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Abstract Background and objectives The Mediterranean Diet (MD) has been recognized for its benefits for human health and sustainability for the planet, but it has considered not easy to reproduce in other populations. The United Nations Educational, Scientific and Cultural Organization (UNESCO) Chair on Health Education and Sustainable Development is fostering a research project (Planeterranea), aiming to identify a healthy dietary pattern based on local foods with the same MD features. The aim of our study is to develop a MD-based food pyramid for Asian populations. Methods Asia was stratified into six areas according to pedo-climatic conditions. For each region a comprehensive scoping review of local crops and typical foods was conducted on several databases such as the US Department of Agriculture (USDA)’s database, the Food and Agriculture Organization of the United Nations (FAO) website, and PubMed, focusing on both plant-based and animal-based foods. Narrative review was then conducted on the identified foods to determine their nutritional composition and planetary health impact. Finally, the collected information was used to build up the Asian food pyramid with details for each respective region. Results We proposed a food pyramid for Asian countries, guaranteeing the same nutritional intake and health benefits as MD, by considering dietary habits and typical foods of this population. From the bottom to the top, Asian fruits and vegetables present similar nutritional profile as those in MD. Whole grains (barley) may represent valid alternative to white rice. Sesame oil represents a source of unsaturated fats and an alternative to olive oil. Legumes (soybean), edible insects, mushrooms and algae, guarantee an adequate intake of plant-based proteins with a complete amino-acid profile and a low environmental impact with respect to animal-based ones. Conclusions This work is a new insight of healthy and sustainable local food system based on MD principles for the Asian population.

In the wake of the COVID-19 pandemic, the surveillance and safety measures of indoor Cultural Heritage sites have become a paramount concern due to the unique challenges posed by their enclosed environments and high visitor volumes. This communication explores the integration of Artificial Intelligence (AI) in enhancing epidemiological surveillance and health safety protocols in these culturally significant spaces. AI technologies, including machine learning algorithms and Internet of Things (IoT) sensors, have shown promising potential in monitoring air quality, detecting pathogens, and managing crowd dynamics to mitigate the spread of infectious diseases. We review various applications of AI that have been employed to address both direct health risks and indirect impacts such as visitor experience and preservation practices. Additionally, this paper discusses the challenges and limitations of AI deployment, such as ethical considerations, privacy issues, and financial constraints. By harnessing AI, Cultural Heritage sites can not only improve their resilience against future pandemics but also ensure the safety and well-being of visitors and staff, thus preserving these treasured sites for future generations. This exploration into AI’s role in post-COVID surveillance at Cultural Heritage sites opens new frontiers in combining technology with traditional conservation and public health efforts, providing a blueprint for enhanced safety and operational efficiency in response to global health challenges.

Phase I clinical trials represent a critical point in drug development because the investigational medicinal product is being tested in humans for the first time. For this reason, it is essential to evaluate and identify the Maximum Tolerated Dose (MTD) and the safety of the new compound. To mitigate the possible risks associated with drug administration and treatment, the European Competent Authority issued various guidelines to provide provisions and harmonize risk management processes. In the UK and Italy, particular attention should be paid to the Medicines & Healthcare Products Regulatory Agency (MHRA) phase I accreditation scheme and the specific rules set by the Italian Drug Authority through the AIFA Determination no. 809/2015. Both reference documents are based on the concept of quality risk management while conducting phase I clinical studies. Moreover, the AIFA determination outlines specific requirements for those sites that want to conduct non-profit phase I clinical trials. Indeed, the document reports peculiar activities to the “Clinical Trial Quality Team”, which is a team that should support the clinical site researchers in designing, starting, performing, and closing non-profit phase I studies. In this paper, we provide a general overview of the main European guidelines concerning the management of risks during phase I trials, focusing on the main peculiarities of the schemes and rules set by the MHRA and AIFA.

