Open data for assessing habitats degree of conservation at plot level. An example dataset of forest structural attributes in Val d'Agri (Basilicata, Southern Italy).

Forests supply multiple ecosystem services and host a large proportion of the Earth's terrestrial biodiversity. In particular, they provide habitats for many taxonomic groups which can be threatened by forest unsustainable management practices. Type and intensity of forest management are widely recognized as the main drivers of structure and functions in forests ecosystems. However, to better understand the impacts and the benefits deriving from forest management, there is a big need to standardize procedures of field data collection and data analysis. Here, we provide a georeferenced dataset of vertical and horizontal structure of forest types belonging to 4 habitat types, sensu Council Directive 92/43/EEC. The dataset includes structural indicators commonly linked to old-growth forests in Europe, in particular the amount of standing and lying deadwood. We collected data on 32 plots (24 of 225 m2, and 8 of 100 m2, according to different forests type) during spring and summer of 2022, in Val d'Agri (Basilicata, Southern Italy). The dataset we provide follows the common national standard for field data collection in forest habitat types, published by ISPRA in 2016 with the aim to promote a greater homogeneity in assessment of habitat conservation status at Country and biogeographical level, as requested by the Habitats Directive.

Impact of the environment on the health: From theory to practice.

The Erice 56 Charter titled "Impact of the environment on the health: from theory to practice" was unanimously approved at the end of the 56th course of the "International School of Epidemiology and Preventive Medicine G. D'Alessandro" held from 3rd to November 7, 2019 in Erice - Sicily (Italy) and promoted by the Study Group of "Environment and Health" of the Italian Society of Hygiene, Preventive Medicine and Public Health. The course, that included lectures, open discussions and guided working groups, was aimed to provide a general training on epidemiological and toxicological aspects of the environmental health impact, to be used by public health professionals for risk assessment, without forgetting the risk communications. At the end of the course 12 key points were agreed among teachers and students: they underlined the need of specific training and research, in the perspective of "One Health" and "Global Health", also facing emerging scientific and methodological issues and focusing on communication towards stakeholders. This Discussion highlight the need to improve knowledge of Health and Environment topic in all sectors of health and environmental prevention and management.

The effect of residual hydrocarbons in soil following oil spillages on the growth of Zea mays plants.

Liquid hydrocarbon pipeline accidents, including leaks due to the illegal or unauthorized collection of petroleum from oil pipelines, are a widespread phenomenon that can lead to pollution that may negatively affect soil quality and plant growth. The aim of this study is to evaluate hydrocarbon uptake and accumulation in Zea mays plants grown on soil affected by spills of fossil fuels. The experiments were conducted in microcosm, mesocosm and field tests. The potential transfer of contaminants from soil to plant and their effects on plant growth were investigated. The results from both the laboratory and field experiments showed that the plants grew better in the uncontaminated soil than in the soil polluted by hydrocarbons. Despite their significantly lower aerial biomass, plants grown in contaminated soil did not show any significant differences in C > 12 concentration, either in shoots or roots, compared to the control plants. Thus, the decrease in plant yield might not be attributed to hydrocarbons accumulation in the plant tissues and may rather be due to a reduced soil fertility, which negatively affected plant growth. Under our experimental conditions, the hydrocarbons present in the contaminated soil were not absorbed by the plants and did not accumulate in plant tissue or in grains, thus avoiding the risk of them entering the food chain.

Novel therapeutic strategies targeting telomere maintenance mechanisms in high-risk neuroblastoma.

