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Pituitary gland metastasis is an unusual event, and pituitary metastasis from lung adenocarcinoma is extremely rare and associated with poor prognosis. To date, approximately 16 cases have been reported. Symptoms of these lesions can mimic hypophysitis, that is a possible immune-related adverse event of ICIs (Immune Checkpoint Inhibitors). Pituitary metastases and hypophisitis are life-threatening diseases and making differential diagnosis is important, because therapy of these conditions is quite different. Differentiating a condition from the other one is difficult, because many imaging features are not specific. In this presented case, cross-sectional imaging, in particular Magnetic Resonance Imaging (MRI), has revealed itself helpful to suggest the diagnosis of pituitary metastasis rather than hypophysitis.

Abstract Background In individuals diagnosed with obstructive sleep apnea syndrome (OSAS), variations in craniofacial structure have been inconsistently documented, showing differing degrees of alteration between obese and nonobese patients. In addition, sleep disturbance has also been shown to induce disequilibrium in this population of patients. This pilot observational study aimed to assess craniofacial values in obese and nonobese subpopulations of patients with OSAS and their correlation and association with the severity of OSAS. We also assessed whether OSAS patients are characterized by an impaired equilibrium in relation to and associated with the severity of OSAS. Methods We included all consecutive adult patients with OSAS. Through cephalometry, we assessed the upper (UPa-UPp) and lower (LPa-LPp) pharynx diameters, superior anterior facial height (Sor-ANS), anterior facial height (ANS-Me), anterior vertical dimension (Sor-Me), posterior facial height (S-Go) and craniovertebral angle (CVA). Furthermore, we analyzed postural equilibrium through a stabilometric examination. Results Forty consecutive OSAS patients (45% female with a mean age of 56 ± 8.2 years) were included. The subgroup of nonobese patients had a reduced UPa-UPp (p = 0.02). Cephalometric measurements were correlated with the severity of OSAS in nonobese patients, whereas only Sor-ANS was correlated with the severity of OSAS in the obese subpopulation. In the overall population, altered craniofacial values are associated with severe OSAS. Although there are differences in equilibrium between obese and nonobese OSAS patients, the stabilometric measurements were not correlated or associated with OSAS severity. Conclusion Altered craniofacial values and compromised equilibrium in OSAS patients are linked to OSAS severity. Therefore, the management of OSAS should be tailored not only to weight management but also to craniofacial and postural rehabilitation to enhance patient outcomes.

The cholecystocolonic fistula (CCF) is an atypical variant of biliary disease, and it is the second most common intestinal fistula after cholecystoduodenal fistula. Intraoperative diagnosis is frequent, which implies challenging surgical management, especially in patients, often aged, with comorbidities. The rarity of this condition, atypical and various presentation, diagnostic and management complexity, makes it a unique surgical entity. We report our experience of an 84-year-old man with a history of chronic cholecystitis who presented with nonspecific symptoms. The imaging tests aroused the suspicion of gallbladder-colic fistula in the preoperative diagnosis, facilitating the subsequent surgical treatment that confirmed the diagnosis.

Wetland areas encompass a range of natural habitats characterized by high animal and plant biodiversity. Understanding the impacts of environmental decline in such areas requires in-depth knowledge of the overall biodiversity. This study dataset provides a first evaluation of important sites of insect and arachnids biodiversity in peat bogs, marshes, and streams in Aspromonte National Park in Calabria, southern Italy. It is a basic faunal survey that aids understanding of the importance of these large faunal groups in sites mainly within this national park. The data obtained highlight a rich insect and spider diversity in this region and provide useful information to use to outline strategies for the conservation and the management of inland aquatic environments at risk from climate change. Moreover, as baseline data, these will be useful for future monitoring and management of other inland aquatic environments that are similar to those of the study sites reported herein.

