Disinfecting Slush Machines by an Innovative Near Ultraviolet Light Emitting Diode (UV LED) Technological System.

Background: Microbial contamination of food and beverages is a topic of great interest. The most innovative technologies take advantage from UV light. This study aimed to evaluate a possible configuration of a nUV LED device at a wavelength of 405 nm installed on slush machines in order to reduce the microbial contamination. Study Design and Methods: Study Design and Methods. The study was conducted in the Department of Molecular and Developmental Medicine, University of Siena, Italy. A nUV LED device with 408 nm wavelength was installed and used on the slush machines. The inner walls of the machine tanks were fouled with contaminated slush, to evaluate the effectiveness of nUV radiation in reducing microbial contamination over time. Results: Experiment results on the slush machine showed a statistically significant logarithmic microbial reduction, in relation with the distance from the nUV LED light source. It has also been shown that the reduction of microbes is possible with a proper management of some parameters: the exposure time, the power and wavelength of the light source, the distance and the obstacles between the light source and the target to be irradiated. Conclusion: To reduce the incidence of foodborne diseases it is necessary to take all necessary precautionary measures, and the use of nUV technology has proved to be a crucial element in achieving this goal.

Evaluating the effect of COVID-19 incidence on Emergency Departments admissions. Results from a retrospective study in Central Italy during the first year of pandemic.

Introduction: The COVID-19 pandemic has had a major impact on the Healthcare System, changing the patterns of Emergency Department access. In fact, accesses for trauma and less severe cases decreased significantly. This decline has generally been attributed to both the effects of the lockdown, imposed by the government, and the fear of being infected by SARS-CoV-2 in the hospital. However, the correlation between these elements is not yet clear, since the accesses to the Emergency Department did not increase either at the end of the lockdown or in the summer when the epidemiological situation was more favorable. Aim: To evaluate the association between trends of Emergency Department accesses and COVID-19 incidence in 2020. Methods: Data on Emergency Department accesses, by month and severity triage code, from 14 hospitals in southeastern Tuscany (Italy) were obtained from hospitals' data warehouse. Official data on new cases of COVID-19 infection were used to calculate incidence. Hospitals were classified into 4 categories. Differences in Emergency Department access by month, triage code, and hospital type were investigated using Kruskal-Wallis analysis. Association between Emergency Department accesses and COVID-19 incidence was evaluated using a random-effect panel data analysis, adjusting for hospital type and triage code. Results: The trend of 268,072 Emergency Department accesses decreases substantially at the first pandemic peak; thereafter, it increased and decreased again until the minimum peak in November 2020. COVID-19 incidence appeared to be overlapping with an inverse direction. Monthly differences were significant (p<0.01) except for most severe codes. There was a significant inverse association between Emergency Department accesses and COVID-19 incidence (Coef. =-0.074, p<0.001) except for most severe cases (triage code 1: Coef. =-0.028, p=0.154). Conclusion: Emergency Department admissions trend followed the COVID-19 incidence, except for the most severe cases. Fear of infection seems to discourage patients from accessing Emergency Department for illnesses perceived as not serious.

Reducing waiting times of elective surgical procedures: effectiveness evaluation of a multi-interventions approach.

Background: Increasing waiting times for elective surgery is a major concern for policymakers and healthcare staff in many countries, due to its effect on health, patient satisfaction and the perceived quality of health-care. Many organizational models to reduce surgical waiting times have been studied, but the international literature indicates that multidimensional interventions on different aspects of the surgical pathway can be more effective in reducing waiting times than interventions focused on optimizing a single aspect. Aim: The aim of the study is to evaluate the effectiveness of a multidimensional intervention in reducing waiting times for elective surgery. Study design: We used a pre-post approach to evaluate the effect of a multidimensional project to reduce waiting times and lists. Methods: In a district general hospital (Italy) with three elective surgery operating rooms open 6 hours/day, 5 days/week (surgery specialties: general surgery, orthopaedics, gynaecology and urology), a project for reducing surgery waiting times was implemented in October 2018. The project focused on three aspects: i) separation of the flow of day surgery from that of ordinary surgery; ii) increasing available operating time by reorganizing the staff; iii) allocation of operating sessions flexibly in proportion to the waiting list. Waiting times for surgery in the periods 1/10/2019-31/12/2019 and 1/10/2018-31/12/2018 were compared by t test. Results: Waiting times for non-high-priority cases shortened significantly for all specialities (p<0.01), ex-cept for urology. For general surgery, orthopaedics and gynaecology, mean waiting times for day surgery decreased from 198 to 100 days (-50%) and for ordinary operations from 213 to 134 days (-37%). Waiting times for high-priority cases also shortened. Conclusions: Our multidimensional project based on reorganization of staff and facilities and on improved scheduling proved effective in reducing waiting times for elective surgery.

