Abitudini, stili di vita e socialità: una cluster analysis di studenti universitari italiani.

The analysis of health determinants in the student population can be useful in raising awareness on safe living conditions in new generations. The selection of specific biomedical markers, like advanced glycation end products (AGEs), and the analysis of social behaviors can support lifestyle choices evaluation. A questionnaire, containing an anamnestic section, a physical activity evaluation section, and a sociological section, was administered to a total of 110 students from two Italian universities, selected from the Faculty of Science of Movement and from the Faculty of Medicine. In addition, all subjects recruited in this study underwent to an AGEs accumulation assessment through skin autofluorescence. A non-hierarchical cluster analysis was performed on the collected data allowed the identification of two group of students: group 1 mainly consisted of male subjects from the Faculty of Science of Movement, characterized by an active lifestyle and a rather detached affective family condition; group 2 largely consisted of female subjects from the Faculty of Medicine, more sedentary and with stable relationships. The data analysis confirmed the correlation between low AGEs levels and healthy lifestyles, but at the same time underlined divergences between students from different Faculties.

A semi-automated protocol for NGS metabarcoding and fungal analysis in forensic.

Metabarcoding through Next Generation Sequencing (NGS) has revolutionized environmental biological studies. The availability of this technical approach has opened the opportunity for a systematic implementation of fungal metabarcoding analysis in forensics, where standardized, sensitive and reproducible protocols are highly desirable. In the present paper, a pipeline including a semi-automated molecular protocol and user-friendly bioinformatics tools are applied to several kinds of environmental samples and forensic caseworks. The identification of fungi that characterize specific environments (like Aspergillus for indoor walls, or Penicillium, Debaryomices and Wickerhamomyces for food storage) can be informative for the provenance of samples. In some situations, fungal analysis cannot allow the identification of a defined environment but seems useful to cluster samples with similar provenance. Based on these considerations, fungal analysis can be included in a wider process of non-human DNA identification in order to provide clues on sample provenance.

Improvement and automation of a real-time PCR assay for vaginal fluids.

The identification of vaginal fluids is crucial in forensic science. Several molecular protocols based on PCR amplification of mfDNA (microflora DNA) specific for vaginal bacteria are now available. Unfortunately mfDNA extraction and PCR reactions require manual optimization of several steps. The aim of present study was the verification of a partial automatization of vaginal fluids identification through two instruments widely diffused in forensic laboratories: EZ1 Advanced robot and Rotor Gene Q 5Plex HRM. Moreover, taking advantage of 5-plex thermocycler technology, the ForFluid kit performances were improved by expanding the mfDNA characterization panel with a new bacterial target for vaginal fluids and with an internal positive control (IPC) to monitor PCR inhibition. Results underlined the feasibility of a semi-automated extraction of mfDNA using a BioRobot and demonstrated the analytical improvements of the kit.

Safety of sports facilities and training of graduates in physical education.

INTRODUCTION: Post-industrial societies have to face the problem of physical inactivity and inappropriate lifestyles. Programs to promote physical activity are strongly supported by supranational, national and local institutions and organizations. These programs can be developed in sport facilities but also in places that are not institutionally dedicated to sport. The use of urban and working sites has the advantage of better reach the various segments of the population, but at the same time requires coordination between various professionals in structuring an effective intervention. METHODS: Bibliographical research in the historical archives of the library of the University of Rome Foro Italico, online databases, paleoigiene (wikigiene), documents archives (GSMS-SItI, WHO, ISS, OsEPi, INAIL, ISTAT, national laws). RESULTS AND CONCLUSION: Several guidelines and regulations face the problem of safety in sport environments. The context is in rapid evolution and directions are provided by public health authorities. Graduates in Sport and Physical Activity, represent an additional resource in terms of: prevention and safety in the workplace, health education, application of preventive and adapted physical activities in the territory. These tasks can be integrated in all prevention stages: e.g. childhood and primary prevention programs in school, adapted physical activity for the elderly. The contribution of public health specialists is strategic in the surveillance and coordination of integrated projects. At the same time, graduates in Physical Education appear to be pivots for health promotion and qualified resources for institutions in the territory. Their training should always include contents related to prevention and safety, regulations on sport and working environments, along with bases of preventive medicine related to the context of physical activity.

The environmental biological signature: NGS profiling for forensic comparison of soils.