PurposeThe coronavirus pandemic (COVID-19) significantly impacted the global economy and health. Italy was one of the first and most affected countries. The objective of our study was to assess the impact of the pandemic and the vaccination campaign on the radiological examinations performed in a radiology department of a tertiary center in Southern Italy.Materials and methodsWe analyzed weekly and retrospectively electronic medical records of case volumes performed at the Radiology Department of “Mater Domini” University Hospital of Catanzaro from March 2020 to March 2022, comparing them with the volumes in the same period of the year 2019. We considered the origin of patients (outpatient, inpatient) and the type of examinations carried out (x-ray, mammography, CT, MRI, and ultrasound). A non-parametric test (Wilcoxon Signed Rank test) was applied to evaluate the average volumes.ResultsTotal flows in the pandemic period from COVID-19 were lower than in the same pre-pandemic period with values of 552 (120) vs. 427 (149) median (IQR) (p

Abstract Background We developed a 13-mer locked nucleic acid (LNA) inhibitor of miR-221 (LNA-i-miR-221) with a full phosphorothioate (PS)-modified backbone. This agent downregulated miR-221, demonstrated anti-tumor activity against human xenografts in mice, and favorable toxicokinetics in rats and monkeys. Allometric interspecies scaling allowed us to define the first-in-class LNA-i-miR-221 safe starting dose for the clinical translation. Methods In this first-in-human, open-label, dose-escalation phase 1 trial, we enrolled progressive cancer patients (aged ≥ 18 years) with ECOG 0–2 into 5 cohorts. The treatment cycle was based on a 30-min IV infusion of LNA-i-miR-221 on 4 consecutive days. Three patients within the first cohort were treated with 2 cycles (8 infusions), while 14 patients were treated with a single course (4 infusions); all patients were evaluated for phase 1 primary endpoint. The study was approved by the Ethics Committee and Regulatory Authorities (EudraCT 2017-002615-33). Results Seventeen patients received the investigational treatment, and 16 were evaluable for response. LNA-i-miR-221 was well tolerated, with no grade 3–4 toxicity, and the MTD was not reached. We recorded stable disease (SD) in 8 (50.0%) patients and partial response (PR) in 1 (6.3%) colorectal cancer case (total SD + PR: 56.3%). Pharmacokinetics indicated non-linear drug concentration increase across the dose range. Pharmacodynamics demonstrated concentration-dependent downregulation of miR-221 and upregulation of its CDKN1B/p27 and PTEN canonical targets. Five mg/kg was defined as the recommended phase II dose. Conclusions The excellent safety profile, the promising bio-modulator, and the anti-tumor activity offer the rationale for further clinical investigation of LNA-i-miR-221 (ClinTrials.Gov: NCT04811898).

Littoral cell angioma (LCA) is a primary splenic hemangioma found mostly in normal red sinus shore cells of the reticuloendothelial cell system of the spleen. In most cases is benign, but sometimes malignancies have been reported. This tumor displayed epithelial and histiocytic properties based on its cell of origin, splenic littoral cells. In this case report, we will describe a case of a 21-year-male presenting with an incidentally discovered LCA illustrated by cross-sectional imaging techniques, highlighting how the diffusional sequence and the positron emission tomography study, thanks to their greater specificity, have contributed to reaching a correct diagnostic orientation more than dynamic studies with contrast agent in both computed tomography and magnetic resonance.

Granulomatosis with polyangiitis (GPA), previously known as Wegener's granulomatosis, is a necrotizing granulomatous vasculitis of the small and medium vessels involving the upper respiratory tract, lungs, and kidneys. In this case report, we will describe the case of a 60-year-old man who presented to our observation with recurrent episodes of hemoptoe, fever, and mucopurulent sputum. The diagnosis was made by radiological and laboratory tests.