[An integrated approach for better contamination control in hospital settings]. / Un approccio integrato per un miglior controllo della contaminazione in contesti ospedalieri.

Disinfection of hospital environments is a cornerstone of intervention strategies to reduce the risk of hospital-associated infections. Many studies show that standard cleaning procedures are not sufficient for proper disinfection of hospital environments and that the addition of no-touch technologies, such us ultraviolet light, can provide deeper sanitisation. This study aims to test whether the application of ultraviolet light after standard procedures improves hygiene levels in the shortest possible time and shows the degree of contamination before and after irradiation. A cross-sectional study was conducted in a real clinical setting in rehabilitation rooms of a contracted clinic "Rugani Hospital" in Monteriggioni (SI), Italy, between December 2019 and August 2020.the study was carried out according to the following protocol: i) quantization of contamination of 12 selected target points in room; ii) attribution to the points of a probability of contamination risk; iii) sampling of a subset of 6 points with probabilistic assignment; iv) evaluation of the pre-post disinfection environmental hygiene using a UV-C system. For the pre-post statistical analysis the non-parametric Wilcoxon test was used; the multivariate MANOVA was used to verify the role of different confounders, with post hoc Bonferroni test. Probabilistic calculations minimised the samplings required to conclude that the application of the ultraviolet light device reduced the level of contamination in a statistically significant manner (p < 0.01) when comparing pre- and post-exposure, with less irradiation time than indicated by the manufacturer.

[Permanent environmental disinfection techniques in hospital settings with infectious risk]. / Tecniche di disinfezione ambientale permanente negli ambienti ospedalieri a rischio infettivo.

While the world's economies avoid the COVID-19 pandemic blockade, there is an urgent need for technologies aimed at reducing the transmission of COVID-19 in confined spaces such as hospital environments. Although the cleaning and disinfection procedures now have rather complex and sophisticated weapons, they do not seem to be sufficient to continuously maintain low levels of environmental microbiological contamination. This result can now be achieved through the cross-use, in space and time, of improved, more efficient and effective technologies. This result can now be achieved through the cross-use, in space and time, of improved technologies. This work highlights the possibility of crossing and cooperation of different disinfection techniques, such as to keep the microbial and viral load low over time.

Rapid detection of Legionella spp in water samples by ScanVIT method: comparison of acid vs heat treatment.

BACKGROUND: A rapid detection of Legionella bacteria in water samples is crucial to minimize the risk of acquiring infections, especially in health care facilities. Different detection methods and different decontamination procedures have been reported to affect the recovery of Legionella spp. Our goal was to test the recovery of Legionella pneumophila and Legionella non-pneumophila species using a kit based on non-specific and species-specific probes to treat water samples after two different decontamination procedures. METHODS: The study was conducted with samples collected in the teaching hospital "Le Scotte" of Siena (Italy). Waters samples were analyzed by: i) ScanVIT method after treatment with acids; ii) ScanVIT method after heating; and iii) cultural standard method after heating. The results of the decontamination procedures and the detection methods were evaluated by comparing the number of Legionella-positive and -negative samples, and the recovery rates (CFU l-1) obtained by ScanVIT and the standard method. RESULTS: We find that ScanVIT method is highly sensitive with both decontamination treatments, yielding a higher recovery of L. pneumophila compared to the standard method. Conversely, ScanVIT associated with the acid-treatment yielded the highest recovery of L. non-pneumophila. CONCLUSIONS: The acid-treatment combined to the ScanVIT method increases the recovery of L. non-pneumophila in water samples compared to both ScanVIT associated with heat-treatment and standard culture method. Thus, this method may represent the best choice to detect L. non-pneumophila in water samples and reduce the risk of infection due to underestimation of Legionella loads.

