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Within the Project MO.NA.CO. the Environmental effectiveness of GAEC cross-compliance Standard 2.2 ‘Maintaining the level of soil organic matter through management of stubble and crop residues’ and economic evaluation of the competitiveness gap for farmers were evaluated. The monitoring was performed in eight experimental farms of the Council for agricultural research and economics (CREA), distributed throughout Italy and with different soil and climatic conditions. Yield parameters and several components of soil organic matter were evaluated in two contrasting treatments applied to one-year rotation of winter durum wheat and maize: i) incorporation into the soil of crop residues (Factual treatment) and ii) burning or removal of crop residues (Counterfactual treatment). The application of the standard ‘crop residue management’ has showed contrasting results with differences (for yield and soil) between the two treatments resulted almost always non significant. The analysis of economic competitiveness gap showed that the CR incorporation is more expensive than CR burning or removal, but the economic disadvantage can be considered rather small and thus easily compensated by Community aids. Therefore, the soil incorporation of crop residues can be considered a ‘good agricultural practice’ that does not penalize farmers in terms of production and cost and at the same time contributes to the maintenance of fertility and soil biodiversity. On the contrary, the removal and burning of residues result in a low or no-addition of organic matter into the soil. Moreover, burning can contribute to decrease the biodiversity and to increase the risk of air pollution, fires and road accidents.

Within the Project MO.NA.CO was evaluated the Environmental effectiveness of GAEC cross-compliance standard 2.2 “Maintaining the level of soil organic matter through crop rotation” and economic evaluation of the competitiveness gap for farmers who support or not the cross-compliance regime. The monitoring was performed in nine experimental farms of the Council for Agricultural Research and Economics (CREA) distributed throughout Italy and with different soil and climatic conditions. Were also evaluated the soil organic matter and some yield parameters, in a cereal monocropping (treatment counterfactual) and a two-year rotation cereal-legume or forage (treatment factual). The two-years application of the standard “crop rotations” has produced contrasting results with regards to the storage of soil organic matter through crop rotation and these were not sufficient to demonstrate a statistically significant effect of treatment in any of the farms considered in monitoring, only in those farms subjected to more years of monitoring was recorded only a slight effect of the standard as a trend. The variations of organic matter in soils in response to changes in the culture technique or in the management of the soil may have long lag times and two years of time are not sufficient to demonstrate the dynamics of SOM associated with the treatment, also in consideration of the large inter annual variability recorded in different monitored sites.

Leaf area index (LAI) is an important biophysical parameter describing vegetation. LAI is typically retrieved from optical remote sensing by empirical models relating LAI to vegetation indices, such as the Normalized Difference Vegetation Index (NDVI). As the relationship between LAI and NDVI is non-linear and crop type dependant, several specific empirical equations relating LAI to NDVI have been developed using field data. This study presented LAIr, an R package to derive LAI from NDVI data from the most comprehensive library of conversion equations. In the package, the range of functions differs on environmental factors, sensors, and vegetation types, allowing flexibility in choosing appropriate options based on specific application, scale of investigation and data availability. We illustrated the use of the package with a case study to compare a generic LAI product with specific NDVI-based LAI estimations. By leveraging empirical knowledge, LAIr enables accurate and context-specific estimation of LAI. The deployment of an open-source R package serves as a valuable tool for aiding researchers in selecting the most appropriate equations for conducting NDVI-to-LAI conversion.

Aim: From the start of the pandemic, several aspects of healthcare policies changed, not least the clinical trials management from recruiting capabilities to the protocol compliance in terms of schedule of procedures, follow-up visits, staff constraints and monitoring. This study aims to assess the impact of the COronaVIrusDisease-2019 (COVID-19) pandemic in the conduction of clinical trials at the site of clinical oncology, Ancona (Italy), to identify the strengths and weaknesses upfront the past emergency, and to select better strategies for future similar situations. Methods: Data from February to July of the years 2019, 2020 and 2021 were collected and three practical parameters of the trial unit were investigated: milestones, performance, and impact. Results: The trials mean numbers were 18, 24, and 23, in 2019, 2020, and 2021 respectively. The pre-Site Initiation Visit (PRE-SIV) rate grew from 66.6% in 2019 to 95.5% in 2021 with a deflection in 2020. Protocol deviations were 40 in the period February-July 2019, in the same period of 2020 the number of deviations increased due to COVID related ones, then there was a significant total decrease in February-July 2021. In 2020 and 2021, all the investigator meetings were online. Conclusions: The growing number of remote Site Initiation Visit (SIV) and meetings over the last 3 years suggests the feasibility of the on-line processes. The significant reduction in protocol deviations during 2021 is probably due to an under check of data during a pandemic. But that is also a possible key indicator of the coping strategy made out by clinical oncology to guarantee the continuity of care in clinical trials and to offer new opportunities of cancer care in a bad scenario such as a pandemic one.

