Search Results (433)

Background: Immune checkpoint inhibitor–tyrosine kinase inhibitor combinations represent a standard first-line option for metastatic renal cell carcinoma (mRCC). However, patients enrolled in pivotal trials often differ from those treated in routine practice. We report real-world outcomes of pembrolizumab plus axitinib within the Campania Oncology Network. Methods: We conducted a multicenter retrospective study including consecutive treatment-naïve mRCC patients who received first-line pembrolizumab plus axitinib between January 2021 and November 2023 across eight regional centers. The primary endpoints were progression-free survival (PFS) and overall survival (OS); secondary endpoints included objective response rate (ORR) and safety. Results: A total of 117 patients were included. IMDC risk was favorable in 19.6%, intermediate/poor in 65%, and unknown in 15.4%. Median age was 59 years, and 53.8% had ECOG performance status ≥ 1. Clear-cell histology accounted for 87.2% of cases; brain metastases were present in 36%. After a median follow-up of 12.8 months, median PFS was 15.1 months (95% CI 9.6–NR), and median OS was not reached. ORR was 27.3%, with a disease control rate of 79.5%; patients with non-clear-cell histology showed an ORR of 41.7%. Disease progression was the main cause of treatment discontinuation (49%), while adverse events (AEs) led to discontinuation in 6% of cases. Grade ≥3 AEs occurred in 14% of patients. Most toxicities were grade 1–2, including diarrhea (23.9%), asthenia (18%), hypothyroidism (12.8%), and hypertension (9.4%). Grade 1–2 AEs were significantly more frequent in females compared with males (57.6% vs. 35.7%, p = 0.05). Conclusions: In this consecutive regional cohort, pembrolizumab plus axitinib showed clinically relevant disease control, although ORR was lower than in pivotal trials. Performance status emerged as a key prognostic factor. Real-world data from oncology networks may support personalized first-line treatment decisions in mRCC. Full article

This study investigates consumer knowledge, perceptions, and purchasing behaviors regarding products with geographical indications and certifications in the Campania region. Traditional Agri-Food Product (PAT) is the regional label used in Italy to identify traditional products whose distribution is so limited that they do not qualify for PDO or PGI designation. In this view, this research examines the diffusion of such products, their economic and sustainability attributes, and alignment with modern objectives, including environmental impact reduction, rural development, and the European Common Agricultural Policy (CAP) 2023–2027. Using a structured questionnaire administered to a sample of 706 respondents, the study combines descriptive statistics and econometric analysis, trying to identify key factors influencing Willingness to Pay (WTP) for certified products and knowledge of certifications. Findings reveal that education, knowledge of certifications, and lifestyle factors positively affect WTP, highlighting opportunities for targeted marketing and awareness campaigns, also emphasizing critical issues in view of new trade scenarios (e.g., Mercosur agreement) and climate change. Full article

In this study, we present a machine-learning approach—a land use random forest (LURF) model—to produce daily PM₁₀ concentration maps at a 1 km resolution across the Campania region for the year 2022. The model combines daily measurements from 13 ARPA Campania monitoring stations with a wide set of spatial and atmospheric information. The predictors include population, land cover, road network, ERA5 meteorological data, satellite aerosol observations from MODIS, output from the CHIMERE chemistry transport model, and a flag identifying days affected by Saharan dust transport. The model is trained and validated using a station-based cross-validation scheme that accounts for spatial correlation between sites. Under this scheme, the LURF reproduces observed concentrations with substantially smaller errors than the raw CHIMERE output (RMSE of 11.0 vs. 23.6 $\mathsf{\mu }$g m⁻³). CHIMERE concentrations and ERA5 meteorology emerge as the most informative predictors, while the dust flag specifically improves the representation of episodic high-PM₁₀ events. The resulting 1-km maps reveal clear urban–rural contrasts. They identify pollution hotspots in the Naples metropolitan area and along major motorways that are not visible in coarser model outputs. Probabilistic exceedance maps further show that meeting the future 2030 EU limit value of 20 $\mathsf{\mu }$g m⁻³ will be challenging across much of the metropolitan area. Overall, the proposed framework provides a low-cost, practical tool for high-resolution PM₁₀ exposure assessment, supporting epidemiological studies, environmental justice analyses, and air quality management in regions with complex terrain and limited monitoring coverage. Full article