Guided mode resonance flat-top bandpass filter for terahertz telecom applications.

In this work, we design and experimentally demonstrate a novel terahertz (THz) filter exhibiting a flattened spectral response in the atmospheric transmission window around the central frequency of 300 GHz. The innovative concept behind this filter is the coupling of Fabry-Perot and guided mode resonances. The latter arise from a two-dimensional patch array patterned on an aluminum layer deposited on a low loss cyclo-olefin polymer. The filter experimental performance shows high transmittance in the flat-top band, with less than 3 dB losses, and high out-of-band rejection, as theoretically expected. This kind of component provides a cost-effective, functional solution for narrowband filtering in emerging THz devices and systems with possible applications in wireless telecommunications.

Chelating Surfaces for Oriented Human Serum Albumin Molecules.

Protein immobilization in a specific conformation or orientation at an interface is influenced by specific interactions with the outer layer of the surface. A strategy to build-up a complex construct which is able to orient protein molecules, based on metal-cation chelation processes, is reported. The proposed methodology implies the formation of a mercaptoundecanoic acid monolayer on a gold surface that is activated to attach covalently the tripeptide glycyl-l-histidyl-l-lysine (GHK) on the surface, whose sites are then employed to chelate copper ions, providing a selective platform for the orientation of human serum albumin (HSA) molecules. The protein adsorption process on GHK and GHK-Cu(II)-complex surfaces was monitored by the in situ quartz crystal microbalance with dissipation monitoring (QCM-D) and force spectroscopy technique. The changes in frequency and dissipation factor as well as the D- f plots from QCM-D measurements help to characterize the changes in the protein conformation and are confirmed by force curve spectroscopy results. An improved kinetic model, based on random sequential adsorption with variable protein footprints, has been developed to predict and simulate the experimentally found HSA average surface coverage onto the GHK and GHK-Cu(II)-complex surfaces.

Aerobic exercise and Orexin A: role of sympathetic activity and redox system.

Aerobic exercise is associated with the sympathetic activation evoking adaptive responses to sustain muscle engagement. Physical exercise can cause alterations in the cardiovascular activity and cellular stress may occur which could be marked by either heart rate (HR), or galvanic skin response (GSR). Moderate plasma levels of reactive oxygen species (ROS) are considered as health markers, absolving to important roles such as adaptive cellular responses to exercise. Orexin A, a hypothalamic peptide, causes a widespread stimulation of the sympathetic nervous system, playing a role in many physiological functions.

Milk nutrition and childhood epilepsy: An ex vivo study on cytokines and oxidative stress in response to milk protein fractions.

We present a pilot study on the effects of milk protein fractions [αS1-casein (CN), αS2-CN, κ-CN, ß-CN, and a mix of α-lactalbumin (α-LA) and ß-lactoglobulin (ß-LG)] from different animal species (bovine, ovine, and caprine) on pro- and anti-inflammatory cytokines and oxidative status in cultured peripheral blood mononuclear cells from children with generalized epilepsy. Peripheral blood mononuclear cells (PBMC) were obtained by density gradient from blood of 10 children with generalized epilepsy (5 males; mean age 33.6 ± 5.4 mo) and 10 controls (5 males; mean age 35.6 ± 6.8 mo). Children with epilepsy were grouped according to cytokine levels as follows: children with epilepsy having low levels of cytokines not different from those of control children (LL-EC); children with epilepsy having cytokine levels at least 5-fold higher (medium levels) than those of control children (ML-EC); and children with epilepsy having cytokine levels at least 10-fold higher (high levels) than those of control children (HL-EC). The production of tumor necrosis factor-α (TNF-α), IL-10, IL-6, and IL-1ß was studied in cultured PBMC incubated with αS1-CN, αS2-CN, κ-CN, ß-CN, and a mix of α-LA and ß-LG from bovine, caprine, and ovine milks. The levels of reactive oxygen and nitrogen species (ROS/RNS) and catalase activity were assessed in cultured supernatant. In the HL-EC group, ß-CN from small ruminant species (ovine and caprine) induced the highest levels of TNF-α, whereas PBMC incubated with αS2-CN from ovine milk and the mix of ß-LG and α-LA from all tested milk species had the lowest levels of TNF-α. Within the HL-EC group, production of IL-1ß was higher for bovine and ovine αS2-CN fractions and lower for caprine and ovine ß-CN and κ-CN. In the HL-EC group, IL-6 was higher in cultured PBMC incubated with αS2-CN from bovine and ovine milk than from caprine milk. The cytokine IL-10 did not differ among milking species. The highest levels of ROS/RNS were found after incubation of PBMC with the ß-CN fraction in bovine milk. Catalase activity was higher in PBMC cultured with ß-CN isolated from bovine and caprine milk and with αS1-CN from ovine milk.

