The Italian herbal products market is the most prosperous in Europe. The proof is represented by the use of these products in several marketing categories, ranging from medicine to nutrition and cosmetics. Market and legislation in Italy are at the same time cause and consequence of this peculiar situation. In fact, the legislation on botanical food supplements in Italy is very permissive and at the same time the market shows an overall satisfaction of users and strong feedback in terms of consumption, which brings a widening use of medicinal plants, formerly the prerogative of pharmaceuticals, to other fields such as nutrition. This review summarizes the market and normative panorama of herbal products in Italy, highlighting the blurred boundaries of health indications, marketing authorizations and quality controls between herbal medicines and non pharmaceutical products, such as food supplements, cosmetics and other herbal-based “parapharmaceuticals”.

ABSTRACT Background: To date, the COVID-19 pandemic has been the foremost health concern for humankind in the new millennia. This paper aims to describe the related hospitalizations in Italy during the first two years of the health emergency. Design and methods: This is a retrospective, population-based study of Italian hospitalizations for patients diagnosed with COVID-19 during the 2020-2021 period, extracted from the National Hospital Discharge Registry. The outcome variables considered include hospital admissions, costs, and length of stay, among other hospitalization-level variables. Costs were estimated through the charges associated with the Diagnosis-Related Group and Major Diagnostic Categories coding system, plus an additional cost attributed to COVID-19 admissions. To these charges was added an extra cost defined by the ministry of health. Results: In Italy, there were 357,354 hospitalizations for COVID-19 attributed to 298,856 patients in 2020 and 399,043 hospitalizations for COVID-19 attributed to 333,447 patients in 2021. COVID-19 patients faced a transfer rate thrice that of other patients. Hospitalizations were concentrated predominantly in the northern regions, particularly in the first year. Hospitalization rates varied by age in a sine wave pattern, peaking in the youngest and oldest age groups, with mortality rates escalating with age— tending to remain below 3% for those under 44 but surging to 40% in individuals over 75. The financial impact of COVID-19 hospitalizations was substantial, with total costs reaching €3.97 billion in 2020 and €4.99 billion in 2021. Costs per admission and per day also rose, from €11,112 and €807 in 2020 to €12,503 and €844 in 2021, respectively. Excluding the added financial burden of COVID-19, costs would have been notably lower. Hospitalizations involving continuous invasive mechanical ventilation were particularly costly (about 24.000 euros x admission), reflecting the significant resources required for these treatments. Conclusion: Implementing a protective pad around the entire health system that leverages networks of family doctors and nurses, connected in real time to the entire health system, can be crucial. Such a network, tasked with monitoring the local epidemiological situation, protecting vulnerable individuals also through telehealth visits, and establishing a triage system for infections in the initial phase, may effectively help in managing virus spread and protecting hospitals from unpredictable waves of admission demand. Strengthening primary health care could be a decisive factor for the future and enhance the system's resilience in facing new challenges.

Abstract: The VSI represents a significant advancement in the assessment of gastrointestinal-specific anxiety among patients with Irritable Bowel Syndrome (IBS) and other Chronic Inflammatory Bowel Diseases (IBD). However, an Italian version of the instrument is not yet available for the reference population. This study utilized a national sample of 500 individuals, including healthy controls and patients with Ulcerative Colitis and Crohn's Disease, to test the validity and reliability of the Italian VSI. Using back-translation methodology to ensure translation fidelity, the research applied a questionnaire and the VSI through an online format to 500 participants. Data analysis revealed that the Italian VSI had excellent psychometric properties, demonstrating high internal consistency (Cronbach’s α = 0.95) and construct validity. The scale proved sensitive in detecting significant differences in visceral sensitivity among groups, highlighting its utility as a clinical and research assessment tool. Specifically, the Italian VSI exhibited a unidimensional factorial structure and maintained a strong correlation with other measures of anxiety and the severity of gastrointestinal symptoms, confirming its role in enhancing the understanding and management of IBS and IBD in Italy.

Background: Over the past decades, efforts have been made to improve the nutritional well-being in people with cystic fibrosis (pwCF). Due to the correlation observed between nutritional indices and lung function, prevailing recommendations consistently advocate for BMI percentile goals at or above the 50th percentile in pwCF. Recent global trends show a notable increase in overweight and obese statuses among pwCF. This study aims to explore the nutritional status of Italian pwCF. Methods: Data from the Italian CF Patient’s Registry were analysed to assess the proportion of individuals categorized as underweight, target weight, overweight, and obese from 2010 to 2021. Patient-level comparison data from 2021 were also examined to identify potential determinants of overweight and obesity. Results: Analysis spanning 2010 to 2021 reveals a decrease of approximately 40% in underweight status among adults, while the proportion of malnourished patients 90, and lower prevalence of Pseudomonas aeruginosa colonization. Conclusions: Our study confirms the evolving nutritional status landscape among Italian adult pwCF, with a significant shift towards overweight and obesity over the past decade. These trends highlight the need for proactive measures within CF standards of care to adapt and address the changing needs of patients.

Electricity price forecasting has become a crucial element for both private and public decision-making. This importance has been growing since the wave of deregulation and liberalization of energy sector worldwide late 1990s. Given these facts, this paper tries to come up with a precise and flexible forecasting model for the wholesale electricity price for the Italian power market on an hourly basis. We utilize artificial intelligence models such as neural networks and bagged regression trees that are rarely used to forecast electricity prices. After model calibration, our final model is bagged regression trees with exogenous variables. The selected model outperformed neural network and bagged regression with single price used in this paper, it also outperformed other statistical and non-statistical models used in other studies. We also confirm some theoretical specifications of the model. As a policy implication, this model might be used by energy traders, transmission system operators and energy regulators for an enhanced decision-making process.

ADHD is a neurodevelopmental disorder that children and also adults can develop. A complex interplay of genetic and environmental factors may underlie interindividual variability in ADHD and potentially related aggressive behavior. Using high-resolution molecular biology techniques, we investigated the impact of some MAOA and SLC6A4 variations on ADHD and aggressive behavior in a group of 80 Italian children with ADHD and in 80 healthy controls.We found that homozygous genotypes of MAOA rs6323 and rs1137070 were associated with an increased risk of ADHD (p=0.02 and p=0.03, respectively), instead the heterozygous genotypes (GT of rs6323 and CT of rs1137030) (p=0.0002 and p=0.0006) were strongly linked to a lower risk of developing this disorder. In patients with aggressive behavior, we highligted only a weak negative association of both MAOA polymorphisms (heterozygous genotypes) with aggressiveness then, suggesting that these genotypes maybe protective towards specific changes in behavior (p=0.05). Interestingly, an increase of the GG genotype of rs6323 (p=0.01) and a decrease of GT genotype (p=0.0005) was also found in patients without aggressive behavior compared with controls. Regarding 5HTT gene genotyping, no allele and genotype differences have been detected among patients and controls. Our work shows that defining a genetic profile of ADHD may help to early detect those patients who are more vulnerable to ADHD and/or antisocial and aggressive behavior and to design precision-targeted therapies.

This paper is aimed at studying the temporal evolution of the surface displacements occurred over the past few years in the ocean-reclaimed platforms of the Shanghai megacity (China), which are mainly ascribable to consolidation processes of large dredger fills and alluvial deposits. With respect to previous analyses carried out over the same area, this work provides a joint multi-platform differential interferometry synthetic aperture radar (DInSAR) analysis, based on the application of the advanced Small BAseline Subset (SBAS) algorithm. This led us to retrieve long-term deformation time-series that are helpful for a better understanding of the on-going deformation phenomena. To this aim, we have exploited two sequences of SAR data collected by the ASAR/ENVISAT and by the COSMO-SkyMed (CSK) sensors, respectively, spanning the whole time period from 2007 to 2016. Unfortunately, the large time gap (of about three years) existing between the available ASAR/ENVISAT and CSK datasets gave rise to additional difficulties for their combination. Nevertheless, this problem has been faced by benefiting from the knowledge of a time-dependent model describing the temporal evolution of the expected deformations affecting the Shanghai ocean-reclaimed platforms.

Background: Gender stereotypes and biases can influence perceptions of competence and suitability for certain medical specialties. Empathy is an important component of an optimal doctor-patient relationship. The scope of our study is to verify the correlation between “empathetic" behavioral style with attention and sensibility to the gender differences of patients of the medical students. Methods: An online survey was conducted using the Jefferson Scale for Empathy (JSE), to measure empathy in the context of health professions education and patient care; and the Nijmegen Gender Awareness in Medicine Scale (N-GAMS), which measures attitudes and assumptions about gender. A total of 234 students (52.1% M; mean age: 22.68±2.48) from Medicine and Surgery at the University of Salerno (Italy) participated, of whom n° 175 were third-year students and n° 59 were fifth-year students. Results: The JSE score shows that male students have higher scores (77.29±12.38) than females (75.91±10.39). Conversely, female students have higher perspective-taking (JSE Factor 1: Male= 51.26±11.84; Female= 52.72±11.88). In addition, third-year students are much more empathetic than their fifth-year colleagues (JSE Score: 3°ys= 77.35±11.46; 5°ys= 74.49±11.33). With reference to the GS, we found that male students have greater sensitivity than their female colleagues (GS: Male= 2.67±0.68; Female= 2.37±0.48); conversely, they have higher scores of gender stereotype towards patients (GRIP: Male= 2±0.88; Female= 1.59±0.61) and doctors (GRID: Male= 1.88±0.89; Female= 1.64±0.63). Also, the third-year students compared to their fifth-year colleagues are characterized by greater gender sensitivity (GS: 3°ys= 2.57±0.62; 5°ys= 2.42±0.57), less bias with respect to patients (GRIP: 3°ys= 1.77±0.79; 5°ys= 1.90±0.78) but, on the other hand, show more stereotypes and prejudices towards doctors (GRID: 3°ys= 1.77±0.81; 5°ys= 1.75±0.74). Conclusions: Humanistic attitudes, including empathy, should be instilled, and evaluated among trainees as an essential part of their postgraduate medical education.

The Work Ability Index (WAI) is the most widely used questionnaire for the self-assessment of working ability. Because of its different applications, shorter versions, and widespread use in healthcare activities, it is worthwhile assessing its characteristics. The WAI was distributed online among the workers of a healthcare company; the results were compared with data contained in the workers' personal health records and with absence registers. 340 out of 575 workers (59.1%) participated; 6.5% of them reported poor work ability. Exploratory factor analysis indicated that the one-factor version best described the characteristics of the WAI. The scores of the complete WAI, the shorter form without the list of diseases, and the minimal one-item version (WAS) had equal distribution and were significantly correlated. The WAI score was inversely related to age and significantly lower in women than in men, but it was higher in night workers than in colleagues due to the probable effect of selective factors. The WAI score was also correlated with absenteeism, but no differences were found between males and females in the average number of absences, suggesting that cultural or emotional factors influence the self-rating of the WAI. Workers tended to overreport illnesses in the online survey compared to data collected during occupational health checks. Musculoskeletal disorders were the most frequently reported illnesses (53%). Psychiatric illnesses affected 21% of workers and had the greatest impact on work ability. Multilevel ergonomic and human factor intervention seems to be needed to recover the working capacity of healthcare workers.

Densely urbanized areas, with a low percentage of green vegetation, are highly exposed to Heat Waves (HW) which nowadays are increasing in terms of frequency and intensity also in the middle-latitude regions, due to ongoing Climate Change (CC). Their negative effects may combine with those of the UHI (Urban Heat Island), a local phenomenon where air temperatures in the compact built up cores of towns increase more than those in the surrounding rural areas, with significant impact on the quality of urban environment, on citizens health and energy consumption and transport, as it has occurred in the summer of 2003 on France and Italian central-northern areas. In this context this work aims at designing and developing a methodology based on aero-spatial remote sensing (EO) at medium-high resolution and most recent GIS techniques, for the extensive characterization of the urban fabric response to these climatic impacts related to the temperature within the general framework of supporting local and national strategies and policies of adaptation to CC. Due to its extension and variety of built-up typologies, the municipality of Rome was selected as test area for the methodology development and validation. First of all, we started by operating through photointerpretation of cartography at detailed scale (CTR 1: 5000) on a reference area consisting of a transect of about 5x20 km, extending from the downtown to the suburbs and including all the built-up classes of interest. The reference built-up vulnerability classes found inside the transect were then exploited as training areas to classify the entire territory of Rome municipality. To this end, the satellite EO HR (High Resolution) multispectral data, provided by the Landsat sensors were used within a on purpose developed "supervised" classification procedure, based on data mining and “object-classification” techniques. The classification results were then exploited for implementing a calibration method, based on a typical UHI temperature distribution, derived from MODIS satellite sensor LST (Land Surface Temperature) data of the summer 2003, to obtain an analytical expression of the vulnerability model, previously introduced on a semi-empirical basis.

