly emphasizing their small-scale production methods, the territorial connotation, and the cultural and environmental sustainability of production. Otherwise, certifying dried pasta as Halal or Kosher can represent a complementary or alternative strategy to differentiate the product and achieve a higher price.

Myasthenia gravis (MG) is the most common neuromuscular junction disorder. We evaluated the MG incidence rate in the province of Ferrara, Northern Italy, over two time frames (2008-2018 and 2019-2022, i.e., the COVID-19 pandemic) and considered early-onset (EOMG), late-onset (LOMG), and thymoma- and non-thymoma-associated MG. Moreover, in the second period, we assessed its possible relationship with SARS-CoV-2 infection or COVID-19 vaccination. We used a complete enumeration approach to estimate the MG incidence and its temporal trend. For the period of 2008-18, 106 new cases were identified (mean incidence rate 2.7/100,000 people). The highest rates were observed for the over-70 age group and in rural areas, with 17% of thymoma-associated MG. During the COVID-19 period, 29 new cases were identified (average incidence rate 2.1/100,000 people), showing a marked (though not statistically significant) decrease in the mean annual incidence compared to the previous period. Again, the highest rate was observed for the over-70 age group. The first period was in line with our previous observations for the period between 1985 and 2007, highlighting a rising incidence of LOMG and a marked decrease in EOMG. During the COVID-19 period, incidence rates were lower in the first years whereas, when the pandemic ended, the previous trend was confirmed.

The aim of this paper is to investigate purchase intention (PI) for meat obtained through a tenderization process based on a treatment with exogenous proteolytic enzymes. Particularly, perceived risks and perceived benefits on the consumer acceptance of tender meat produced through this emerging technology have been evaluated. In order to achieve the stated objective, a survey was conducted on a national representative sample of Italian consumers (N = 1006), who received information about the traditional and the emerging tenderization processes. Principal Component Analysis and Structural Equation Model were applied to the collected data. Results show that consumer purchase intention for meat treated with exogenous proteolytic enzymes was strongly influenced by perceived benefits and weakly influenced by perceived risks. Another important result is that perceived benefits are mainly affected by trust in science. Finally, a Cluster Analysis was performed to distinguish consumer segments with different response patterns., Competing Interests: Declaration of Competing Interest The authors declare no conflict of interest., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

We present a rare case of a traumatic lesion of the tibial fibers of the sciatic nerve with spared peroneal fibers. A 33-year-old victim of a three month earlier stabbing attack came to our attention with gait impairment and weakened left foot plantar flexion and left foot internal rotation and supination. Based upon clinical signs and neurophysiological investigations we suspected that a traumatic injury of the left tibial nerve had occurred. Ultrasound examination detected a lesion of part of the left sciatic nerve, in a different site than expected. The patient was immediately enlisted for a tailored surgical reconstruction., Competing Interests: Conflicts of interest: The authors do not report any financial or personal connections with other persons or organizations which might negatively affect the contents of this publication and/or claim authorship rights to this publication., (© 2023 Pietro Antenucci et al., published by Sciendo.)

This study aims to estimate the market value, or implicit prices, associated with the main craft beer attributes (e.g., beer style, organic, gluten-free, and package-related features) and support producers in detecting the more profitable marketing strategies. For this purpose, we conducted an empirical analysis employing sales data of craft beers from the Italian online market, and we estimated a hedonic price model via ordinary least squares. Results show that the type of package and cup only has moderate effects on price. Furthermore, a moderate premium price is found for gluten-free craft beers, while craft beers with organic labels and Italian origin do not benefit from the higher price. Instead, the beer style adopted strongly affected the product price: the highest premium prices were detected for Barleywine (+49.9%) and Italian Grape Ale (+39.6%) beer styles. Furthermore, relevant premium prices, higher than +25%, were estimated for other beer styles such as Sour, Fruit Beer, and Stout. Results suggest that artisanal breweries can effectively differentiate their product according to the beer style. To the best of our knowledge, the current study offers the first empirical evidence on how beer styles as well as other product characteristics affect the market price of craft beer by using secondary data.