The majority of high-risk neuroblastomas can be divided into three distinct molecular subgroups defined by the presence of MYCN amplification, upstream TERT rearrangements or alternative lengthening of telomeres (ALT). The common defining feature of all three subgroups is altered telomere maintenance; MYCN amplification and upstream TERT rearrangements drive high levels of telomerase expression whereas ALT is a telomerase independent telomere maintenance mechanism. As all three telomere maintenance mechanisms are independently associated with poor outcomes, the development of strategies to selectively target either telomerase expressing or ALT cells holds great promise as a therapeutic approach that is applicable to the majority of children with aggressive disease.Here we summarise the biology of telomere maintenance and the molecular drivers of aggressive neuroblastoma before describing the most promising therapeutic strategies to target both telomerase expressing and ALT cancers. For telomerase-expressing neuroblastoma the most promising targeted agent to date is 6-thio-2'-deoxyguanosine, however clinical development of this agent is required. In osteosarcoma cell lines with ALT, selective sensitivity to ATR inhibition has been reported. However, we present data showing that in fact ALT neuroblastoma cells are more resistant to the clinical ATR inhibitor AZD6738 compared to other neuroblastoma subtypes. More recently a number of additional candidate compounds have been shown to show selectivity for ALT cancers, such as Tetra-Pt (bpy), a compound targeting the telomeric G-quadruplex and pifithrin-α, a putative p53 inhibitor. Further pre-clinical evaluation of these compounds in neuroblastoma models is warranted.In summary, telomere maintenance targeting strategies offer a significant opportunity to develop effective new therapies, applicable to a large proportion of children with high-risk neuroblastoma. In parallel to clinical development, more pre-clinical research specifically for neuroblastoma is urgently needed, if we are to improve survival for this common poor outcome tumour of childhood.

State of the art: Vest Nile Virus circulation surveillance in Italy and transfusion risk early prevention methods.

After the Chikungunya outbreak in 2007 in Italy, a national Plan for the surveillance of human vector-borne diseases has been implemented and annually updated on the basis of the epidemiological changes based-evidences. The transfusion Authorities cooperates, since 2008, with public health services and veterinary (entomological and ornithological) surveillance systems. In some Italian regions, a common protocol for exchanging data is in place to identify the West Nile Virus (WNV) circulation in birds and mosquitoes: the goal is to anticipate the introduction of WNV-NAT screening in blood donors and, on the other hand, to limit testing only in geographic areas where the virus circulation is actual. The integration of surveillance activities and a multidisciplinary approach made it possible to introduce efficient and preventive measures for reducing the risk of of transmission of WNV trough blood, tissues and organ donation.

Mediating factors of a school-based multi-component smoking prevention intervention: the LdP cluster randomized controlled trial.

The aim of this study was to investigate factors mediating the effects of Luoghi di Prevenzione (LdP) smoking prevention intervention based on social competence and social influence approaches, and characterized by peer-led school-based interventions, out-of-school workshops, school lessons, and by enforcing the school anti-smoking policy. Students aged 14-15 years in 13 secondary schools in Reggio Emilia, Italy (989 students) were randomly assigned to the LdP intervention or a control condition. The baseline and follow-up surveys were carried out before and 18 months after the intervention, respectively.The outcomes were cigarette daily and frequent smoking and smoking at school. Multilevel multiple mediation analyses were carried out in order to study effect mediation. The mediators were normative perception, positive and negative beliefs, refusal skills for smoking, social acceptability perception, risk perception, smoking knowledge and awareness about dangers of second-hand smoking.The intervention effects were explained by the social influence component through the mediator refusal skills for smoking. The programme also showed to significantly increase risk perception and smoking knowledge, even though these mediators had no effect on smoking. Moreover, LdP intervention directly reduced smoking in school areas. Future interventions should maintain and strengthen the LdP social influence component and the part regarding the school anti-smoking policy.

Laparoscopic ultrasound: a surgical "must" for second line intra-operative evaluation of pancreatic cancer resectability.

BACKGROUND: Advanced laparoscopy for pancreatic cancer surgery should include laparoscopic ultrasound (LUS), in order to accurately evaluate resectability and rule out the presence of undetected metastases and/or vascular infiltration. LUS should be done as a preliminary step whenever pre-operative imaging casts doubts on resectability. PATIENTS AND METHODS: We hereby report our experience of 18 consecutive patients, aged 43-76, coming to our attention during a six months period (Jan-Jun 2013), with a diagnosis of pancreas head or body cancer. RESULTS: LUS allowed to rule out undetected metastases or mesenteric vessels infiltration in 11 patients (61.1%), who were submitted, as previously scheduled, to radical duodeno-pancreatectomy (9 cases) and spleno-caudal pancreatectomy (2 cases). Among the remaining patients, three had been correctly evaluated as non resectable radically at pre-operative work out, and confirmed at LUS, while LUS detected non resectable disease in further 4 patients (22.2%), who underwent palliative procedures. In 2 patients of this group liver micro-metastases were found, while 2 were excluded because of mesenteric vessels infiltration. CONCLUSIONS: LUS provided a higher level of diagnostic accuracy, allowing in our experience to exclude 4 patients from radical surgery (22.2%). The evaluation of surgical resectability is an issue of crucial importance to decide surgical strategy in pancreas tumor surgery. In our opinion LUS should be considered a mandatory step in laparoscopic approach to pancreatic tumors, to better define disease staging and evaluate resectability.