Interferons (IFNs) and IFN-stimulated genes (ISGs) play essential roles for the control of viral infections. Their expression in infants with respiratory syncytial virus (RSV) bronchiolitis is poorly defined. Human endogenous retroviruses (HERVs) represent 8% of our genome and modulate inflammatory and immune reactions. TRIM28 and SETDB1 participate in the epigenetic regulation of genes involved in the immune response, including IFNs and HERVs. No study has explored the expression of HERVs, TRIM28, and SETDB1 during RSV bronchiolitis. We assessed, through a PCR real-time Taqman amplification assay, the transcription levels of six IFN-I ISGs, four IFNλs, the pol genes of HERV-H, -K, and -W families, the env genes of Syncytin (SYN)1 and SYN2, and of TRIM28/SETDB1 in whole blood from 37 children hospitalized for severe RSV bronchiolitis and in healthy children (HC). The expression of most IFN-I ISGs was significantly higher in RSV+ patients than in age-matched HC, but it was inhibited by steroid therapy. The mRNA concentrations of IFN-λs were comparable between patients and age-matched HC. This lack of RSV-driven IFN-III activation may result in the defective protection of the airway mucosal surface leading to severe bronchiolitis. The expression of IFN-III showed a positive correlation with age in HC, that could account for the high susceptibility of young children to viral respiratory tract infections. The transcription levels of every HERV gene were significantly lower in RSV+ patients than in HC, while the expressions of TRIM28/SETDB1 were overlapping. Given the negative impact of HERVs and the positive effects of TRIM28/SETDB1 on innate and adaptive immune responses, the downregulation of the former and the normal expression of the latter may contribute to preserving immune functions against infection.

Since 2012, kiwifruit vine decline syndrome (KVDS) has severely compromised all major kiwifruit-growing areas in Italy. Thus far, etiological studies were mainly focused on waterlogging effects or on the isolation of microorganisms from diseased plants; therefore, an all-encompassing picture of KVDS microbiota is still missing. This work aims to describe oomycete and fungal communities associated with KVDS and to identify key taxa potentially involved in the disease through a metabarcoding approach on root endosphere and rhizosphere samples. Two nearby fields with similar pedoclimatic conditions were identified based on KVDS spreading during a 4-year survey (2016 to 2019). In total, four sampling areas were selected, one from the control field with no sign of KVDS (asymptomatic site) and three from the KVDS-affected field (diseased site): (i) asymptomatic until the sampling date in 2018, (ii) symptomatic since 2018, and (iii) symptomatic since 2017. Total genomic DNA samples were subjected to a nested PCR approach separately targeting the internal transcribes spacer 2 regions of fungal and oomycete communities. The communities were compared in terms of α- and β-diversities, and key taxa were identified using univariate differential abundance tests. Major differences in taxa distribution were observed between samples from the different sites (asymptomatic and diseased) and were mostly linked to the oomycete community. Phytophthora sojae was the main taxa characterizing the diseased site and supposed to be involved in the disease and Phytopythium spp. were found related to the different plant health status. Finally, Dactylonectria macrodidyma, Phytopythium citrinum, and Thielaviopsis basicola were also proposed as new KVDS-related pathogens.