Developing a new predictor of health expenditure: preliminary results from a primary healthcare setting.

OBJECTIVES: Risk adjustment is a widely used tool for health expenditure prediction and control. Early approaches for estimating health expenditure were based on patient demographic variables alone, whereas more recent models incorporate patient information, such as chronic medical conditions, clinical diagnoses, and self-reported health status. Many studies have investigated the health expenditure predictive capacity of single demographic, morbidity, or health-related quality of life measures, but the best models prove to be those that include them all. The aim of this study was to develop an index that combines measures of perceived health and disease severity and to compare its efficacy in predicting health expenditure with that of the measures taken individually. STUDY DESIGN: This is a linked cross-sectional study. METHODS: In 2009 and 2010, the health-related quality of life questionnaire SF-36 (8 scales, two indices: Physical Component Summary [PCS] and Mental Component Summary [MCS]) was distributed to 886 patients of general practitioners in the Province of Siena, Italy. Severity of diseases was calculated for each patient using the Charlson Index (CH-I) and Cumulative Illness Rating Scale Severity Index (CIRS-SI). Siena Local Health Unit 2012 data on health expenditure were obtained for each patient. Multivariate linear regression was applied to test the performance of severity (CH-I, CIRS-SI) and perceived health (PCS and MCS) measures in predicting health expenditure. The indexes that predicted health expenditure best were then combined in a new tool, and its expenditure predictive capacity was tested. RESULTS: The best health expenditure predictors proved to be PCS and SI (R2 = 0.15 and R2 = 0.17, respectively). When combined in a new index (PCS-SI), better predictive capacity of health expenditure was obtained than with the two single measures separately (R2 = 0.19). CONCLUSIONS: A multidimensional indicator proved to be a better predictor of healthcare expenditure than single health measures.

Effectiveness of ATP bioluminescence to assess hospital cleaning: a review.

INTRODUCTION: Contamination of hospital surfaces plays an important role in the transmission of several healthcare-associated microorganisms, therefore methods for evaluating hospital surfaces' cleaning gain particular importance. Among these, there are visual inspection, quantitative microbiology, fluorescent markers and adenosine triphosphate (ATP) bioluminescence. The latter seems to provide interesting features, detecting the presence of ATP on surface (as Relative Light Units, RLU), a proxy of organic matter and microbial contamination. Several studies have investigated the effectiveness of this technology; with this research, we aim to summarize the most significant results. METHODS: A systematic review was conducted. The keywords (namely, "ATP", "bioluminescence", "hospital" and "surfaces") were searched in PubMed/MEDLINE and Scopus databases, in order to find relevant data, from January 2000 to October 2014. After the selection, we globally considered 27 articles. RESULTS: Most of the studies were conducted in United Kingdom and in USA. Different threshold RLU benchmark values were identified by analyzed studies. Fourteen of these researches compared the ATP bioluminescence with microbiological methods, 11 identified a significant correlation between the two methods, although poor or not complete for 5. DISCUSSION: ATP bioluminescence is not a standardized methodology: each tool has different benchmark values, not always clearly defined. At the moment, we can say that the technique could be used to assess, in real time, hospital surfaces where cleanliness is required, but not sterility.

Factors that could influence women's participation in colorectal cancer screening: an Italian study.