Wastewater monitoring has been recognized as a valid tool for monitoring coronavirus disease 2019 (COVID-19) diffusion. In this paper we analyse a dataset composed by the measurements of SARS-CoV-2 RNA load in 605 raw wastewater samples collected from nine wastewater treatment plants (WWTPs) in the Campania region from October 2021 to May 2025. We analyse the correlation structure of the dataset using multivariate statistical techniques with the aim of identifying the most representative sentinel WWTPs and thus optimizing the number of samples. Results of spatial analysis showed that there are two isolated elements, SA3 and NA1, with the highest and lowest SARS-CoV-2 load values, respectively, and other two clusters (Cl1 and Cl2) from the other WWTPs. Temporal analysis showed that NA3 WWTP had a statistically significant difference in SARS-CoV-2 load from 2022 to 2023. Our method suggests limiting samplings to three sites, as follows: SA3 (which can act as a sentinel site because it is the first site that records variation in viral load) and two with the higher variation coefficients (CV%) belonging to the two clusters, as follows: CE1 for Cl1 and NA4 for Cl2. This data analysis procedure could allow to focus only on certain WWTPs for SARS-CoV-2 monitoring, to promptly identify outbreaks. Full article

Here, the proximate composition, total amino acid content and antioxidant activity of Agria, Désirée and Kennebec potato varieties cultivated on the Matese plateau (Campania region, Southern Italy) were evaluated. Significant differences were observed among varieties in terms of proteins (1.98–3.07 g/100 g FW), carbohydrates (12.05–15.78 g/100 g FW) and moisture (78.42–84.68 g/100 g FW), while lipids were consistently low (~0.1 g/100 g FW), ~2.6-fold lower than ‘gold’ potatoes, used as a reference. Ashes were relatively high (1.10–1.39 g/100 g FW), ~1.4-fold higher than ‘gold’ potatoes. Total amino acid profiles were similar, although statistically significant differences were observed for Glx (glutamic acid + glutamine) and Asx (aspartic acid + asparagine), which are the most abundant amino acids, followed by valine, arginine and lysine. The chemical score of essential amino acids highlights that Matese potato varieties have a high nutritional content of phenylalanine + tyrosine and threonine, with average chemical scores of ~99.8% and 91.6%, respectively, while leucine is the limiting amino acid. The free amino acid profile does not show statistically significant differences. The total phenolic content (TPC) of analysed varieties (57.85–123.27 mg GAE/100 g of FW) was higher than those reported in the literature and directly correlated with the evaluated antioxidant activity (ABTS and DPPH). Finally, Matese potatoes are rich in potassium, phosphorus, calcium and magnesium, with minor minerals (~1.6%) and selenium traces (~0.53 µg/100 g FW). Overall, these findings highlight the potential of Matese potatoes to enhance local consumption, preserve culinary heritage and support gastronomic tourism growth. Full article

Background/Objectives: Beyond health benefits, plant-based diets are increasingly recognized for their contribution to environmental sustainability. This study aimed to evaluate knowledge of the health benefits of fruits, vegetables, and antioxidants, adherence to the Mediterranean Diet (MD), and propensity toward sustainable food purchasing in an adult population from Southern Italy, and to explore the relationships among these factors. Methods: A cross-sectional online survey was conducted among 311 adults living in the Campania region. Data were collected on knowledge of fruit and vegetable health benefits, antioxidant knowledge, adherence to the MD assessed using the Medi-Lite score, and attitudes toward sustainable food purchasing. Differences were examined according to gender, age, and educational level. Pearson’s correlation analyses and multiple logistic regression models were used to investigate associations between nutrition knowledge, dietary adherence, and sustainability-related behaviors. Results: Participants showed a medium–high level of knowledge regarding the health benefits of fruits and vegetables, while knowledge of antioxidants was moderate and significantly higher among older adults. Overall adherence to the MD was moderate, with lower consumption of vegetables, legumes, and fish. Most participants reported limited attention to sustainability when purchasing food. Both knowledge of fruit and vegetable health benefits and antioxidant knowledge were positively associated with sustainable food purchasing. In regression analyses, lower nutrition knowledge was independently associated with reduced odds of sustainable purchasing, whereas adherence to the MD was not a significant predictor. Conclusions: Although nutrition knowledge was generally adequate, its translation into sustainable food choices remained limited. These findings support the need for integrated public health strategies to encourage healthier and more environmentally responsible dietary behaviors. Full article