Background and Objectives: In this study, we applied one-step real time rt-PCR technology type II INF signature to blood and nasopharyngeal (NPS) swabs of acute early recovery children < 1 years hospitalized for bronchiolitis with laboratory-confirmed RSV infection. Materials and Methods: A prospective observational case–control study was conducted in 2021–2022. The study took place in Children Hospital “Regina Margherita”, Torino Italy. The study included 66 infants, of which 30 patients were hospitalized for bronchiolitis due to RSV infection and 36 age-matched controls. Inclusion criteria included a positive RSV test for infants with bronchiolitis. We collected peripheral blood and nasopharyngeal swabs for relative quantification of type II Interferon signature by One-Step Multiplex PCR real time. Results: IFN levels were downregulated in the peripheral blood of bronchiolitis patients; these data were not confirmed in the nasopharyngeal swab. There was no correlation between NPS and the type II IFN score in peripheral blood. Conclusions: our study shows for the first time that type II IFN score was significant reduced in peripheral blood of infants with bronchiolitis by RSV compared to age-matched healthy controls; in the NPS swab this resulted downregulation was not statistically significant and the type II IFN score in the NPS swab can be used as marker of resolution of infection or improvement of clinical conditions.

Introduction. MicroRNA (miR) 155 has been implicated in the regulation of innate and adaptive immunity as well as antiviral responses, but its role during respiratory syncytial virus (RSV) infections is not known. The objective of this study was to investigate the expression of miR-155 using pharyngeal swabs and peripheral blood in infants with RSV infection and uninfected controls. Methods. A prospective age-matched study was conducted in primary care in Torino from 1 August 2018 to 31 January 2020. We enrolled 66 subjects, 29 of them patients with RSV infection and 37 age-matched uninfected controls, and collected pharyngeal swabs and peripheral blood in order to assess miR-155 expression with real-time stem–loop–TaqMan real-time PCR. Results. The data show that there is no correlation between pharyngeal swabs and peripheral blood with respect to miR-155 expression. The 1/ΔCq miR-155 expression levels in throat swabs in RSV bronchiolitis patients and healthy controls were 0.19 ± 0.11 and 0.21 ± 0.09, respectively, and were not significantly different between healthy controls and bronchiolitis (p = 0.8414). In the peripheral blood, miR-155 levels were higher than those of healthy control subjects: 0.1 ± 0.013 and 0.09 ± 0.0007, respectively; p = 0.0002. Discussion. Our data provide evidence that miR-155 expression is higher in peripheral blood during RSV infection but not in swabs. This difference in the timing of sample recruitment could explain the differences obtained in the results; miR-155 activation is probably only assessable in the very early stages of infection in the swab and remains visible for longer in the blood. New investigations are needed in order to clarify whether the miR-155 expression in swabs can be influenced by different stages of virus disease of infants.

Phytosanitary bulletins released at weekly interval by eight Italian regional plant protection services in the growing seasons 2012–2017 were used to derive an harmonized dataset of grapevine downy mildew infection risk and phenological observations. The downy mildew infection risk (n = 8816) was classified using a 5-point Likert response item ranging from ‘very low’ (1) to ‘very high’ (5) by six independent evaluators with domain expertise in agronomy, phytopathology and agrometeorology. Common criteria have been used in the risk assessment, considering (i) the presence of disease symptoms in field surveys, (ii) the host phenological susceptibility, (iii) the weather forecasts in the next week from the bulletin release date, (iv) the advice to apply a fungicide treatment and (v) the outputs of epidemiological models. The phenological observations are provided as BBCH codes (n = 1689), which have been either transcribed from the phytosanitary bulletins or derived from the narrative description of the visual observation. Phenological data refer to the main early and late grapevine varieties in the eight regions (NUTS-2 administrative unit). Each record is associated with the NUTS-2 and NUTS-3 (31 provinces) administrative unit of reference, to the growing season (2012–2017), and refers to the individual risk assessment by the six evaluators. The dataset is hosted by the Centre for Agriculture and Environment of the Italian Council for Agricultural Research and Economics. These data could be helpful to researchers who develop either grapevine phenological models or process-based epidemiological predictive algorithms in order to refine their calibration and evaluation, as well as being a valuable resource for stakeholders in charge of evaluating the effective implementation of Integrated Pest Management in the decision-making process of public plant protection services in Italy. The dataset is freely available here.