The aim of the present study was to investigate the incidence of breast (females), prostate, testicular and thyroid cancer in the Italian National Priority Contaminated Sites (NPCSs), served by cancer registries, where the presence of endocrine disruptors (EDs), reported to be linked to these tumors, was documented. Evidence of carcinogenicity of EDs present in NPCs was assessed based on evaluation by international scientific institutions/committees. Standardized Incidence Ratios (SIRs) were computed for each NPCS and cancer site with reference to the time window 1996-2005. Excess incidence of one or more cancer site at study was found in twelve out of fourteen NPCSs. Significantly increased SIRs were found for breast cancer in eight NPCSs, for prostate cancer in six, for thyroid cancer (both gender) in four and for testicular cancer in two. Non significantly increased SIRs were found in five NPCSs for testicular cancer and in two for thyroid cancer (males). Even if increased incidence of one or more cancer sites at study were found in several NPCSs, the ecological study design and the multifactorial etiology of the considered tumors do not allow reaching conclusions in terms of causal links with environmental contamination. In light of the observation of some excesses in SIRs, continuing epidemiological surveillance is warranted.

This study delves into hospital mobility, understood as an indicator of perceived service quality, across the Italian regions of Apulia and Emilia Romagna, utilizing logistic regression among machine learning techniques. The focus is on how structural, operational, and clinical variables impact patient perceptions of service quality, influencing their healthcare choices. Through the analysis of mobility trends with machine learning, significant differences between regions were uncovered, highlighting the influence of regional context on perceived quality. The integration of SHAP (SHapley Additive exPlanations) values into our analysis provided deeper insights into the logistic regression model, elucidating the specific contribution of each variable to perceived healthcare quality. This incorporation of SHAP values underscores the study's commitment to employing advanced, explainable AI techniques to enhance the interpretability and fairness of healthcare service evaluations. The choice of logistic regression elucidated the impact of specific variables on quality perception, offering essential insights for optimizing healthcare resource distribution and underscoring the importance of data-driven strategies to foster more equitable, efficient, and patient-centred healthcare systems. Contributing to the understanding of perceived quality dynamics within the healthcare context, the research paves the way for further investigations into enhancing accessibility and service quality, leveraging machine learning as a tool for improving healthcare services efficiency in diverse regional settings.

Polar stratospheric clouds (PSCs) form in polar regions typically between 15 and 25 km, when the local temperature is sufficiently low. PSCs play an important role in the ozone chemistry and the dehydration and denitrification of the stratosphere. Lidars with a depolarization channel may be used to detect and classify different classes of PSCs. The main PSC classes are water ice, nitric acid trihydrate (NAT) and supercooled ternary solutions (STS), the latter being liquid droplets consisting of water, nitric acid and sulphuric acid. PSCs have been observed at the lidar observatory at Concordia Station from 2014 on. The harsh environmental conditions at Concordia during winter render successful lidar operation difficult. In order to facilitate the operation of the observatory several measures have been put in place to achieve an almost complete remote control of the system. PSC occurrence is strongly correlated with local temperatures and is affected by dynamics, as the PSC coverage during the observation season shows.

Childhood emotional abuse (CEA) has been linked to a range of unfavorable outcomes, including the development of unhealthy personality traits and maladaptive coping mechanisms and behaviors. In this study, our objective was to investigate whether neuroticism and perfectionism act as mediators in the relationship between CEA and workaholism, while also evaluating the gender invariance of the hypothesized model. A cohort of 1176 young workers, with a balanced gender representation (50% female), aged 18-25, participated in the study by completing self-report questionnaires. The results revealed significant connections between all direct and indirect links, indicating a complex interplay between childhood emotional abuse, neuroticism, perfectionism, and workaholism. Importantly, the mediation model exhibited no significant differences between genders, suggesting that the identified relationships are consistent across both male and female participants. This research underscores the critical importance of early identification of childhood emotional abuse and advocates for the implementation of trauma-informed care to address the negative consequences of emotional abuse, ultimately aiming to prevent the development of workaholism. Furthermore, the findings emphasize the necessity for tailored prevention strategies, focusing on mitigating neuroticism and perfectionism as potential pathways for effective therapeutic interventions.

in the following article I analyze the trend of cultural and creative employment in the Italian regions between 2004 and 2022 through the use of ISTAT-BES data. After presenting a static analysis, I also present the results of the clustering analysis aimed at identifying groupings between Italian regions. Subsequently, an econometric model is proposed for estimating the value of cultural and creative employment in the Italian regions. Finally, I compare various machine learning models for predicting the value of cultural and creative employment. The results are critically discussed through an economic policy analysis.

Background: Open AI developed ChatGPT, a language model based on the GPT architecture, designed for text-based communication. Trained on diverse internet texts, ChatGPT generates contextually appropriate responses using machine learning. It understands input through analysis and context interpretation, generating coherent and contextually relevant responses. Interaction is possible through messaging platforms. Materials and Methods: In November 2023, we utilized ChatGPT 3.5, the default version at that time, to answer questions from the Italian National Residency Program Admission Tests (SSMs) of 2021, 2022, and 2023. The questions cover clinical, diagnostic, analytical, therapeutic, and epidemiological scenarios, sometimes accompanied by images. The study compared ChatGPT's answers to the official corrections on the Italian Ministry of University and Research (MUR) website. The scoring method used for evaluation was 1 point for correct answers, 0 points for unanswered questions, and -0.25 points for incorrect answers, reflecting the SSM test scoring system. Results: In summary, ChatGPT was tested with a total of 420 questions, 140 for each test. It achieved an overall accuracy of 80.48%, providing correct answers for 338 questions and incorrect answers for 82 questions. When faced with questions containing both text and images, it answered 55% correctly and 45% incorrectly. The model's performance varied over time, with an 82.14% accuracy rate in 2021 and 2022 (115 correct out of 140) and a 77.14% accuracy rate in 2023 (108 correct out of 140). Applying thisscoring method to the SSM test, ChatGPT would have scored 105 points in 2021 and 2022, and 100 points in 2023. Conclusions: ChatGPT has exhibited above-average performance in the last three SSM tests, highlighting its robust capability to interpret clinical scenarios and offer precise diagnostic and therapeutic guidance. Despite this, some limitations persist, notably the software's inability to interpret non-textual information.

In this article, we analyze the relationships that connect graduates from high school, the training system and employment rates and conditions in the Italian regions between 2004 and 2022. The data used refer to the Istat Bes database. The results show that the growth in the number of high school graduates is positively associated with higher university education and employment with the exception of job satisfaction. Subsequently we also present a clusterization with k-Means algorithm confronting the Silhouette Coefficient with the Elbow Method. Finally, we confront seven different machine-learning algorithms for the prediction of the level of graduated from high school. We also present economic policy suggestions to increase schooling in the Italian regions. The results are critically discussed.

During the last 150 years, the trout-culture industry focused on enhancing trout populations by stocking, in response to the growing anglers’ demand and the habitat degradation associated to the rapid urbanization and hydropower development. The industrialized north of Italy, home to the Italian Alpine and subalpine trout populations, is the source of most of the revenues of the national trout-culture industry. Its rapid growth and the massive introduction of non-native interfertile trouts eroded the genetic diversity of native lineages, leading to harsh confrontations between scientists, institutions, and sportfishing associations. We review here the state of art of the taxonomy and distribution of the northern Italian native trouts, presenting both scientific results and historical documentation. We think the only native trouts in this region are Salmo marmoratus, widespread in this region, plus small and fragmented populations of S. ghigii, present only in the Southwestern Alps. We strongly recommend the interruption of stocking of domesticated interfertile non-native trouts in this area, and recommend the adoption of Evolutionary Significant Units for salmonid fishery management. We further propose future research directions for a sustainable approach to the conservation and ecosystem management of the fishery resources and inland waters of northern Italy.

In the following article I take into consideration the role of knowledge workers in the Italian regions. The analysed data refers to the ISTAT-BES database. The metric analysis consists of an in-depth analysis of the trends of the regions and macro-regions, followed by clustering with the k-Means algorithm, the application of machine learning algorithms for prediction, and the presentation of an econometric model with panel methods date. The results are also critically discussed in light of the North-South divide and the economic policy implications.

Cancer cells require substantial amounts of energy and substrates for their metabolic hyperactivity, enabling the synthesis of new cells at the expense of healthy ones. Preliminary in vitro data suggest that a mix of free essential amino acids (EAA-mix) can promote cancer cell apoptosis by enhancing autophagy. This study aimed to confirm, both in vitro and in vivo, whether EAA intake could influence the development of colon cancer in mice. We investigated changes in cancer proliferation in CT26 cells treated with EAA-mix, and in mice fed with EAA rich modified diets (EAARD) as compared to those on a standard laboratory diet (StD). CT26 cells were injected subcutaneously (s.c.) or intraperitoneally (i.p.). After 21 days, tumors were removed and measured. In vitro data corroborated that EAA-mix impairs cancer growth by inducing autophagy and apoptosis. In vivo data revealed that mice on StD developed significantly larger (s.c.) and more numerous (i.p.) cancers than those on EAARD. EAA administration appears to influence cancer cell survival with notable anti-proliferative properties.

In the last decade, robotic-mediated rehabilitation has emerged as a potential solution to improve repetitive task training. Each device in this field has a unique development history shaped by engineers’ expertise in specific programming languages or platforms. In this work we adopt an approach that tries to abstract from the final implementation with the aim to make control logic more shareable and understandable. The authors will present the outcomes of the application of a Rapid Control Prototyping strategy to an upper-limb robotic exoskeleton. A model-based design approach implemented on a real-time target machine is presented. This modern design approach was explored with several control strategies and was used to test the exoskeleton’s performances. The proposed method highlights how it is possible to develop the entire control architecture in a single programming environment.

In the following article I analyze the determinants of regular internet users in the Italian regions. The data is analyzed both in terms of static analysis and also through the application of the k-Means algorithm optimized with the Elbow method. Subsequently, an econometric model is presented for estimating regular internet users in the Italian regions based on variables that reflect the state of technological innovation and digital culture. The results are analyzed and discussed in light of the implications that digitalisation has for triggering economic growth.

In recent years, there has been an intensification of weather variability worldwide as a result of climate change. Some regions have been affected by drought, while others have experienced more intense rainfall. The incidence and severity of mouldy grain and mycotoxin contamination during the growing and harvesting seasons have increased as a result of these weather conditions. Addi-tionally, torrential rains and wet conditions may cause delays in grain drying, leading to mold growth in the field. In July 2023, a wheat field in Lecco (Lombardy, Italy) was affected by torren-tial rains that led to the development of the Claviceps fungi. In the field, dark sclerotia were identi-fied on some ears. Wheat ears, kernels and sclerotia were collected and analyzed by LC-MS/MS at IZSLER, Food Chemical Department, in Bologna. The wheat ears, kernels and sclerotia were ana-lyzed for 12 ergot alkaloids (EAs) according to (EU) Regulation 2023/915 (er-gocornine/ergocorninine; ergocristine/ergocristinine; ergocryptine/ergocryptinine; ergome-trine/ergometrinine; ergosine/ergosinine; ergotamine/ergotaminine), after QuEChERS (Z-Sep/C18) purification. The analyzed sclerotia showed significant differences in total alkaloids content that varies between 0.01-0.5% (w/w), according to the results of 2017 EFSA scientific report. EAs de-tected in sclerotia were up to 4951 mg/kg, in wheat ears up to 33 mg/kg, and in kernels were 1 mg/kg. Additional mycotoxins including ochratoxin A, deoxynivalenol, zearalenone, fumonisins, T2-HT2 toxins, and aflatoxins were investigated in wheat kernels, after purification with immu-noaffinity columns (IAC). The analysis revealed the presence of deoxynivalenol in wheat kernels at a concentration of 2251 µg/kg. It is expected that climate change will increase the frequency of extreme weather events. In order to mitigate the potential risks associated with mycotox-in-producing fungi and to ensure the protection of human health, it is suggested to implement of-ficial controls in the field.

Psychological wellbeing can be impacted substantially by changes in body image during youth, which can be a predictive factor for positive or negative attitudes, such as for self-esteem and satisfaction. In this study, adherence to the thinness model and to healthy behaviours were analysed in terms of the emotional patterns and body management of the young female Italian population (N = 2287). Skinny girls fitting better with the thinness model tended to develop higher positive emotional patterns, but their body management was low. Findings suggest the urgent need for preventive programmes to enhance awareness of healthy behaviours against appearance models.

Aim: The purpose of this study was to collect prevalence data of Hypomineralized Second Primary Molars (HSPM) and Molar Incisor Hypomineralization (MIH) among pediatric patients treated by dental practitioners in Northern Italy and assess the practitioners’ awareness of these conditions. Methods: A cross-sectional pilot study was conducted using a structured online questionnaire administered through Google Forms. The survey comprised 10 single-choice questions addressing the prevalence of opacities affecting molars and an index of HSPM and MIH in caries-free children aged 6-9 years, categorized by percentage. Results: A total of 315 dentists participated in the survey, yielding a response rate of 31.5%. The majority of respondents (59%) reported HSPM prevalence in 1-25% of their patients, while 18% observed no opacity in any of their patients. MIH was observed in HSPM patients in 1-25% and 25-50% of cases, as reported by 44% and 31% of respondents, respectively. Among non-HSPM patients, MIH was observed in 1-25% of children (reported by 74% of respondents). Conclusion: The findings from this pilot survey show substantial agreement with existing prevalence data on HSPM and MIH reported in the literature. The co-occurrence rate of HSPM and MIH defects supports the hypothesis of HSPM potentially serving as a predictor of MIH. The study underscores a significant need to enhance awareness of these defects for early diagnosis and effective management. Additionally, there is a call for the promotion of standardized diagnostic protocols to obtain more accurate epidemiological data.