The identification of the source of a specific soil sample is a crucial step in forensic investigations. Rapid advances in next generation sequencing (NGS) technology and the strong reduction of the cost of sequencing have recently opened new perspectives. In the present work a metabarcoding approach has been successfully applied to forensic and environmental soil samples, allowing the accurate and sensitive analysis of microflora (mfDNA), plants, metazoa, and protozoa DNA. The identification of the biological component by DNA metabarcoding is a strong element for the discrimination of samples geologically very similar but coming for distinct environments.

Improving long-term prediction of first cardiovascular event: the contribution of family history of coronary heart disease and social status.

OBJECTIVE: The aim of this study is to assess whether family history of coronary heart disease (CHD) and education as proxy of social status improve long-term cardiovascular disease risk prediction in a low-incidence European population. METHODS: The 20-year risk of first coronary or ischemic stroke events was estimated using sex-specific Cox models in 3956 participants of three population-based surveys in northern Italy, aged 35-69 years and free of cardiovascular disease at enrollment. The additional contribution of education and positive family history of CHD was defined as change in discrimination and Net Reclassification Improvement (NRI) over the model including 7 traditional risk factors. RESULTS: Kaplan-Meier 20-year risk was 16.8% in men (254 events) and 6.4% in women (102 events). Low education (hazard ratio=1.35, 95%CI 0.98-1.85) and family history of CHD (1.55; 1.19-2.03) were associated with the endpoint in men, but not in women. In men, the addition of education and family history significantly improved discrimination by 1%; NRI was 6% (95%CI: 0.2%-15.2%), raising to 20% (0.5%-44%) in those at intermediate risk. NRI in women at intermediate risk was 7%. CONCLUSION: In low-incidence populations, family history of CHD and education, easily assessed in clinical practice, should be included in long-term cardiovascular disease risk scores, at least in men.

[Comparison of cultural methods for the recovery of Pseudomonas aeruginosa: the UNI EN ISO 16266 reference method and the alternative method Pseudalert®]. / Confronto di metodi colturali per il rilevamento di Pseudomonas aeruginosa: il metodo di riferimento UNI EN ISO 16266 e il metodo alternativo Pseudalert®.

BACKGROUND: For the water analysis, for Pseudomonas aeruginosa a presumptive positive result can be achieved in 40- 48 hours using the traditional membrane filtration technique followed by an additional 24-48 hour confirmation stage. Conversely, the Pseudalert Quanti-Tray™ method can give confirmed results after 24-28 hours. In this case, actively growing strains of Pseudomonas aeruginosa show a confirmed positive result when a specific enzyme cleaving the substrate in the reagent produces a blue fluorescence under 365 nm ultraviolet light. A comparison of the performance of the Pseudalert respect to the standard method was conducted using statistical methods. METHODS: Drinking water was analyzed in parallel with the membrane filtration technique using Pseudomonas CN agar (UNI EN ISO 16266) and the Pseudalert. Confirmation test are requested by the standard method and although Pseudalert Quanti-Tray™ gives confirmed results, all the positive isolates were also confirmed. Data were analyzed by statistical methods. RESULTS: For drinking water, Pseudalert showed a very high sensitivity (98,8%) and a high percentage of specificity (96,8%). From a total of 889 positive isolates, a very high confirmation rates (99,3%) was calculated. Statistical analyses confirmed that the two methods were not statistically different. CONCLUSIONS: These results indicate that the Pseudalert produces confirmed results in a shorter time than the standard reference method allowing the detection of Pseudomonas aeruginosa with no further confirmation steps. It could be a valid alternative method for the water analysis.

The municipal waste management: a comparison between Germany and Italy.

BACKGROUND: In the European scenario Municipal Waste Management (MWM) is very heterogeneous, and many countries did not achieve yet the decoupling between economic growth and MW production. The objectives of the study were to evaluate temporal trends of MWM and economic indicators to evidence differences between Germany and Italy, and to assess the relationship between economic indicators and MW production, to highlight whenever decoupling was achieved. METHODS: Time series analyses (1995-2010) of data related to MWM and income/consumption indicators were performed, and simple regression analyses were run to evaluate the relationship between economic drivers and MW production. RESULTS: Income/consumption indicators show a constant increment in both countries, while different trends appear for MWM. German MW production was reduced, and, over the years, the main disposal method rose from landfill towards recycling. On the contrary, Italian MW production increased, and landfilling has been always the most common method for disposal waste. Besides, the percentage of MW collected separately and packaging recovered was higher in Germany than in Italy for all the investigated period. Moreover, Germany appears to have decoupled MW production from economic growth, while Italian MW production is significant positively associated to it. CONCLUSIONS: Germany emerges as a virtuous country, while Italy appears as the "example not to follow". Differences could be determined by the contribution of several factors, such as educational levels, urbanization, population characteristics, employment/unemployment rates, expenditure in research and health issues, that should be studied indeed.