Despite the great amount of information on the European Grapevine Moth (EGVM), Lobesia botrana (Lepidoptera: Tortricidae), and the effective strategies available for its management, this moth remains the main key pest damaging grapevines in the Mediterranean and Central Europe wine-growing areas. Synthesizing and manipulating its sex pheromone components fostered the development of new dispensers to boost the effectiveness and sustainability of mating disruption (MD) programs. Recent MD research has highlighted that the effectiveness of aerosol emitters is comparable to that of passive dispensers when applied in large, uniform sites such as Spanish vineyards. However, aerosol emitters that are equally effective in geographical areas characterized by small-sized vineyards, typical of many Italian regions, have not received enough research attention. To face this challenge, herein the experimental aerosol emitter (product code: Isonet® L MISTERX843) was tested at three different application rates (i.e., 2, 3 and 4 units/ha) in three study sites, two in Tuscany (Central Italy in 2017 and 2018) and one in Emilia-Romagna (Northern Italy in 2017), respectively, for a total of five trials. To assess the efficacy of this novel MD aerosol emitter, three different application densities were compared with an untreated control and two grower’s standards. The latter were represented by passive (Isonet® L TT) and active (Checkmate® Puffer® LB) release dispensers, already on the market for EGVM MD and applied at, respectively, 200–300 and 2.5–4 units/ha. MD carried out with Isonet® L MISTERX843 led to zero catches of males in the pheromone traps. They also allowed for a significant reduction in the number of infested flower clusters and bunches, as well as in the number of nests per flowers cluster/bunch, if compared to the untreated control. As a general trend, MD effectiveness was fully comparable, or even better, if compared to the grower’s standard. In conclusion, our research pointed out that the Isonet® L MISTERX843 can allow for effective EGVM management in small-sized Italian vineyards. Lastly, our economic evaluation showed that the MD whole cost per hectare using active or passive release devices was comparable.

Background: Colic is a common condition in infants

Background: Recurrent wheezing is a common clinical manifestation in childhood, and respiratory syncytial virus infection is a well-known risk factor. However, the genetic background favoring the development of recurrent wheezing is not fully understood. A possible role of macrophage receptor with collagenous gene (MARCO) polymorphism has been recently proposed.Objective: To investigate a correlation between MARCO rs1318645 polymorphisms and susceptibility to recurrent wheezing during childhood.Methods: We prospectively recruited 116 infants, of which 58 with respiratory syncytial virus bronchiolitis and 58 controls hospitalized at Regina Margherita Children's Hospital, Turin, Italy, between November 2014 and April 2015. All subjects were investigated for MARCO rs1318645 polymorphisms in the first period of life. Genotyping of rs1318645 was carried out by TaqMan mismatch amplification mutation assay real-time polymerase chain reaction procedure. Subjects were then enrolled in a 5-year follow-up study to monitor the occurrence of wheezing and respiratory infections.Results: The analysis of MARCO rs1318645 of allelic frequencies shows an increasingly significant risk to develop recurrent infection (p = 0.00065) and recurrent wheezing (p = 0.000084) with a wild-type C allele compared with a G allele. No correlation was found between wheezing and past respiratory syncytial virus infection (p = 0.057) and for a history of atopy in the family (p = 0.859).Conclusion: Our finding showed that subjects with C allelic MARCO rs1318645 polymorphism are at higher risk for recurrent infection and wheezing episodes during the first 5 years of life. Future studies of genetic associations should also consider other types of polymorphisms.

Abstract Background Vitamin K is a key point for guarantee normal blood clotting and its level in newborns is commonly low, so a supplementation after delivery is mandatory. Vitamin K prophylaxis in newborns is still an open field of debate: many types of protocol have been proposed in different years and Countries, and sometimes with great variability inside the same Nation (for instance, in Italy a national consensus is not available, so different protocols are employed). Recommendations include different protocols for healthy newborns born at term, but the unpreventable presence of bleeding favouring factors (i.e. blood vessels malformations) or limiting intestinal absorption of liposoluble vitamins (i.e. cholestasis), which could be unrecognized or subclinical in the perinatal period, rises some concerning about the most precautionary route of administration and the timing of further doses after the first one given at birth. The purpose of this report is to underline the most recent evidences available in literature and to arise a debate about this topic, in order to stimulate the production of evidence-based guidelines concerning the prophylaxis with vitamin K1 in newborn infants, considering that many bleeding risk factors are not recognizable at birth. Case presentation We are hereby presenting an emblematic case concerning the risk of intracranial bleeding in an apparently healthy newborn: the described infant did not show any pathological elements in pregnancy history or perinatal life which suggest a possible increased risk of bleeding and the needing of a particular approach in the administration of vitamin K1, but at the end of the first week of life presented an intracranial bleeding with neurological symptoms that required treatment for vitamin K deficiency. Conclusions Univocal recommendations about vitamin K prophylaxis are not available and the contrast between oral and intramuscular routes persists unsolved. The difficulty to certainly identify an infant eligible for oral administration of vitamin K1 at birth suggests that the intramuscular route should be preferred. How to prosecute the supplementation in the first months of life is still an open topic of debate.