BackgroundThe optimal strategy for the treatment of recurrent and/or advanced endometrial cancer is still undefined. Recently, despite the lack of any predictive biomarker, the combination of pembrolizumab with lenvatinib has improved survival outcomes. We here report the long-term management of lung toxicity in a patient with endometrial cancer, and we critically review the current therapeutic options for this disease.ResultsA patient with heavily pretreated endometrial cancer took pembrolizumab plus lenvatinib for 1 year, achieving a persistent partial response with a time to treatment failure of 18 months, despite relevant lung toxicity that did not affect the remarkable overall clinical benefit. A systematic review of this combination underlines the efficacy outcome despite toxicity. Interestingly, the literature review on lung toxicity suggested the role of anti-angiogenetic agents in the pathogenesis of lung cavitation, probably related to direct treatment activity, and disclosed a potential radiological sign predictive of the activity of anti-angiogenetic agents.ConclusionWe underline the efficacy of pembrolizumab plus lenvatinib in the current treatment landscape of endometrial cancer, underscoring the relevance of a correct management of toxicity.

The SARS-CoV-2 vaccination campaign is probably one of the most historic public hygiene measures in modern medicine. The drama of the pandemic has forced the scientific community to accelerate the development and commercialization of vaccines, thereby enhancing the phases of active surveillance. Among the adverse events following immunization (AEFI) reported, those of an audiovestibular interest, such as sudden sensorineural hearing loss (SSNHL), tinnitus, dizziness, and vertigo, constitute a very small percentage. There are many plausible etiological hypotheses, and scientific research needs to pay more attention to the correct collection of data, which up until now have often been inadequate and fragmented, on which to base future studies. SSNHL, new onset tinnitus, vertigo, and dizziness require a prompt evaluation, while the proposed treatment is the same as it is for events unrelated to vaccination. These are uncommon adverse events, and the risk rates for these diseases have not increased in conjunction with the COVID-19 vaccinations, therefore there is no justification of any hesitation towards the vaccination campaign.

BackgroundColorectal cancer (CRC) is considered one of the most frequent neoplasms of the digestive tract with a high mortality rate. Left hemicolectomy (LC) and low anterior resection (LAR) with minimally invasive laparoscopic and robotic approaches or with the open technique are the gold standard curative treatment.Materials and methodsSeventy-seven patients diagnosed with CRC were recruited between September 2017 and September 2021. All patients underwent a preoperative staging with a full-body CT scan. The goal of this study was to compare both types of surgeries, LC-LAR LS with Knight–Griffen colorectal anastomosis and LC-LAR open with Trans-Anal Purse-String Suture Anastomosis (the TAPSSA group), by positioning a No-Coil transanal tube (SapiMed Spa, Alessandria, Italy), in terms of postoperative complications such as prolonged postoperative ileus (PPOI), anastomotic leak (AL), postoperative ileus (POI), and hospital stay.ResultsThe patients were divided into two groups: the first with 39 patients who underwent LC and LAR in LS with Knight–Griffen anastomosis (Knight–Griffen group) and the second with 38 patients who underwent LC and LAR by the open technique with the TAPSSA group. Only one patient who underwent the open technique suffered AL. POI was 3.76 ± 1.7 days in the TAPSSA group and 3.07 ± 1.3 days in the Knight–Griffen group. There were no statistically significant differences in terms of AL and POI between the two different groups.ConclusionThe important point that preliminarily emerged from this retrospective study was that the two different techniques showed similarities in terms of AL and POI, and therefore, all the advantages reported in the previous studies pertaining to No-Coil also hold good in this study regardless of the surgical technique used. However, randomized controlled trials are needed to confirm these findings.

A 62 years old woman 6 months after left total hip prosthesis referred to our institution for persistent pain and warm, stiff, and swollen joint. 18F-FDG CT/PET Images showed an intense focal uptake corresponding to the external margin of inter-trochanteric region of prosthesis and inside the stem inferiorly, but common decision was to reconstruct PET images without attenuation correction and now showed a complete and unexpected disappearance of focal and pathological FDG uptake. This case shows the potential propagation of CT artifacts into PET emission data close to metal implants and should be taken in account together to SUV values.