Exposure to emissions from municipal solid waste incinerators and miscarriages: a multisite study of the MONITER Project.

BACKGROUND: Miscarriages are an important indicator of reproductive health but only few studies have analyzed their association with exposure to emissions from municipal solid waste incinerators. This study analyzed the occurrence of miscarriages in women aged 15-49years residing near seven incinerators of the Emilia-Romagna Region (Northern Italy) in the period 2002-2006. METHODS: We considered all pregnancies occurring in women residing during the first trimester of pregnancy within a 4km radius of each incinerator. Addresses were geocoded and exposures were characterized by a dispersion model (ADMS Urban model) producing pollution maps for incinerators based on PM10 stack measurements and for other pollution sources based on NOx ground measurements. Information on pregnancies and their outcomes was obtained from the Hospital Discharge Database. Simplified True Abortion Risks (STAR)×100 estimated pregnancies were calculated. We ran logistic regressions adjusting for maternal characteristics, exposure to other sources of pollution, and sites, considering the whole population and stratifying by miscarriage history. RESULTS: The study analyzed 11,875 pregnancies with 1375 miscarriages. After adjusting for confounders, an increase of PM10 due to incinerator emissions was associated with an increased risk of miscarriage (test for trend, p=0.042). The odds ratio for the highest quartile of exposed versus not exposed women was 1.29, 95% CI 0.97-1.72. The effect was present only for women without previous miscarriages (highest quartile of exposed versus not exposed women 1.44, 95% CI 1.06-1.96; test for trend, p=0.009). CONCLUSION: Exposure to incinerator emissions is associated with an increased risk of miscarriage. This result should be interpreted with those of a previous study on reproductive health conducted in the same area that observed an association between incinerator exposure and preterm births.

Human and entomological surveillance of Toscana virus in the Emilia-Romagna region, Italy, 2010 to 2012.

Toscana virus (TOSV), transmitted by phlebotomine sandflies, is recognised as one of the most important causes of viral meningitis in summer in Mediterranean countries. A surveillance plan based on both human and entomological surveys was started in 2010 in the Emilia-Romagna region, Italy. Clinical samples from patients with neurological manifestations were collected during 2010 to 2012. The surveillance protocol was improved during these years, allowing the detection of 65 human infections. Most of these infections were recorded in hilly areas, where sandflies reach the highest density. Entomological sampling around the homes of the patients resulted in a low number of captured sandflies, while later sampling in a hilly area with high number of human cases (n=21) resulted in a larger number of captured sandflies. Using this approach, 25,653 sandflies were sampled, of which there were 21,157 females, which were sorted into 287 pools. TOSV RNA was detected by real-time PCR in 33 of the pools. The results highlighted the role of Phlebotomus perfiliewi as the main vector of TOSV and a potential link between vector density and virus circulation. This integrated system shows that an interdisciplinary approach improves the sensitiveness and effectiveness of health surveillance.

The experience of West Nile virus integrated surveillance system in the Emilia-Romagna region: five years of implementation, Italy, 2009 to 2013.

Predicting West Nile virus (WNV) circulation and the risk of WNV epidemics is difficult due to complex interactions of multiple factors involved. Surveillance systems that timely detect virus activity in targeted areas, and allow evidence-based risk assessments may therefore be necessary. Since 2009, a system integrating environmental (mosquitoes and birds) and human surveillance has been implemented and progressively improved in the Emilia-Romagna region, Italy. The objective is to increase knowledge of WNV circulation and to reduce the probability of virus transmission via blood, tissue and organ donation. As of 2013, the system has shown highly satisfactory results in terms of early detection capacity (the environmental surveillance component allowed detection of WNV circulation 3­4 weeks before human cases of West Nile neuroinvasive disease (WNND) occurred), sensitivity (capacity to detect virus circulation even at the enzootic level) and area specificity (capacity to indicate the spatial distribution of the risk for WNND). Strong correlations were observed between the vector index values and the number of human WNND cases registered at the province level. Taking into consideration two scenarios of surveillance, the first with environmental surveillance and the second without, the total costs for the period from 2009 to 2013 were reduced when environmental surveillance was considered (EUR 2.093 million for the first scenario vs EUR 2.560 million for the second). Environmental surveillance helped to reduce costs by enabling a more targeted blood unit testing strategy. The inclusion of environmental surveillance also increased the efficiency of detecting infected blood units and further allowed evidence-based adoption of preventative public health measures.

