Search Results (588)

The Abruzzo (AB) donkey is a mountain-adapted Italian population listed as a genetic resource at risk of extinction (census ≈ 600 animals; no studbook). We aimed to provide the first comprehensive morphometric description of the breed and to compare it with the Martina Franca (MF) donkey, its main progenitor. Sixty-nine adult donkeys (56 females, 13 males) from six farms were measured in 2024. Twenty-three linear traits plus body weight and body condition score were recorded three times by a single operator. Descriptive statistics, Welch’s t-test or Mann–Whitney U test with Benjamini–Hochberg correction, PCA and LDA with leave-one-out cross-validation were performed in R; comparison with MF was based on published summary statistics. Coefficients of variation for the three studbook-admission parameters were ≤0.10 in both sexes. Sixteen of 26 traits showed significant sex dimorphism, with the largest effect sizes for rump height, medial canthal distance and wither height. LDA correctly classified 94% of animals by sex. AB females were significantly smaller than MF in 22 of 23 shared traits but had a wider thorax (p = 0.012). The sexual dimorphism observed in the Abruzzo donkey is male-biased and predominantly size-based, with a minor and well-localised shape component in the head region. Males are significantly larger than females for all axial measurements (wither height A: +6.5 cm, +5.3%; rump height B: +6.4 cm, +5.0%; trunk length D: +12.1 cm, +9.5%), for thoracic circumference (M: +7.1 cm, +5.0%), for body weight (+49.9 kg, +20.6%) and for the main head traits (CM: +4.3 cm, +20.0%; G: +3.6 cm, +12.5%; H: +1.3 cm, +11.1%; E: +2.0 cm, +3.8%); no trait shows a significant female bias after BH-FDR correction. The AB donkey shows a uniform mesomorphic phenotype, smaller and stockier than MF, supporting the establishment of an official studbook. Full article

Objectives: This study investigated the interplay between pre- and post-match physiological responses and subsequent emotional changes in male water polo players competing in the Italian Serie C league (third national level, sub-elite), focusing on differences between official championship (competitive) and non-competitive (training) settings. Methods: Sixteen male Italian Serie C water polo players participated. Salivary biomarkers (cortisol, immunoglobulin A (IgA), and uric acid) were measured, alongside psychological assessments of cognitive anxiety, somatic anxiety, and self-confidence. Measurements were taken before and after both training and competition matches. Results: A significant anticipatory rise in salivary cortisol was observed before competition matches compared to training, highlighting the psychological stress associated with competitive events. Post-match, cortisol levels remained elevated to a greater extent after competition. Salivary IgA levels decreased significantly following both training and competition, with a more pronounced reduction after official matches, and exhibited a negative correlation with cortisol. Salivary uric acid, a marker of oxidative stress, increased post-exercise and was significantly higher after competition. Players reported higher somatic and cognitive anxiety and lower self-confidence before competition compared to training, and pre-competition cortisol levels were positively correlated with both anxiety measures and negatively correlated with self-confidence. Conclusions: These findings highlight the distinct physiological and psychological responses elicited by competitive versus non-competitive settings in water polo, emphasizing the importance of considering the emotional context when monitoring athletes’ stress and recovery. The social meaning of competitive contexts may be embodied, impacting stress and immune responses. Full article

Objectives: Volleyball playing positions are associated with different functional demands. This study compared postural control, jump performance, and upper-limb mobility across playing roles in competitive male volleyball players. Methods: Fifty male volleyball players competing in the Italian Serie C championship were equally distributed across five roles: middle blockers (MB), liberos (LIB), opposite hitters (OH), setters (SET), and outside hitters (HIT). Using a wearable inertial sensor, athletes performed bipodalic balance tasks with eyes open and closed, dominant- and non-dominant-leg single-leg balance, squat jump (SJ), countermovement jump (CMJ), and bilateral upper-limb flexion and extension tests. Results: Significant role-related differences emerged in balance and jump performance. In bipodalic balance, the eyes-open condition showed a mixed pattern, with HIT displaying the largest ellipse area and SET showing the highest path-related values, whereas in the eyes-closed condition, HIT showed the highest values across all stabilometric parameters. In the single-leg stance, OH showed the largest postural excursions on the dominant side, while LIB stood out on the non-dominant side. In jump tests, MB showed the best vertical performance in both SJ and CMJ, whereas LIB and SET generally showed the lowest outputs. Temporal differences also emerged across roles. Upper-limb mobility was similar across roles in flexion, while extension showed a role-specific pattern, with SET displaying greater ROM than LIB, HIT, and OH. Conclusions: Volleyball roles are associated with distinct functional profiles in balance, jump mechanics, and upper-limb mobility. This integrated assessment may support more specific training, monitoring, and injury-prevention strategies. Full article