BACKGROUND: Colorectal cancer (CRC) is the 2nd most common cancer in women worldwide. In Italy, only 50% of people invited to get the Fecal Occult Blood Test (FOBT) decided to do it. Women's participation in breast and cervical screening is, instead, very high (>70%). The aim of our study was to investigate the beliefs, the feelings and the psychological factors that could influence the participation of women in CRC screening. METHODS: We conducted a cross sectional study, in the Hospital of Siena, Central Italy, in 2011. We administered a questionnaire to 507 women of all ages, who attended mammography or clinical breast examination. The adherence to CRC screening was analyzed only in the group of 207 older women (age >50 years). We performed descriptive, bivariate and logistic regression analysis to identify whether an association was present between participant characteristics, willingness and adherence to screening. RESULTS: Family history of colorectal cancer (OR 4.3; p<0.007) and the General Practitioner's advice (OR: 3.4; p<0.003) were associated with a greater adherence to screening (colonoscopy). The embarrassment was another factor related to colonoscopy compliance (OR: 0.34; p<0.016). CONCLUSION: Family history of CRC, pain or embarassment and GP's advice are the factors that correlated more strongly (positively or negatively) with adherence to colorectal cancer screening. These elements should be further analyzed to choose the best solution to improve the adherence in campaigns on colorectal cancer.

Health status of homeless persons: a pilot study in the Padua municipal dorm.

OBJECTIVES: Homeless persons can be considered a vulnerable group and several studies showed in this group an higher prevalence of chronic and infectious diseases, a lower mental health status, and a higher abuse of alcohol. The aim of our study was to investigate the health status of homeless in Padua, Italy, administering a questionnaire composed by SF-36 and EQ-5D. DESIGN: We conducted a cross-sectional study from 15 December 2015 to 15 February 2016. SETTING AND PARTICIPANTS: We enrolled in our study 73 homeless persons welcomed in the municipal dorm of Padua. 5 persons refused to participate in the study; 9 had a mental status incompatible with the participation to the study. MAIN OUTCOME MEASURES: We administered to the participants a questionnaire composed by three parts: in the first part we asked sociodemographic information (gender, age, nationality, qualification, height and weight) to calculate BMI, time spent at the dorm, period of homelessness, alcohol intake, smoking habit, availability of a general practitioner, emergency room visits in the last year, admissions in the last year, pre-existing conditions and in act, participation in screening programs. The second part was represented by the Short Form 36 questionnaire. The third part by the EQ-5D questionnaire. RESULTS: Our sample was composed by 79% men and 21% women. 54.7% were Italian. The mean age was 48 years. 72.8% were smoker and 60,3% drunk alcohol. In this latter group 28.8% drunk more than 1 liter of wine per day. Non Italian homeless smoke less than the Italian: this difference is statistically significant (OR = 3.7 p = 0.032 ). Only 9 foreigners had a general practitioner compared to 30 Italian homeless: this difference is statistically significant (OR = 60 P < 0.01). 43 of the 59 respondents (72.8 % ) said to suffer from some disease. No one reported a history of tuberculosis. The most represented diseases were pneumonia (30%), myocardial infarction (17%), hepatitis C (13.5%). Participation in screening programs was very low. From the analysis of the SF-36 results, homeless persons obtained lower scores than Italian population. In our study, 40 persons reported a level 2 or 3 in the EQ-5D dimension called "anxiety/ depression". In the EQ visual-analogue scale, the homeless population showed a lower perception of its health status. CONCLUSION: Compared to the general population, the homeless reported a worse mental health, and this showed that they represent a particularly vulnerable group. Moreover they had a higher percentage of incorrect habits for their health (alcoholism and tobacco addiction), they suffered from chronic conditions, and tended to have a higher frequency of accesses to the emergency rooms. It would be better to improve the state of health of the homeless, through initiatives that could reduce the causes of homelessness, and that could prevent the onset of diseases in this group.

Peripheral nerve field stimulation for chronic neuropathic pain: a single institution experience.