The right to live with dignity during the final stages of existence, enshrined in national and supranational Charters of Rights, represents a significant step towards humanizing medicine and is integral to the right to health. Palliative Care, rooted in health, dignity, and therapeutic self-determination, has emerged as a fundamental human right and a moral imperative within health systems. It seeks to alleviate suffering, emphasizing the holistic well-being of patients with life-limiting illnesses. This paper provides a comprehensive global perspective on Palliative Care, with special attention to its implementation in Italy. Palliative Care is a crucial dimension of care, designed to enhance the quality of life for patients suffering from progressive and incurable diseases. Despite its growing need due to an aging population and increased prevalence of chronic illnesses, still remains a significant disparity in access to these essential services worldwide. Insufficient resources, legislative constraints, and limited training for healthcare providers pose challenges to the widespread adoption of Palliative Care. In Italy, although laws have been enacted to ensure the provision of Palliative Care, its availability remains inconsistent across different regions. Financial constraints and insufficient support hinder the comprehensive dissemination of these services. Recognizing the significance of Palliative Care, the Catholic Church also endorses its implementation as a response to human suffering and an approach to end-of-life care. Efforts to strengthen Palliative Care are critical to meeting the rising demand and ensuring access to compassionate and dignified care for all individuals in need. Through legislative advancements and adequate resources, Italy can make significant strides in advancing the provision of Palliative Care.

The Sustainable Development Goals (SDGs) require collaboration among academia, indus-try, citizens, public administration and politics. Analysis and monitoring of the SDGs is a deci-sive step in evaluating possible corrective actions. In this regard, this paper assesses the perfor-mance of Italian regions in 2021 compared to the values recorded in 2020. An online survey among academics aims to support Multi-criteria decision analysis (MCDA) choices, which aims to calculate a sustainability score for Italian regions. The results, based on 27 targets, show that the northern regions show better performance, with the province of Trento topping the list. This is followed by Valle d'Aosta and the province of Bolzano, confirming the trio that emerged in the previous year. A very interesting fact is the growth of the central regions, which overall tend to reach a value close to that of the northern regions. In particular, Toscana, Marche and Lazio stand out for a good performance. It is also confirmed that the southern regions occupy the last places in the ranking with the only excep-tion being Abruzzo. The implications of this paper move toward a pragmatic approach that goes beyond the ideological in order to arrive at solutions and projects that are viewed with sharing by stake-holders. There is a need to foster collaboration between different territorial realities in order to achieve a social community in which young people have a role in which they can grow and share their ideas. Made in Italy is a target on which to enhance the SDGs to help make the Medi-terranean area a crossroads of the future global economy.

Mothers’ own milk (MOM) for premature babies is considered a life-saving drug for its proven protective action against the complications of prematurity and for the effects on the outcome in the short and long term, especially the neurological one. We studied the use of the MOM for WLBWs over a 5-year period. Statistical comparisons concerned data on feeding with the MOM during stay in NICU and at discharge with respect to maternal and neonatal variables (gestational age, birth weight, type of pregnancy if single or twin, maternal age) and to feeding data (timing of the start of the Minimal Enteral Feeding and the availability of the MOM, the achievement of the Full Enteral Feeding, the type of nutrition at discharge). We observed an increase, between 2017 and 2021, of MOM use (p=0.003). The availability of the MOM occurred on average on the fourth day of life and improved over the years. Start of MEF with human milk averaged 1.78 days and 54.3% of VLBWs received MEF with donor milk on the first day of life (50% within the first 6 hours). The average MOM at discharge was 47.6% with 36.1% exclusive MOM (EMOM) and an increase from 45.8% in 2017 (EMOM 33.3%) to 58.82% (EMOM 41.18%) in 2021. The mean average daily growth of the weight improved (p<0.001) during this period. There is no statistical difference between infants fed with MOM and those fed with bank milk. The maternal age, the start day of the MOM feeding and gestational age have a significant impact on the type of feeding at discharge.

The object of this work is to report some preliminary results on the mechanical harvesting of blueberry fruits of cv. Cargo® in the Piedmont region, one of the most productive areas of Italy that is specialized for fresh blueberry production. The automatization of harvesting operations could represent a competitive advantage for the investigated area’s blueberries supply chain, but could act as a limitation to maintaining the quality of fresh berries. A prototype machine and a commercial harvester (Easy Harvester®) were compared to manual picking, considering harvest efficiency (share of loss), labor productivity and harvesting cost. In the indicated context, the cost of labor exceeds 2.00 euros per kg of sellable product. The use of the prototype allowed a 37% re-duction of this cost, and the use of the Easy Harvester® allowed a reduction of about two thirds. It should be emphasized that these positive performances do not consider two other aspects: the re-duction in the marketable volume (attributable to losses in the harvest and post-harvest phase), and the reduction in the net sale price by 0.30 euros due to the sorting/selection costs in the ware-house. In this study, we highlight how the transition to mechanical harvesting requires the trans-formation of several farming and warehouse operations, such as new crop varieties, new field configurations, and new packaging processes. However, a possible technical improvement of the Easy Harvester® machine could represent an opportunity for Italian companies in the planning of the production and marketing of berries, involving all actors of the supply chain. Further research on the use of mechanization in the sector must still be continued and supported.

In forensic acoustics, a possible area of analysis is represented by unwanted sound that 1 is perceived as a source of intrusion or disturbance within a certain auditory context. This context 2 is defined as the "auditory scene" and refers to the set of sounds present in a specific environment. 3 The presence of unwanted sounds in the auditory scene can cause a wide range of negative effects, 4 including disturbance, discomfort, moral or immoral harm, and other types of negative impact on the 5 health and well-being of individuals exposed to noise. In 2022, the technical specification UNI/TS 6 11844:2022 dedicated to the measurement and analysis of intrusive noise was published. The standard 7 introduces the concept of intrusive noise and defines its calculation methods based on environmental 8 measurements. The purposes of this technical specification is to provide an objective support to 9 methods already in used in acoustic disputes, where the assessment of the annoyance of a noise is 10 often a subjective evaluation of the technician. This work delves into the application to some real 11 cases, identifying the potentiality and the limits of the standardized method.

Drinking water, in addition to the best-known chemical and biological agents, contains radionuclides of both natural and artificial origin, which can contribute significantly to the overall effective dose received by the population. The Italian Decree Law 28/2016, implementing 2013/51/EURATOM Directive, establishes the activities for risk management and the parameter values for different radionuclides activity concentrations. In addition to the institutions involved, annually the National Inspectorate for Nuclear Safety and Radiation Protection (ISIN), publishes the monitoring reports of environmental radioactivity in Italy, including radioactivity in drinking water. The purpose of the study was to integrate ISIN reports with 2018 to 2020 data by collecting measurements performed by institutional laboratories to obtain a more complete information and adding, for the Campania region, some data not yet published. This new updated report was not significantly different from ISIN’s one, meaning that those publications are nevertheless extremely representative of the radioactivity in Italian drinking water. However, the study allowed to obtain a more detailed data also including measurements not considered in ISIN reports, for instance, radon-222 activity concentrations. This may be of great usefulness for all radiation protection stakeholders in order to ensure environmental protection, pollution prevention and the population safety.

This study compares lifestyles behaviour in Italian and Latvian university students, to assess if there are differences for sex, age, university or studies specialties. An online questionnaire investigating 8 lifestyle dimensions has been compiled by 156 (43,6 % females) from Italy and 105 from Latvia (82,9% females). Answers were collected between April and December 2020. Presence of smokers are negligible. The questionnaire showed to have a good internal consistency (Cronbach α =.929). On the total group, significant statistically differences were found for all the dimensions regarding age, sex, study specialty and university. Physical activity was associated with healthier lifestyles choices. Geographical-induced differences were found (eating and sleep behaviours, alcohol awareness) as well as socio-economic differences. Female students shown to be more stressed than males. Occupational wellness increased by age. Sport students shown more health awareness. Many of the differences found in the total group disappeared when comparing only sport students of the two university, showing females increasing their scores. This result can be explained by a masculinization effect of sport.

We applied a generalized SEIR epidemiological model to the recent SARS-CoV-2 outbreak in the world, with a focus on Italy and its Lombardia, Piemonte, and Veneto regions. We focus on the application of a stochastic approach in fitting the model numerous parameters using a Particle Swarm Optimization (PSO) solver, to improve the reliability of predictions in the medium term (30 days). We analyze the official data and the predicted evolution of the epidemic in the Italian regions, and we compare the results with data and predictions of Spain and South Korea. We link the model equations to the changes in people’s mobility, with reference to Google’s COVID-19 Community Mobility Reports. We discuss the effectiveness of policies taken by different regions and countries and how they have an impact on past and future infection scenarios.

Unlike other SDGs, the SDG4 about quality education is not a goal in itself, but rather a tool to achieve different goals. Universities in this respect play a crucial role in the short-term implementation of SDGs for education, including new approaches and contents. Current academic debates explore the best practices via deductive-theoretical or inductive-experiential methods, yet not always considering the geographical, and therefore cultural and infrastructural factors affecting the success and the failure of such practices. In this paper, we systematize the implementation of SDGs in Italian universities from 2016 to 2019. Eighteen experiences have been collected after a national call by the Italian Network of Sustainable Universities (RUS) aimed at mapping the current landscape of SDG related actions. Results have been analyzed according to two criteria: 1- the educational "container" where the SDGs implementation takes place (from random workshops to dedicated courses); 2- the different organizational scales (from the foundation of a new department to the campaigns by local green teams). With this paper, we do not propose a total refunding or "deus-ex-machina" solutions, disregarding the local factors and the local resources in Italian universities. On the contrary, we draw a map to propose the reuse of an existing structure with adjustments, retrofitting and renewal actions towards holistic and coordinated sustainability efforts. Results show that, within the Italian context, SDGs implementation is still primarily understood as a strategic element for branding and promoting the green image of the Athenaeum. Secondarily, it is seen whether as a separate discipline to be inserted into existing curricula and original teachings or as a conceptual tool for remedying specific societal challenges through random workshops or fieldworks. Conclusions highlight the value of this first Country-wide systematization of the Italian Higher Education Institutions toward SDGs implementation. This exercise avoids individual experiences remaining isolated and self-concluded, and, most importantly, provides comparability and transferability criteria to help similar cases. Further works envisage the recognition of same elements in the broader European traditions, as well as the enhancement of stimuli for a personal and societal transformation generated by the partnership of all those people and institutions engaged in the exciting yet urgent defy of today's societal challenges.

The paper aims to investigate on the determinants of the capital structure of the Italian SMEs and it is based on a large panel of Italian manufacturing SMEs observed in the years 2001-2013. The analysis achieves a comparative investigation between the capital structure of the firms belonging in the Southern region, the so-called Italian Mezzogiorno that is the slow growing area of the country, and the firms of the Center-northern region of Italy, that is the more developed area of the country. Fixed effect panel techniques applied to the several standard leverage models allows to reaffirm some distinctive features showing differences of the financial behavior of regional firms.

There is evidence that the tendency to adopt a particular pattern of causal inference, known as attributional style, is likely to be associated with specific pattern of psychopathology among youth. This study aims to assess preliminary psychometric properties of the Italian Children’s Attributional Style Questionnaire-Revised (CASQ-R) and to explore the presence of any subgroups of children and early adolescents from the general population who might exhibit internally homogeneous and externally heterogeneous attributional styles, through cluster analyses, delving also potential sociodemographic and clinical differences among the identified clusters of attributional styles. A sample of 337 children was recruited and their attributional styles and depressive symptoms were analyzed. Four distinct clusters emerged using the six CASQ-R subscales in a multivariate finite mixture model. In particular, high levels of depressive symptoms were reported by children showing high scores in all the negative attributional subscales (globality, internality and stability) and medium scores in all the positive attributional subscales. Conversely, low levels of depressive symptoms were reported by children showing medium-to-high scores in the positive attributional subscales and low-to-medium scores in the negative attributional subscales. The identified clusters shed light on distinct patterns associated with depressive symptoms, offering potential insights for targeted interventions.

The author attempts to reconstruct the climatic vicissitudes of the Mediterranean to explain why only broadly distributed Eurasian forest species have penetrated the Mediterranean peninsulas. He has carried out a bibliographic survey of the status of breeding forest birds in Italy over 15 decades (1872-2022) in order to establish an objective long-term trend (stable, increasing, decreasing, etc.). The number of breeding forest birds in Italy amounts to 61; their distribution, with a few exceptions, indicates that they are widespread in Eurasia, but only a small percentage of Eurasian forest species have colonized Italy and the other Mediterranean peninsulas, namely 49 in Iberian, 61 in Italian and 64 in Balkan peninsulas; a small percentage of them (between 10.9 and 14.3%) belongs to trans-Saharan migrants. The similarity between the forest species on the three peninsulas (Iberian, Italian and Balkan) results between 0.45 and 0.48, indicating a certain differ-ence in the overall fauna on the three territories. Not all species have penetrated southwards into the three peninsulas; for example, some that stopped in the Italian Alps have instead arrived to the forests of Greece, at a latitude corresponding to southern Italy, or species that in Italy stopped in the northern Apennines in the other two peninsulas have instead arrived far south. Iberian peninsula and the island of Corsica hold three endemic species among breeding forest birds, Italian and Balkan peninsulas have not endemic species. Overall, the Mediterranean presently hosts mainly neo-endemic taxa among forest bird species; the only paleo-endemics can be considered the three species of nuthatches living in Corsica, Algeria, and Turkey (other than Caucasus and the islet of Lesvos) and Le Vaillant’s woodpecker in the Maghreb (North Africa). Italian forests cover ca. 40% of land surface and since 1980’ are increasing, but 22% of them do not have a natural origin. However, it is difficult to know the true increase of forests, because some of them are fired every year. The presence of some ecologically demanding forest birds depends on the age of the trees, permanent open spaces and other characteristics at the edge of woodland.