Understanding the trophic ecology of fish in mountain lakes is essential for interpreting their functional roles and managing these ecosystems. This study investigated the diet, population structure, and prey selectivity of lake charr (Salvelinus umbla) in three glacial basins of the Eastern Italian Alps: Fusine Superiore, Fusine Inferiore, and Raibl Lakes. In summer 2024, 106 fish were sampled using multi-mesh gillnets, alongside Surber sampling of littoral macrobenthos. Biometric analysis revealed populations dominated by larger size classes (>18 cm), with significant sexual dimorphism, as females were longer and heavier than males. Dietary analysis showed strong reliance on littoral Hexapoda (~90% of prey). High Schoener’s overlap index values (α > 0.90) indicated no clear ontogenetic dietary shifts in the sampled size classes, suggesting that the productive littoral zone provides a stable resource. Ivlev’s electivity index revealed lake-specific prey selection patterns, with Hexapoda positively selected in Lake Fusine Inferiore, Bivalvia and Malacostraca positively selected in Lake Raibl, and weak or absent selectivity in Lake Fusine Superiore. S. umbla appears to be a broad opportunistic feeder with site-specific prey selectivity shaped by local resource structure. Given its debated native status, these findings provide an ecological baseline for assessing its potential effects on benthic communities. Full article

Background/Objectives: Legume allergy is increasingly recognized as plant-based diets expand and legume proteins are widely used in processed foods. We aimed to characterize the clinical features, sensitization profiles, and management outcomes of IgE-mediated legume allergy in Italian children. Methods: This retrospective single-center study (January 2022–January 2024) included children (<18 years) allergic to ≥1 index legume (pea, lentil, chickpea, common bean, or soy). Diagnosis required a compatible clinical history and evidence of IgE sensitization. Clinical and allergy characteristics were analyzed. Results: Fifty-five children (63.6% male) were included; all had atopic comorbidities, and 96.4% had additional food allergies. Median age at first reaction was 18 months; anaphylaxis occurred at onset in 12.7%, most frequently triggered by pea. Pea (70.9%) and lentil (69.1%) were the most prevalent allergies, with pea causing 50% of index-legume anaphylaxis. Multi-legume allergy predominated (74.5%), with frequent co-allergy among pea, lentil, and chickpea (56–86%). Soy allergy was less frequent and mainly associated with Gly m 4 sensitization. Single-legume allergy (25.5%) was associated with later onset (54 vs. 15 months; p = 0.013) and liver transplantation (21% vs. 2%; p = 0.047). Peanut co-allergy occurred in 25.5%. Among 34 oral food challenges (OFCs), 23.5% were positive, including one case of pea-induced anaphylaxis. Of 16 oral immunotherapy (OIT) protocols initiated, 31.3% reached the full target maintenance dose, 37.5% remained on a lower, partial maintenance dose, and 31.3% were discontinued due to oral allergy syndrome (OAS). Conclusions: Pediatric legume allergy is characterized by early onset, frequent multi-legume involvement, and common co-allergies. In this cohort, pea allergy was associated with the highest proportion of severe reactions. Species-specific differences in severity, patterns of multi-legume involvement, and OIT outcomes should be interpreted cautiously given the limited sample size, while highlighting the need for tailored management and improved risk assessment across legume species. Full article