The Italian market of processed tomatoes (whole peeled and unpeeled tomatoes, chopped tomato pulp, tomato purée, and concentrated tomato paste) rose, thanks to the Italian tradition of using such products in many recipes of cuisine, until early 2000; since then, it has declined to date. Moreover, such products are traditionally considered low-price products, and their market is characterized by intense price competition. Thus, recently, producers have started to differentiate their products as a way to achieve higher margins, and escape from competition in price. By using the sales data of Italian processed tomatoes sold in several retail stores and a hedonic price model, we estimated the implicit prices associated with several attributes that are currently available in processed tomato products on the market. We find that a protected designation of origin, organic certification, and flavoring, as well as the indication of tomato variety, are the most valuable features of processed tomato products sold in the Italian market. This implies that product differentiation strategies that could be suggested to producers as the most effective are those aimed at enhancing the territorial link of the product, the environmental sustainability of the production process, and organoleptic product features, as well as its convenience.

Health claims have been introduced in food labelling to support consumers' awareness of healthy food choices and to enhance a healthy diet. Even though many countries around the world have developed legislation and guidelines to regulate the introduction of health claims on food labels, there is the evidence that many consumers do not understand the meaning of these claims. This study analyses whether Italian consumers really understand authorized health claims on extra-virgin olive oil and what are the drivers of such understanding. An Olive Oil Health Claims Understanding index was constructed and embedded in a structured questionnaire, which was then administered to a representative sample of Italian household members who are responsible for food shopping (N = 1,030). Results from the survey showed that only 36% of the respondents understood the meaning of the authorized health claims on extra-virgin olive oil. Moreover, the findings confirmed that the understanding of health claims is related to socio-demographic, personal and psychographic characteristics of consumers, as well as to their attitudes toward using food as medicine. Outcomes also proved the central role of nutrition knowledge in affecting understanding of health claims., (Copyright © 2021 Elsevier Ltd. All rights reserved.)

Providing information to consumers through the label is a means for food companies to inform consumers about product's attributes, including the country of origin (COO). In the EU, COO labeling has been made mandatory for several categories of food products, to enable consumers to make informed choices at the point of sale. In particular, Regulation (EU) No 29/2012 has introduced a mandatory country-of-origin labeling system for extra virgin olive oil (EVOO). In the present study, conducted in Italy, we test whether there is a price differential associated with the COO information for EVOO. To this end, we employ a hedonic price model and data about the purchase of EVOO products collected from 982 consumers at the supermarket checkout. Having interviewed these consumers, we also assess the share of EVOO consumers that correctly identify the country of origin of the product purchased. Our findings point out that, in Italy, the EVOO with domestic origin, indicated on the label, benefits of a premium price equal to +35% compared to the product labeled as blend of European EVOOs, while a discount of -10.8% is attached to EVOOs from a non-European origin. A significant share of consumers in our sample (19.04%) is, however, unable to correctly identify the origin of the EVOO purchased. This label misuse mostly occurs among consumers who report that they had purchased Italian EVOO, while they had actually purchased a blend of European EVOOs. Female and more highly educated consumers are less likely to misuse label information about the product's origins.

The aim of this paper is to investigate consumers' preferences and willingness to pay (WTP) for functional mozzarella cheese whose health benefits (reduced fat and enrichment in omega-3) are communicated by using nutrition claims (article 8) and health claims (articles 13 and 14) of the EU Regulation 1924/2006. In order to achieve the stated objective a choice survey was developed and administered to a sample of Italian respondents. The product attributes and attribute levels included in the choice experiment were obtained from in-depth interviews conducted with stakeholders working on the development of this new product in the Italian region of Puglia. Results show that many participants were not aware of functional food. Marketing segmentation performed via latent class analysis indicates that the development of this hypothetical product should be based on the addition of naturally enriched omega-3. In terms of health communication under Regulation 1924/2006, heterogeneity of preferences of the nine identified segments reveals that respondents have a clear preference for products from the Puglia region, for the combined nutrition claim over single nutrition claims and for the reduction of disease health claim (article 14) over the health claim (article 13). In monetary terms, willingness to pay for health claims is higher than nutrition claims.

Innovation is fundamental for all agri-food companies to increase competitiveness, however the industrial process of extra virgin olive oil (EVOO) has changed very little over the last few decades. As it is a traditional food product (TFP), the main obstacle to innovation is precisely its traditional nature. According to the literature, any innovation regarding TFPs should be considered in terms of the specific product, and market success mainly depends upon the perceptions and traits of consumers. The present study evaluated the willingness of consumers to buy an innovative EVOO obtained by ultrasound extraction (ultrasonic EVOO) through an ordered logit model. The sample was composed by 961 EVOO consumers. The average age of respondents was 39 and the majority were female (55.4%). At first, the respondents reacted almost equally to the idea of buying ultrasonic EVOO, with 49% of the sample stating they were not willing to buy the product and 51% stating that they were willing to. The major insight from our study is that consumers who are the most willing to buy the product are those who formed a positive quality perception after being introduced to the key characteristics of the new product. In addition, the willingness to buy seems to be higher for consumers who prefer EVOO with a fruity flavour and without a sweet taste, for consumers who attach great importance to the taste of food and with a higher than average educational level. This predominant role of consumers' perception in the case of innovative TFPs should, thus, be researched further., (Copyright © 2018 Elsevier Ltd. All rights reserved.)