BackgroundTo prospectively evaluate the diagnostic accuracy of magnetic resonance imaging (MRI) for the planning of surgical treatment of deep pelvic endometriosis.Materials and MethodsFrom January 2020 to December 2021, we evaluated 72 patients with symptoms characteristic of endometriosis to plan appropriate surgical treatment. Sensitivity (Se), specificity (Sp), positive and negative predictive values (VPP/VPN), and the accuracy of MRI for the detection of deep pelvic endometriosis were calculated.ResultsSeventy-two patients (mean age, 35.5 years; range, 20–46 years) suspected of having pelvic endometriosis were recruited. Pelvic endometriosis was confirmed at pathologic examination in 56 (77.7%) of 72 patients. A total of 22 (39.3%) of 56 patients were subjected to video laparoscopy (VLS), and 16 (72.2%) of 22 were treated by surgery. Se, Sp, VPP, and VPN in intestinal endometriosis diagnosis were, respectively, 100%, 93.3%, 100%, and 87.5%, and diagnostic accuracy was 95.4%. MRI Se in ureteral endometriosis diagnosis was 50%, Sp 100%, VPP 100%, VPN 78%, and diagnostic accuracy 82%. MRI Se in endometrioma diagnosis was 92.3%, Sp 100%, VPP 100%, VPN 90%, and diagnostic accuracy 95.4%. MRI Se in rectum-vaginal septum (SRV) endometriosis diagnosis was 80%, Sp 100%, VPP 100% VPN 85.7%, and diagnostic accuracy 91%. The MRI Se in the diagnosis of endometriosis involving ULS was 100%, Sp 92.8%, VPP 89%, VPN 100%, and diagnostic accuracy 95.4%. Complete concordance results in a 100% accuracy for all calculated values in diagnosing bladder endometriosis localizations.ConclusionMR imaging demonstrates high accuracy in detecting deep pelvic endometriosis in specific locations. It allows the localization of deep pelvic lesions with highly fibrotic components that are hardly recognizable with other imaging methods and not visible with VLS.

The distribution and knowledge on the Mediterranean mantid Iris oratoria (Linnaeus, 1785) is here updated. Despite is beautiful appearance and presence in the social media, the scientific knowledge on its real distribution is poor and incomplete and this may affect its conservation at local scales. Citizen science records have been here compared with traditional science records, here updated with many new and original localities: this species is reported for the first time for Libya, Malta, Calabria and many Mediterranean islands and islets. The ecological preferences have been investigated in a retrodunal transect to investigate the preferred vegetation patterns for this species. The general value of citizen science records in evaluating the real distribution of a species have been tested here, using Iris oratoria as a case study for further investigations.

The expectation is that the phenology of an herbivore is influenced by abiotic factors and its own population density during development. In this study, we investigated how the pupal density affected the pupal traits and emergence of Thaumetopoea pityocampa moths over a period of 3 years in two clearings in a pine forest. The pupae were larger in years when the pupal density was high and in the clearing exposed to less solar radiation. There was no relationship between the time of pupation and pupal size. Large pupae were positively correlated with an early emergence of adult moths and a longer period of adult emergence. Up to 13.9% of the pupae developed without cocoons, especially in years when they were abundant, but this did not affect the emergence of the moths. Incidence of pupal diapause was density-dependent and only occurred at a low level in dense populations. Overall, our results indicate that gregariousness confers important fitness-related advantages in this species.