The Italian grey partridge (Perdix perdix italica Hartert, 1917) is a subspecies endemic to the Italian peninsula, considered extinct in the wild, and it is included in Annex I of the EU Bird Directive. The aim of our project is to reintroduce a viable population of the endemic taxon into a protected area in north-east Italy, using genetically selected founder birds belonging to the original Italian genetic lineage. From 2021 to 2023, a total of 30,078 partridges were reintroduced to Valle del Mezzano using a soft-release method, and 241 of them were equipped with VHF transmitters to evaluate survival, dispersal and spacing behaviour of the released birds. Furthermore, male spring counts using the playback method were performed to assess the number of reproductive pairs. The overall survival was 21.86%; the Cox proportional hazards model, including time-dependent effects, showed that neither sex (HR = 1.20, p = 0.28) nor body mass significantly influenced survival. The release year was included as a stratification factor, and site-level heterogeneity was negligible. These results show that survival dynamics were not explained solely by individual traits. Dispersal distance and spatial behaviour were affected by the release year, while sex had only a minor effect and body mass had no impact. Local heterogeneity contributed to variability but did not override the strong temporal pattern. The number of calling males in spring ranged from 152 to 267, with variations between years. Overall, our findings suggest that post-release performance in reintroduced individuals is influenced more by environmental factors than by inherent individual traits. In conclusion, despite high mortality rates among reintroduced birds, the first breeding nucleus of Italian partridges since their extinction in the wild has been observed. Full article

Background: Epidemiological alerts about the possible spread of different pathogens have highlighted the risk of international travelers contracting infectious diseases when visiting endemic areas. The role of travelers in disease transmission underscores the importance of pre-travel consultations, which provide critical information on health risks, vaccinations, and preventive measures. Understanding travelers’ risk perceptions and behaviors is essential for enhancing global health security in the post-pandemic era. Methods: A cross-sectional study (June 2023–January 2024) was conducted by administering an anonymous questionnaire at the Rome-Fiumicino Airport International Prophylaxis Clinic (USMAF-SASN). The questionnaire explored demographics, travel patterns, risk perceptions, vaccination behaviors, and sources of health information. Descriptive statistics and a multivariable logistic regression analysis were performed to identify low-risk perception predictors. Results: Among 217 participants, 89.8% were Italian, with a balanced representation of genders. The primary purpose of travel was tourism (61.6%), followed by work-related trip (23.1%). While 77.1% rated preventive measures as effective, 23.2% evaluated infection risk as low. Being male (aOR 3.63, 95% CI 1.37–9.61), and being a hotel user (aOR 6.27, 95% CI 2.43–16.15), was significantly associated with a lower risk perception. As expected, healthcare professionals and individuals using institutional healthcare sources showed a higher risk awareness. Vaccination uptake at the Airport Clinic was motivated by self-protection, vaccine confidence, and poor time flexibility to access local vaccination services, and last-minute plans, making the airport a more convenient option. Conclusions: Travelers’ risk perception is influenced by gender, profession, accommodation type, and information sources. Public health strategies should enhance health literacy, promote pre-travel consultations, and improve access to preventive services. Strengthening collaborations between health authorities, educational institutions, and the travel sector is key to mitigating health risks and ensuring global health security. Future interventions should address structural vaccination barriers and improve outreach to under-informed travelers. Full article