Background and Objectives: Non-melanoma skin cancers (NMSCs) include basal cell carcinoma (BCC) and squamous-cell carcinoma (SCC), as well as a wide range of rare skin tumors. NMSCs is the most frequently diagnosed type of tumor among Caucasians. We aimed at estimating the incidence and mortality of NMSCs in the Salento area (Lecce province, Southern Italy), whose population is assumed to experience heavy and frequent sun exposure due to climatic/environmental factors, both for working and leisure activities. Materials and Methods: We computed the incidence of NMSCs in the Province of Lecce by examining the comprehensive real-world data collected by the local cancer registry, which covers all the 830,000 inhabitants, over a period of fifteen years (from 2003 to 2017), with a focus on the latest 5 years (2013–2017) for the analysis of the different histologic morphologies of these tumors. The incidence of NMSCs has been described in terms of absolute frequencies, crude rates and age-adjusted direct standardized rates (DSR). Joinpoint analysis was used to examine temporal trends in the incidence of NMSCs and estimate annual percent changes (APCs). Results: During the period of 2003–2017, the incidence of NMSCs reached a direct standardized rate (DSR) of 162.62 per 100,000 in men (mortality 1.57 per 100,000) and 89.36 per 100,000 in women (mortality 0.52 per 100,000), respectively. The incidence significantly increased among both men and women across the entire period. Basal cell carcinoma (BCC), with its different morphologies, represented about 67.6% of the NMSCs in men (n = 2139 out of a total of 3161 tumors observed between 2013 and 2017) and about 75.8% of the NMSCs in women (n = 1718 out of a total of 2264 tumors from 2013 to 2017), thus accounting for the vast majority of NMSCs. The results are consistent with the literature data carried out both at national and international level. Conclusions: Proper monitoring of this phenomenon through timely reporting and recording of all new NMSC cases is necessary to develop new preventive strategies.

The global healthcare industry plays a crucial role in preserving human health and well-being [...]

Abstract Background Med-Index is a one-health front-of-pack (FOP) label, based on Mediterranean diet (MedDiet) principles, developed to summarize information about the nutritional properties and related-health benefits of any food as well as its sustainable production processes, and the associated food company’s social responsibility parameters in a new “Planeterranean” perspective. Thus, Med-Index can be adopted in and by any European region and authority as well as worldwide; this is achieved by consumption and cooking of locally available and sourced foods that respect MedDiet principles, both in terms of healthy nutrition and sustainable production. The huge body of scientific evidence about the health benefits of the MedDiet model and principles requires a comprehensive framework to encompass the scientific reliability and robustness of this tool. A systematic review was carried out to examine the association between human health and adherence to MedDiet patterns upon which the “Med-Index” tool was subsequently developed. Methods MEDLINE and PubMed databases were searched for eligible publications from 1990 to April 2023. Systematic literature reviews, with or without meta-analysis, of clinical trials and observational studies were screened by two independent investigators for eligibility, data extraction, and quality assessment. English language and the time interval 1990–2023 were applied. A registry code CRD42023464807 was generated on PROSPERO and approved for this search protocol. The corrected covered area (CCA), calculated to quantify the degree of overlap between reviews, gave a slight overlap (CCA = 4%). Results A total of 84 systematic reviews out of 6681 screened records were selected. Eligible reviews included studies with predominantly observational designs (61/84, 72.6%%), of which 26/61 referenced studies of mixed observational and RCT designs, while 23/84 (27.4%) were RCT-only systematic reviews. Seventy-nine different entries were identified for health outcomes, clustered into 10 macro-categories, each reporting a statistically significant association with exposure to the MedDiet. Adherence to MedDiet was found to strongly benefit age-related chronic diseases (21.5%), neurological disorders (19%), and obesity-related metabolic features (12.65), followed by CVDs (11.4%), cancer (10.1%), diabetes (7.5%), liver health (6.3%), inflammation (5%), mortality (5%), and renal health (1.2%). The quality of the studies was moderate to high. Conclusion In the context of a “Planeterranean” framework and perspective that can be adopted in any European region and worldwide, MedDiet represents a healthy and sustainable lifestyle model, able to prevent several diseases and reduce premature mortality. In addition, the availability of a FOP, such as Med-Index, might foster more conscious food choices among consumers, paying attention both to human and planetary health.