The Inventory Déjà Vu Experiences Assessment (IDEA) is the only screening instrument proposed to evaluate Déjà vu (DV) experience. Here we intended to validate the Italian version of IDEA (I-IDEA) and at the same time to investigate the incidence and subjective qualities of DV phenomenon in Italian healthy adult individuals on basis of an Italian multicentre observational study. In this study we report normative data on the I-IDEA, collected on a sample of 542 Italian healthy subjects aging between 18 to 70 years (average age 40, range 18-70) with a formal educational from 1-19 years. From September 2013 to March 2016 were recruited 542 healthy volunteers from ten outpatient neurological clinics in ItalyAll participants (i.e family members of neurological patients enrolled, medicine’s student, physicians) had no neurological or psychiatric illness and they gave informed consent to participate in the study. All subjects enrolled had self-administered the questionnaire and they are able to complete I-IDEA test without any support. In total 396 (73%) of the 542 healthy controls had DV phenomenon. The frequency of DV was inversely related to age as well as to derealisation, jamais vu, precognitive dreams, depersonalization, paranormal activity, remembering dreams, travel frequency and daydreams (all P<0.012). The Italian version of IDEA maintains good properties in Italian version, thus confirming that this instrument is reliable for detecting and characterising the DV phenomenon.

The Individual Work Performance Questionnaire (IWPQ) can be defined as the individual be-haviour capable of generating value and competitive advantage for the organization. It is a mul-ti-dimensional construct, consisting of task performance, contextual performance and counter-productive work behavior. Albeit important, a comprehensive measure of individual job per-formance is still lacking in the Italian context. This paper describes the validation of an Italian adaptation of the IWPQ. A back translation procedure was used. To investigate the psychometric properties of the 18-item Italian IWPQ, 1053 participants (502 men, 47.7%; 551 women, 52.3%) were enrolled; the age of participants ranged between 19 and 69 (Mage=34.6, SD= 11.8), and for the oc-cupation, the sample is classified in blue collar 32.5%, pink collar 33% and white collar 34.5%. Exploratory and confirmatory factor analyses and multigroup confirmatory factor analyses were performed to test the structural factor of the IWPQ. The results supported the goodness of the IWPQ in the Italian context and the scales were found consistent with the original structure. One item was omitted due to a low factor loading, resulting in a final 17-item structure. Multigroup confirmatory factor analysis showed that the factor solution was invariant across both gender and occupational category and found evidence of metric invariance, uniqueness and scalar invariance, and structural invariance. Convergent and discriminant validity were also tested and showed.

Type 1 diabetes (T1D) has shown an increase in the incidence rate of about 3% per year over the last two decades. Continuous Insulin Subcutaneous Therapy (CSII) is widely used in the paediatric population with diabetes; however, it requires more preparation by the treating team and careful selection of potential users. Prescriptive provisions vary from Region to Region and the perspective of health workers still remains an unexplored area. The aim of the research project is to explore the representations of a group of diabetologists and psychologists working in pediatric diabetology on the national territory, regarding roles, functions and activities as part of a multidisciplinary team; their views on the potential benefits of CSII and the types of individuals applying for the use of technology. A socio-anagraphic data sheet was administered and two homogeneous focus groups were conducted by profession; they were audio recorded. The transcripts produced were analysed using the Emotional Text Mining (ETM) methodology. Each of the two corpus generated three clusters and two factors: for diabetologists, a focus on the patient in different levels of care emerged, collaborating both with other health professionals and with the territory, through the proposal of an intervention where the medical aspect is often represented by technology; also for psychologists there was a representation of interdisciplinary networking, with a greater focus on the processes inherent the management of pathology, from acceptance to the elaboration and integration of diabetes in the family narrative. The understanding of the representations of health professionals working in pediatric diabetes about new technologies can contribute to the consolidation of a network of professionals through a targeted work on possible critical issues emerged.

There is much discussion among clinicians, epidemiologists, and public health experts about why case fatality rate from COVID-19 in Italy (at 13.3% as of April 20, 2020, versus a global case fatality rate of 6.9%) is considerably higher than estimates from other countries (especially China, South Korea, and Germany). In this article, we propose several potential explanations for these differences. We suggest that Italy’s overall and relative case fatality rate, as reported by public health authorities, is likely to be inflated by such factors as heterogeneous reporting of coronavirus-related fatalities across countries and the iceberg effect of under-testing, yielding a distorted view of the global severity of the COVID-19 pandemic. We also acknowledge that deaths from COVID-19 in Italy are still likely to be higher than in other equally affected nations due to its unique demographic and socio-economic profile. Lastly, we discuss the important role of the stress imparted by the epidemic on the Italian healthcare system, which weakened its capacity to adequately respond to the sudden influx of COVID-19 patients in the most affected areas of the country, especially in the Lombardy region.

Keywords: Arachis quality; pod separation; plant extraction, peanut

The European Food Safety Authority (EFSA) has identified some risk factors for the occurrence of side effects linked to energy drinks (EDs) consumption by young people. Tachycardia, sleeplessness, caffeine addiction may be caused by excessive consumption of EDs during parties, sport matches, ect. EDs consumption has been evaluated in a sample of students in Italy together with some aspects of their lifestyle. The survey was performed in two high schools from September 2014 to June 2015. 583 students between 14 to 18 years were recruited and a standard questionnaire (EFSA checklist) was used to collect information on responders characteristics, beverages consumption, EDs with alcohol, and EDs and sports. 350 out of 583 responders (60%) consumed EDs and 146 out of 583 responders (25%) reported an occasional alcohol consumption. Despite 82 out of 146 alcoholic drinkers (56%) were EDs-alcohol consumers, only 70 out of 583 adolescents (12%) reported habitual EDs consumption. Moreover, 38 out of 379 (10%) of all physically active adolescents reported frequent EDs consumption before sportive trainings. Study results highlight the need for primary prevention measures in communication campaigns and training delivered by school to limit potential health threats related to excess of EDs consumption.

The impact of the COVID-19 pandemic and the quarantine measures on children and adolescents’ hospitalization psychiatric has been poorly studied, especially in Italy, the first European country to adopt social restrictions. To fill this gap, this retrospective study examined changes in admissions to our child and adolescent psychiatry ward from the emergency department during the two COVID-19 quarantine periods in Italy (March to June 2020; October 2020 to January 2021) compared with two reference periods (defined as 12 months prior to the respective quarantine periods). Specifically, we examined data on the number of inpatients and the distribution of psychopathological disorders (i.e., psychosis, mood disorder) and self-injurious behaviors. The results revealed significantly fewer admissions during the first quarantine period relative to the first reference period and, conversely, significantly more admissions during the second quarantine period relative to the second reference period. Of note, the results showed an increased frequency of mood disorders, non-suicidal self-injurious behaviors and suicidal ideation during the quarantine periods, compared to the reference periods. The findings underline the need to focus on the psychopathological profile of children and adolescents with patient-tailored therapeutic interventions and suggest the importance of developing psychological healthcare services for future emergency periods..

Persons with stroke-induced aphasia (PWAs) are often impaired in tense/time reference (TR) production. It is not clear, however, whether PWAs’ impaired TR production is due to TR-related encoding or retrieval deficits. This study aims at disentangling TR-related encoding deficits from TR-related retrieval deficits in aphasia. Two sentence completion tasks (SCTs) tapping production of past and future reference were administered to eight Greek-speaking PWAs, eight Russian-speaking PWAs, six Italian-speaking PWAs, seven English-speaking PWAs and four groups of language-, age- and education-matched healthy controls. SCT 1 tapped TR-related encoding processes and TR-related retrieval processes to a similar extent. SCT 2 predominantly tapped TR-related retrieval processes. All four control groups performed at ceiling. Three Greek-speaking PWAs, one Russian-speaking PWA, three Italian-speaking PWAs and two English-speaking PWAs showed between-task dissociations. A double dissociation emerged, as some Greek-, Russian- and English-speaking PWAs performed better on SCT 1 than on SCT 2, whereas other Greek- and Italian-speaking PWAs performed worse on SCT 1 than on SCT 2. It will be shown that the experimental design employed here has the potential to disentangle TR-related encoding deficits from TR-related retrieval deficits, as both PWAs with selective TR-related encoding deficits and PWAs with selective TR-related retrieval deficits were identified.

As the emission regulations get more and more stringent in the different fields of energy and environmental systems, the electric and fuel cell vehicles (FCV) have attracted growing attention by automakers, governments, and customers. Research and development efforts have been focused on devising novel concepts, low-cost systems, and reliable electric/fuel cell powertrain. In fact, electric and fuel cell vehicles coupled with low-carbon electricity sources offer the potential for reducing greenhouse gas emissions and exposure to tailpipe emissions from personal transportation. In particular, Pedal Assisted Bicycles (PAB) popularity is rising in urban areas due to their low energy consumption and environmental impact. In fact, when electrically moved, they are zero emission vehicles with very low noise emissions, as well. These positive characteristics could be even improved by coupling a PAB with a fuel cell based power generation system, thus increasing the vehicle autonomy without influencing their emissions and consumption performances. In this paper, four types of vehicles are compared from an environmental and accessibility point of view: conventional car, bus, electric PAB and hydrogen fuel cell PAB; for such vehicles, the respective utilization stages are accounted for, i.e. without considering the manufacturing process. The analysis has been carried out comparing different vehicles performance along different routes of an Italian middle-size city, Viterbo, which represents a very good pilot case as its Municipality is adopting many solutions suggested by European Union (EU) through the planning tool called Sustainable Energy Action Plan (SEAP). The comparison is based on an ad-hoc developed mathematical procedure, which includes environmental (greenhouse gas and air pollution emissions), health (pollutants toxicity levels) and accessibility time (waiting times) indicators. According to this analysis, electric and fuel cell PAB exhibit interesting advantages over the other vehicles. However, the global economic efficiency of electric or fuel cell apparatus depends substantially on the exploited source of electrical energy.

The following article analyses the relationship between the mental health index and the variables of the Environment, Social and Governance-ESG model in the Italian regions between 2004 and 2023. The econometric analysis is aimed at investigating in detail the relationships between the mental health index and the individual components of the ESG model. The results are critically discussed

The following article analyzes Italian companies with more than 10 employees that use online sales tools. The data used were acquired from the ISTAT-BES database. The article first presents a static analysis of the data aimed at framing the phenomenon in the context of Italian regional disparities. Subsequently, a clustering with k-Means algorithm is proposed by comparing the Silhouette coefficient and the Elbow method. The investigation of the innovative and technological determinants of the observed variable is carried out through the application of a panel econometric model. Finally, different machine learning algorithms for prediction are compared. The results are critically discussed with economic policy suggestions.

In the following article, we analyse the determinants of the number of physicians in the context of ISTAT BES-Benessere Equo Sostenibile data among twenty Italian regions in the period 2004-2022. We apply Panel Data with Random Effects, Panel Data with Fixed Effects, and Pooled OLS-Ordinary Least Squares. We found that the number of Physicians among Italian regions is positively associated, among others, to “Trust in the Police and Firefighters”, “Net Income Inequality”, and negatively associated, among others, to “Research and Development Intensity” and “Soil waterproofing by artificial cover”. Furthermore, we apply the k-Means algorithm optimized with the Silhouette Coefficient and we find the presence of two clusters. Finally, we confront eight different machine-learning algorithms to predict the future value of physicians and we find that the PNN-Probabilistic Neural Network is the best predictive algorithm.

Rapid online surveys are an important tool in tracking the public’s knowledge and perceptions during infectious disease outbreaks. In June 2020, during the early phases of COVID-19 vaccines development, a survey had been conducted, aimed at assessing attitudes and opinions about vaccination of 885 Italian adults, in addition to their vaccine literacy levels (i.e. skills of finding, understanding and using information about vaccines). In January 2021, the same questionnaire has been administered to a similar population (n=160). Interactive vaccine literacy was significantly higher than in June 2020 (mean score 3.38 vs 3.27 respectively, P=.0021). The percentage of participants willing to be vaccinated against COVID-19 was assessed by the means of either-or questions, and was equally high in both surveys (>90%), which is quite reassuring, despite metrics based on categorical scales cannot identify hesitant subjects.