BACKGROUND: Peripheral nerve field stimulation (PNFS) is a novel neurosurgical procedure consisting of implantation of subcutaneous leads in specific painful areas in different types of painful, drug-resistant syndromes. The objective of this study was to evaluate the efficacy of PNFS in several patients affected by different chronic neuropathic pain syndromes, along with its risks, limits and possible correlation between the results achieved and the patients' main symptoms. METHODS: Twenty-two patients affected by different types of chronic neuropathic pain were submitted to PNFS at the Department of Neurosurgery of the Istituto Neurologico "C. Besta" in Milan between July 2009 and July 2013. The visual analog scale (VAS) and variations in the use of analgesic drugs, along with complications, were considered to assess results. RESULTS: In 59 % of our patients, an average pain reduction of 5.50 points on the visual analog scale was observed (average pre-implant score 8.86 and average post-implant score 3.36). These patients reduced their analgesic drug use after PNFS. We observed no early or long-term complications after our last follow-up evaluation. CONCLUSIONS: PNFS can be considered an effective and safe option to treat carefully selected, drug-resistant and chronic neuropathic pain patients; the reversibility of the procedure and its lack, at least in our hands, of long-term complications may contribute to wider use of this procedure.

History and Medicine: ex voto as a tool for health and epidemiological surveillance.

BACKGROUND: Ex voto is a donation for a divinity, a Saint or to Virgin Mary for a received mercy. From the analysis of an ex voto it's possible to obtain lots of information and therefore it can be used as a tool for health and epidemiological surveillance, to study morbidity in the past. The aim of this study was the creation of a database to rebuild epidemiological events and diseases, using ex voto as a source of health surveillance. METHODS: We chose to study votive pictures using three types of sources: photographed alive, on-line archives, books and photographic collections. Ex voto have been saved in an Hard Disk, numbered and inserted in a database, then analyzed using Stata®. RESULTS: total of 6231 ex voto were collected and catalogued in our database. Ex voto referring to diseases are the most represented (41%), but they have decreased with the time. Road accidents (21.4%) have a constant increase, especially with the appearance of cars and motorcycles. Aggressions (5.45%) decrease constantly; warlike accidents (4.44%) had a peak in the period including both world wars; non professional accidents (10.60%) and accidents at work (3.79%) increase without peaks; maritime accidents (8.88%) have not uniform ups and downs during the time. CONCLUSIONS: The database let us rebuild epidemiological events of the past, which are not deductible from other sources. Our purpose is to expand in the space-time our source data in order to perform an interesting comparison between past and present.

Mobility trends of Patients across Italian Regions: implications for planning and evaluation of hospital services.

BACKGROUND: The study of patients' mobility is useful for health planning and identifying deficiencies in care supply. The Italian Health Service, with 21 different regional realities, can be considered as a macrocosmic test bench. Our study aims: (1) to describe the trend of patients' hospital mobility across the Italian Regions; (2) to offer an immediate visual approach for decision making; (3) to identify some factors involved in patient's mobility. STUDY DESIGN: Observational cross sectional study. METHODS: We used ordinary and day hospital discharge data from 1998 to 2014. The study was carried out using: (1) the Gandy's Nomogram (GN), a graphical tool that assesses the power of attraction and the escape's containment of hospital regional networks; (2) the vector analysis; (3) the trend analysis with Cuzik's test; (4) the panel data analysis, with multiple logistic regression model. RESULTS: The mean number of annual admissions, in Italian hospitals, was 10,976,290, progressively decreasing from 2001 to 2014, and 7% of it occurred "in mobility". We have drawn the different paths of patients' mobility by Regions and observed critical situations almost in Regions of Southern Italy, compared with Regions of the Centre-North. Moreover we analyzed the factors implied in such mobility, highlighting that attraction is influenced by the hospitalization rate in private structures, by the percentage of graduates in the Regions, and by the number of hospital beds/10,000 inhabitants; while escapes are influenced by GDP per capita, by the number of hospital beds/10,000 inhabitants and by the sanitary expenses per capita of the Region. CONCLUSIONS: We have shown the potentialities of the GN, applicable at micro level but also on a large scale in the analysis of patients' hospital mobility; and this, together with panel data analysis, can lead to a more conscious and effective health planning.

Italian medical students quality of life: years 2005-2015.