Background: Prevention of latent tuberculosis infection (LTBI) in healthcare workers (HCWs) to ensure the “Right to Occupational Safety” is a special challenge globally, as HCWs have a higher risk of acquiring the infection in hospital settings because of frequent close exposure to patients suffering from tuberculosis (TB). Methods: Aretrospective study was performed with the aim of assessing the prevalence of LTBI related to demographical and occupational risk factors among HCWs employed in a large hospital in Italy. The study involved 1461 HCWs screened for LTBI by Mantoux tuberculin skin test (TST) and then confirmed with Interferon Gamma Release Assay (IGRA) test in case of positivity. Immunosuppressed and BGC-vaccinated workers were tested directly with IGRA. Results: LTBI was diagnosed in 4.1% of the HCWs and the prevalence resulted lower than other studies conducted in low TB incidence countries. The variables significantly linked with higher frequency of the infection were: age ≥40 years (OR = 3.14; 95% CI: 1.13–8.74; p < 0.05), length of service ≥15 years (OR = 4.11; 95% CI: 1.48–11.43; p < 0.05) and not being trained on TB prevention (OR = 3.46; 95% CI: 1.85–6.46; p < 0.05). Not trained HCWs presented a higher risk of LTBI also after adjustment for age and length of service, compared to trained HCWs. Conclusions: screening of HCWs for LTBI should be always considered in routinely occupational surveillance in order to early diagnose the infection and prevent its progression. Safety policies in hospital settings centered on workers’ training on TB prevention is crucial to minimize LTBI occurrence in HCWs.

In encyclopaedic dictionaries published until 1955, the word “tumour” was defined as an “occupational disease suffered by the workers of chemical industries”, thus referring to a very specific cause [...]

The International One Health Conference 2023, scheduled for October in Barcelona, fosters a collaborative, multidisciplinary approach to health involving professionals, academics, and decision-makers. Operating in a hybrid format, the conference aims to bridge the gap between scientific knowledge and policies, aligning with the Sustainable Development Goals (SDGs) and Health in All Policies (HiAP). Emphasizing community involvement and the symbiotic relationship between basic needs, sustainable lifestyles, and empowerment, the conference envisions a comprehensive approach to sustainable development. D’Alisa introduces a framework incorporating participative democracy, recognizing the interconnectedness of economic, social, environmental, and participative democratic dimensions. Framing questions for the conference delve into critical aspects, addressing the integration of the One Health framework within health sectors, emphasizing interlinkages between health, climate change, and decision-making. The conference’s five-dimension framework tackles the complexity of One Health, addressing concerns, solutions, and opportunities in a holistic paradigm.

This study aims to assess the situation of Italian hotspots for migrant reception during the COVID-19 pandemic, and specifically analyzing the situation of two hotspots located in the Sicily Region (Pozzallo harbor and Lampedusa Island), to identify critical issues. At the same time, we hypothesize solutions to guarantee the respect of human rights and suggest an operational protocol to be applied in similar situations, considering that the migration phenomenon is increasing and involving new geographical areas. Based on data obtained through the site inspections, the facilities of Pozzallo and Lampedusa exceeded their capacity to adequately contain the spread of the SARS-CoV-2 infection. Considering these findings, we suggest a practical workflow summarizing the main actions that should be applied to contain COVID-19, or other infectious disease, spreading in hotspots for migrants. The impact of the COVID-19 pandemic on migrants has received limited attention, although the migration phenomenon did not slow down during the pandemic period. Regarding the risk of spreading infectious diseases such as COVID-19, it is necessary that those countries who are most exposed to migration flows, such as Italy, plan dedicated strategies to minimize the possibility of transmission of SARS-CoV-2, using adequate protocols to monitor the possible insurgence of variants of interest (VOIs) or variants of concern (VOCs). Finally, it is important to state that these suggestions could be applied in any future pandemics.

By 2024, the European Commission will examine a new sustainable labeling framework. Here we describe the development of a new food product labeling system, named Mediterranean Index (Med Index), aimed at promoting adherence to the Mediterranean diet (healthy and sustainable nutritional pattern) by stimulating citizens to practice physical activity consistent with the energy intake of meals and encouraging producers to make healthier and more sustainable food products. It is characterized by the possibility of integrating 27 criteria addressing the issue of sustainable food production processes in the frame of three pillars: nutritional, environmental, and social sustainability. It is conceived as a holistic front-of-pack (FOP) label, complete and applicable by food producers as it is based on measurable criteria, widely shared by stakeholders, but usually adopted on an individual basis.

Abstract In 2010, November 16th, the Mediterranean diet was given the recognition of UNESCO as an “Intangible Heritage of Humanity” as this dietary pattern is rooted in the preservation of tradition, land, and biodiversity. In addition, mounting evidence supported the pivotal role of the Mediterranean diet in the prevention of non-communicable diseases. Nevertheless, the application of this dietary pattern in non-Mediterranean countries is still challenging. “Planeterranean” is an attempt of the UNESCO Chair of “Health Education and Sustainable Development” to prompt each country to rediscover its own heritage and develop healthier dietary patterns based on traditional and local foods.