Understanding how an adequate food security may be determined, how nutritional intakes evolve over time and are influenced by global dynamics are few of the questions scholars are trying to answer. In addition, a great interest is devoted to the changes in consumers' preferences and expectations as well as to the analysis of food innovations and their impact on the global market. We review the recent and emerging trends in food supply chains of selected sectors (fruits and vegetables, meat, and seafood), and deepen on emerging trends in the food industry. By presenting the evidence provided by the literature and emphasizing the unresolved research questions, we offer a critical view of future directions that should be followed by research agenda., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

This systematic literature review collects and summarizes research on consumer acceptance and preferences for nutrition-modified and functional dairy products, to reconcile, and expand upon, the findings of previous studies. We find that female consumers show high acceptance for some functional dairy products, such as yogurt enriched with calcium, fiber and probiotics. Acceptance for functional dairy products increases among consumers with higher diet/health related knowledge, as well as with aging. General interest in health, food-neophobia and perceived self-efficacy seem also to contribute shaping the acceptance for functional dairy products. Furthermore, products with "natural" matches between carriers and ingredients have the highest level of acceptance among consumers. Last, we find that brand familiarity drives consumers with low interest in health to increase their acceptance and preference for health-enhanced dairy products, such as probiotic yogurts, or those with a general function claim., (Copyright © 2017 Elsevier Ltd. All rights reserved.)

In our perinatal unit we applied the ten steps of WHO/UNICEF for Baby Friendly Hospital Initiative and evaluated the percentage of exclusive (EBF) or complementary breastfeeding (CBF), and of formula fed (FF) healthy full-term infants (HFI) at hospital discharge (HD). HFI performing EBF at HD were 85.3%, a quite high value. At the age of 3 mths EBF percentage ranged between 59-62.4%, and at 6 mths it decreased to 51.7-37.7%. Customer satisfaction questionnaire at HD ranked "good" to "very good" in 92.8%. Causes of breastfeeding reduction with time and comparison with previous and actual situation in Italy and civilized countries are discussed.

The present systematic review was performed to assess consumer purchasing behaviour towards fish and seafood products in the wide context of developed countries. Web of Science, Scopus, ScienceDirect and Google Scholar engines were used to search the existing literature and a total of 49 studies were identified for inclusion. These studies investigated consumer purchasing behaviour towards a variety of fish and seafood products, in different countries and by means of different methodological approaches. In particular, the review identifies and discusses the main drivers and barriers of fish consumption as well as consumers' preferences about the most relevant attributes of fish and seafood products providing useful insights for both practitioners and policy makers. Finally, main gaps of the existing literature and possible trajectories for future research are also discussed., (Copyright © 2014 Elsevier Ltd. All rights reserved.)

Nowadays the ability to provide outpatient services with exceptional quality is paramount to long-term survival of hospitals, as the revenues from outpatient services are predicted to equal or exceed inpatient revenues in the near future. Identifying the relative weight of different dimensions of healthcare quality service which concur together to determine outpatients satisfaction is very important, as it can help healthcare managers to allocate resources more efficiently and identify managerial actions able to guarantee higher levels of patients' satisfaction. This study proposes the use of Artificial Neural Network (ANN) as a knowledge discovery technique for identifying the service quality factors that are important to outpatient. An ANN model is developed on data from a panel of outpatients of public healthcare services.