The leaf area index (LAI) is a direct indicator of vegetation activity, and its relationship with the normalized difference vegetation index (NDVI) has been investigated in many research studies. Remote sensing makes available NDVI data over large areas, and researchers developed specific equations to derive the LAI from the NDVI, using empirical relationships grounded in field data collection. We conducted a literature search using “NDVI” AND “LAI” AND “crop” as the search string, focusing on the period 2017–2021. We reviewed the available equations to convert the NDVI into the LAI, aiming at (i) exploring the fields of application of an NDVI-based LAI, (ii) characterizing the mathematical relationships between the NDVI and LAI in the available equations, (iii) creating a software library with the retrieved methods, and (iv) releasing a publicly available software as a service, implementing these equations to foster their reuse by third parties. The literature search yielded 92 articles since 2017, where 139 equations were proposed. We analyzed the mathematical form of both the single equations and ensembles of the NDVI to LAI conversion methods, specific for crop, sensor, and biome. The characterization of the functions highlighted two main constraints when developing an NDVI-LAI conversion function: environmental conditions (i.e., water and light resource, land cover, and climate) and the availability of recurring data during the growing season. We found that the trend of an NDVI-LAI function is usually driven by the ecosystem water availability for the crop rather than by the crop type itself, as well as by the data availability; the data should be adequate in terms of the sample size and temporal resolution for reliably representing the phenomenon under investigation. Our study demonstrated that the choice of the NDVI-LAI equation (or ensemble of equations) should be driven by the trade-off between the scale of the investigation and data availability. The implementation of an extensible and reusable software library publicly queryable via API represents a valid mean to assist researchers in choosing the most suitable equations to perform an NDVI-LAI conversion.

Aim: Studies have shown that Lactobacilli reuteri probiotics can affect cells that play a key role in the immune system. This in vivo Italian study investigated how Lactobacillus reuteri DSM 17938 influenced CC-chemokine receptor 7 (CCR7) and interleukin 10 (IL-10) in breastfed colicky infants.Methods: Our University hospital in Turin recruited 50 healthy outpatients, at a median age of approximately 1 month, from September 2017 to August 2018. They were randomized to daily Lactobacillus reuteri DSM17938 (1 × 108 cfu) or a placebo for 28 days from recruitment. We collected peripheral blood and evaluated the expression of CCR7 messenger ribonucleic acid using the real-time TaqMan reverse transcription polymerase chain reaction method at baseline and after the study period.Results: We found increased expression of CC-chemokine receptor 7 in infants treated with the probiotic, but not the controls (p < 0.0026). No differences were observed for interleukin 10 after the study period in either group. At baseline, daily crying time was comparable in the probiotic and control groups: 341 (25) vs. 337 (29) min., respectively (p = 0.450). After 28 days, daily mean crying time decrease statistically in the probiotic group: 78 (23) vs. 232 (31), respectively (p < 0.001).Conclusion: The increase in CC-chemokine receptor 7 might have been a response to probiotic treatment. As a relatively small sample was used to conduct this study, our research needs to be replicated in different settings, and over time, to produce comparable findings.

