First synthesis of silicon nanocrystals in amorphous silicon nitride from a preceramic polymer.

We report the first synthesis of silicon nanocrystals embedded in a silicon nitride matrix through a direct pyrolysis of a preceramic polymer (perhydropolysilazane). Structural analysis carried out by XRD, XPS, Raman and TEM reveals the formation of silicon quantum dots and correlates the microstructures with the annealing temperature. The photoluminescence of the nanocomposites was investigated by both linear and nonlinear measurements. Furthermore we demonstrate an enhanced chemical resistance of the nitride matrix, compared to the typical oxide one, in both strongly acidic and basic environments. The proposed synthesis via polymer pyrolysis is a striking innovation potentially allowing a mass-scale production nitride embedded Si nanocrystals.

Sex differences in food choices, adherence to dietary recommendations and plasma lipid profile in type 2 diabetes - The TOSCA.IT study.

BACKGROUND AND AIMS: Diabetic women have a more adverse plasma lipid profile than men. Sex differences in dietary habits may play a role, but are little investigated. The study evaluates the quality of diet, adherence to the nutritional recommendations of the Diabetes and Nutrition Study Group and their relation with plasma lipid in men and women with diabetes. METHODS AND RESULTS: We studied 2573 people, aged 50-75, enrolled in the TOSCA.IT study (clinicaltrials.gov; NCT00700856). Plasma lipids were measured centrally. Diet was assessed with a semi-quantitative food frequency questionnaire. Women had a more adverse plasma lipid profile than men. Women consumed significantly more legumes, vegetables, fruits, eggs, milk, vegetable oils, and added sugar, whereas men consumed more starchy foods, soft drinks and alcoholic beverages. This stands for a higher proportion (%) of energy intake from saturated fat and added sugar (12.0 ± 2.4 vs 11.5 ± 2.5 and 3.4 ± 3.2 vs 2.3 ± 3.2, P < 0.04), and a higher intake of fiber (11.2 ± 2.8 vs 10.4 ± 2.6 g/1000 Kcal/day) in women. Adherence to the recommendations for saturated fat and fiber consumption was associated with significantly lower LDL-cholesterol regardless of sex. Adherence to the recommendations for added sugars was associated with significantly lower triglycerides and higher HDL-cholesterol in men and women. CONCLUSIONS: Men and women with diabetes show significant differences in adherence to nutritional recommendations, but sex differences in plasma lipid profile are unlikely to be explained by nutritional factors. Adherence to the nutritional recommendations is associated with a better plasma lipid profile regardless of sex, thus reinforcing the importance of substituting saturated for unsaturated fat sources, increasing fiber and reducing added sugar intake.

A novel multisensory device for the assessment and rehabilitation of perceptual and attentional competencies.

The present study aims to assess a novel technological device suitable for investigating perceptual and attentional competencies in people with or without sensory impairment. The TechPAD is a cabled system including embedded sensors and actuators to enable visual, auditory, and tactile interactions and a capacitive surface receiving inputs from the user. The system is conceived to create multisensory environments, using multiple units controlled separately and simultaneously. We assessed the device by adapting a spatial attention task comparing performances in different cognitive load conditions (high or low) and stimulation (unimodal, bimodal, or trimodal). 28 sighted adults were asked to monitor both the central and peripheral parts of the device and to tap a target stimulus (either visual, auditory, haptic, or multimodal) as fast as they could. Our results suggest that this new device can provide congruent and incongruent multimodal stimuli and quantitatively measure parameters such as reaction time and accuracy, allowing to investigate perceptual mechanisms in multisensory environments.Clinical Relevance-The TechPad is a reliable tool for the assessment of spatial attention during interactive tasks. its application in clinical trials will pave the way to its role in multisensory rehabilitation.

Early visual deprivation disrupts the mental representation of numbers in visually impaired children.