Excess dietary sodium and inadequate potassium intake in Italy: results of the MINISAL study.

OBJECTIVE: As excess sodium and inadequate potassium intake are causally related to hypertension and cardiovascular disease, the MINISAL-GIRCSI Program aimed to provide reliable estimates of dietary sodium and potassium intake in representative samples of the Italian population. DESIGN AND METHODS: Random samples of adult population were collected from 12 Italian regions, including 1168 men and 1112 women aged 35-79 yrs. Electrolyte intake was estimated from 24 hour urine collections and creatinine was measured to estimate the accuracy of the collection. Anthropometric indices were measured with standardised procedures. RESULTS: The average sodium excretion was 189 mmol (or 10.9 g of salt/day) among men and 147 mmol (or 8.5 g) among women (range 27-472 and 36-471 mmol, respectively). Ninety-seven % of men and 87% of women had a consumption higher than the WHO recommended target of 5g/day. The 24 h average potassium excretion was 63 and 55 mmol, respectively (range 17-171 and 20-126 mmol), 96% of men and 99% of women having an intake lower than 100 mmol/day (European and American guideline recommendation). The mean sodium/potassium ratio was 3.1 and 2.8 respectively, i.e. over threefold greater than the desirable level of 0.85. The highest sodium intake was observed in Southern regions. Sodium and potassium excretion were both progressively higher the higher the BMI (p < 0.0001). CONCLUSIONS: These MINISAL preliminary results indicate that in all the Italian regions thus far surveyed dietary sodium intake was largely higher and potassium intake lower than the recommended intakes. They also highlight the critical association between overweight and excess salt intake.

The SNPs in the human genetic blueprint era.

The analysis of human genetic variability can lead to the comprehension of medical issues and to the development of personalized therapeutic protocols. Single nucleotide polymorphisms, are the most common type of human genetic variation and have been associated to disease development and phenotype forecasting. The recent technologies for DNA sequencing and bioinformatic analysis are now giving the opportunity to develop new diagnostic and prevention approaches also through health promotion protocols. The genetic data management is at the same time underlining technical limitations and old ethical issues.

Molecular enrichment for detection of S. aureus in recreational waters.

The identification of rapid methods for the control of recreational water and of aquatic environments with similar characteristics is necessary to provide adequate levels of health safety for users. Molecular techniques have been proposed in recent years as a viable alternative to traditional microbiological methods, as they offer various advantages and are less time consuming than traditional tests. An innovative protocol based on molecular enrichment that allows the identification of low concentrations of Staphylococcus aureus in recreational water has been developed. The method is based on the specific amplification of prokaryotic genomic DNA by the usage of universal primers for 23S rDNA; subsequently, a second amplification step is performed with specific real-time polymerase chain reaction (PCR) primers and probe. This approach shows sensitivity levels similar to those observed with microbiological tests, with the additional benefits of the specificity typical of nucleic acids techniques. This methodology is easily applicable also to other microbiological parameters, representing an important milestone in hygiene monitoring by the detection of specific pollution indicators.

Population based strategy for dietary salt intake reduction: Italian initiatives in the European framework.

Excess dietary sodium chloride (salt) intake is etiologically related to hypertension and cardiovascular disease (CVD). Moderate reduction of salt intake reduces blood pressure (BP) and is expected to contribute to reduce the risk of CVD. Previous community-based trials to reduce BP by means of salt reduction were very successful. The initial positive results of national strategies of dietary salt intake reduction in several European countries, driven by the initiative of the World Health Organisation (WHO) and non-governmental organisations such as the World Action of Salt and Health (WASH), have paved the way for action in other European Union (EU) member states. In Italy, several initiatives aiming at reduction of salt intake at the population level have been recently undertaken. These initiatives include i) the evaluation of current dietary habits promoted by the Working Group for Dietary Salt Reduction in Italy (GIRCSI); ii) the chemical analysis of the bread salt content, a major source of sodium intake in Italy, and the agreement between the bakers' associations and the Ministry of Health for a gradual reduction of the bread salt content; iii) the implementation of educational campaigns to increase population awareness, iv) the involvement of the food catering system. In the immediate future, food reformulation must be extended to other food categories in collaboration with industry, foods' salt targets ought to be defined, the food labelling system must be improved and population salt awareness must be further increased through educational campaigns. The GIRCSI Working Group is committed to pursue these objectives.