1) Background: Parents are increasingly fascinated by alternative weaning methods, such as ba-by-led or vegetarian weaning. However, international pediatric societies are still cautious to-wards alternative weaning methods, due to their significant risk of nutritional deficiencies. The aim of this study is to describe the attitude of Italian pediatricians towards unconventional weaning, with particular regard to vegetarian and baby-led. (2) Methods: A 20-question ques-tionnaire was sent to Italian pediatricians, from January to December 2019; (3) Results: Responses were received from 73/1000 (7.3%) pediatricians. The vast majority of surveyed pediatricians (78.1%) is familiar with baby-led and vegetarian weaning, but only 24.7% is in favor of their practice. A significant number of pediatricians (63.0%) received request from parents for an al-ternative weaning regimen. (4) Conclusions: The survey revealed a significant gap between pedi-atricians’ attitude and parental demand concerning unconventional weaning. This could signifi-cantly impair the alliance between parents and pediatricians with the risk to expose infants and children to severe nutritional deficiencies due to self-management by parents with poor surveil-lance from health professionals.

The role of public-sector organizations (PSOs) for promoting the agenda of sustainability accounting and accountability is often not adequately considered [1]. In the public sector universe, Local Governments are close to their communities and thus have a particularly important role to play in the pursuit of sustainability goals [2,3]. Hence, further research is still needed to understand if Local Governments Organizations (LGOs) are still using reporting tools to promote sustainable development. The empirical data show that the Sustainability Report (SR) is not having the spread assumed in the past years; over time, the great majority of Italian Municipalities does not continue or embark on a path of sustainability reporting. The findings suggest the fashion of SR in Italy is falling and it seems that the SR tool is a “mere trend reporting based on descriptive indicators leads to decreasing interest from internal and external audiences” [4]. The carrot is unsuccessful; maybe the mandatory requirements could be a stick?

The COVID-19-medical emergency has ended worldwide, yet there is still a need to evaluate the psychological impact of these years of unprecedented changes on students’ life. Methods: This study aims to assess and compare COVID-19-related stressors (Relationships-and-Academic-Life; Isolation; Fear-of-Contagion) and psychophysical symptoms reported by university students in April-2020, April 2021, and April 2022. The predictive role of COVID-19-related stressors on psychophysical symptoms within each time was also tested. Data were collected among 637 university students in April-2020 (n = 197), April-2021 (n = 200), April-2022 (n = 240). Results: In April-2022, perceived Isolation and Fear-of-Contagion decreased from the peak registered in April-2021, but stress related to Relationships-and-Academic-Life remained noteworthy high. A sharp and ongoing increase in psychophysical symptoms was found, with more than 50% of students reporting clinical levels of Sleep-Disorders, Depression, Psychoticism, and Interpersonal-Sensitivity. In April-2022, students still perceiving stress related to Relationships-and-Academic-Life and Isolation were at risk for Anxiety, Somatization, and Sleep-Disorders, while those still perceiving stress related to Fear-of-Contagion were also at risk for Depression, Obsessive-Compulsive, and Psychoticism. Conclusion: Findings emphasized the long-lasting detrimental effects of the COVID-19-related stress. Interventions must pinpoint the complex post-pandemic adjustment process and their effects on university students' psychophysical health.

In a digitally oriented society, smartphones provide continual online accessibility to daily life, while simultaneously predisposing adolescents to engage in prolonged connections for various purposes, thus escalating the risk of Internet Addiction (IA). Cognitive processes such as multitasking and attentional shifting are frequently associated with smartphone activities. Additionally, online engagements may serve as emotional strategies for regulating negative states (e.g., boredom and distress), redirecting attention towards more gratifying activities, such as social media content. This study delves into cognitive-emotional processes (emotion regulation, attention impulsiveness, online vigilance, and multitasking) and emotional/behavioural factors (emotional problems, conduct problems, hyperactivity/inattention, peer relationships, and prosocial behaviours) that may be implicated in smartphone activities and technology addiction among adolescents. A community sample (N=676) of Italian high school students (42.2% females) completed the Smartphone Distraction Scale (SDS), the Strength and Difficulties Questionnaire for internalizing/externalizing symptoms (SDQ), and the Internet Addiction Test (IAT) to assess the presence and severity of IA. The scores on the Smartphone Distraction Scale were found to be positively associated with IA levels. Furthermore, students exhibiting higher internalizing/externalizing symptoms, particularly those with traits of Attention Deficit Hyperactivity Disorder (ADHD), are more likely to manifest problematic smartphone usage. The implications for screening adolescents more susceptible to developing IA symptoms and for implementing preventive interventions are discussed.

Detecting the trends of species and populations is fundamental to identify taxa with high conservation priority. Unfortunately, long-term monitoring programs are challenging and often lacking. The Italian agile frog Rana latastei is endemic to Northern Italy and adjacent countries, is considered vulnerable by the IUCN, and is protected at the European level. However, quantitative estimates of its decline are extremely scarce. In this study, we document the trends in abundance and distribution of Rana latastei within the Monza Park, which currently represents the area closer to the type locality of the species. Wetlands within the park were monitored from 2000 to 2023; counts of egg clutches were taken as a measure of reproductive output and of the abundance of breeding females. In 2000, the species occurred over a significant proportion of the park. Total abundance showed strong yearly variation but remained rather constant from 2000 to 2019. However, Rana latastei disappeared from the park around 2021 and was never detected in 2022-23. The decline is probably related to the joint effect of multiple factors, including the conversion of breeding sites for farming, inappropriate water management, invasive alien species, and severe drought. The local extinction of Rana latastei occurred despite legal protection, highlighting the need for more effective and stringent tools for the conservation of European biodiversity.

Ventricina del Vastese is a traditional dry fermented sausage from Central Italy not yet charac-terized for occurrence, identity and safety of coagulase negative staphylococci (CNS), a bacterial group technologically important for this kind of products. Therefore, in this study, 98 CNS isolates from four manufacturers were differentiated by Repetitive element palindromic PCR (Rep-PCR) and identified by 16S rRNA gene sequencing. These were examined for genes encoding biogenic amine (BA) production, resistance to aminoglycosides, β-lactams and tetracyclines and staphylococcal enterotoxins (SEs). Staphylococcus succinus (55%) predominated, followed by S. xylosus (30%), S. epidermidis (7.4%), S. equorum (3.1%), S. saprophyticus (3.1%) and S. warneri (1%). One S. succinus subsp. casei isolate was slightly β-hemolytic. SEs and the histidine decarboxylase gene hdcA were not detected, while the tyrosine decarboxylase gene tdcA was detected in four S. xylosus isolates. A blaZ beta-lactamase gene and tetracycline resistance genes tetK (six isolates) and tetA (one isolate also bearing tetK) were found, respectively. However, fewer hazardous and AR traits compared to CNS examined in other studies were found, as a probable consequence of using meat from animals reared in conditions that allow to minimize pathogen circulation and antibiotic use. Therefore, appropriate production conditions can reduce these threats.

The geographic variability of the dorsal pattern (DP) of the Italian wall lizard, Podarcis siculus, across its native range was studied with the aim to understand whether the distributions of this phenotypic trait were more shaped by allopatric differentiation rather than adaptive processes. A total of 1298 georeferenced observations scattered across the Italian peninsula and the main islands (Sicily, Corsica and Sardinia) were obtained from citizen science databases and five DPs were characterized by different shapes of the dark pattern (“reticulated”, “campestris”, “reticulated/campestris” and “striped”) or by absence of it (“concolor”). Frequencies of different DP phenotypes differ between the two main mtDNA lineages settled in central-northern and in southern Italy respectively. This pattern may be indicative of a role of long-term allopatric historical processes in determining the observed pattern. The analysis also identified a putative wide area of secondary contact, in central southern Italy, characterized by high diversity of the DP. Generalized Linear Models (GLMs), used to estimate a possible association between bioclimatic variables and the observed phenotypic variation, showed that each of the five DPs is correlated to different environmental factors and show different distribution of areas with high probability of occurrence. However, for all but one of the DPs, the area with the greatest probability does not correspond exactly to the real distribution of the DP. Conversely, the “concolor” phenotype does not seem related to any particular mtDNA lineage and it shows a preference for areas with high temperature and low rainfall. This is in agreement with the expectation of low amount of melanin of the dorsal pattern that, in the study areas, is characterized by a light uniform coloration which could confer a better thermoregulation ability in high temperatures environments avoiding overheating.

Italy is the leading European producer of rice. The transition to organic farming could represent a solution for environmental protection, as well as for the economic sustainability of farms, consumer safety and as a measure of climate mitigation, but it currently displays several weaknesses in the control and certification system. The objective of the current study is to propose advice for improving the control and certification scheme in the organic rice sector. To achieve this aim, we adopted a qualitative methodology based on participant observation at stakeholders’ meetings, focus groups, community-led workshops and deep interviews with relevant local actors. Findings show that there are some solutions to mitigate the weakness of the Italian certification scheme. The study also produces managerial implications to improve the Italian organic rice system.

The work proposes a backtesting analysis in comparison between the Lee-Carter and the Cairns-Blake-Dowd mortality models, employing Italian data. The mortality data come from the Italian National Statistics Institute (ISTAT) database and span the period 1975-2014, over which we computed back-projections evaluating the performances of the models in comparisons with real data. We propose three different backtest approaches, evaluating the goodness of short-run forecast versus medium-length ones. We find that both models were not able to capture the improving shock on the mortality observed for the male population on the analyzed period. Moreover, the results suggest that CBD forecast are reliable prevalently for ages above 75, and that LC forecast are basically more accurate for this data.

Healthcare workers' stress, burnout, and job dissatisfaction were exacerbated by the Covid-19 pandemic, whose mid-term negative effects are still present. The aim of this study was to investigate in healthcare workers the effect of the dimensions of burnout (Psychophysical exhaustion, Relational deterioration, and Professional inefficacy) on Career satisfaction. These relationships were evaluated by considering the direct and mediated effects of Disillusion. For these purposes, the Link Burnout Questionnaire (LBQ) and the Career Satisfaction Scale (Occupational Stress Indicator - OSI) were administered to 295 healthcare professionals working at three Italian public hospitals in Cagliari, Italy. The analyses were conducted using the Partial Least Square Structural Equation Model (PLS-SEM) method. Findings highlight that healthcare workers were in a condition of work distress, high risk of burnout, and career dissatisfaction. Also recognized was the direct negative effect of burnout dimensions on career satisfaction. Finally, the mediated negative effect of Disillusion in the relationship between burnout and career satisfaction was identified. This study emphasizes the relevance of the dimension of Disillusion, and its “bright side” Fulfilment, in healthcare workers, specifically referring to the disregarded relationship between burnout and career satisfaction.

Despite its remote discovery (1977) and numerous reports of its presence in vari-ous plant species in many countries, the available molecular information for the artichoke Italian latent virus (AILV) is still limited to a single complete genome sequence (RNA1 and 2) isolate from grapevine (AILV-V) and to a partial sequence portion from RNA2 of an isolate of unknow origin and host, both reported in the GenBank. Here we report the results of molecular analyses conducted on RNA2 of AILV isolates, sequenced for the first time in this study, together with the first-time finding of AILV in a new host plant species, i.e., chard (Beta vulgaris subsp. vulgaris). The different AILV isolates sequenced are from artichoke (AILV-C), gladiolus (AILV-G), sonchus (AILV-S) and chard (AILV-B). At the bio-logical level, the AILV-B was found to be involved with vein clearing and mott-ling symptoms on chard leaves. At the molecular level, sequencing results of RNA2 segments showed that AILV-C, AILV-G, AILV-S and AILV-B were 4,629 nt in length (excluding the 3’ terminal polyA tail), hence one nt shorter than that of AILV-V reported in the GenBank. The comparative sequence analysis between the CR of RNA2 of all isolates showed that AILV-V was the most variable isolate, with the lowest sequence identities of 83.2% and 84.7% at the nucleotides and amino acids levels, respectively. Putative intra-species sequence recombination sites were predicted among the AILV isolates, of which the AILV-V, AILV-C and AILV-B genomes were found to be mostly involved. This study adds further mo-lecular information on the previously unrecorded high genomic variability of the Nepoviruses of subgroup B, together with information on recombinations that may have conditioned the infection and transmission of AILV in nature; thus learning the way forward to design a new integrated pest management of chard plantation.

Artificial Intelligence (AI) is becoming increasingly important, especially in the medical field. While AI has been used in medicine for some time, its growth in the last decade has been remarkable. Specifically, Machine Learning (ML) and Deep Learning (DL) techniques in medicine have been increasingly adopted thanks to the growing abundance of health-related data, improved suitability of such techniques for managing large data-sets, and more computational power. The Italian scientific community has been instrumental in advancing this research area. This article aims to conduct a comprehensive investigation of the ML and DL methodologies and applications used in medicine by the Italian research community in the last five years.