Several shreds of evidence indicate that visual deprivation does not alter numerical competence neither in adults nor in children. However, studies reporting non-impaired numerical abilities in the visually impaired population present some limitations: (a) they mainly assessed the ability to process numbers (e.g. mathematical competence) rather than represent numbers (e.g. mental number line); (b) they principally focused on positive rather than negative number estimates; (c) they investigated numerical abilities in adult individuals except one focusing on children (Crollen et al. in Cognition 210:104586, 2021). Overall, this could limit a comprehensive explanation of the role exerted by vision on numerical processing when vision is compromised. Here we investigated how congenital visual deprivation affects the ability to represent positive and negative numbers in horizontal and sagittal planes in visually impaired children (thirteen children with low vision, eight children with complete blindness, age range 6-15 years old). We adapted the number-to-position paradigm adopted by Crollen et al. (Cognition 210:104586, 2021), asking children to indicate the spatial position of positive and negative numbers on a graduated rule positioned horizontally or sagittally in the frontal plane. Results suggest that long-term visual deprivation alters the ability to identify the spatial position of numbers independently of the spatial plane and the number polarity. Moreover, results indicate that relying on poor visual acuity is detrimental for low vision children when asked to localize both positive and negative numbers in space, suggesting that visual experience might have a differential role in numerical processing depending on number polarity. Such findings add knowledge related to the impact of visual experience on numerical processing. Since both positive and negative numbers are fundamental aspects of learning mathematical principles, the outcomes of the present study inform about the need to implement early rehabilitation strategies to prevent the risk of numerical difficulties in visually impaired children.

[Epigenetics and environmental exposure to xenobiotics]. / Epigenetica ed esposizione ambientale a xenobiotici.

Environmental pollution, together with predisposing genetic factors, plays a key role in determining short and long-term adverse effects on human health. In the industrialized countries the identification of etiology related to diseases of environmental origin has then become a research of priority interest. With regard to this, it has been widely demonstrated that different chemical compounds, such as endocrine disruptors, are able to modify the epigenetic characteristics of a human being. According to recent studies, the paradigm "genotype is strongly correlated with a phenotype" is changing in favor of the concept that a phenotype is defined by a "genotype and by an epigenome". Thus, there is a genotype identical for all cells associated to the epigenome that causes changes in gene expression without modifying the nucleotide sequence of the genome, through alterations in DNA methylation, histone modifications and the pathway of small non-coding RNAs. The epigenome is easily affected by different factors, such as aberrations of normal epigenetic processes that can be caused by environmental factors as exposure to xenobiotics, social behavior and nutritional deficiencies. Epigenetic changes are thus a biological response to environmental stress factors and may be transmitted to the offspring. As the elimination of the environmental factor determines the possible reversion of epigenetic modifications, it seems not to play a role in the natural selection process. However, epigenetic aberrations affect gene expression by interfering with the stability and survival of cells and with the inactivation of onco-suppressor genes. Thus, it is of considerable interest to investigate about the possible elements of induction of epigenetic processes in order to implement prevention protocols. Moreover, the gene expression screening through high through-put techniques like microarray, represent a new tool for the identification of new epigenetic indicators in order to monitor the early biological effects on the population exposed to xenobiotics.

A Novel Wearable and Wireless Device to Investigate Perception in Interactive Scenarios.

The aim of the present work is to introduce a novel wearable device suitable to be used to investigate perception in interactive tasks, on individuals with and without sensory disabilities. The system is composed by small units embedded with sensors and actuators that allows emitting different kind of stimuli (light, haptic, sound) and to record the user response, thanks to a capacitive sensor. We validated the system by implementing an interception task in three different sensory modalities: visual, tactile and auditory. Six subjects with normal sight were asked to tap either a static or a moving stimulus generated by 6 units placed on their forearm. Results suggest that the system can effectively provide new insights in characterizing how perception principles vary when perceptual judgement occurs through different senses. This confirms the device potential in contributing to the design of rehabilitation protocols rooted on neuroscientific findings, for people with sensory impairments.

Near-ideal spontaneous photon sources in silicon quantum photonics.

While integrated photonics is a robust platform for quantum information processing, architectures for photonic quantum computing place stringent demands on high quality information carriers. Sources of single photons that are highly indistinguishable and pure, that are either near-deterministic or heralded with high efficiency, and that are suitable for mass-manufacture, have been elusive. Here, we demonstrate on-chip photon sources that simultaneously meet each of these requirements. Our photon sources are fabricated in silicon using mature processes, and exploit a dual-mode pump-delayed excitation scheme to engineer the emission of spectrally pure photon pairs through inter-modal spontaneous four-wave mixing in low-loss spiralled multi-mode waveguides. We simultaneously measure a spectral purity of 0.9904 ± 0.0006, a mutual indistinguishability of 0.987 ± 0.002, and  >90% intrinsic heralding efficiency. We measure on-chip quantum interference with a visibility of 0.96 ± 0.02 between heralded photons from different sources.

[Contribution of ISPESL (National Institute for Occupational Safety and Prevention) for protecting workers from exposure to avian influenza]. / Il contributo dell'ISPESL per la protezione di lavoratori esposti a virus dell'influenza aviaria.