[Nature-like swimming ponds and bathing: public health issues for congruous guidelines]. / Biopiscine e balneazione: considerazioni igienico sanitarie per lo sviluppo di adeguate linee guida.

Nature-like swimming ponds represent an emerging approach to recreational waters. The substitution of traditional disinfection with biodepuration enhances environmental sustainability, but implies relevant public health issues. No European regulations are available while several countries delivered local guidelines. Appropriate microbiological analysis, user education, and correct water management based on HACCP approach, represent key points for the development of future guidelines.

The Italian register of cardiovascular diseases: attack rates and case fatality for cerebrovascular events.

BACKGROUND: The Italian register of cardiovascular diseases is a surveillance system of fatal and nonfatal cardiovascular events in the general population aged 35-74 years. It was launched in Italy at the end of the 1990 s with the aim of estimating periodically the occurrence and case fatality rate of coronary and cerebrovascular events in the different geographical areas of the country. This paper presents data for cerebrovascular events. METHODS: Current events were assessed through record linkage between two sources of information: death certificates and hospital discharge diagnosis records. Events were identified through the ICD codes and duration. To calculate the number of estimated events, current events were multiplied by the positive predictive value of each specific mortality or discharge code derived from the validation of a sample of suspected events. Attack rates were calculated by dividing estimated events by resident population, and case fatality rate at 28 days was determined from the ratio of estimated fatal to total events. RESULTS: Attack rates were found to be higher in men than in women: mean age-standardized attack rate was 21.9/10,000 in men and 12.5/10,000 in women; age-standardized 28-day case fatality rate was higher in women (17.1%) than in men (14.5%). Significant geographical differences were found in attack rates of both men and women. Case fatality was significantly heterogeneous in both men and women. CONCLUSIONS: Differences still exist in the geographical distribution of attack and case fatality rates of cerebrovascular events, regardless of the north-south gradient. These data show the feasibility of implementing a population-based register using a validated routine database, necessary for monitoring cardiovascular diseases.

The Emerging Risk Factors Collaboration: analysis of individual data on lipid, inflammatory and other markers in over 1.1 million participants in 104 prospective studies of cardiovascular diseases.

Many long-term prospective studies have reported on associations of cardiovascular diseases with circulating lipid markers and/or inflammatory markers. Studies have not, however, generally been designed to provide reliable estimates under different circumstances and to correct for within-person variability. The Emerging Risk Factors Collaboration has established a central database on over 1.1 million participants from 104 prospective population-based studies, in which subsets have information on lipid and inflammatory markers, other characteristics, as well as major cardiovascular morbidity and cause-specific mortality. Information on repeat measurements on relevant characteristics has been collected in approximately 340,000 participants to enable estimation of and correction for within-person variability. Re-analysis of individual data will yield up to approximately 69,000 incident fatal or nonfatal first ever major cardiovascular outcomes recorded during about 11.7 million person years at risk. The primary analyses will involve age-specific regression models in people without known baseline cardiovascular disease in relation to fatal or nonfatal first ever coronary heart disease outcomes. This initiative will characterize more precisely and in greater detail than has previously been possible the shape and strength of the age- and sex-specific associations of several lipid and inflammatory markers with incident coronary heart disease outcomes (and, secondarily, with other incident cardiovascular outcomes) under a wide range of circumstances. It will, therefore, help to determine to what extent such associations are independent from possible confounding factors and to what extent such markers (separately and in combination) provide incremental predictive value.

Decline in cognitive functioning is associated with a higher mortality risk.