According to the EASL Guidelines for the management of hepatocellular carcinoma, transcatheter arterial chemoembolization is the first-line treatment recommended for intermediate-stage HCC. Furthermore, it is widely accepted that patients beyond the Milan criteria can be considered for a liver transplant after successful downstaging to within the Milan criteria. Response to downstaging treatments significantly influences not just drop-outs, but also the rate of post-transplantation tumor recurrences. TACE with degradable starch microspheres represents an alternative to conventional TACE with lipiodol and TACE with drug-eluting beads, and it leads to transient arterial occlusion allowing lower activation of hypoxia-inducible factors and less release of vascular endothelial growth factor, a promoter of neoangiogenesis, tumor proliferation, and metastatic growth. In patients with intermediate-stage HCC and a Child-Pugh score of 8 or 9, life expectancy may be dominated by cirrhotic liver dysfunction, rather than by the tumor progression itself; hence, locoregional treatments might also be detrimental, precipitating liver dysfunction to an extent that survival is shortened rather than prolonged. Data on tolerability, toxicity, and effectiveness of DSM-TACE are limited but encouraging. Between January 2015 and October 2020, 50 consecutive patients with intermediate-stage hepatocellular carcinoma and a Child-Pugh score of 8/9, who had undergone DSM-TACE as the first-line treatment, were eligible for the study. A total of 142 DSM-TACEs were performed, with a mean number of 2.84 procedures per patient. The mean time-to-downstaging was 19.2 months, with six patients successfully downstaged. OS was about 100% at six months, 81.8% at 12 months, and 50% at 24 months. Twenty-two patients experienced adverse events after chemoembolization. The median OS and safety of DSM-TACE in this study are comparable with other published investigations in this field. Furthermore, 12% of patients were successfully downstaged. Hence, the results of the current investigation demonstrate that DSM-TACE is effective and safe in intermediate-stage HCC, achieving an interesting downstaging rate. Such data were observed in the population subset with a Child-Pugh score of 8 or 9, in which life expectancy may be determined by cirrhotic liver dysfunction, so the achievement of a balance between the safety and efficacy profile of the TACE treatment is crucial.

In patients with early-stage hepatocellular carcinoma, awaiting liver transplantation, current guidelines by AASLD and ESMO recommend a bridging therapy with a loco-regional treatment to prevent progression outside transplantation criteria. The standard of care in delaying disease progression has been recognized to be the transarterial chemoembolization. Permanent occlusion of tumor feeding vessels has effects on tumour stromal microenvironment by inducing intra- and intercellular signaling processes counteracting hypoxia, such as the release of vascular endothelial growth factor, a promoter of neoangiogenesis, tumour proliferation and metastatic growth. Among chemoembolization interventions, TACE with degradable starch microspheres represents an alternative to conventional cTACE and DEB-TACE and it minimizes detrimental effects on tumour stromal microenvironment, guaranteeing a transient occlusion of tumour feeding arteries and avoiding VEGF overexpression.Between January 2015 and September 2020, 54 consecutive patients with early-stage hepatocellular carcinoma and Child-Pugh stage B, who had undergone DSM-TACE as a bridging therapy while awaiting liver transplantation, were eligible for the study. A total of 154 DSM-TACE was performed, with a mean number of 2.85 procedures per patient. 18 patients (33.3%) succeeded in achieving liver transplantation, with a mean waiting time-to-transplantation of 11.7 months. The cumulative rates of patients still active on the WL at 6 months were about 91 and 93% when considering overall drop-out and tumour-specific drop-out respectively. Overall survival was about 96% at 6 months and 92% at 12 months. 17 patients experienced adverse events after the chemoembolizations. For patients with HCC in the transplant waiting list and within the Child-Pugh B stage, life expectancy may be dominated by the liver dysfunction, rather than by the tumour progression itself. In this population subset, the choice of LRT is critical because LRT itself could become a dangerous tool that is likely to precipitate liver dysfunction to an extent that survival is shortened rather than prolonged. Hence, the current study demonstrates that DSM-TACE is not far from being an ideal LRT, because it has an excellent safety profile, maintaining an efficacy that guarantees a clear advantage on the dropout rate with respect to the non-operative strategy, thus justifying its use.