This retrospective observational study describes the results of an ad-hoc designated prevention protocol aimed at containing the spread of the scabies infestation among healthcare workers (HCWs) of a large University Hospital in Italy. The outbreak started on October 2022 and a preventive protocol was set up thanks to a multidisciplinary approach. HCWs at high scabies risk were defined as subjects working in UOs with more than five confirmed cases of scabies, close contacts of a confirmed case of scabies, or HCWs with signs and symptoms of the disease. All cases of at high scabies risk underwent a dermatological examination and the infested HCWs were suspended from work until definitive healing. Mass prophylactic treatment was established for all HCWs working in UOs with more than five confirmed cases of scabies. Until March 2023, out of 183 screening dermatological examinations, 21 (11.5%) were diagnostic for scabies. We obtain a prevalence of scabies of 2.6% (21/800) and a duration of the outbreak of 14.7 weeks. Statistical analysis shows a significant association between scabies and being a nurse and have an allergy to dust mites. We obtained a low prevalence of scabies infection, limiting the duration of the outbreak and the related economic burden.

Introduction: The image of the nurse is a source of concern because of its impact on recruitment to the profession, policy decisions about the profession, funding of nursing services, consumer use of nursing services and how the image of the nurse affects nursing practice. Aim: This study aims to assess the psychometric properties of the Italian version of the Nursing Attitudes Questionnaire (NAQ-IV). Methods: 564 persons between the years 2022 and 2023 with heterogeneous ages and occupations from Northern, Central and Southern Italy participated in the study. Cronbach's alpha, item versus total correlations, skewness and kurtosis were calculated; factor analysis was performed using principal axis factoring and the viramax rotation method. Results: The results showed a Cronbach's alpha of 0.89 on the scale and between 0.88 and 0.89 between the factors; all items tested for correlation between the item and the total and the criteria for variance in the responses. Factor analysis showed a 4-factor model explaining more than 59.91% of the variance, with the largest variance being explained by the 'Role & professionalism' factor (25.96%). Conclusion: These results allow for a discussion regarding the theoretical framework of the NAQ-IV and provide a reliable and valid instrument for the comparison of welfare, organisation of health services, role, professionalism, stereotypes, values, advocacy, motivation and perceived satisfaction with the figure of the nurse and nursing care.

Background: Endometriosis is a female chronic inflammatory disease in which endometrial tissue develops outside the uterine cavity. It is a complex pathology, that significantly contributes to morbidity in premenopausal women, leading to chronic pain, infertility, and subfertility negatively impacting the physical, and emotional well-being and overall quality of life. The public health burden of endometriosis remains elusive and challenging to determine, and this uncertainty can lead to inadequate healthcare services and treatments. Objective: To estimate the incidence and prevalence of endometriosis in Italy using the hospital discharge records database. Population-based retrospective study. Nationwide between 2011 and 2020. Methods: From the National Hospital Discharge Database were selected all admissions with a diagnosis of endometriosis (ICD-9-CM, codes 617.x), supported by the presence of a procedure code of laparoscopy or any other surgical procedure allowing direct visualisation of the lesions. Main outcomes measures Incidence and prevalence of endometriosis were estimated for the entire 2010-2020 period and by individual year, analysing the time trend and variability in different geographical areas of Italy. Results: A total of 134,667,646 women aged 15–50 years with one or more hospitalisations for endometriosis in all Italian hospitals. The incidence of endometriosis in Italy during this period was 0.839 per 1000 women (CI95% 0.834-0.844), exhibiting a statistically significant decreasing trend over the years. A discernible north-south gradient was observed, with higher rates documented in the northern regions. The prevalence rate stood at 14.0 per 1000 during the same period, and a similar north-south geographical gradient was identifiable in the prevalence rates as well. Conclusions: The utilization of national-level hospital data enables the generation of incidence and prevalence data for endometriosis without variations in methods and definitions, facilitating the evaluation of temporal trends and regional comparisons. Understanding and quantifying this phenomenon is essential for appropriate healthcare planning in various Italian regions.

In the following article, we estimate the Renunciation of Healthcare Services-RHS in Italian regions in the context of the Environmental, Social and Governance-ESG model during the period 2004-2022. The data were acquired from the ISTAT-BES dataset. The data were analyzed using the following econometric techniques: Panel Data with Fixed Effects, Panel Data with Random Effects, Pooled Ordinary Least Squares-OLS, Weighted Least Square-WLS,. Results show that RHS tends to growth with the E-Component, is negatively associated to the S-Component, and positively associate with the G-Component within the ESG model. Furthermore, a clusterization with the unsupervised k-Means algorithm is presented and the results are discussed with a confrontation between optimal and suboptimal k values optimized with the Silhouette Coefficient. Finally, a confrontation among eight different machine-learning algorithms is performed to predict the future value of RHS. Outcomes show that the Simple Regression Tree is the best predictive algorithm and that the level of RHS is predicted to growth on average of 4.4% for the Italian regions. Results are critically discussed.

In this article, we analyse the ESG determinants of the “Elderly People Treated in Integrated Home Care”-EPIHC in the Italian regions between 2004 and 2022. We used data from the ISTAT-BES database. We used different econometric techniques i.e.: Panel Data with Random Effects, Panel Data with Fixed Effects, Pooled Ordinary Least Squares-OLS and Weighted Least Squares-WLS. The results show that the EPIHC is positively associated with “Nurses, midwives, and Soil sealing by artificial cover" and negatively associated with "Museum heritage density and relevance" and "Trust in law enforcement agencies and firefighters fire". Furthermore, we have applied a k-Means algorithm with the Silhouette Coefficient and we find the presence of two clusters. Finally, we propose a confrontation among eight different machine-learning algorithms and we find that Linear Regression is the best predictive algorithm.

Introduction: Real-world safety studies can provide important evidence on the thromboembolic risk associated with COVID-19 vaccines, considering that millions of people have been already vaccinated against COVID-19. In this study, we aimed to estimate the incidence of thromboembolic events after COVID-19 vaccination and to compare the Oxford–AstraZeneca vaccine with other COVID-19 vaccines. Methods: We conducted a retrospective real-world safety study using data from two different data sources: the Italian Pharmacovigilance database (Rete Nazionale di Farmacovigilanza, RNF) and the Campania Region Health system (Sistema INFOrmativo saNità CampanIA, SINFONIA). From the start date of the COVID-19 vaccination campaign (December 27th, 2021) to September 27th, 2022, information on COVID-19 vaccinations and thromboembolic evets were extracted from the two databases. The reporting rate (RR) and its 95% confidence interval (95%CI) of thromboembolic events for 10,000 doses was calculated for each COVID-19 vaccine. Moreover, the odds of being vaccinated with the Oxford–AstraZeneca vaccine vs. the other COVID-19 vaccines in cases with thromboembolic events vs. controls without thromboembolic events were computed. Results: A total of 12,692,852 vaccine doses were administered in Campania Region, of which 6,509,475 (51.28%) were in female and mostly related to the Pfizer-BioNtech vaccine (65.05%), followed by Moderna (24.31%), Oxford–AstraZeneca (9.71%), Janssen (0.91%), and Novavax (0.02%) vaccines. A total of 641 ICSRs with a COVID-19 vaccines and a vascular events were retrieved from the RNF for the Campania Region, of which 453 (70.67%) were in female. Most ICSRs reported the Pfizer-BioNtech vaccine (65.05%), followed by Oxford–AstraZeneca (9.71%), Moderna (24.31%), and Janssen (0.91%). A total of 2,451 events were reported in the ICSRs (3.8 events for ICSRs) of which 292 were thromboembolic events. The highe RRs of thromboembolic events were found with the Oxford–AstraZeneca vaccine (RR: 4.62, 95%CI: 3.50-5.99) and Janssen vaccine (RR: 3.45, 95%CI: 0.94-8.82). Thromboembolic events were associated with a higher likelihood of exposure to the Oxford–AstraZeneca vaccine compared to Pfizer-BioNtech (OR: 6.06; 95%CI: 4.22-8.68) and Moderna vaccines (OR: 6.46; 95%CI: 4.00-10.80). Conclusion: We observed a higher reporting of thromboembolic events with viral-vector based vaccines (Oxford–AstraZeneca and Janssen) and an increased likelihood of being exposed to the Oxford–AstraZeneca vaccine compared to the mRNA vaccines (Pfizer-BioNtech and Moderna) among thromboembolic cases.

Background and objectives: Huntington disease (HD) is characterized by motor, cognitive and psychiatric manifestations and is caused by an expansion of CAG repeats over 35 triplets on the huntingtin (HTT) gene. However, expansions in the range 27-35 repeats (intermediate allele) can be associated with pathological phenotypes. The onset of HD is conventionally defined by the onset of motor symptoms, but psychiatric disturbances can precede the motor phase by up to twenty years. The aims of the present study are to identify HD patients in the pre-motor phase of the disease among patients diagnosed with bipolar disorders and to evaluate any differences between bipolar patients carrying normal HTT allele and patients with expanded HTT gene. Methods: We assessed the HTT genotype in an Italian cohort of 69 patients affected by bipolar disorder type 1 and type 2. Results: No patient was found to be a carrier of the pathological HTT allele, but 10% of bipolar subjects carried an intermediate allele. Carriers of the intermediate allele were older at onset of psychiatric symptoms than non-carriers. Conclusion: The pathological HTT gene was not associated with bipolar disorder, while we found a higher frequency of the intermediate allele among the bipolar population with respect to healthy controls.

Ketogenic dietary therapies (KDTs) are an effective and safe non-pharmacological treatment for drug-resistant epilepsy, but adherence can be challenging for both patients and caregivers. In Europe, there are no adequate tools to measure it other than monitoring ketosis. This study aimed to adapt and validate the Brazilian adherence questionnaire, Keto-check, into the Italian version: iKetoCheck. Using the Delphi technique, 12 judges validated the contents through agreement rate and the Content Validity Index (CVI). The iKetocheck was self-completed electronically by drug-resistant epilepsy or GLUT1 deficiency patients within an interval of 15 days to measure its reproducibility. Test-retest reliability was evaluated using Pearson correlation and relative significance test. Exploratory and confirmatory factorial analyses were made using Factor software. The final tool, iKetoCheck, consists of 10 questions with 5-point Likert scale answers. It evaluates various aspects such as informing caregivers about the diet, organization of meals, measurement of ketosis, weighing food consumed, diet negligence, use of carbohydrate-free medications, attending follow-up visits, reading food labels, consulting an expert for dietary concerns, and cooking at home. The factorial analysis resulted in three factors: "attention," "organization," and "precision," with satisfactory results for indices in exploratory and confirmatory analyses. Although higher mean values of ketonemia measurement were observed in patients with a higher adherence score, these values were not statistically significant (p=0.284). In conclusion, iKetoCheck is a valid tool for evaluating KDTs' adherence in Italian drug-resistant epilepsy or GLUT1 deficiency patients. It can provide valuable information to improve patient management and optimize the effectiveness of KDTs.

: The paper aims to present a conceptual framework for developing territorial development strategies based on crowdsourcing technologies to enhance intangible heritage, setting this framework within the context of Italian inner areas defined by a policy framework oriented towards the territorial development of marginal areas. For this reason, the work intends to provide the necessary background information for the development of such strategies, examining the technological aspects, a precise definition of the concept of intangible heritage, the application of a socially innovative strategy for marginal territories, and a framework of strategic actions necessary to implement solutions capable of involving local communities from the bottom up and ensuring a widespread redistribution of the benefits in the development of these technologies. The paper's objective is, therefore, to bridge the gap between different debates: technological innovation, the enhancement of intangible heritage, and territorial development based on socially innovative strategies, providing a key information framework for experts and scholars who intend to approach these topics or develop projects based on these tools and objectives.

According to several evidence, forest environmental seems able to provide beneficial effects on functional and psychological parameters, related to cardiovascular, metabolic, respiratory functions as well depression and anxiety. The aim of this study is to investigate the effect of a one-day forest walking in Selva di Castelfidardo (AN, Italy) on 37 participants aged 21-68, most of them living in either urban or suburban areas of large cities. We observed a statistically significant effect on sympathovagal balance by the means of heart rate, systolic and diastolic blood pressure, body temperature, skin temperature, skin conductance, HRV parameters (AVNN, SDNN, rMSSD, pNN50, LF, HF, LF/HF ratio), oxygen oximetry, PEF, FEV1. A significant difference was also detected on the Perceived Stress Scale responses (19.27 pre vs 13.81 post-immersion, p=<0,05; -28,3% variation). Our data contribute to increase the body of literature about the effect of forest walking, adding data on an Italian area qualified for forest bathing.

The present study aims to examine the role the social and digital infrastructures might have during the building process of the Smart Regions in the Italian context. Within this framework, it is possible to identify some essential research questions, such as why the same regions are growing faster than the other and which type of effects could be generated from the different connectivity between the regions. Since the Smart Region concept is still composed of technical reports, pilot projects and experiences from a limited number of cities on the international stage, this work it is tried to use a new approach, applying either a neuronal model, the Self-Organizing Maps, and the multivariate regression approach, to extrapolate the existence of possible future conditions for the rising of Smart Regions in Italy, studying the evolution of the used database during the period 2005 – 2016. From the analysis what emerged is that the only bridging social capital dimension, empirically speaking, feed the regional innovation growth because the structure of social relationship facilitates interactions across social, political and economic agents; but there are institutional deficits, most pronounced in Italy and other European countries.