A key component of research on disaster risk in modern-age society in the inland areas of the Campania Region, southern Italy, was discovered in parish registers. Ecclesiastical archives, containing thousands of largely unpublished pages, served as a rich source of information on disruption and casualties. The parish registers preserved in these archives from the 16th century provide demographic records as well as notes on the most terrible events that affected society at the time. They include the catastrophic effects of seismic events recorded in this sector of the southern Apennines, an area characterised by high seismicity due to the complex dynamics of the convergence zone between the African and Eurasian plates. New findings reveal a more precise number and previously unreported deaths in several villages, confirming and suggesting some macroseismic intensities for the 1694 seismic event; moreover, further evidence was found for the hypothesised 1692 seismic event. A greater number of deaths was observed in some villages during the 1702 and 1732 events. Parish documents provided details about local construction techniques adopted after the well-known earthquake of 1732, including the use of more resilient materials and design modifications. Full article

The viae romanae (Roman roads) were constructed according to precise designs and exceptional engineering techniques, ensuring their strength and durability. They represent an immeasurably important factor in human history. Their impact has been universal, facilitating the movement of people, goods, ideas, beliefs and religions over the centuries. The Via Appia Regina Viarum, built between the end of 4th and 1st centuries BCE, connected Rome to Brundisium, spanning the region of Latium and Apulia. The road initially crossed the coastal plains of the Tyrrhenian Sea (in Latium) before cutting through the reliefs and river valleys of the southern Apennines (in Campania) and finally crossing the regio Apulia et Calabria via Tarentum, to the harbor of Brundisium, along the Adriatic coast. In 2024, the Italian Ministry of Culture proposed the ‘Via Appia Regina Viarum’ for inscription on the Unesco World Heritage List, recognizing its unique and exceptional testimony to Roman civilization. Later that same year, the nomination was accepted, and today, the Via Appia is part of the UNESCO World Heritage List. A significant contribution to this nomination came from the multidisciplinary studies and research conducted along the Via Appia between the ancient cities of Beneventum and Aeclanum in the Campanian Apennine, including: (1) geoarcheological investigation aimed at identifying the ancient path of the road, which was not well documented in the area between Beneventum and Aeclanum; (2) studies focused on cultural and geological heritage along the road and its surrounding landscapes, enhancing the value of the nomination; and (3) the organization of social and cultural events designed to disseminate scientific findings and raise awareness among scientists, students, local and national administrators, local food and wine producers, and the general public. This paper highlights the pivotal role of geoscience at all stages of the project: from preliminary field surveys and mapping of landforms and lithofacies, to targeted field and geophysical surveys, to archaeological excavation and geoarchaeological consideration, and to the dissemination of new data through cultural events. Full article

The assessment of the hydromorphological state of a river is fundamental for both correctly evaluating its ecological conditions and planning its restoration. Despite this, there is a critical gap in studies on this topic in Southern Italy, although they are recommended by several EU Framework Directives. This research provides a contribution to filling this gap by assessing the hydromorphological quality of the Middle and Lower Sabato River (Southern Italy), by using the method officially adopted by the Italian Institute for Environmental Protection and Research (ISPRA), named IDRAIM. The method presents the advantage of considering the specific Italian context in terms of channel adjustments and anthropogenic impacts. However, it also considers pre-existing geomorphological approaches developed in other countries that make the method applicable at least in the entire Mediterranean area. To apply the method, in this study, we used data obtained by GIS analysis, remotely sensed data, and field-surveyed data. The study has highlighted that, in the Middle and Lower Sabato R., eight river reaches out-of-fifteen have displayed a “moderate or sufficient” morphological quality, five reaches a “good” morphological quality, while the remaining two reaches have been characterized by a “poor” morphological quality. Functional alterations have seemed to prevail over artificiality and intensity of short-term channel adjustments in conditioning hydromorphological quality. These results will be a key starting point for already planned studies dealing with both the restoration of the Sabato R. and flood hazard and risk assessment. Full article