A practical approach for the detection of DNA nanostructures in single live human cells by fluorescence microscopy.

In the last decade, in vivo studies have revealed that even subtle differences in size, concentration of components, cell cycle stage, make the cells in a population respond differently to the same stimulus. In order to characterize such complexity of behavior and shed more light on the functioning and communication amongst cells, researchers are developing strategies to study single live cells in a population. In this paper, we describe the methods to design and prepare DNA-based fluorescent tetrahedral nanostructures, to deliver them to live cells and characterize such cells with epifluorescence microscopy. We report that HeLa cells internalize these nanostructures spontaneously with a higher efficiency with respect to single-stranded or double-stranded oligonucleotides. Our findings suggest that DNA tetrahedra could serve as a platform for the realization of a series of multifunctional intracellular biosensors for the analysis of single live cells.

Aedes albopictus (Diptera: Culicidae) population size survey in the 2007 chikungunya outbreak area in Italy. II: Estimating epidemic thresholds.

Our study compared different estimates of adult mosquito abundance (Pupal Demographic Survey [PDS], Human Landing Collection [HLC], Number of Bites declared by Citizens during interviews [NBC]) to the mean number of eggs laid in ovitraps. We then calculated a disease risk threshold in terms of number of eggs per ovitrap above which an arbovirus epidemic may occur. The study was conducted during the summers of 2007 and 2008 in the Emilia-Romagna region of Italy where a chikungunya epidemic occurred in 2007. Ovitrap monitoring lasted from May to September, while adult sampling by means of PDS, HLC, and NBC was repeated three times each summer. Based on calculated rate of increase of the disease (R(0)) and the number of bites per human per day measured during the outbreak, we estimated that only 10.1% of the females transmitted the chikungunya virus in the principal focus. Under our conditions, we demonstrated that a positive correlation can be found between the females' density estimated by means of PDS, HLC, and NBC and the mean number of eggs in the ovitraps. We tested our hypothesis during the 2007 secondary outbreak of CHIKV in Cervia, and found that R(0) calculated based on the number of biting females estimated from the egg density was comparable to the R(0) calculated based on the progression of the human cases. The identification of an epidemic threshold based on the mean egg density may define the high risk areas and focus control programs.

Radiation doses to the population of the Emilia-Romagna region from medical exposures.

PURPOSE: The aim of this study was to supplement the analysis of data related to conventional radiography (CR), computed tomography (CT) and nuclear medicine (NM) with those related to interventional radiology (IR), and illustrate the contribution of all these radiological procedures to radiation exposure of the Emilia-Romagna population in Italy. MATERIALS AND METHODS: We gathered information about the number and mean doses of 30 interventional procedures performed in 17 hospitals of the Emilia-Romagna region. Seven hospitals were selected, and requests were made for numerical values of the dose-area product (DAP) in various IR procedures measured in the field. From these values, we calculated the 2006 annual collective effective dose (S), per-procedure dose and total dose, as well as the average per-capita dose to the Emilia-Romagna population. RESULTS: The 20 procedures amongst CR, CT, NM and IR that in 2006 contributed the most to Emilia-Romagna population radiation dose are described in detail: CR, CT, NM and IR contribute to approximately 10%, 66%, 9% and 15% of the total dose, and to 70%, 21%, 3% and 6% of procedure frequency, respectively. The S and average per-capita doses were 5,237 person-Sv and 1.2 mSv, respectively. CONCLUSIONS: IR procedures deliver high doses to the patient. Therefore, the same attention should be paid to radiation protection as with other high-dose examinations. As IR operators are often not radiologists, special attention should be paid to education in radiation protection of the professionals involved.

Imported cases of dengue virus infection: Emilia-Romagna, Italy, 2010.