The demand for a reduced use of pesticides in agriculture requires the development of specific strategies for managing arthropod pests. Among eco-friendly pest control tools, pheromone-based mating disruption (MD) is promising for controlling several key insect pests of economic importance, including many lepidopteran species. In our study, we evaluated an MD approach for managing the honeydew moth (HM), Cryptoblabes gnidiella, an emerging threat for the grapevine in the Mediterranean basin. The trials were carried out in two study sites, located in Tuscany (central Italy, years 2017–2019) and Apulia (southern Italy, years 2016 and 2018–2019), and by applying MD dispensers only in April, in April and July, and only in July. To evaluate the effects of MD, infested bunches (%), damaged area (%) per bunch, and number of living larvae per bunch were compared among plots covered with MD dispensers, insecticide-treated plots (Apulia only), and untreated control plots. Male flights were monitored using pheromone-baited sticky traps. Except for the sampling carried out in Tuscany in 2018, where HM infestation level was very low, a significant difference was recorded between MD and control plots, both in terms of HM damage caused to ripening grapes and/or number of living larvae per bunch. Overall, our study highlighted that MD, irrespective of the application timing, significantly reduced HM damage; the levels of control achieved here were similar to those obtained with the application of insecticides (no MD). However, MD used as stand-alone strategy was not able to provide complete pest control, which may instead be pursued by growers with an IPM approach.

Leptin is a 16 kDa lipophilic protein hormone secreted by adipocytes and its most significant function is to inform the brain with negative feedback that regulates food intake. Recently the protein found in human breast milk was related to breast feeding and onset of obesity, and the evidence of a low probability to develop pediatric obesity in children fed with breast milk was also confirmed. Since leptin could have a critical role, its quantitation both in human breast, bovine milk and in infant formula products is interesting. For this reason, we developed an analytical method based on immunoaffinity purification followed by an analysis with nano-High Pressure Liquid Chromatography coupled with High Resolution Mass Spectrometry analyzer (nano-HPLC-HRMS) to identify and quantify leptin in milk samples and performed a pilot study using samples of human breast milk, bovine milk and infant formulas. With an obtained lower limit of quantitation (LLOQ) of 100 ng mL−1 we quantified leptin in human breast milk finding an average of 6.70 ng mL−1. Our results show that leptin was under LLOQ both in bovine milk and in infant formula products. In conclusion, the developed analytical method here described was suitable to quantify leptin in milk samples with a good sensitivity and selectivity, and without the use of radioactive reagents.

Eight years after the first record in Italy, Kiwifruit Decline (KD), a destructive disease causing root rot, has already affected more than 25% of the area under kiwifruit cultivation in Italy. Diseased plants are characterised by severe decay of the fine roots and sudden wilting of the canopy, which is only visible after the season’s first period of heat (July–August). The swiftness of symptom appearance prevents correct timing and positioning for sampling of the disease, and is therefore a barrier to aetiological studies. The aim of this study is to test the feasibility of thermal and multispectral imaging for the detection of KD using an unsupervised classifier. Thus, RGB, multispectral and thermal data from a kiwifruit orchard, with healthy and diseased plants, were acquired simultaneously during two consecutive growing seasons (2017–2018) using an Unmanned Aerial Vehicle (UAV) platform. Data reduction was applied to the clipped areas of the multispectral and thermal data from the 2017 survey. Reduced data were then classified with two unsupervised algorithms, a K-means and a hierarchical method. The plant vigour (canopy size and presence/absence of wilted leaves) and the health shifts exhibited by asymptomatic plants between 2017 and 2018 were evaluated from RGB data via expert assessment and used as the ground truth for cluster interpretation. Multispectral data showed a high correlation with plant vigour, while temperature data demonstrated a good potential use in predicting health shifts, especially in highly vigorous plants that were asymptomatic in 2017 and became symptomatic in 2018. The accuracy of plant vigour assessment was above 73% when using multispectral data, while clustering of the temperature data allowed the prediction of disease outbreak one year in advance, with an accuracy of 71%. Based on our results, the unsupervised clustering of remote sensing data could be a reliable tool for the identification of sampling areas, and can greatly improve aetiological studies of this new disease in kiwifruit.

Many types of dorsal neoplasm of early infancy are described in literature ranging from benign to aggressive. Some are more common while others quite unusual. Here, we describe a newborn with a lumbosacral soft tissue mass. Positivity of S-100 and vimentin was compatible with the neural cell line and the high proliferation rate of major activity cells (biopsy Ki67 20%) suggests an aggressive nature. An exclusively surgical approach was chosen and no clinical or radiological signs of recurrence have been observed after 2 years of follow-up. This case is atypical for location, histological pattern, radiological aspect, and clinical behavior. Diagnosis is hard to define and limited to a mesenchymal neoplasia with myxoid tracts. The described aspects raise concerns about clinical and therapeutic approach, classification, and radiological follow-up of sacral tissue masses in newborns.