Vespa orientalis is an emerging pest in southern Italy, with increasing impacts on bees in apiculture and urban environments. This study assessed the attractiveness of three bait types—beer, canned peaches, and commercial fish-based cat food—used in transparent plastic bottle traps deployed in apiary and urban sites across the Campania region. Trapping was conducted from September to October in 15 apiaries and 10 urban areas. A total of 419 hornets (V. orientalis and V. crabro) were collected. V. crabro showed a strong preference for beer-baited traps, whereas V. orientalis did not exhibit significant bait preferences, although most captures occurred in protein-baited traps. Species composition differed between environments, with V. orientalis more prevalent in urban sites. Overall, low capture rates of V. orientalis despite high presence in apiaries suggest that conventional attractant-based trapping is poorly suited for this species, highlighting the need for behaviour-based monitoring tools. Full article

Background: Artificial intelligence (AI) is poised to fundamentally reshape healthcare delivery, offering unprecedented advancements in diagnostics, treatment personalization, and operational efficiency. However, a growing body of international research reveals a critical “optimism–knowledge gap”: healthcare professionals are enthusiastic about AI’s potential but possess limited technical knowledge and practical experience. This gap compromises the safe and effective implementation of AI tools. The Italian healthcare context presents a unique and amplifying challenge, as it is defined by the stringent “human-in-the-loop” oversight mandated by the Garante per la protezione dei dati personali (Italy’s Data Protection Authority). This legal framework makes clinician competence not just a goal, but a prerequisite for regulatory compliance. Objective: This study aimed to provide an exploratory quantitative assessment of AI awareness, practical application, and understanding of its limitations among a sample of clinicians in Italy. It specifically sought to compare the preparedness of hospital-based clinicians and general practitioners (GPs) and to identify the workforce’s perceived educational needs within this unique legal environment. Methods: A descriptive, cross-sectional survey was conducted from February to August 2025. Using a non-probability convenience sampling method via professional networks, the survey yielded 362 total responses. Data were analyzed descriptively and inferentially using Chi-square (${\chi }^2$) tests to compare cohort responses on familiarity, practical exposure, knowledge of limitations, and interest in further training. Results: A universal and high demand for education was found, with 89.9% of all respondents being “Moderately” or “Very” interested in learning more about AI. This optimism coexists with dangerously low practical exposure. The gap was most profound among GPs, 44.1% of whom have “Never” used an AI tool—a rate significantly higher than hospital clinicians (34.9%; ${\chi }^2=3.14$, p = 0.045). Furthermore, 32.6% of GPs admitted that they “understand some benefits but not the limitations.” Conclusions: Italian clinicians mirror the global optimism–knowledge gap. These findings underscore the urgent need for structured, continuous education in AI literacy to address ethical and regulatory imperatives within the Italian healthcare system. Full article

Spinal muscular atrophy (SMA) is a rare neuromuscular disorder causing progressive muscle weakness. Severe SMA forms are typically observed up to six months postnatally. Disease-modifying therapies provide significant benefits, making newborn screening (NBS) essential for timely diagnosis and treatment initiation. The NBS programme evaluated infants born between April 2023 and October 2024 in the Campania region, Italy. DNA was amplified to detect homozygous deletion of the SMN1 gene by RT-PCR and SMN2 copy number using multiplex ligation-dependent probe amplification. Following treatment, motor functions were assessed using CHOP-INTEND and Bayley III scales. Among 62,801 infants screened for SMA, thirteen (11 females, 2 males) tested positive. The distribution of SMN2 copy numbers was as follows: eight patients had two copies, one patient had three, and four patients had four copies. One year after treatment, motor outcome data were available for four of the eight patients with two SMN2 copies. Among these patients, one achieved the milestones of walking without support, and three were standing with support. At 24 months, three of these patients were walking independently. Pre-symptomatic treatment markedly improves motor function development. This underscores the urgent need for large-scale newborn screening to prevent diagnostic delays and ensure timely, effective therapy. Validated care protocols must be established to facilitate early diagnosis and intervention. Full article