Health is a key aspect of our modern society that requires a multidisciplinary approach and that needs to bring together professionals, academics and decision makers in order to bridge the gap between current scientific knowledge and policies. The International One Health Conference: A systemic approach to manage urban and natural resources (One-Health 22) was held on 27–28 September 2022 in Catania (Italy) and aimed to share and discuss systemic approaches to One Health to efficiently manage urban and natural resources. The One health conceptual framework and its applications in the urban resilience domain and health care sector have been at the core of the congress’ dialogues. The Conference activated synergic dialogues among disciplinary research fields and action domains among researchers, experts and students.

In submitting conference proceedings to Medical Sciences Forum, the volume editors of the proceedings certify to the publisher that all papers published in this volume have been subjected to peer review administered by the volume editors [...]

Non-communicable diseases (NCDs) lead to a dramatic burden on morbidity and mortality worldwide. Diet is a modifiable risk factor for NCDs, with Mediterranean Diet (MD) being one of the most effective dietary strategies to reduce diabetes, cardiovascular diseases, and cancer. Nevertheless, MD transferability to non-Mediterranean is challenging and requires a shared path between the scientific community and stakeholders. Therefore, the UNESCO Chair on Health Education and Sustainable Development is fostering a research project—“Planeterranea”—aiming to identify a healthy dietary pattern based on food products available in the different areas of the world with the nutritional properties of MD. This review aimed to collect information about eating habits and native crops in 5 macro-areas (North America, Latin America, Africa, Asia, and Australia). The information was used to develop specific “nutritional pyramids” based on the foods available in the macro-areas presenting the same nutritional properties and health benefits of MD.

Abstract Background Non-Communicable Diseases (NCDs) are leading causes of mortality. These conditions are also known as chronic diseases of long duration and generally slow progression. Physical activity (PA) is a main factor to delay symptoms and consequences of NCDs. In last decades, reduced physical exercise has been observed across all ages. Despite educational campaigns aimed at modifying unhealthy habits, it is difficult to promote healthy lifestyles in general population. Poor interest, lack of motivation, as well as career and family commitments hinder people’s participation in regular PA programs. In this study we propose a theoretical person-centred approach to actively involve general population in enhancing their opportunity to perform PA based on personalized needs and targets. Methods We defined four profiles of baseline PA levels (inactive, moderately inactive, moderately active, and active people) by referring to Metabolic equivalents (METs) based on individual answers to General Practice Physical Activity Questionnaire (GPPAQ). Results Based on the answers to the GPPAQ and by computing the related METs for each profile of baseline exercise levels, we developed an innovative person-centered web-based algorithm/function for enhancing and measuring PA participation in community settings. This function can compute evidence-based standardized profiles of participants, personalized goals of PA being functional to the purpose of maintaining or gaining health benefits, as well as the type and duration of PA needed to reach these goals. Conclusion It might be speculated that this approach would be a reliable method for increasing people’s self-efficacy and population adherence to recommended levels of PA. However, this theoretical proposal requires to be implemented in further research.

Background: Intra- and juxta-articular osteoid osteomas are rare, representing less than 10% of all osteomas. Compared to the classic diaphyseal or metaphyseal site of long bones, they often have an atypical onset, a longest diagnostic delay, and frequent initial misdiagnoses, with pictures that can mimic inflammatory monoarthritis. We aimed to describe a case series, and to provide a literature review of this uncommon and misleading tumor location. Methods: We performed a retrospective analysis of patients referred to three pediatric rheumatology centers, with a final diagnosis of articular osteoid osteoma. A review of the literature was additionally conducted. Results: We included 10 patients with a mean age of 14 years. All patients with unusual sites (olecranon fossa, lumbar vertebra, distal phalanx of the toe, fibula) had a misdiagnosis, and cases with initial suspicion of monoarthritis had the longest diagnostic delay, up to 24 months. The literature review confirms the significant risk of misdiagnosis, and an average time from symptom onset to diagnosis ranging from 0.4 to 1.8 years. Conclusions: Articular osteoid osteoma may mimic arthritis, especially in adolescence. Knowledge of the atypical forms of presentation, and of the clinical and radiological pitfalls, reduces the risk of diagnostic error.