BACKGROUND: Quality of Life (QoL) is a concept used to indicate the general wellness of persons or societies. University students report a low quality of life and a worse perception of their health status, because of a situation of greater discomfort in which they live during the course of the study, especially in faculties with an important emotional burden, such as medical schools. The aim of the study was to evaluate the perceived health status of first year medical students. METHODS: We conducted a cross sectional study in the time span 2005-2015, administering the questionnaire Short Form 36 (SF-36) to first-year students of the School of Medicine of the University of Siena, Italy. In addition to demographic information such as gender and the age we investigated the region of residence, marital status, employment status, and smoking habits; height and weight were required to calculate the body mass index (BMI) to evaluate a possible physical discomfort connected with the perception of health status. The data from the questionnaires were organized and processed by software Stata® SE, version 12.1. RESULTS: 1,104 questionnaires were collected. Medical students reported lower SF-36 scores, compared to the Italian population of the same age. Female gender and smoking habits influence negatively the score of several scales. Body Mass Index is positively correlated with the Physical Activity, while Age is negatively correlated with Social Activities. CONCLUSIONS: The perceived quality of life of the Italian medical students is lower when compared to the general population. This confirms that the condition of student implies additional problems, as other studies reports. It would be better to improve it, developing students' resilience. It would be interesting to extend this research to students of other years, from other faculties and other locations, to gain a broader view about the QoL of the Italian students.

Validation of Armadillo officinalis Dumèril, 1816 (Crustacea, Isopoda, Oniscidea) as a bioindicator: in vivo study of air benzene exposure.

This study tests the potential for using Armadillo officinalis as a bioindicator of exposure to and activation of benzene metabolic pathways using an in vivo model. A. officinalis specimens collected in a natural reserve were divided into a control and three test groups exposed to 2.00, 5.32 or 9.09 µg/m(3) benzene for 24h. Three independent tests were performed to assess model reproducibility. Animals were dissected to obtain three pooled tissue samples per group: hepatopancreas (HEP), other organs and tissues (OOT), and exoskeleton (EXO). Muconic acid (MA), S-phenylmercapturic acid (S-PMA), two human metabolites of benzene, and changes in mtDNA copy number, a human biomarker of benzene exposure, were determined in each sample; benzene was determined only in EXO. MA was measured by high-performance liquid chromatography (HPLC) with ultraviolet (UV) detection, S-PMA by triple quadrupole mass spectrometer liquid chromatography with electro spray ionization (LC-MS-ESI-TQD), mtDNA by real-time quantitative PCR and end-point PCR, and benzene by quadrupole mass spectrometer head-space gas chromatography (HSGC-MS). MA and S-PMA levels rose both in HEP and OOT; EXO exhibited increasing benzene concentrations; and mtDNA copy number rose in HEP but not in OOT samples. Overall, our findings demonstrate that A. officinalis is a sensitive bioindicator of air benzene exposure and show for the first time its ability to reproduce human metabolic dynamics.

Pregnancy and internet: sociodemographic and geographic differences in e-health practice. Results from an Italian multicenter study.

OBJECTIVES: Since the new millennium, the number of e-health users has significantly increased. Among these, a particular category of people who are interested by this phenomenon is the one of pregnant women. The aim of the present study is to assess the sociodemographic and geographic differences existing in a sample of Italian pregnant women who search for information on the web. STUDY DESIGN: Multicenter cross-sectional survey. METHODS: The present study has been conducted from November 2011 to September 2012, in seven Italian cities, located in the North, in the Centre and in the South of Italy. Data were collected through an anonymous questionnaire, administered in waiting rooms of outpatient departments by trained medical doctors. Data were analysed through multivariate logistic regression models. RESULTS: Overall, 1347 responders were interviewed. Eighty-six percent of them declared to surf the internet to retrieve pregnancy-related information. The most searched topics were fetal development (51.3%), healthy lifestyle during pregnancy (48.7%), physiology of pregnancy (39.8%), generic and specific tips/advices during pregnancy (37.2%) and lactation (36.8%). Statistically significant differences (P < 0.05) according to geographic origin, age and educational level were found with regard to the most frequently searched information on the Web, the reasons that pushed pregnant women to practice e-health, and the possibility to change lifestyles after e-health. CONCLUSIONS: Our findings suggest that the phenomenon of pregnancy e-health is widespread and show social and geographic differences, in particular about city of residence, age and educational level. It might encourage healthcare professionals to be more available and exhaustive during routine visits and to be more careful about web content on this topic, also addressing the different needs into different geographic contexts.