Background and Objectives: The COVID-19 pandemic was associated with major disruptions, not only at the environmental, social, and economic levels but also in the public health systems and, therefore, emergency care utilisation. Prior to the pandemic, one of the most significant issues in the ED was overcrowding, with a consequent percentage of people leaving the ED without being seen (LWBS). The aim of this study was to assess the association between the 2020 COVID-19 pandemic and the number of LWBS, compared with the rates recorded during the same period in 2019 and 2021. Materials and Methods: A retrospective comparative observational study of ED admissions was conducted in two university hospitals in Ancona (Italy) between 9 March and 3 May 2020 and in Gran Canaria (Spain) between 14 March and 10 May 2020, corresponding to the lockdown in the two countries, respectively. ED visits were assessed during the defined periods, separately for the Italian and Spanish contexts and between groups, comparing the two contexts for each year. Results: In Italy, during the 2019 timeframe, 597 (7.0%) of 8568 patients who arrived in the ED left before being seen; during the same period in 2020, 100 (3.2%) of 3100; and in 2021, 334 (6.0%) of 5555. In Spain, patients leaving the ED prior to medical consult in 2019 were 567 (4.0%) out of 14,034 visits; in 2020, they amounted to 185 (2.6%) out of 7208; and in 2021, they were 528 (4.0%) out of 13,214. The results of the logistic regression analysis for Italy and Spain showed that male sex [odds ratio (OR), 95% confidence interval (CI): 1.38 (1.24–1.53)], age group between 17 and 43 years compared to those subjects older than 74 years old [OR (95%CI): 4.04 (3.34–4.88)] and a lower priority code at triage were significantly associated with a higher odds of LWBS. Conclusions: The findings suggest that the COVID-19 pandemic was associated with changes in only some characteristics of the profiles and types of patients leaving the ED, while it had a strong impact on the number of patients who left the ED before medical examination. The observed decrease in ED visits and LWBS rates in 2020 suggests that the COVID-19 pandemic has changed the population’s use of the ED, highlighting the potential need for improved public and professional awareness of appropriate care pathways and the role of health professionals in them. Full article

Background: Shift-working healthcare workers (HCWs) are at elevated cardiovascular (CV) risk due to chronic circadian disruption; however, gender-stratified data on CV risk profiles and modifiable risk factor distribution by occupational exposure duration remain scarce in the Italian hospital setting. This cross-sectional study aimed to characterise the 10-year CV risk profile and the distribution of modifiable risk factors in a hospital-based sample of shift-working HCWs. Methods: A retrospective cross-sectional study was conducted using data from routine occupational health surveillance of shift-working HCWs at a large Italian hospital in Salento, Southern Italy (survey year: 2025). The 10-year CV risk was estimated using the CUORE Project algorithm, validated for the Italian population. Risk was stratified by gender, age group, and shift work duration. Multivariable logistic regression models, adjusted for age, marital status, and presence of children at home, evaluated associations between selected risk factors and CV risk category. The study was reported in accordance with STROBE guidelines. Results: Of 765 HCWs included (320 males, 445 females; mean age 49.3 ± 8.5 years), male workers showed a significantly higher mean 10-year CV risk score (4.98 ± 2.8 vs. 1.34 ± 0.9; p < 0.05). Among male workers, the odds of moderate/high CV risk increased progressively with shift work duration (aOR 6.4 for >30 years). Males also showed significantly higher prevalence of arterial hypertension, overweight, and obesity across all strata. Conclusions: Male shift-working HCWs represent a higher-risk subgroup, characterised by a greater burden of modifiable cardiovascular risk factors. Integration of validated risk assessment tools into occupational health surveillance may support targeted preventive strategies in hospital settings. Full article

Training distress is a multifactorial psychophysiological response resulting from the interaction of sustained high-intensity training, insufficient recovery, and additional psychosocial stressors. It manifests through mood disturbance, elevated perceived stress, fatigue, sleep disruption, and physical symptoms, and represents a precursor to maladaptive outcomes such as overtraining syndrome. The Multicomponent Training Distress Scale (MTDS) integrates these dimensions into a single monitoring framework; however, no validated Italian version has been available. The present study aimed to develop and provide a validation of the Italian Multicomponent Training Distress Scale (IMTDS). The IMTDS was administered to 536 Italian-speaking recreational and competitive sport participants (276 males, 260 females; age range = 16–35 years, M = 25.31, SD = 5.62). Exploratory Structural Equation Modeling supported the hypothesized six-factor structure (Depression, Vigor, Physical Symptoms, Sleep Disturbances, Stress, Fatigue), demonstrating acceptable model fit (CFI = 0.97, TLI = 0.92, RMSEA = 0.10). Internal consistency was satisfactory to high across subscales (ω = 0.82–0.88), and test–retest analyses indicated temporal stability. Intercorrelations among dimensions were consistent with theoretical expectations. These findings provide evidence that the IMTDS is a reliable instrument for monitoring training distress in Italian-speaking athletes. Full article