Background: Nowadays, young people face several health challenges. As children and teenagers spend most of their time in the classroom, schools may have the opportunity to positively influence students’ quality of life, playing a crucial role in fostering their health. The aim of this review was to analyze evidence that demonstrated why school is the ideal setting for thepromotion of young generations’ wellbeing. Methods: We have reviewed the available literature about health promotion in school setting, searching for articles and books published from 1977 to 2020. A total of 74 articles and 17books were selected and assessed. Results: The promotion of students’ wellbeing could reduce the prevalence of measurable unhealthy outcomes and improve their academic achievements. At least 80% of all cases of heart diseases, strokes, type 2 diabetes and one third of all cancers can be prevented through health education. In this perspective, primary prevention and health promotion should start as early as possible, finding in the school the ideal setting of action. Effective school-based preventive approaches should raise students’ motivation towards a personal interiorization of health knowledge and develop in young people a critical thinking about harmful consequences of the most common risky behaviours. Educators should receive adequate training concerning health topics and become expert in the most innovative approaches to effectively engage students in adopting healthy lifestyles. Conclusion: As primary educational institution, school should integrate students’ health promotion in its ordinary teaching and learning practices in the perspective of "better health through better schools".

The issue of indoor air quality (IAQ) concerns 64 million students across Europe, but it is still a neglected topic, although it impacts both their health and learning outcomes. Classroommicroclimate is the first key factor determining a healthy or unhealthy school environment, and it is influenced by ventilation, temperature and humidity rate. Classrooms are usually crowded, overheated and poorly ventilated, thus resulting in possible increases of carbon dioxide (CO2), that can cause several problems when its concentrations exceed the value of 0.15 percentage volume of CO2 (1500 ppm) or even at lower levels (1000 ppm). CO2 can also arise from outside the school, being widely produced by the combustion of fossils or road traffic. Anthropogenic activities are responsible for the emission of nitrogen dioxide (NO2) and polycyclic aromatic hydrocarbons(PAH) too, which represent other possible external contaminants potentially impairing IAQ. Furtherdangerous exposures for students’ health are those related to natural emission of gas Radon, which typically accumulates in poorly ventilated classrooms, and volatile organic compounds (VOCs, released by building materials, paints, furnishings, detergents), while chemicals substances (i.e.cyanoacrylate, lead, cadmium, nickel) might be contained in school materials. Finally, particulate matter (PM2.5 and PM10) originating from road traffic, domestic heating or industrial activities represent additional possible contaminants impacting schools’ air quality. Poor IAQ might result in mild adverse events (i.e. headaches, nausea etc.) or cause respiratory problems. More frequently, IAQ affects students’ attention and their school performances, as widely documented by many studies. Standardized tests administered to pupils exposed to poor IAQ (to assess reading and mathematical abilities) systematically result in worse outcomes compared to students staying in healthy classroom environments. In this paper, we present recommendations of UNESCO Chair on Health Education and Sustainable Development and Italian Society of Environmental Medicine(SIMA) to ensure an optimal IAQ at school, including some post-COVID-19 issues.

Background COVID-19 pandemic resulted in about 165 million infections and 3.4 million deaths all over the world across 15 months. The most severe clinical presentation of COVID-19 diseases is interstitial pneumonia. Methods In this paper we describe clinical outcomes based on radiological features as well as the pattern of haematochemical parameters and IgG/IgM antibodies in 75 patients hospitalized due to COVID-related interstitial pneumonia not requiring intensive care assistance. Each patient underwent routine laboratory tests, including inflammatory markers and coagulation profile at baseline. Computed Tomography (CT) was performed at baseline and after 3 months to assess the persistence of radiological sequelae. A Generalized Linear Model (GLM) was used to test for each patient the association between individual haematochemical parameters at the time of hospital admission and the subsequent radiological features after three months. The presence of IgG antibodies was quantitatively determined in 70 patients at the time of hospital admission and after 3 months. A subgroup of 49 and 21 patients underwent additional dosage of IgG after 6 and 12 months, respectively. IgM serological antibodies were available for 17 patients at baseline and 61 at T3, with additional follow-up for 51 and 20 subjects after 6 and 12 months, respectively. Results Only 28 out of 75 patients discharged from the hospital were totally healed after 3 months, while 47 patients (62.7%) still presented radiological sequelae. According to the GLM model, specific haematochemical baseline parameters—such as IL-6, GPT, platelets and eosinophil count—showed a statistically significant association with the presence of radiological sequelae at month 3 highlighting an OR = 0.5, thus meaning that subjects completely healed after 3 months presented half levels of IL-6 at baseline compared to patients with sequelae. In general, IgG serum levels were always higher than IgM at the time of hospitalization (75% at T0; n = 12 out of 16 patients with data available in both visits), after 3 months (72.1%; n = 44 out of 61 pts.), after 6 months (56.8%; 25 out of 44 pts.), and one year after hospitalization (60%; 12 out of 20 pts.). Overall, IgG and IgM serum levels presented a statistically significant decreasing trend from the baseline to month 3, 6 and 12. One patient presented an increase in IgM between baseline and month 3 but negative PCR test for SARS-COV2 on throat swab. Conclusions As supported by our findings on 75 patients, COVID-related interstitial pneumonia triggers early IgG levels (higher than IgM) that gradually decrease over 12 months. Mid-term sequelae are still detectable at lung Computed Tomography after 3 months from the hospital admission. Occasionally, it is possible to observe increase of IgM levels in presence of low concentrations of IgG and negative PCR ELISA tests for SARS-COV2 RNA. Baseline levels of IL-6 could be proposed as predictor of radiological mid/long-term sequelae after COVID-related interstitial pneumonia.