The circulation of viruses of medical and veterinary importance is monitored to evaluate risks to both human and animal health. Among the species most commonly used in surveillance programs, the wild boar (Sus scrofa) plays a key role due to its high population density and its contacts with rural swine herds in the areas under investigation. In the present study, molecular (real-time PCR) and serological analyses were conducted on wild boar samples collected in the regions of Apulia, Basilicata, Campania, and Calabria. Specifically, molecular detection was applied to IAVs, FLVs, and Porcine PCV-2, while serological testing was used to assess exposure to IAVs, FLVs, and ADV. Serological results showed an 8.31% positivity for IAVs, whereas viral presence detected by PCR was 1.17%. No active infections were detected for WNV, with only a single seropositive sample (0.30%), while ADV showed a seroprevalence of 2.61%. PCV-2 was detected exclusively by molecular analysis in 66 out of 223 tested animals (29.6%). The overall objective of the study is to deepen the understanding of virus circulation in the wildlife of Southern Italy, using the wild boar as an additional sentinel species for epidemiological surveillance activities. The distinctive feature of the project lies in its multi-pathogen approach applied to a reference population distributed across a particularly wide geographical area, allowing for the simultaneous assessment of the circulation of different viruses over a large territory. Full article

The transition towards climate neutrality requires the development of spatially explicit planning approaches that account for territorial differences and land-use dynamics. Within this conceptual framework, this study has the objective of identifying and discussing spatially explicit planning approaches that can support the transition to climate neutrality in different regional spatial contexts. With reference to this research question, a methodological framework is introduced and applied that is designed to support climate neutrality through spatial planning strategies. Carbon sequestration (CS) serves as a key metric to evaluate both the current state and the temporal evolution of this process, examined in connection with the provision of specific ecosystem services (ESs) within the relevant spatial setting. The work is structured as follows. An approach is developed to define the provision of ESs. Drawing on previous research and detailed assessments of environmental, landscape, and socio-cultural features, the study considers the following ESs: maintaining or improving habitat quality to sustain the life cycles of wild species valuable to humans; regulating climate by mitigating land surface temperature; agricultural and forestry production; and nature-based recreational opportunities. Moreover, spatial relationships between CS capacity and ES provision are examined through geographically weighted regressions, allowing comparisons across Basilicata, Campania, and Sardinia, three Regions in southern Italy forming the Italian Mezzogiorno. The multifunctional characteristics of ES supply contributes to optimizing CS capacity and advancing climate neutrality goals. In particular, in all three regional contexts, high values of CS capacity elasticity are recognized in relation to habitat quality and ground temperature mitigation, and very low elasticity conditions as regards the supply of recreational ESs and agricultural and forestry production. Full article

This research investigates the uptake of potentially toxic elements (PTEs) by Brassica rapa L. grown in volcanic and clay soils with high natural background levels of these elements, and assesses related human health risks. The study was conducted in two Italian regions that produce B. rapa L. for food use (Campania and Sicily). The results of this exploratory research indicate that the naturally elevated concentrations of PTEs in soils lead to correspondingly high levels of these elements in B. rapa L. The investigated soils exhibited marked chemical differences. Volcanic soils had higher Total Organic Carbon (TOC) and PTEs concentrations alongside lower pH and Cation Exchange Capacity (CEC) than clayey soils. In the investigated plants, PTEs accumulated mainly in roots and stems, with notable Hg levels in leaves. While As exceeded safety limits in only one edible sample from volcanic soil, Cd, Hg, and Pb frequently surpassed them. Health risk assessments revealed significant carcinogenic and non-carcinogenic risks from plants grown on volcanic soils, with levels that remain unacceptable even at low consumption rates. In contrast, lower risk levels are associated with the consumption of Brassica rapa grown in clay soils, with values that are generally considered tolerable at low consumption rates. The preliminary findings of this study highlight that natural soil enrichment can cause PTE levels in B. rapa L. that often exceed safe consumption thresholds. These results provide a foundation for future research aimed at more thoroughly investigating the mechanisms of metal uptake by edible plants in areas naturally enriched with PTEs in order to enhance the safety and sustainability of our food. Full article