The Italian Peninsula, a natural pier across the Mediterranean Sea, witnessed intricate population events since the very beginning of human occupation in Europe. In the last few years, an increasing number of modern and ancient genomes from the area has been published by the international research community. This genomic perspective started unveiling the relevance of Italy to understand the post-Last Glacial Maximum (LGM) re-peopling of Europe, the earlier phase of the Neolithic westward migrations, and its linking role between Eastern and Western Mediterranean areas after the Iron Age. However many open questions are still waiting for more data to be addressed in full. With this review, we summarize the current knowledge emerging from the available ancient Italian individuals and, by re-analysing them all at once, we try to shed light on the avenues future research in the area should cover. In particular, open questions concern i) the fate of pre-Villabruna Europeans and to what extent their genomic components were absorbed by the post-LGM hunter-gatherers; ii) the role of Sicily and Sardinia before LGM; iii) to what degree the documented genetic structure within the Early Neolithic settlers can be described as two separate migrations; iv) what are the population events behind the marked presence of an Iranian Neolithic-like component in Bronze Age and Iron Age Italian and Southern European samples.

This review is devoted to present the history of CARDIOSIM© software simulator platform, which was developed in Italy to simulate the human cardiovascular and respiratory system. The first version of CARDIOSIM© was developed at the Institute of Biomedical Technologies of the National Research Council in Rome. The first platform version published in 1991 ran on PC with disk operating system (MS-DOS) and was developed using the Turbo Basic language. The last version runs on PC with Microsoft Windows 10 operating system; it is implemented in Visual Basic and C++ languages. The platform has a modular structure consisting of seven different general sections, which can be assembled to reproduce different pathophysiological conditions. The software simulator can reproduce the most important circulatory phenomena in terms of pressure and volume relationships. It represents the whole circulation using a lumped-parameter model and enables the simulation of different cardiovascular conditions according to Starling’s law of the heart and a modified time-varying elastance model. Different mechanical ventilatory and circulatory devices have been implemented in the platform including thoracic artificial lung, ECMO, IABP, pulsatile and continuous right and left ventricular assist devices, biventricular pacemaker and biventricular assist devices. CARDIOSIM© is used in clinical and educational environment.

Equine hepacivirus (EqHV, Flaviviridae, Hepacivirus) is a small, enveloped, RNA virus generally causing sub-clinical hepatitis with occasional fatalities. EqHV is reported in equids worldwide, but for Italy data are limited. To address this, a survey study was set up to estimate prevalence at national level and among different production categories (equestrian, competition, work and meat and reproduction) and national macro-regions (North, Central, South and Islands). Data obtained testing 1801 horse serum samples by Real-Time RT PCR were compared within the categories and regions. The NS3 fragment of the PCR-positive samples was sequenced by Sanger protocol for phylogenetic and mutational analysis. The tertiary structure of the NS3 protein was also assessed. The estimated national prevalence was 4.27% [1.97-6.59, 95%CI] and no statistical differences were detected among production categories and macro-regions. The phylogenesis confirmed the distribution in Italy of the three known EqHV subtypes, suggesting also a possible fourth sub-type that however requires further confirmation. Mutational profiles that could also affect the NS3 binding affinity to the viral RNA were detected. The present paper demonstrates that EqHV should be included in diagnostic protocols when investigating causes of hepatitis and in quality control protocols for blood derived products, due to its parental transmission.

We propose that the short−term memory (STM), when processing a sentence, uses two uncorrelated processing units in series. The clues for conjecturing this model emerge from studying many novels of the Italian and English Literatures. This simple model, referring to the surface of language, seems to describe mathematically the input-output characteristics of a complex mental process involved in a reading/writing a sentence. We show that there are no significant mathematical/statistical differences between the two literary corpora by considering deep-language variables and linguistic communication channels, therefore, the surface mathematical structure of alphabetical languages is very deeply rooted in human mind, independently of the language used. The first processing unit is linked to the number of words between two contiguous interpunctions, variable Ip, approximately ranging in Miller’s 7±2 range; the second unit is linked to the number of Ip’s contained in a sentence, variable MF, ranging approximately from 1 to 6. The overall capacity required to process fully of a sentence ranges from 8.3 to 61.23 words, values that can be converted into time by assuming a reading speed, giving the range 2.64~19.54 seconds for fast-reading and 5.3~30.1 seconds for average reader. Since a sentence conveys meaning, the surface features we have found might be the starting point to arrive at an Information Theory that includes meaning.

(1) Background: Mpox was declared an international public health emergency by WHO. Initially, Smallpox vaccine in Italy was offered only to laboratory personnel at direct risk of infection. Currently, Healthcare workers (HCWs) are all considered by European Centre for Disease Prevention and Control (ECDC) to be at low or moderate risk. (2) Methods: To assess smallpox vaccination coverage among HCWs in an Italian hospital with different levels of risk of exposure to Mpox infection and to assess their attitudes toward vaccination, a self-report was administered to HCWs stratified at high and low/moderate risk. (3) Results: Of the 338 HCWs evaluated, 60.36% provided the requested data; among them the percentage of previously vaccinated staff was 38.7%, which corresponds to 23.4% of the total HCWs in the departments considered. Considering those born before 1979 as vaccinated, vaccination coverage increases from 23.4% to 41.4%. The department with the highest percentage of vaccinated is infectious diseases (60.5%); The percentage of HCWs who adhered to vaccination is 23%; only 8.8% of laboratory staff want to vaccinate, compared with 100% of midwives. The department with the highest percentage of vaccination adherence is proctology (85.7%). (4) Conclusions: Given the vaccination adherence rate and the vaccination coverage of the departments analyzed, it would be useful to extend vaccination against Smallpox to frontline HCWs involved in patient care in Italy too.

Background: Cutaneous malignant melanoma (CMM) is one of the most aggressive types of skin cancer. Currently, innovative approaches such as target therapies and immunotherapies have been introduced in clinical practice for the treatment of metastatic CMM. Data of clinical trials and real life studies that evaluate the outcomes of these therapeutic associations are necessary to establish their clinical utility. The aim of this study is to investigate the types of oncological treatments employed in the real-life clinical management of patients with advanced CMM in several Italian centers which are part of the Clinical National Melanoma Registry (CNMR), and the oncological outcomes obtained. Methods: CNMR collects data of patients with a histologically confirmed diagnosis of primary CMM treated in one of the 38 Italian institutions (hospitals, research institutes, etc.) participating in the network. Melanoma-specific survival and Overall survival were calculated. Kaplan-Meier curves and medians of OS and 95% CI are presented overall and by immunotherapy and target treatments. The Log-rank test compared curves by treatments. Multivariate Cox regression models were used to estimate the hazard ratios adjusting for confounders and other prognostic factors. Results: The median follow-up time was 36 months (range 1.2-185.1). 787 CMM were included in the analysis with completed information about therapies.Global immunotherapy showed a significant improved survival compared with all other therapies (p=0.001). 75% was the highest reduction of death reached by nivolumab/pembrolizumab immunotherapy (anti-PD1 HR=0.25 95% CI 0.14-0.42), globally immunotherapy was significantly associated with improved survival, either for anti-CTL A4 monotherapy or combined with anti-PD1 (HR=0.47;95% CI 0.33-0.66 and HR=0.26; 95% CI 0.15-0.46, respectively). Conclusions: The nivolumab/pembrolizumab and the combination of ipilimumab can be considered the best therapy to improve survival in a real-world-population. The CNMR can complement clinical registries with the intent of improving cancer management and standardizing cancer treatment.

One of the major problem of photovoltaic grid integration is limiting the solar-induced imbalances since these can undermine the security and stability of the electrical system. Improving the forecast accuracy of photovoltaic generation is becoming essential to allow a massive solar penetration. In particular, improving the forecast accuracy of large solar farms generation is important both for the producers/traders to minimize the imbalance costs and for the Transmission System Operators to insure stability. In this article, we provide a benchmark for the day-ahead forecast accuracy of utility scale PV plants in 1325 locations spanning the country of Italy. We then use these benchmarked forecasts and real energy prices to compute the economic value of forecast accuracy and accuracy improvement in the context of the Italian energy market regulatory framework. Through this study, we further point out some several important criticisms of the Italian “single pricing” system that brings to paradoxical and counterproductive effects regarding the need to reduce the imbalance volumes. Finally, we propose a new market-pricing rule and innovative actions to overcome these undesired effects of the current dispatching regulations.

Growing body of evidence endorse the hypothesis of a protective role played by the in-utero environment on a suitable fetal programming, mainly sustained by fitting maternal diet. Our purpose was to assess the linkage between maternal food intake and poor obstetric results, with a special focus on typical Italian food. A cross sectional study including delivering women was designed. A self-reported questionnaire about socio-demographic data, obstetric history, and food frequency intake during pregnancy was administrated. A composite of adverse perinatal outcomes (APO) was constructed. Statistically significant differences were found between APO and control group in smoking habit (9.7 vs. 3.2%, p=0.045) and BMI at delivery (27.9±4.9 vs. 26.9±3.9, p=0.003). Women complicated by any or more APOs reported increased rates of pasta (5.3± 3.6 vs.4.4±1.9 times per week, p<0.001) and pizza (1.9±3.4 vs. 1.1±0.6, p<0.001) intake, with lower consumption of vegetables (5.4±3.9 vs. 7.1±2.9, p<0.001). By logistic regression analysis and after adjustments for maternal age, ethnicity, SES, maternal BMI at delivery, excessive ingestion of pizza (aOR 1.676, 95%CI 1.199-2.343, p=0.033), but not pasta (aOR 1.077, 95%CI 0.950-1.211, p=0.244), was found associated with APO. Vegetable consumption showed a protective role in reducing APOs (aOR 0.897, 95%CI 0.818-0.985, p=0.022). Nutrition in pregnancy should minimalize pizza intakes.

Air pollution and the increasing production of greenhouse gases has prompted greater use of renewable energy sources; the EU has set the use of green energy at 32 percent by 2030. With this in mind, in the last 10 years the demand for pellets in Italy has more than doubled making Italy the second largest consumer in Europe. The quality of the pellets burned in stoves is crucial to indoor and outdoor pollution. Among other parameters, moisture and ash are used to classify pellets according to EN ISO 17225:2014. This work involved the analysis of the organic and inorganic fraction of both some finished products on the Italian market and some raw materials (e.g., wood chips) sampled according to the technical standard EN 14778:2011. The analytical results showed the presence of some substances potentially harmful to human health such as formaldehyde, acetone, toluene and styrene for the organic fraction and nickel, lead and vanadium for the inorganic fraction. The chemometric approach showed that it is the inorganic fraction which is most responsible for the diversification of the samples under study. The detection of some substances may be a warning bell about the impact of such materials both for the environment and for the human health.

The following article analyses the relationship between the mental health index and the variables of the Environment, Social and Governance-ESG model in the Italian regions between 2004 and 2023. First of all, a static analysis is proposed aimed at identifying trends relating to mental health in the Italian regions with indication of the regional gaps. Subsequently, a clustering with k-Means algorithm is proposed. Below is a comparison of 11 machine learning algorithms for predicting the performance of the mental health index. Finally, the article offers some economic policy suggestions. The results are critically discussed in light of the scientific literature.

Abstract: Background: The vaccination status of patients with inflammatory bowel disease (IBD) should be investigated before starting any treatment, and patients eventually vaccinated against vaccine preventable diseases (VPDs). Vaccination rates in patients with IBD are known to be suboptimal. The aim of this study was to investigate the vaccination coverage, attitude towards vaccinations and its possible determinants among a national cohort of IBD patients. Methods: An anonymous web-based questionnaire was sent by the Italian IBD patients’ association (AMICI) in February 2021. Previous vaccination status and patients’ attitude towards vaccinations were rec-orded. The factors influencing their attitudes were examined using crude and adjusted odds ratios (AdjORs) with 95% confidence intervals (CIs). Results: Among 4039 patients invited, 1252 patients (including 729 women, median age 47.7 [37–58]) completed the questionnaire, a response rate of 25.3%. Patients declared being vaccinated against: 74.1% tetanus, 67.7% flu (last season), 43.3% MMR, 37.1% HBV, 29.1% pneumococcus, 20% meningitis, 16% HAV, 15.3% VZV, 7.6% HPV. Two hundred and fifty-nine (20.7%) did not remember every previous vaccination. One thousand one hundred and twelve (88.8%) expressed a positive attitude towards vaccination, 91 (7.3%) were indifferent, 49 (3.9%) reported being opposed to vaccinations. The belief of possible return of VPDs with decline of vaccination coverage rates was the factor most strongly related to a positive at-titude towards vaccinations (AdjOR 5.67, 95% CI 3.45-9.30, p-value <0.001). Conclusions: A low vaccination rate against some VPDs was found among a national cohort of patients with IBD, despite a generally positive attitude towards vaccinations.

Sex/gender (S/G) differences in ASD language profiles have been poorly investigated. The present study aims to explore whether male (M) and female (F) children with ASD and with normal non-verbal cognitive abilities differ in their linguistic profiles. A sample of 76 Italian children with ASD (range: 4.9 – 8 years), including 50 M and 26 F, was retrospectively recruited. Language profiles were analyzed using standardized tests for the evaluation of receptive and expressive vocabulary as well as grammar. Grammatical comprehension was the most impaired domain compared to the other language measures in both M and F children. Comparing language profiles between S/G, F showed significantly better scores than M in grammatical production (p=.002), and M showed better active negative sentences comprehension (p=.035). Moreover, comparing the language profiles between M and F with receptive disorder, F had significantly worse grammatical comprehension and better grammatical production than M. Even among children without receptive disorder, F had significantly higher grammatical production scores. The S/G differences in language profile, particularly better expressive language in F than M, can partially contribute to the delayed ASD diagnosis or underdiagnosis of F without intellectual disability. Finally, our results document the importance of accurately investigating both expressive and receptive abilities in children with ASD.