Background: Dental caries remain a major public health issue among Italian children, with prevalence exceeding 60% in specific subgroups and marked socioeconomic gradients. Objectives: This multicenter study aimed to describe baseline caries experience, malocclusions, and oral hygiene status in pediatric populations residing in three Italian regions and to develop and preliminarily evaluate the feasibility of an integrated care pathway for the prevention and management of caries and malocclusions. Materials and Methods: Within the CCM 2024 program (ID 10), a cross-sectional baseline assessment was conducted on 795 children aged 6–11 years, examined in school settings and via mobile dental units. Caries experience was assessed using the dmft/DMFT indices and International Caries Detection and Assessment System (ICDAS) criteria. Malocclusions were evaluated using the Index of Orthodontic Treatment Need (IOTN). Oral hygiene was assessed through standardized clinical indices. The proposed care pathway comprises three tiers: (1) universal, school-based oral health education; (2) targeted clinical preventive and interceptive interventions; and (3) telemedicine/AI-supported follow-up for high-risk children. Descriptive and multivariable statistical analyses were performed. Results: At baseline, overall caries burden was low. No statistically significant differences in dmft/DMFT were observed between males and females. A non-significant trend toward higher caries indices was found among children with a positive breastfeeding history. By contrast, oral hygiene level was strongly associated with caries indices: children with insufficient hygiene had the highest dmft/DMFT, those with moderate hygiene showed intermediate values, and those with optimal hygiene presented the lowest caries experience. In multivariable models, oral hygiene emerged as the main independent predictor of dmft/DMFT. Conclusions: In this low-caries cohort, oral hygiene was confirmed as the principal modifiable determinant of caries risk. A tiered, school- and community-based care pathway focused on hygiene promotion, early screening, and minimally invasive clinical interventions appears feasible at baseline and may be scalable, with the aim of reducing the burden of caries and malocclusions and improving equity in pediatric oral health. Full article

Background: Necrotizing fasciitis (NF) is a rapidly progressive, life-threatening soft tissue infection characterized by fascial necrosis, with mortality rates of 20–30%. Despite its rarity, NF is increasingly encountered due to the rising prevalence of predisposing factors. Data from Southern European tertiary centers remain scarce. Methods: We retrospectively reviewed all patients ≥18 years with radiological and/or surgical diagnosis of NF managed at IRCCS Policlinico San Matteo, Pavia, Italy, between November 2018 and August 2023. Clinical, microbiological, and treatment data were extracted from electronic medical records. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score was calculated retrospectively. The Charlson Comorbidity Index was computed for each patient. Given the small sample size, we adopted a purely descriptive analytical approach without inferential testing. Results: Thirteen patients met inclusion criteria (median age 58 years, IQR 44.5–79.5; 69.2% male). The most common comorbidities were diabetes mellitus (6/13, 46.2%), renal failure (4/13, 30.8%), and chronic liver disease (4/13, 30.8%). The age-adjusted Charlson Index ranged from 0 to 11 (median 4). Lower limbs were the most frequently affected anatomic site (5/13, 38.5%), followed by the perineal/genital region (Fournier gangrene, 4/13, 30.8%). Type II (monomicrobial) NF predominated (9/13, 69.2%). Microbiological cultures were positive in 8/13 patients (61.5%): Gram-positive cocci were isolated in 5/8 (62.5%) and mixed aerobic/anaerobic flora in 3/8 (37.5%). Empirical antibiotic regimens included a piperacillin–tazobactam backbone in 6/12 (50.0%) patients and a meropenem-based combination in 5/12 (41.7%); 6/12 patients underwent targeted de-escalation after culture results. Two patients (15.4%) died in hospital, both with Fournier gangrene and Type I infection (mortality 2/4, 50.0% in Type I vs. 0/9 in Type II). The median length of stay was 26 days (IQR 17–28.5). All patients had LRINEC ≥6 at admission, with 9/13 (69.2%) classified as high risk (≥8). Conclusions: In this small retrospective Italian cohort, NF was most frequently associated with diabetes and high comorbidity burden. Type I (polymicrobial) infections, predominantly involving the perineal region, showed worse outcomes than Type II infections. The clinical experience accumulated during this study period subsequently informed the development of an institutional empirical antimicrobial protocol for skin and soft tissue infections at our hospital. Full article