Influenza virus A/H5N1 occurs mainly in birds, in which is highly contagious and deadly, and does not usually infect people. Most of the cases occurred in humans resulted from people having direct or close contact with H5N1 infected poultry or contaminated surfaces. The circulation of influenza viruses in birds, humans and other hosts represents a public and animal health threat, with important economic consequences. Controlling avian influenza in poultry, in particular with biosecurity measures, is the primary method to reduce human risk from infection. Enhanced surveillance both in poultry and in wild birds proved effective for the early detection of the infection. Worldwide most countries developed strategic plans, guidelines and recommendations for effective disease prevention and control. Moreover documents were specifically prepared to keep specific categories of workers adequately informed on how to avoid or minimize exposure to the viruses. In accordance with the Italian Decree 626/94, recently amended by the Decree 81/08, regarding the protection of workers from risks related to exposure to biological agents at work, the Department of Occupational Medicine of ISPESL prepared one booklet directed to people working with poultry and, together with Corpo Nazionale Vigili del Fuoco, two booklets addressed to fire brigade who could be at various levels involved in outbreak disease control and eradication activities. In fact information and training are essential aspects of a global preventive and protective strategy.

[Gene expression and environmental exposure to xenobiotics: overview and applications]. / Espressione genica ed esposizione ambientale a xenobiotici: overview e applicazioni.

Industrial chemicals, pesticides, pharmaceuticals, foods, heavy metals, air pollutants, and naturally occurring substances, are an integral part of our daily lives. Environmental exposure can induce changes in gene regulation associated with human diseases. A new discipline of toxicology is "predictive toxicology" that defines the relationship between the structure and activity of the genome and the adverse biological effects of exogenous agents. Toxicogenomic technologies allow complete assessment of the functional activity of biochemical pathways, and of the structural genetic (sequence) differences among individuals (polymorphisms), that were previously unattainable. Microarray technology provides the means to study multiple pathways and mechanisms at concurrent times. Gene expression is a sensitive indicator of toxicant exposure, disease state, and cellular metabolism and thus represents a way of characterising how cells and organisms adapt to changes in the external environment. The application of these technologies to toxicology can lead us into a new era when genotypes and toxicant-induced genome expression, proteins, and metabolite patterns can be used to screen compounds for hazard identification, to monitor individual exposure to toxicants, to track cellular responses to different doses, to assess mechanisms of action, and to predict individual variability in sensitivity to toxicants and potential ways to improve risk assessment.

[HCV genotyping in health professionals: controversies and perspectives]. / Genotipizzazione dell'HCV in operatori sanitari: controversie e prospettive.

Healthcare workers (HCW) are at risk of acquiring blood-borne infections, including HCV Although current evidence does not suggest an increased prevalence of HCV infection among HCW, transmission of infection following occupational exposure has been demonstrated. Moreover, HCV can establish a persistent, chronic infection contributing to progressive liver disease, and post-exposure prophylaxis against HCV infection is not currently available. Problems still arise in the health surveillance of healthcare workers HCV infected. The use of virologic assays has become essential in the management of hepatitis C virus (HCV) infection, in order to improve the diagnosis of the infection, to guide the treatment decisions, and to assess the virologic response to antiviral therapy. Although several studies have specifically evaluated the role of HCV genotypes, many questions have not been answered. It is thought that HCV genotypes are important epidemiological markers, but more investigations are needed to elucidate their role regarding the progression and the pathogenesis of liver disease. The clinical implication of HCV genome heterogeneity, the different genotyping methods and the possible role of HCV genotypes as a parameter that could help health surveillance of infected HCW are described in this paper.

ENA screen chemiluminescence immunoassay: a random access method in autoimmunology.

Recently, autoimmunity, due to an increase in examination requests, has become an independent area of laboratory research, which needs management optimization in terms of quality, time, and flexibility. Therefore, we have evaluated the screening of extractable nuclear antigens (ENA) antibodies both with a chemiluminescence immunoassay and the enzyme-linked immunosorbent assay (ELISA) method, which was used in our laboratory, as a reference kit. The most important difference between these two methods is the possibility of processing serum samples with a random access system, which is different from batch methods.

[The need to improve the quality of laboratory results in the study of biological occupational risk]. / Necessità di migliorare la qualità dei risultati di laboratorio nello studio del rischio biologico occupazionale.