Background: Tales were transmitted from one generation to another, enriching young people with values, beliefs, imagination and creativity. Children’s literature still plays a crucial part in education as it provides knowledge and entertainment, representing a typical example of"edutainment". In this paper, we carried out a review to examine pedagogic, didactic and psychological/therapeutic dimensions of children’s literature, with the aim of highlighting its role in promoting students’ holistic development and wellbeing. Methods: We have searched for original articles (from 1960s to 2019), by using the following keywords: "fairytales" or "fairy tales" or "folktales" or "fables" AND "education" or"development" or "learning" or "teaching" or "school" or "curriculum" or "classroom" AND"children" or "child" or "kids" or "childhood" AND "health" or "wellbeing". Results: We found 17 studies concerning pedagogic aspect of children literature, while 21 and17 studies were selected for didactic and therapeutic dimensions, respectively. From a pedagogic point of view, tales convey basic values useful for children lives. In a didactic perspective, properly chosen storybooks represent a valuable resource for school activities, improving students’ language skills and building up a friendly/respectful classroom environment. Children stories are also used by health professionals for therapeutic purposes (bibliotherapy) to prevent unhealthy habits and addictions, or address psychosomatic disorders. Finally, storybooks and web-based/digital stories can be an effective vehicle for health contents, to encourage the adoption of healthy lifestyles among schoolchildren. Conclusion: Children’s literature and storytelling could be helpful in promoting students’ global development and wellbeing, when included in school curricular activities.

Lactoferrin (Lf) is a cationic glycoprotein synthetized by exocrine glands and is present in all human secretions. It is also secreted by neutrophils in infection and inflammation sites. This glycoprotein possesses antimicrobial activity due to its capability to chelate two ferric ions per molecule, as well as to interact with bacterial and viral anionic surface components. The cationic features of Lf bind to cells, protecting the host from bacterial and viral injuries. Its anti-inflammatory activity is mediated by the ability to enter inside the nucleus of host cells, thus inhibiting the synthesis of proinflammatory cytokine genes. In particular, Lf down-regulates the synthesis of IL-6, which is involved in iron homeostasis disorders and leads to intracellular iron overload, favoring viral replication and infection. The well-known antiviral activity of Lf has been demonstrated against DNA, RNA, and enveloped and naked viruses and, therefore, Lf could be efficient in counteracting also SARS-CoV-2 infection. For this purpose, we performed in vitro assays, proving that Lf exerts an antiviral activity against SARS-COV-2 through direct attachment to both SARS-CoV-2 and cell surface components. This activity varied according to concentration (100/500 μg/ml), multiplicity of infection (0.1/0.01), and cell type (Vero E6/Caco-2 cells). Interestingly, the in silico results strongly supported the hypothesis of a direct recognition between Lf and the spike S glycoprotein, which can thus hinder viral entry into the cells. These in vitro observations led us to speculate a potential supplementary role of Lf in the management of COVID-19 patients.