Lethocerus patruelis (Stål, 1854) is the only European member of the Belostomatidae family. During the last decades Lethocerus patruelis records have become frequent in south-eastern Italy, probably due to multiple accidental introductions or a natural westward spread of its range. The first records of Lethocerus cfr. patruelis for the Calabria region are here reported. The first individual was observed alive and photographed in Villapiana (Cosenza province), while the second one was found and collected in Prunella (Melito di Porto Salvo municipality, Reggio Calabria province). The status of Lethocerus patruelis in this region and in Italy as introduced or naturally spreading species is yet to be assessed.

The present paper proposes a new methodology to characterize the landslide susceptibility of the Reggio Calabria metropolitan area. For this purpose, various factors were used, such as land use, slope, rainfall, elevation, lithology, distance from roads and rivers, and thanks to the use of GIS devices and the AHP method, the landslide risk was defined for the whole territory. The values obtained were classified into four categories: low, moderate, high, and very high. They were then exported into the GIS environment to produce a landslide susceptibility map. The study carried out demonstrates the fragility of the Calabrian territory. From the results obtained, in fact, 66% of the metropolitan territory of Reggio Calabria appears to have a medium–high landslide risk.

A quali-quantitative analysis of diterpenoid composition in tissues obtained from different organs of Pinus nigra subsp. laricio (Poiret) Maire (Calabrian pine) was carried out. Diterpene resin acids were the most abundant diterpenoids across all the examined tissues. The same nine diterpene resin acids were always found, with the abietane type prevailing on the pimarane type, although their quantitative distribution was found to be remarkably tissue-specific. The scrutiny of the available literature revealed species specificity as well. A phylogeny-based approach allowed us to isolate four cDNAs coding for diterpene synthases in Calabrian pine, each of which belonging to one of the four groups into which the d3 clade of the plants’ terpene synthases family can be divided. The deduced amino acid sequences allowed predicting that both monofunctional and bifunctional diterpene synthases are involved in the biosynthesis of diterpene resin acids in Calabrian pine. Transcript profiling revealed differential expression across the different tissues and was found to be consistent with the corresponding diterpenoid profiles. The isolation of the complete genomic sequences and the determination of their exon/intron structures allowed us to place the diterpene synthase genes from Calabrian pine on the background of current ideas on the functional evolution of diterpene synthases in Gymnosperms.

Diagnostic imaging in bladder cancer plays an important role since it is needed from pretreatment staging to follow-up, but a morphological evaluation performed with both CT and MRI showed low sensitivities and specificities in detecting pathologic lymph nodes, due to the occurrence of false positive results. Implementation of functional information provided by PET/CT could be a determinant in the management of patients with muscle-invasive bladder cancer. A focus on the role of 18F-FDG PET/CT and alternative tracers in patients with muscle-invasive bladder cancer is provided in this analysis in order to outline its potential applications in staging settings and response evaluation after neoadjuvant chemotherapy.

Terpenoids make up the biggest and most diversified class of chemical substances discovered in plants, encompassing over 40,000 individual compounds. In conifers, the production of terpenoids, either as oleoresin or emitted as volatile compounds, play an important role in the physical and chemical defence responses against pathogens and herbivores. In the present work, we examined, for the first time to the best of our knowledge, the terpenic defensive relations of Calabrian pine (Pinus nigra subsp. laricio (Poiret) Maire), facing the attack of the pine processionary moth (Thaumetopoea pityocampa (Denis and Schiffermüller, 1775)), brought about in the open on adult plant individuals growing at two distinct forest sites. Among the volatile terpenoids emitted from pine needles, bornyl acetate [(4,7,7-trimethyl-3-bicyclo[2.2.1]heptanyl) acetate] was the most frequently and selectively associated with the infestation, increasing during the period of most intense trophic activity of the caterpillars (defoliation), and decreasing thereafter. Although further work is needed to clarify whether the observed response reflects defence reactions and/or they are involved in communication among the infested plants and their biotic environment, the present results boost the currently growing interest in the isolation and characterization of plant secondary metabolites that can be used to control pests, pathogens, and weeds.