Fish Aggregating Devices (FADs) are anchored floating structures often made with cheap scrapped materials and used to aggregate pelagic fish under their artificial shadow. Globally, the dangerous impact of FADs has well known. They pose a severe threat due to known and unknown levels of bycatch, the danger to navigation, and their high potential to become marine litter. Entanglement and consequent mortality in FADs of protected species and species of conservation concern (e.g., sharks, sea turtles, and cetaceans) are a serious concern for several international inter-governmental bodies (e.g., EU, GFCM, and IWC). This work describes the first case of a cetacean, a striped dolphin (Stenella coeruleoalba), killed by a FAD in the Mediterranean Sea. This dolphin was found stranded along the coast of the central Tyrrhenian Sea. The evidence suggests that this specimen suffered a painful death. Although this is the first confirmed case of a cetacean killed by a FAD in Italian waters, given the extent of the deployment of FADs, the scale of this type of interaction with protected species might be seriously underestimated. Therefore, actions and monitoring need to be implemented urgently to effectively protect and conserve marine biodiversity.

In late April 2022, during the hearing of the audio files from an unsupervised bioacoustic assessment of the shearwater populations (Aves, Procellariiformes) on the coast of Pantelleria island (Italy, Sicily), a cricket song of unknown attribution was heard. The first bioacoustic analyses, including FFT-based spectrograms and sound pressure envelopes, confirmed that it could not be attributed to the known sound of any Italian nor Mediterranean species of cricket. In the ensuing weeks, field research made on purpose in the original station and in further localities in the southern coast of Pantelleria provided photographs, living specimens and further audio records. As soon as the photos were shared among the authors, it became clear that the species belonged to the genus Acheta. Further bioacoustic analyses and morphological comparison with type specimens of Mediterranean and North-African congenerics in relevant collections and in the scientific literature were conducted: they confirmed that the findings could only be attributed to a still undescribed species, that escaped detection due to its impervious and unfrequented habitat. Acheta pantescus n. sp. is apparently restricted to the effusive coastal cliffs of the island of Pantelleria, a habitat whose scant extension and vulnerability require environmental protection actions such as the inclusion in a special Red List by the IUCN Italian Committee.

The feasibility of hydroelectric plants depends on a variety of factors: water resource regime, geo-graphical, geological and environmental context, available technology, construction cost and eco-nomic value of produced energy. Choices about the building or renewal of hydroelectric plants should be based on the forecast of the future trend of these factors at least during the project life of the system. Focusing on the economic value of the produced energy this paper examines its influ-ence on the feasibility of hydroelectric plants. Analysis, referred to Italian case, were based on three different phases: i) the economic sustainability of small-scale hydroelectric plants under a minimum price guaranteed to the hydroelectric operator; ii) the estimate of the incentives to reach the thresholds of "acceptability" and "bankability" of the investment; iii) the analysis of results ob-tained in the previous phases using a model of the evolution of the electricity price in the period 2014-2100.

The report describes organizational and occupational strategies adopted by Lody Public Hospital (the first epicentre of Covid-19 outbreak in Italy) in order to face pandemic. Occupational Safety System (OSH) introduced infection prevention and control strategies (IPC) for the protection of healthcare workers (HCWs, while a reorganization of whole hospital based on the level of intensity of care for COVID-19 patients was estabilished. Screening on HCWs (N= 248) by nasopharyngeal swabs for SARS-CoV-2 and comparison between HCWs and local population (N=1123) are shown. These preliminary data, collected from 25^th February till 25^th March 2020, confirms that measures adopted mitigate the effects of virus transmission within the hospital and reduced the HCW component of the transmission of the infection. Additional studies in depth are currently underway.

Keywords: Cystic fibrosis, Cystic Fibrosis Transmembrane Conductance Regulator gene, CFTR, Next Generation Sequencing, Cystic fibrosis carriers

This study compares lifestyles behaviour in Italian and Latvian university students, to assess if there are differences for sex, age, university or studies specialties. An online questionnaire investigating 8 lifestyle dimensions has been compiled by 156 (43,6 % females) from Italy and 105 from Latvia (82,9% females). Answers were collected between April and December 2020. Presence of smokers are negligible. The questionnaire showed to have a good internal consistency (Cronbach α =.929). On the total group, significant statistically differences were found for all the dimensions regarding age, sex, study specialty and university. Physical activity was associated with healthier lifestyles choices. Geographical-induced differences were found (eating and sleep behaviours, alcohol awareness) as well as socio-economic differences. Female students shown to be more stressed than males. Occupational wellness increased by age. Sport students shown more health awareness. Many of the differences found in the total group disappeared when comparing only sport students of the two university, showing females increasing their scores. This result can be explained by a masculinization effect of sport.

Statistics of languages are calculated by counting characters, words, sentences, word rankings. Some of these random variables are also the main “ingredients” of classical readability formulae. Revisiting the readability formula of Italian, known as GULPEASE, shows that of the two terms that determine the readability index G – the semantic index G_C, proportional to the number of characters per word, and the syntactic index G_F, proportional to the reciprocal of the number of words per sentence −, G_F is dominant because G_C is, in practice, constant for any author throughout seven centuries of Italian Literature. Each author can modulate the length of sentences more freely than he can do with the length of words, and in different ways from author to author. For any author, any couple of text variables can be modelled by a linear relationship y=mx, but with different slope m from author to author, except for the relationship between characters and words, which is unique for all. The most important relationship found in the paper is, in author’s opinion, that between the short−term memory capacity, described by Miller’s “7∓2 law”, and the word interval, a new random variable defined as the average number of words between two successive punctuation marks. The word interval can be converted into a time interval through the average reading speed. The word interval is spread in the same of Miller’s law, and the time interval is spread in the same range of short−term memory response times. The connection between the word interval (and time interval) and short−term memory appears, at least empirically, justified and natural, and should further investigated. Technical and scientific writings (papers, essays etc.) ask more to their readers. A preliminary investigation of these texts shows clear differences: words are on the average longer, the readability index G is lower, word and time intervals are longer. Future work done on ancient languages, such as Greek or Latin, could bring us a flavor of the short term−memory features of these ancient readers.

The paper comes from the need to search for criteria useful for the valorization of heritage towns, located in rural and/or inland areas of Italy, now affected to depression and depopulation process. To this end, the authors point out how territorial identity can constitute the theoretical foundation to influence the development policies and, in particular, the tourism development for sustainability process It was therefore decided to interview a number of stakeholders who could contribute with their professionalism and expertise to identify possible paths and processes for the enhancement of these areas for tourism development. The methodology was based on be to be interviews with open questions, which allowed to identify a SWOT analysis, offering a guideline for a correct governance of these rural areas for their tourist enhancement, in terms of sustainability of development and tourist attractiveness. The study is an observatory that will monitor the implementation of sustainable tourism enhancement of the borghi, heritage town

Legionnaires’ disease is normally acquired by inhalation of legionellae from a contaminated environmental source. Water systems of large buildings, such as hospitals, are often contaminated with legionellae and therefore represent a potential risk for the hospital population. In this study, we demonstrated the constant presence of Legionella in water samples from the water system of a large university hospital in Messina (Sicily, Italy) consisting of 11 separate pavilions during a period of 15 years (2004-2018). In total, 1346 hot water samples were collected between January 2004 and December 2018. During this period, to recover Legionella spp. from water samples the standard procedures reported by the Italian Guidelines emanated in 2000 were adopted; from May 2015 to 2018 Italian Guidelines revised in 2015 (ISS, 2015), were used. The most water samples (72%) were positive to L. pneumophila serogroups 2-14 whereas L. pneumophila serogroup 1 accounted for the 18% and Legionella spp. for the 15%. Most of the positive samples were found in the buildings where are situated critical wards as ICU, Neurosurgery, Surgeries, Pneumology and Neonatal Intensive Unit Care. We highlighted the importance of a continuous monitoring of hospital water samples to prevent the potential risk of nosocomial legionellosis.

Abstract: Background: Nurses worldwide are acknowledged for their role in health education across various settings. However, doubts often arise regarding their competence in this domain. This study aims to validate the Nurse Health Education Competence Instrument (NHECI) linguis-tically and culturally for the Italian context. Methods: Following Beaton et al.’s (2000) guidelines, we conducted cross-cultural adaptation to develop the Italian version of the questionnaire. Results: The Italian version demonstrates good internal consistency and stability, making it suita-ble for assessing nursing students during clinical internships and practicing nurses. Availability of Italian tools promotes research in healthcare, ensuring patient-centric care. Conclusions: The validity and reliability of the Italian version of the instrument for assessing health education competencies, essential for self-assessment among health education nurses, are established.

Throughout the Covid19 period, families were forced to stay indoors, adapting to online school-ing, remote work, and virtual social engagements, inevitably altering the dynamics within households. There is a notable increase in mental health challenges in terms of anxiety and de-pression in children and adolescents. This study intends to explore the psychosocial effects of the Covid-19 pandemic in Italian families adopting self- and proxy-report questionnaires on anxiety, anger, and health-related quality of life. The results showed that approximately 20% obtained a clinical anxiety score and only 10% obtained a clinical anger score. There was found a difference in the perception of the quality of life reported by the child and that perceived by the parent. The stepwise regression model showed that total anxiety scores were predicted by sex, quality of life scores from the parents' self-report version and total anger score. Another stepwise regression model identified physiological and social anxiety as the best predictors that impact the quality of life. Parental well-being actively influences the well-being of children, so it is fundamental to implement preventive programmes and promote child well-being providing parents the most adequate support possible.

In the following article, it is presented an investigation of the determinants of Beds for High-Care Specialties-BHCS in the Italian regions in the context of Environmental, Social and Governance-ESG approach. Data from ISTAT-BES for 20 countries in the period 2004-2021 are been used. Different econometric techniques have been applied i.e.: Pooled Ordinary Least Squares, Panel Data with Fixed Effects, Panel Data with Random Effects, Dynamic Panel at 1 stage. Furthermore, a cluster analysis performed with a k-Means algorithm optimized with the Silhouette Coefficient indicated the presence of three clusters. Finally, eight different machine-learning algorithms are analysed to predict the future value of BHCS. The results show that the Artificial Neural Network-ANN algorithm is the best algorithm. The future value of BHSC is expected to growth on average of 4.88% for the analysed regions.

Audit&amp;Feedback (A&amp;F) consists of multidimensional quality improvement activities, but its optimal design is still debated. Our study aims to outline how interventions of the Italian EASY-NET research program were designed, to explore whether desirable characteristics of an "ideal" A&amp;F were adopted. A&amp;F design included description of the working group, targeted clinical behaviors, selected indicators, sources, feedback procedures, corrective actions expected. Information was classified into four topics: nature of the desired action, type of data available, feedback display and delivery. Out of 9 projects, 3/9 aimed at changing a focused clinical behavior, 6/9 were generic; all projects identified clinicians as recipients, 8 explicitly considered managers. It was planned to develop an average of 27 indicators from administrative databases, as needed supplemented by ad hoc data collection. Five projects included outcome measures. Comparators derived from scientific literature or from territorial real-life data. Feedback was scheduled every 12, 6 or 3 months, or upon request, delivered as aggregate data (graphs and tables) via web platforms, e-mail, workshops, and individual meetings. In conclusion, at an early stage the projects were mostly “wide focused”, but improvements in A&amp;F design and delivery have been introduced, and projects, still ongoing, will offer interesting insights on A&amp;F effectiveness.

The European Green Deal has set a concrete strategic plan to increase farm sustainability. At the same time, the current global challenges, due to climate change and fuels and commodity market crisis, combined with the Covid-19 pandemic and the ongoing war in Ukraine, comprise the need for quality food, but also the reduction of negative external effects of agricultural production, with fair remuneration for the farmers. In response, precision agriculture has great potential to contribute to the sustainable development. Precision agriculture is a farming management that provides a holistic system approach to managing the spatial and temporal crop and soil variability within a field to improve the farm’s performance and sustainability. However, farmers are still hesitant to adopt it. On these premises, the study aims to evaluate the impacts of precision agriculture technologies on farm profitability, agronomic and environmental management by farmers adopting (or not) these technologies, using the case study method. In detail, the work focuses on the period 2014-2022 for two farms that cultivate durum wheat in Central Italy. The results suggest that the implementation of precision technologies can guarantee economic and agri-environmental efficiency. Results could serve as a basis for developing a program to start training in farms as well as suggest policy strategies.

The paper provides a critical synthesis of analysis and evaluation of some case studies in the Italian national context, which allowed, through an inductive method, to assess, in terms of integration and coherence, the process of transposition of climate change adaptation contents, possibly already contained within a regional urban framework (Regional Urban Laws) or specific Regional Adaptation Strategies or Local Adaptation Plans, within the territorial and urban planning tools of metropolitan or local scale.