This paper performs an overview about researches and clinical trials on gut microflora and the use of probiotics, and seeks to define a new picture of current literature in order to propose an evidence-based practice approach for the treatment of infantile colic. Colics are a self-limiting, benign and widespread disturbance in the first three months of life, but provide a great disturbance on family life, also because this condition is frequently undervalued by physicians and available literature doesn’t provide univocal indication about management and treatment. Literature reports growing evidences about the effectiveness of dietary approach or supplementation with probiotics. This article tries to evaluate available evidences through GRADE system, in order to underline limitations, inconsistency and publication bias of old clinical trials. However, this choice could provide multiple and discordant results. According to the growing of new systematic reviews, evaluations about evidences and recommendations in health care are complex, and might show up different results. Moreover, up to date many different definitions and outcome measures for infantile colic have been proposed in clinical trials: many take in account crying time, but a minor part also consider parental perception. The effectiveness of complementary and alternative treatments and behavioural interventions needs to be further investigated. Recently, the possible action of microbiota as a cause of colics and the use of some probiotic strains for the treatment have raised great interest. It has been also postulated that parent-infant interaction may influence infantile colic, but further researches on educational and psychological intervention are required in order to better clarify this issue, as well as further investigations are needed in order to provide more reliable evidence-based guidelines. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy) · October 26th-31st, 2015 · From the womb to the adult Guest Editors: Vassilios Fanos (Cagliari, Italy), Michele Mussap (Genoa, Italy), Antonio Del Vecchio (Bari, Italy), Bo Sun (Shanghai, China), Dorret I. Boomsma (Amsterdam, the Netherlands), Gavino Faa (Cagliari, Italy), Antonio Giordano (Philadelphia, USA)

OBJECTIVE: Reports on leptin concentrations in pediatric populations lack reference values for infants in the first months of life. Our study was conducted on healthy full-term infants between 2002 and 2012 to determine serum leptin reference values in subjects less than 18 months old. METHODS: Routine outpatient blood tests for serum leptin were performed on 317 infants using a radioimmunoassay method. The median and 10th-90th percentiles were calculated to obtain reference values using quantile regression. Values established in this study were compared with another independent cohort of 110 infants. RESULTS: The median (IQR) serum leptin concentration in the infants was 2.37 (3.26) ng/ml (n = 317). The median leptin concentration was 2.81 (3.49) ng/ml (n = 202) in infants younger than 6 months of age, 1.44 (2.27) ng/ml (n = 59) in infants between 6-12 months of age and 1.77 (2.05) ng/ml (n = 56) in infants between 12-18 months of age. We obtained leptin reference values based on age by estimating the lower and upper percentiles. In the entire cohort, the median (IQR) leptin concentration was 2.22 (3.11) ng/ml in males (n = 168) and 2.60 (3.32) ng/ml in females (n = 149). According to the type of feeding median serum leptin concentration was higher in breast-fed infants (n = 188) than in formula-fed infants (n = 129) (2.63 (3.34) ng/ml vs. 2.12 (2.77) ng/ml; p

Aim. To provide bone status assessment in infancy using quantitative ultrasound (QUS) applied to second metacarpus.Methods. 103 healthy term infants and 3 patients with rickets, aged ≤ 12 months, underwent metacarpal QUS evaluation using QUS DBM Sonic Aurora IGEA (MO, Italy), which measures speed of sound (mcSOS) and bone transmission time (mcBTT).Results. In the total sample, median (interquartile range) of mcSOS was 1640.00 (26.0) m/s and mcBTT 0.82 (0.21) µs. Moreover, reference values for age were obtained based on estimation of the lower and upper percentiles. We observed a statistical significant difference between groups of age for mcSOS (p = 0.016). In a multiple linear regression model, we found a relation between age at enrolment and mcSOS (β = −0.608; p = 0.000) and mcBTT (β = −0.819; p = 0.001). A positive correlation between mcSOS and mcBTT has been observed (r = 0.631; p = 0.000). All the patients with rickets showed values of mcSOS and mcBTT lower than the 10th percentile.Conclusion. Our findings show that this new simple technique appears to be a promising tool for monitoring bone mineral status in pediatric clinical practice and in early life. Furthermore, it could be considered a useful method to investigate and to monitor the role of different factors on programming of bone health and it should be tested as a new method for monitoring subjects with rickets during therapy.