Objectives A number of studies have shown that the airborne transmission route could spread some viruses over a distance of 2 meters from an infected person. An epidemic model based only on respiratory droplets and close contact could not fully explain the regional differences in the spread of COVID-19 in Italy. On March 16th 2020, we presented a position paper proposing a research hypothesis concerning the association between higher mortality rates due to COVID-19 observed in Northern Italy and average concentrations of PM10 exceeding a daily limit of 50 µg/m3.Methods To monitor the spreading of COVID-19 in Italy from February 24th to March 13th (the date of the Italian lockdown), official daily data for PM10 levels were collected from all Italian provinces between February 9th and February 29th, taking into account the maximum lag period (14 days) between the infection and diagnosis. In addition to the number of exceedances of the daily limit value of PM10, we also considered population data and daily travelling information for each province.Results Exceedance of the daily limit value of PM10 appears to be a significant predictor of infection in univariate analyses (p6.0, comparable with the highest values estimated for China.Conclusion A significant association has been found between the geographical distribution of daily PM10 exceedances and the initial spreading of COVID-19 in the 110 Italian provinces.

The airborne route of transmission of SARS-CoV-2 was confirmed by the World Health Organization in April 2021. There is an urge to establish standardized protocols for assessing the concentration of SARS-CoV-2 RNA in air samples to support risk assessment, especially in indoor environments. Debates on the airborne transmission route of SARS-CoV-2 have been complicated because, among the studies testing the presence of the virus in the air, the percentage of positive samples has often been very low. In the present study, we report preliminary results on a study for the evaluation of parameters that can influence SARS-CoV-2 RNA recovery from quartz fiber filters spotted either by standard single-stranded SARS-CoV-2 RNA or by inactivated SARS-CoV-2 virions. The analytes were spiked on filters and underwent an active or passive sampling; then, they were preserved at −80 °C for different numbers of days (0 to 54) before extraction and analysis. We found a mean recovery of 2.43%, except for the sample not preserved (0 days) that showed a recovery of 13.51%. We found a relationship between the number of days and the recovery percentage. The results presented show a possible issue that relates to the quartz matrix and SARS-CoV-2 RNA recovery. The results are in accordance with the already published studies that described similar methods for SARS-CoV-2 RNA field sampling and that reported non-detectable concentrations of RNA. These outcomes could be false negatives due to sample preservation conditions. Thus, until further investigation, we suggest, as possible alternatives, to keep the filters: (i) in a sealed container for preservation at 4 °C; and (ii) in a viral transport medium for preservation at a temperature below 0 °C.

Glycans play a fundamental role in several biological processes, such as cell–cell adhesion, signaling, and recognition. Similarly, abnormal glycosylation is involved in many pathological processes, among which include tumor growth and progression. Several highly glycosylated proteins found in blood are currently used in clinical practice as cancer biomarkers (e.g., CA125, PSA, and CA19-9). The development of novel non-invasive diagnostic procedures would greatly simplify the screening and discovery of pathologies at an early stage, thus also allowing for simpler treatment and a higher success rate. In this observational study carried out on 68 subjects diagnosed with either breast or lung cancer and 34 healthy volunteers, we hydrolyzed the glycoproteins in saliva and quantified the obtained free sugars (fucose, mannose, galactose, glucosamine, and galactosamine) by using high-performance anion-exchange chromatography with pulsed-amperometric detection (HPAEC-PAD). The glycosidic profiles were compared by using multivariate statistical analysis, showing differential glycosylation patterns among the three categories. Furthermore, Receiver Operating Characteristics (ROC) analysis allowed obtaining a reliable and minimally invasive protocol able to discriminate between healthy and pathological subjects.

The present study aims at evaluating the economic impact of the use of hyaluronic acid (Hyalubrix®60/HyalOne) as an alternative to surgery in the treatment of hip osteoarthritis, consistently with the therapeutic protocol envisaged in the Ortobrix study. To quantify the cost and efficacy of the treatment options under evaluation, the perspective of both the Italian NHS and the Society was considered. To this end, a decision analysis model was created over a 4-year period, to quantify the cost of treatments, procedures and adverse events, as well as the benefits expressed as survival rates and reduced lost workdays. The results show that, since the treatment with Hyalubrix® enables to avoid or delay the need for Total Hip Replacement (THR) surgery, it is possible to reduce mortality, adverse events and total costs. Hyalubrix®, given in the hip by ultrasound-guided intra-articular injection as an alternative to surgery is the most favourable option, helping preserve the survival rate over a 4-year period, of approximately 1 in 100 patients considered candidates for THR, preserve work capacity for a total differential amount of 500 days, and achieve considerable savings in economic terms, of approximately 550,000 € and 600,000€ euros from the NHS and the Societal perspectives, respectively.