Dengue is a significant mosquito-borne infection in humans, and its worldwide prevalence is rapidly increasing. In 2010, 83 serum samples from febrile travellers returning from dengue-endemic countries to a region in north-eastern Italy, densely infested with Aedes albopictus, were analysed for dengue virus (DENV). DENV RNA was detected in 20.5% of patients. By RT-PCR, DENV serotypes 1 and 3 were the most common. DENV must be identified early in symptomatic travellers returning from high-risk countries, to prevent outbreaks where potential vectors exist.

Aedes albopictus (Diptera: Culicidae) population size survey in the 2007 Chikungunya outbreak area in Italy. I. Characterization of breeding sites and evaluation of sampling methodologies.

The population of Aedes albopictus (Skuse) (Diptera: Culicidae) was measured in four towns in northern Italy by means of Stegomyia indices (house index: percentage of houses with at least one active breeding site; container index: percentage of containers with larvae; and Breteau index: number of active breeding sites per premises), pupae per premises index (PPI), pupae per hectare index (PHI), and ovitrap monitoring. A detailed investigation on types and number of productive or potential larval habitats in the inspected premises was performed. Catch basins were the most productive breeding sites in both private and public areas. The influence of the premises maintenance and premises shading indices (PMI and PSI) on the population indices and the correlations between the latter and egg density were assessed. The highest PPI was found in badly maintained premises, most times combined with shady coverage. Stegomyia indices and PPI were well correlated with each other, but not with the PHI, which also included the pupae collected in public areas. We obtained a highly positive correlation (R = 0.86) between the PHI and weekly mean egg density estimated 7-14 d after inspection of the premises. The number of females per hectare, calculated using the Focks model, was correlated with the mean egg density of the week after sampling (R = 0.79), and we propose that ovitrap monitoring can be used to evaluate the efficiency of the control activities or to determine a mean egg density threshold for epidemic risk evaluation.

West Nile virus circulation in Emilia-Romagna, Italy: the integrated surveillance system 2009.

Following a large West Nile virus (WNV) epidemic in northeastern Italy in 2008, human and animal surveillance activities were implemented in Emilia Romagna. Human surveillance was performed by serology or genome detection on blood and cerebrospinal fluid for all suspected cases suffering from acute meningoencephalitis in the regional territory. Animal surveillance consisted of passive and active surveillance of horses and active surveillance of wild birds and mosquitoes. Between 15 June and 31 October 2009, nine of 78 possible cases of West Nile neuroinvasive disease were confirmed (three fatal). From May to October, 26 cases of neurological West Nile disease were confirmed among 46 horses. The overall incidence of seroconversion among horses in 2009 was 13%. In 2009, 44 of 1,218 wild birds yielded positive PCR results for WNV infection. The planned veterinary and entomological surveillance actions detected WNV activity from the end of July 2009, about 2-3 weeks before the onset of the first human neurological case. Passive surveillance of horses seems to be an early and suitable tool for the detection of WNV activity, but it will be less sensitive in the future, because an intensive programme of horse vaccination started in June 2009.

Temporal trend of diagnostic medical exposure to the Emilia-Romagna region population.

PURPOSE: This paper illustrates the annual trends in medical radiation exposure due to conventional radiography (CR), computed tomography (CT) and nuclear medicine (NM) procedures of the Emilia-Romagna population from 2001 to 2006. MATERIALS AND METHODS: We gathered information about the type, number and mean doses of CR, CT, and NM examinations performed in 17 hospitals of the Emilia-Romagna region. In particular, numerical values of the following dosimetric parameters were requested: entrance skin dose for CR, CT dose index and dose-length product for CT and activity administered for NM. Lastly, the annual collective dose S and annual average per-caput dose were calculated. RESULTS: The 13 diagnostic imaging procedures that were the greatest contributors to the Emilia-Romagna population dose between 2001 and 2006 were identified and, for the year 2006, their percentage contribution to total procedures and population dose are indicated. CR, CT and NM accounted for 12%, 78% and 10% of the dose, and 83%, 15% and 2% of total procedures, respectively. The annual trends of S and average per capita dose are shown, and the theory underlying the use of these parameters is briefly discussed. CONCLUSIONS: This type of study relies heavily on the analysis of field data and as such, the growing attention paid in recent years to procedure optimisation should continue, and expand even for the justification of the procedures themselves as justification has a significant impact on the reduction of S and per-caput doses.