The management of unresectable metastatic melanoma is a major clinical challenge because of the lack of reliably effective systemic therapies. Blocking cytotoxic T lymphocyte-associated antigen-4 (CTLA-4) has recently been proposed as a strategy to enhance cell-mediated immune responses to cancer, and clinical trials have demonstrated that anti-CTLA-4 therapy can produce durable outcomes with different response patterns than cytotoxic chemotherapy. We enrolled eight out of 155 patients with advanced melanoma in a multicentre phase II trial that evaluated the activity and tolerability of ipilimumab, a fully human, anti-CTLA-4 monoclonal antibody ( www.clinicaltrials.gov ; NCT00289627; CA184-008). Here we report our experience with three of these patients, who experienced progressive disease after a variety of previous therapies, including prior immunotherapies, and who achieved good outcomes with ipilimumab. One patient had a partial response ongoing at 17+ months on ipilimumab despite failure with four prior therapies, and the other two patients showed durable stable disease, both still ongoing at 17+ and 20+ months, respectively. The patient achieving a partial response experienced no side effects while receiving ipilimumab. The other two patients developed immune-related adverse events (irAEs) including rash (one case; grade 2) and diarrhoea (both cases; grades 1 and 2, respectively); the histopathology of colon biopsy samples from both was suggestive of colitis, with an abundant CD8+ T-cell infiltrate. Nausea, vomiting and acute pancreatitis were also observed in one patient. In addition, immunohistochemical findings of a dense CD8+, TIA1+ and granzyme B+ lymphoid infiltrate within a biopsied lesion provide indirect evidence of functional T-cell activation induced by treatment. These case reports highlight the potential for anti-CTLA-4-based therapy in previously treated patients with advanced melanoma. Moreover, because the patterns of response to ipilimumab differ from chemotherapy, we need to understand how and when patients may respond to treatment so that appropriate clinical decisions can be made.

The procedures that allow identification have evolved during the time inevitably, as a consequence of ever new technologies that can simplify and widen their own application. Nevertheless, it is interesting to focus the attention on how, although time goes by and the use of complex tools, these techniques are based on principles already used by our predecessors and able to resist to the changes imposed by our age. Indeed, if DNA studies can be considered to be recent discovery, the other identification techniques find their reason in past ages; for example dactyloscopy science, identification through bones, forensic odontology that represent milestones of this discipline. Our study underlines that a few aspect of this science have been completely abandoned, some of them are used in the recent identification inquires, other represent a milestone in the development of this science.

1,25-Dihydroxyvitamin D3 [1,25(OH)2D3] is a secosteroid hormone that regulates bone metabolism, controls calcium homeostasis, and possesses immunomodulatory properties. We show here that 1,25(OH)2D3 contributes to the regulation of development and function of mast cells, which play a critical role in several inflammatory disorders. 1,25(OH)2D3 promotes apoptosis and inhibits maturation of mouse bone marrow-derived mast cell precursors. Dose-dependent inhibition of mast cell differentiation by 1,25(OH)2D3 is observed at discrete, intermediate stages of mast cell development, identified by expression of c-kit, FcepsilonRI, and IL-3 receptor-alpha chain, and depends on the expression of the vitamin D receptor (VDR). It is important that mast cell progenitors obtained from VDR-ablated mice undergo an accelerated maturation in vitro and give rise to more responsive mast cells than wild-type. Furthermore, histological analysis of mast cell density in peripheral tissues reveals a moderate increase in the number of mast cells in the skin of VDR-deficient mice compared with wild-type animals. These data support the hypothesis of a physiological role of 1,25(OH)2D3 in mast cell development and suggest novel, therapeutic uses of 1,25(OH)2D3 analogs.

The aim of the study is to show the colorectal cancer trend in Umbria, a central Italian region, from 1978 to 1999. Data concerning regional incidence, mortality and survival derived from an ad hoc survey carried out in Umbria in the period 1978-1982 and from Umbria Population-based Registry (RTUP) for the years 1994-1999. The incidence of colorectal cancer increases in both sexes, expecially for the age class > 75 years. Mortality rises slightly, without no difference between sexes. Survival of patients with colorectal cancer has improved in the two sexes from 45 to 74 years-age, while the lower survival has registered for age between 75 and 84 years. We concluded that the situation in Umbria is quiet good, but it is affected by aging of Umbrian population. Delaying in diagnosis or inefficacy in therapy can explain shorter survival in older patients.

Parathyroid cysts are very uncommon lesions, with about 200 cases in the literature. Differential diagnosis is difficult, particularly with thyroid mass and symptoms of cervical compression and hyperparathyroidism are described. We present a case in which the diagnosis was intraoperative and discuss the treatment of this unusual disease.

A small fraction of solid mass in the head of the pancreas are inflammatory rather neoplastic in origin. The failure to recognize the true nature of a solid tumor in the head of pancreas may lead to an incorrect treatment strategy. This is a report of a patient with clinical history of pancreatic cancer which computed tomography showed a mass in the head of the pancreas with radiologic characteristics of malignancy. The patient underwent exploratory laparotomy with the finding of a mass in the head of the pancreas. The inflammatory palpable characteristic of the mass led to a intraoperative biopsy to confirm the preoperative diagnosis. With the benign result of the biopsy, the final diagnosis was duodenal ulcer which penetrates in the pancreatic parenchyma.