OBJECTIVE: This study investigates the association between 5-year change in cognitive functioning and subsequent mortality. METHODS: Four hundred and ninety-three Dutch and Italian men from the Finland, Italy, and the Netherlands Elderly (FINE) Study, born between 1900 and 1920, participated in the present study between 1990 and 2000. Cognitive functioning was measured with the Mini-Mental State Examination in 1990 and 1995, and mortality data were obtained until the year 2000. A proportional hazard analysis was used to investigate the association between 5-year change in cognitive functioning and subsequent 5-year mortality. Adjustments were made for age, education, country, lifestyle factors, prevalence of chronic diseases and, additionally, for baseline cognitive functioning. RESULTS: Men whose cognition decreased (more than 1 standard deviation) between 1990 and 1995 had a 2-fold higher risk of dying in the following 5 years compared with men whose cognition was stable (adjusted hazard ratio=1.9; 95% confidence interval 1.3-2.7). Mortality risk of men whose cognition improved between 1995 and 2000 was not different from men whose cognition was stable (adjusted hazard ratio=1.1, 95% confidence interval 0.7-1.9). CONCLUSION: A decline in cognitive functioning is associated with a higher mortality risk.

Coffee consumption is inversely associated with cognitive decline in elderly European men: the FINE Study.

OBJECTIVE: To investigate whether coffee consumption is associated with 10-year cognitive decline in elderly men, as results of previous studies obtained hitherto have been controversial and prospective information on this association has been lacking. DESIGN, SUBJECTS AND SETTING: Six hundred and seventy six healthy men born between 1900 and 1920 from Finland, Italy and the Netherlands participated in a 10-year prospective cohort study. Cognitive functioning was assessed using the Mini-Mental State Examination (0-30 points, with a higher score indicating better cognitive performance). Coffee consumption was estimated in cups per day. A mixed longitudinal model was used to investigate the association between baseline coffee consumption and 10-year cognitive decline. Multiple adjustments were made. RESULTS: Men who consumed coffee had a 10-year cognitive decline of 1.2 points (4%). Non-consumers had an additional decline of 1.4 points (P<0.001). An inverse and J-shaped association was observed between the number of cups of coffee consumed and cognitive decline, with the least cognitive decline for three cups of coffee per day (0.6 points). This decline was 4.3 times smaller than the decline of non-consumers (P<0.001). CONCLUSIONS: Findings suggest that consuming coffee reduces cognitive decline in elderly men. An inverse and J-shaped association may exist between the number of cups of coffee consumed and cognitive decline, with the least cognitive decline for men consuming three cups of coffee per day.

Survivin and Cyclooxygenase-2 are co-expressed in human and mouse colon carcinoma and in terminally differentiated colonocytes.

In the evolution of colon rectal cancer (CRC) the imbalance between cell proliferation and apoptosis is considered one of the prominent causes of tumor induction and/or progression. In order to establish the role of anti apoptotic proteins in colon cancer development, we studied with immunohistochemical techniques the expression of Survivin in a mouse model of colon carcinogenesis induced by 1,2-dimethyl-hydrazine treatment. In this mouse model Survivin was over-expressed during tumor development, showing a distribution mimicking that described in the correspondent human malignancies. We also correlated Survivin distribution with COX-2 and beta-Catenin expression patterns. The co-localization of COX-2/beta-Catenin/Survivin in the same epithelial cells in tumor samples lends credence to possible in vivo regulatory effects of COX-2 and beta-Catenin on the intracellular Survivin levels in mouse and human colon cancer.

Regional variability in the prevalence of cerebral white matter lesions: an MRI study in 9 European countries (CASCADE).

White matter lesions (WML) on MRI of the brain are common in both demented and nondemented older persons. They may be due to ischemic events and are associated with cognitive and physical impairments. It is not known whether the prevalence of these WML in the general population differs across European countries in a pattern similar to that seen for coronary heart disease. Here we report the prevalence of WML in 1,805 men and women drawn from population-based samples of 65- to 75-year-olds in ten European cohorts. Data were collected using standardized methods as a part of the multicenter study CASCADE (Cardiovascular Determinants of Dementia). Centers were grouped by region: south (Italy, Spain, France), north (Netherlands, UK, Sweden), and central (Austria, Germany, Poland). In this 10-year age stratum, 92% of the sample had some lesions, and the prevalence increased with age. The prevalence of WML was highest in the southern region, even after adjusting for differences in demographic and selected cardiovascular risk factors. Brain aging leading to disabilities will increase in the future. As a means of hypothesis generation and for health planning, further research on the geographic distribution of WML may lead to the identification of new risk factors for these lesions.