Knowledge, attitudes and practices survey after an outbreak of chikungunya infections.

In 2007, the first chikungunya outbreak ever occurring in a temperate area of the Northern Hemisphere was reported in Emilia-Romagna, Italy. The present study aims to evaluate knowledge, attitudes and practices regarding chikungunya infection. Information was collected by standardised telephone questionnaire, administered to 325 people during a seroprevalence survey performed in the outbreak area. Most people (61%) knew that Chikungunya virus is transmitted through mosquito bites. A significant proportion of respondents perceived chikungunya infection as a high-risk disease (49.8%) and declared their intention to use mosquito repellents in the future (47.4%). Willingness to use skin repellents was more often declared by women, residents in households with children and people who knew infection transmission routes, while perception of high risk related to Chikungunya did not influence claimed future behaviour. Knowledge of the mechanisms of infection transmission was inversely related to risk perception: elderly people were less likely to know the disease than young people, but ranked the risk highest compared to younger age groups. Less educated residents were much more likely to perceive a high risk. After a chikungunya infection outbreak in a temperate area, where mosquito-borne infections have not been previously reported, only half of the study participants declared their intention to use individual protection in the future. Anticipated behaviour was not explained by the level of risk perception, but was associated with knowledge of the disease and demographic characteristics.

Inhibitors of HSP90 block p95-HER2 signaling in Trastuzumab-resistant tumors and suppress their growth.

The anti-HER2 antibody Trastuzumab (Herceptin) has been proven to be effective in the treatment of HER2-overexpressing breast cancer; resistance, however, invariably emerges in metastatic tumors. The expression of p95-HER2, a form of HER2 with a truncated extracellular domain that lacks the Trastuzumab binding epitope, has been implicated as a mechanism of resistance to the antibody. We utilized an in vivo tumor model that overexpresses p95-HER2 and showed it to be resistant to the signaling and antitumor effects of Trastuzumab. We find that both full-length and p95-HER2 interact with the HSP90 chaperone protein and are degraded in tumor cells exposed to HSP90 inhibitors in tissue culture and in vivo. Loss of expression of p95-HER2 is accompanied by downregulation of the phosphoinositide-3 kinase/AKT and extracellular signal-regulated kinase signaling pathways and inhibition of cell proliferation. Chronic administration of HSP90 inhibitors in vivo results in sustained loss of HER2 and p95-HER2 expression and inhibition of AKT activation, together with induction of apoptosis and complete inhibition of tumor growth in Trastuzumab-resistant, p95-HER2-overexpressing models. Thus, p95-HER2 is an HSP90 client protein, the expression and function of which can be effectively suppressed in vivo by HSP90 inhibitors. HSP90 inhibition is therefore a potentially effective therapeutic strategy for p95-HER2-mediated Trastuzumab-resistant breast cancer.

Long-term follow-up of neuroblastoma-associated opsoclonus-myoclonus-ataxia syndrome.

OBJECTIVE: The aim of this study is to describe the long-term neurological, neuropsychological and neuroradiological sequelae and to determine prognostic factors for neurological outcome in children with neuroblastoma-associated opsoclonus-myoclonus-ataxia (OMA) syndrome. METHODS: Data on medical history were collected for the study patients. Examinations with grading of neurological signs, neuropsychological tests and brain magnetic resonance imaging with spectroscopy were performed during a follow-up clinic. RESULTS: Fourteen subjects entered the study. All had localized neuroblastoma and they were evaluated after a median of 7.8 years. Patients with a chronic/multiphasic neurological course received steroids combined with intravenous immunoglobulins in the majority of cases. 71% presented neurological sequelae and 62% had a full-scale IQ below the normal range. All patients showed at least some deficit in the neuropsychological functions assessed (language, visual-motor integration, memory, attention and motor ability). Long-term deficits were more frequently detected in patients with an interval of more than 2 months between OMA onset and its diagnosis, even if in most comparisons statistical significance was not reached. Cerebellar atrophy, observed in 36% of patients, was not associated with the neurological outcome. CONCLUSIONS: Persisting disability is present in most children with neuroblastoma-associated OMA. However, our results support the role of an early diagnosis of OMA in reducing sequelae and encourage the use of new immunosuppressive therapies.