Pulmonary alveolar microlithiasis is a disorder in which many tiny fragments (microliths) of calcium phosphate gradually accumulate in alveoli. Loss of function mutations in the gene SLC34A2 coding for the sodium phosphate co-transporter (NaPi-IIb) are responsible for genetic forms of alveolar microlithiasis. We now report a consanguineous Italian family from Calabria with two affected members segregating alveolar microlithiasis in a recessive fashion. We describe, for the first time, a novel loss of function mutation in the gene coding for NaPi-IIb. A careful description of the clinical phenotype is provided together with technical details for direct sequencing of the gene.

This study elaborates on a typology of demographic change and tests this definition at the lowest granular level (LAU2, municipality) with official data. This typology distinguishes between fragile and resilient municipalities based on population dynamics (in terms of duration and intensity) over 1991–2021. This study’s second aim is to elaborate a spatial autoregressive econometric model to evaluate to what extent and in which direction the rate of participation of potential beneficiaries of the Rural Development Programmes (RDPs) of 2014–2020 is affected by demographic change and other explanatory variables. Regression models compare the results of the OLS (aspatial) and spatial autoregressive models (SAR) of four types of participation rates (all RDP schemes; all LEADER schemes; sectoral schemes of RDP and LEADER; non-sectoral schemes of RDPs and LEADER). This comparison makes it possible to understand the differences between centralised and decentralised management and between sectoral and broader rural-targeted schemes. The results of the models appear attractive in interpreting the role of RDP instruments in different regions and local areas. First, the rate of participation is strongly dependent on macro-regional differences. Regarding the demographic factors at the local level, this study highlights that demographic fragility does not necessarily hamper the use of RDP measures. Conversely, the participation rate in RDP policy schemes seems particularly significant in very fragile areas, whereas significance has yet to be proved in other demographic typologies. This result holds particularly true for the policy uptake of non-sectoral schemes. Furthermore, LEADER decentralised interventions fit the fragile areas more than resilient and vital ones due to the territorially targeted approach followed by the Local Action Groups.

Posterior cruciate ligament (PCL) injury is a rare ligamentous knee injury which most commonly occurs due to direct trauma; it represents only 0.65% of knee injuries. On the basis of magnetic resonance imaging (MRI), PCL injury is divided into surgical and non-surgical. In the last few years we have witnessed an increasing interest in regenerative medicine. The use of innovative techniques allow the reduction of rehabilitation times in sports injuries. Platelet-Rich-Plasma (PRP) is a plasma-derived which stimulate the tissue repair. The objective of our work is to compare the rehabilitation times in PCL non-operative injuries treated with standard conservative treatment and PCL injuries treated with autologous PRP followed by rehabilitation program. We divided patients into two different groups: Group A formed by patients who underwent a standard conservative rehabilitation program and Group B which included patients treated by ultrasound guided PRP injection and following physiotherapy program. Both groups of patients resumed sports activities; however the rehabilitation times for patients which had undergone treatment with autologous PRP injection were reduced compared to patients who underwent a standard conservative treatment.

This study aims to answer the following research questions: (a) to what extent do EU rural development supports for investments address territorial differences of rural areas, especially concerning the differences between rich and intensive areas, on one hand, and marginal and peripheral rural areas on the other hand; (b) how does present governance and the delivery system of measures supporting rural investments contribute to the financial support of marginal and peripheral rural areas? To respond to these questions, the research examined 747 calls for tender in all Italian regions related to 16 types of investment measures and a global amount of EUR 67 billion Euros and 49,410 representative projects approved in 17 Italian regions during the period 2014–2020. Delivery mechanisms included the rules that have been set up to define recipient eligibility and selection criteria of the rural development programmes. The distributive effects of RDP investment support measures appear evidently uneven, especially in agricultural and agro-industrial competitiveness measures, which are mainly allocated in already dynamic and strongly competitive areas. Delivery mechanisms boost disparities when funds are allocated through the “open competition” approach. Instead, the modulation of territorial criteria in the implementation phase can provide effective results in terms of reducing disparities in fund allocation and outreaching the most lagging areas. There are two main novelties of this research: (a) the analysis of territorial criteria in the calls for tenders for investment support, and (b) the effects of these criteria on expenditure distribution at the municipal level (LAU2 in the EU nomenclature). This study has been carried out outside the formal methodological approaches promoted by the European Commission for RDP evaluation and might be considered a complementary approach to evaluation reporting activity. This study might provide two significant contributions to the debate on rural areas. First, a “combined” approach to the definition of rurality (mixing “structural” and “locational” approaches) might provide a better analytical framework in line with the evolution of the literature on rurality. Second, the delivery systems that put more emphasis on territorial targets, as they were presented in this study, might be an essential component of a place-based policy.