In the field of occupational medicine, the laboratory medicine gives fundamental contribution not only to evaluate the risk connected to different environmental, biologic, chemical and physical factors, but also to manage the quality of the work condition. For this purpose, it's fundamental that the finalized health efficiency measures and the individuation of interventions partially or totally based on laboratory results, have to be correlated to reliable analytical results, to be validated by internal and external quality controls. During the last years, a new and in some way innovative interest in occupational exposition to biological agents increased. Although, in this sphere, the immunoenzimatic methods are widely used, standardization and quality controls are often absent. For the molecular investigation that is widely used in occupational medicine, adequate quality control systems should be promoted. The work medicine, as the laboratory medicine, should develop "Quality Assurance" programmes not only referred to different occupational infections study, but also to the use of different laboratory methodologies, including immunochemical, cellular, molecular or the ones ending by ... omic as proteomic, genomic, transcriptomic, etc.. The carrying out of such programmes is necessary to aim to support the integration in the involved different professional positions, to guarantee higher comprehension, transparency and reliability on analytical results.

[New tools for the study of occupational allergies related to animals]. / Nuovi strumenti per lo studio delle allergie occupazionali di origine animale.

Animal laboratory workers are exposed at the Laboratory Animal Allergy (LAA). About 10% of them develop asthma. Currently, by the use of innovative methodologies, numerous allergens from the laboratory animals have been sequenced and analyzed. Between them, the allergens by rats and mouse, the experimental models more utilized. Proteomic approach or protein microarray permit the study of several allergens, belonging to the proteins known as lipocalins, and of immunological response in susceptible individuals. Moreover, availability of on-line data banks permit a knowledge more and more detailed and up-to-date regarding the allergens of the interest. Between the advantage of the proteomic there is the use of small amount of biological fluids, as the serum, in association with the possibility to studied a great number of allergens on a single support. The study of LAA by the use of proteomic will permit to identify the animal allergens more accurately, providing also a valid tool at the methodologies traditionally used, and for the planning of the preventive and protective measures.

[Virus C hepatitis: successful therapy in a health care worker]. / Epatite C: la vittoria della terapia sul virus in un operatore sanitario.

Hepatitis C viral is a problem of population health. The World Health Organization considers Hepatitis C an epidemic, a "silent" epidemic because a patient living with Hepatitis C can be infected for decades before being discovered. Recent data show an estimated number of 170 million patients infected with hepatitis C virus in the world. Number of new infections per year has declined from an average of 240,000 in the 1980s to about 26,000 in 2004. The incidence of HCV infected patients is estimated to 500-600 new cases in a year in Italy. Chronic infection is present in 55%-85% of infected persons. Approximately one third of the patients develop cirrhosis over a number of years, which can lead to liver failure and other serious complications. There is no vaccine and no completely effective treatment. Recent data show PEG-IFN-RBV combination therapy is most effective. We describe one HCV infected individual case report with HCV genotype 1b who received combination therapy for 4 weeks. Levels of HCV RNA became undetectable after an mouth of treatment.

[Brugada syndrome and work place: two case report]. / Sindrome di Brugada e lavoro: due casi clinici.

Brugada Syndrome (BS) is a primary electrical disease of the heart that causes sudden cardiac death or life-threatening ventricular arrhythmias. This disease is hereditary syndrome genetically determined. The pattern of transmission is autosomic dominant. Several mutations linked to this syndrome affecting the gene SCN5A which encodes for the cardiac sodium channel have been described. Recent studies showed the disease is responsible for 4 to 50% of sudden deaths. A typical electrocardiographic (ECG) finding consists of the ST-segment elevation in the right precordial leads. These ECG patterns, which appears permanently or intermittently in patients, are unmasked by antiarrhythmic agents. This syndrome has a very poor prognosis when left untreated: one third of patients having suffered from syncopal episodes or resuscitated from near-sudden death develops a new episode of ventricular tachycardia within 2 years. The only available treatment is the implantable cardioverter-defibrillator. We report two cases of probable BS in workers exposed to occupational risks. These case reports demonstrate the importance of surveillance, particularly of cardiac examination for identifying patients at risk of ventricular arrhythmogenic events.

[Emerging infectious diseases among swine workers]. / Patologie infettive emergenti per gli addetti ad allevamenti suinicoli.

In the last years emerging infections represent an important problem of public health and occupational medicine. Biological agents and their hosts exist in a precariously balanced and continuously evolving relationship, influenced by their environment. RNA viruses are responsible for most of the emerging diseases. Epidemics that recently affected the world of work are zoonoses, such as cases of SARS in healthcare staff Dutch poultry workers infected with the avian virus A/H7N7 in 2003, the current threat of avian flu A/H5N1 to poultry workers. Workers at risk include those who are in contact with live or dead infected animals, with aerosols, dust or surfaces contaminated by animal secretions, persons engaged in animal breeding and trade, veterinaries, and others. Pigs are at risk of acquiring many viral and bacterial diseases and, consequently, could be able to transmit some of these infections to occupationally exposed subjects. The aim of our study is to set out some emerging zoonosis that could affect swine workers, an occupational sector where a proper assessment of biological risks is difficult to perform.