The aim of this study was to evaluate the efficacy of the subjective Wong–Baker faces pain rating scale (WBFS) and of the objective skin conductance fluctuation (SCF) test in assessing pain in children undergoing venipuncture. One-hundred and fifty children (aged 5–16 years) entered the study. All underwent venipuncture at the antecubital fossa to collect blood specimens for routine testing in the same environmental conditions. After venipuncture, the children indicated their pain intensity using the WBFS, whereas the number of SCFs was recorded before, during and after venipuncture. So, pain level was measured in each child with WBFS and SCF. We found that the level of WBFS-assessed pain was lower in all children, particularly those above 8 years of age, than SCF-assessed pain (p

To analyze the global microbial composition, using large-scale DNA sequencing of 16 S rRNA genes, in faecal samples from colicky infants given L. reuteri DSM 17938 or placebo.Twenty-nine colicky infants (age 10-60 days) were enrolled and randomly assigned to receive either Lactobacillus reuteri (10(8) cfu) or a placebo once daily for 21 days. Responders were defined as subjects with a decrease of 50% in daily crying time at day 21 compared with the starting point. The microbiota of faecal samples from day 1 and 21 were analyzed using 454 pyrosequencing. The primers: Bakt_341F and Bakt_805R, complemented with 454 adapters and sample specific barcodes were used for PCR amplification of the 16 S rRNA genes. The structure of the data was explored by using permutational multivariate analysis of variance and effects of different variables were visualized with ordination analysis.The infants' faecal microbiota were composed of Proteobacteria, Firmicutes, Actinobacteria and Bacteroidetes as the four main phyla. The composition of the microbiota in infants with colic had very high inter-individual variability with Firmicutes/Bacteroidetes ratios varying from 4000 to 0.025. On an individual basis, the microbiota was, however, relatively stable over time. Treatment with L. reuteri DSM 17938 did not change the global composition of the microbiota, but when comparing responders with non-responders the group responders had an increased relative abundance of the phyla Bacteroidetes and genus Bacteroides at day 21 compared with day 0. Furthermore, the phyla composition of the infants at day 21 could be divided into three enterotype groups, dominated by Firmicutes, Bacteroidetes, and Actinobacteria, respectively.L. reuteri DSM 17938 did not affect the global composition of the microbiota. However, the increase of Bacteroidetes in the responder infants indicated that a decrease in colicky symptoms was linked to changes of the microbiota.ClinicalTrials.gov NCT00893711.

BACKGROUND: The clinical significance of weakly acidic reflux in infants is unclear. Skin conductance is a novel not-invasive method to evaluate discomfort. The aim of our study was to evaluate reflux-induced discomfort in infants with gastroesophageal reflux disease using simultaneously combined skin conductance and esophageal multichannel intraluminal impedance and pH monitoring. METHODOLOGY/PRINCIPAL FINDINGS: Infants with gastroesophageal reflux symptoms were investigated for almost 20 hours divided into 120-second intervals. Temporal relationships between refluxes and discomfort were evaluated calculating the symptom association probability. Twelve infants aged 17-45 days were studied. Out of 194.38 hours of adequate artifact-free MII/pH and skin conductance monitoring, 584 reflux events were observed; 35.78% were positive for stress, of which 16.27% were acid and 83.73% weakly acidic. A significant association between refluxes and discomfort (p

Growing evidence suggests that a complex relationship exists between the central nervous system and peripheral organs involved in energy homeostasis. It consists in the balance between food intake and energy expenditure and includes the regulation of nutrient levels in storage organs, as well as in blood, in particular blood glucose. Therefore, food intake, energy expenditure, and glucose homeostasis are strictly connected to each other. Several hormones, such as leptin, adiponectin, resistin, and ghrelin, are involved in this complex regulation. These hormones play a role in the regulation of glucose metabolism and are involved in the development of obesity, diabetes, and metabolic syndrome. Recently, their presence in breast milk has been detected, suggesting that they may be involved in the regulation of growth in early infancy and could influence the programming of energy balance later in life. This paper focuses on hormones present in breast milk and their role in glucose homeostasis.