The article focuses on the role of Localized Agri-food Systems (LAFS) in the provision of environmental and social benefits (ESBs) in peripheral areas, by comparing two case studies in Italy: bergamot production in Grecanic area (Calabria region) and a basket of local products in Garfagnana area (Tuscany region). On the basis of the evidence collected through semi-structured interviews with key stakeholders, the paper shows the different mechanisms by which LAFS may stimulate the provision of ESBs in such areas. In both case studies the provision of ESBs was the result of the interplay among three different types of drivers: markets factors, the set of policies implemented in the specific territorial context and collective actions performed by local actors to promote new governance patterns and new institutions. The article shows that in peripheral areas LAFS, alongside food production, have a strong potential in delivering a broad range of environmental and social benefits, which are highly valued by local communities and consumers. However, this potential varies to large extent according to the socio-economic and institutional settings, as well as on the type of interactions of market drivers with public policies and collective action.

This article explores the role of a specific Localised Agri-food System (LAFS) in the provision of Environmental and social benefits (ESBs) in densely cultivated, industrialised, and populated areas by analysing the core of the processing tomato supply chain of northern Italy (Parma and Piacenza). The research examines how the interplay of market drivers, public policies, and collective actions favoured farming, technological, and organisational innovations geared to support long-term economic growth and tackle, at the same time, environmental challenges. The tomato supply chain is characterised by a favourable convergence of attitudes, policies, and market conditions that over time allowed for fruitful interactions between private stakeholders and between the supply chain and public players. Decades of key stakeholders’ interconnections within the tomato supply chain led to a success story of economic growth and attention to a new balance between agro-industry and environment, for the benefit of producers/processors, consumers, and natural resources. Profitability strategies inevitably imply intensification of farming in order to maximise profit levels per hectare, however, the tomato supply chain found a collective motivation that could grant profitability and concurrently reward producers and processors for attention paid to safeguarding the environment—giving evidence that intensification does not necessarily conflict with requirements in support of sustainability.

This paper will address the changes the CAP post‐2013 may bring to its second pillar in EU countries. After the presentation of the legislative package put forward by the European Commission, a debate emerged in some countries on how to define rural development strategies for the period 2014‐2020. The paper will discuss positive innovations and main challenges of the new rural development policies with respect to what happened in the 2007‐2013 period. In particular, the paper intends to focus on the following issues: 1) which relevant changes have been introduced in the rural development framework; 2) how these changes can influence the preparation of the next programming period 2014-2020, looking more in depth at three countries (Italy, Spain and France); 3) what lessons can be drawn from this reform and the initial implementation in three countries in terms of institutional changes and their likely success and failure. This analysis concludes that the success or failure of the 2014-2020 reform of rural development will significantly depend on what types of transaction costs and incentive systems will be brought about within the programming system. These two factors in turn will strongly depend on the way the different actors will perceive the different costs and incentives, their expectations on the role of rural development programmes in a context where budget for agriculture is shrinking everywhere, and finally their capability to build new strategic alliances and cooperation at every level (national, regional and local) with other economic and social actors. Future policy scenarios might bring new and heavy constraints to rural development policies and consequently might also reduce the opportunities of institutional innovations.