[QuantiFERON-TB Gold test in homeless shelter staff: preliminary results]. / Test QuantiFERON-TB Gold in addetti all'assistenza: risultati preliminari.

Tuberculosis (TB) continues to be a major cause of disability and death and it has become a real problem in industrialized countries. The spread of HIV, the increasing immigration rate of people from countries with endemic TB and the growth of drug-resistant Mycobacterium tuberculosis strains extend its impact. Since the spread of the infection occurs early, health care workers are particularly exposed to the risk of contracting and/or transmitting the mycobacterium. In health care settings, policies and procedures for TB control should be developed, including health surveillance. Until recently the tuberculin skin test was the only available method for diagnosing tuberculosis, however it suffers several methodological weaknesses: high rate of false positive results in vaccinated populations, the subjectivity of the evaluation and the booster effect. Recently, the introduction of new in vitro serological tests, as the Quantiferon TB-Gold in tube (QFT-TB), may overcome these problems. The QFT-TB is based on the quantification of interferon-gamma released from sensitized lymphocytes in whole blood incubated overnight with PPD from M. tuberculosis and control antigens. The present study was performed on 27 nuns (homeless shelter staff) who were at risk for contracting tuberculosis. The prevalence of positive tests was 15 out 27 (55.5%).

Auditory attention at the onset of West syndrome: correlation with EEG patterns and visual function.

At the onset of West syndrome a specific impairment of visual function has been clearly demonstrated, while other aspects of sensorial development, and in particular of the auditory function, have been less studied. The aim of this study was to evaluate auditory function and orienting responses at the onset of West syndrome, and to relate the results with EEG patterns, visual function and neurodevelopmental competence. A prospective multicentric study was performed on 25 successively enrolled infants with West syndrome; all the patients underwent a full clinical assessment, including MRI and video-EEG, visual function and auditory orienting responses (AORs) as well as Griffiths' developmental scales. The whole assessment performed at the onset of spasms (T0) was repeated after two months (T1). AORs resulted significantly impaired both at T0 and T1. At the onset of spasms a highly significant relationship of auditory attention with visual function and neurodevelopmental competence was shown in both cryptogenic and symptomatic forms, but it was no longer present after two months. Our results may suggest a possible pervasive effect of the epileptic disorder on sensory processing, associated to a deficit of neurodevelopment. Although we failed to show a significant correlation between auditory orienting responses and EEG patterns, some evidence seems to support at least partially an influence of the epileptic disorder per se on the genesis of the sensorial impairment. A longer follow up and a larger cohort will be useful for a better clarification of these findings.

[Occupational medicine and new risks]. / La medicina del lavoro e i nuovi rischi.

Technological and socio-economic changes in the world of work are having a strong impact on the life of individuals and organizations. Individuals expect security, a feeling of belonging, and recognition; organizations constantly demand more flexibility, participation and productivity. Inside this growing gap we find today's new risks: they reflect at-risk work settings, where organizational "discomfort" is most likely to develop. Against this backdrop, dominated by a feeling of precariousness, workers have to re-visualize their jobs. This is a complicated and tiring process, as they have to demolish the old models they already have in their minds, so they can replace them with new, more appropriate ones. Occupational medicine has a role on two levels in this process. The first, close to the workers themselves, calls for the ability to understand the new risks, interpreting them in relation to the organizational settings. The second involves a path within the discipline, crossing over the first role but in the opposite direction to the usual one: from the dominant model of medicine by classification to reinstatement of the clinical dimension. This attributes importance to a research approach to problems, and calls for the construction of networks both within occupational medicine and between disciplines.

[Biosafety in laboratories concerning exposure to biological agents]. / La biosicurezza nei laboratori per gli esposti ad agenti biologici.

Laboratory workers are exposed to a variety of potential occupational health hazards including those deriving from infectious materials and cultures, radiations, toxic and flammable chemicals, as well as mechanical and electrical hazard. Although all of them are significant, this paper will focus on biological hazards present in clinical and research laboratories. In fact, in spite of numerous publications, guidelines and regulations, laboratory workers are still subject to infections acquired in the course of their researches. This paper describes some aspects that include good microbiological practices (GMPs), appropriate containment equipment, practices and operational procedures to minimize workers' risk of injury or illness.