Background: Genetic testing in hypertrophic cardiomyopathy (HCM) yields variable positivity rates. Identifying clinical predictors of positive genetic tests could improve pre-test counseling and refine expectations about diagnostic yield. Methods: We analyzed consecutive genotyped HCM probands from a contemporary multicenter cohort across four Italian tertiary centers. Genotype positivity was defined as the presence of ≥1 pathogenic or likely pathogenic variant (ACMG classes 4–5). Multivariable logistic regression identified predictors of genotype positivity. Sensitivity analyses assessed the incremental value of left atrial volume index (LAVI) ≥ 34 mL/m² and the mode of first clinical presentation. Results: Among 274 genotyped probands (median age at diagnosis 54 years; 62% male), 86 (31%) were genotype-positive (38% MYBPC3, 29% MYH7). Age at diagnosis <40 years (OR 2.38, 95%CI 1.26–4.51, p = 0.008), family history of sudden cardiac death/major ventricular arrhythmias (OR 2.34, 95%CI 1.16–4.84, p = 0.019) and family history of non-ischemic cardiomyopathy (OR 1.92, 95%CI 1.04–3.54, p = 0.038), were independently associated with genotype positivity whereas arterial hypertension was inversely associated (OR 0.42, 95%CI 0.23–0.77). Maximal left ventricular wall thickness > 20 mm and gender were not predictive of genotype positivity. Inclusion of LAVI modestly improved the model performance (AUC 0.769, p = 0.016, ΔAUC +0.024; DeLong p = 0.016) but without leading to meaningful patient reclassification. Conclusions: Genotype positivity in HCM links to earlier onset and family history; traditional severity markers and initial presentation may not independently suggest genetic causality. These findings may help shape a personalized approach to genetic counseling in HCM. Full article

Background: Contralateral recurrence following surgically treated primary spontaneous pneumothorax represents clinical concern yet remains poorly understood. This study aims to expand the current understanding by evaluating a large, multicenter cohort over a 10-year period and to determine the true incidence of contralateral recurrence assessing the potential role of clinical factors in risk stratification. Methods: A total of 479 patients surgically treated for PSP (2012–2024) across three Italian high-volume centers were retrospectively reviewed. Secondary pneumothorax, patients <18 years old, lung emphysema or intraparenchymal large bullae, and the thoracotomy approach were excluded. The association between categorical variables and contralateral recurrence was assessed using the chi-square (χ²) test, while the association with continuous variables was evaluated using the t-test. Time to recurrence was analyzed using Kaplan–Meier survival curves. Variables with a p-value < 0.05 were considered statistically significant. Results: We identified 59 patients who experienced contralateral recurrence: 45 were males, the mean age was 26.66 ± 12.32 and the mean BMI was 22.00 ± 2.92; only 13 were active smokers. Age (p < 0.001) and smoking history (p = 0.029) were significantly associated with contralateral recurrence in univariate analysis, though these were not confirmed in multivariate analysis. Among the cohort of recurrence, 53 patients only had a recurrence on the contralateral side, with a median time to recurrence of 139 days. The incidence rate ratio (IRR) of recurrence for patients with a mean age of <34 years was 1.23, which translates to a 23% increased risk. No significant impact of age (p = 0.25), sex (p = 0.67), or smoking (p = 0.59) on the time to recurrence on the other side was observed through Kaplan–Meier analysis. The peak incidence for the first episode of PNX surgically treated and contralateral recurrence was observed in October, November and January. Conclusions: This study highlights a 12% contralateral recurrence rate after PSP surgery. Younger age is associated with earlier contralateral recurrence. Seasonality may influence recurrence patterns. Further studies should explore underlying mechanisms and preventive strategies. Full article

Positive mental health (PMH) has recently become a key topic in biomedical research. Previous studies have explored the correlation between biological and psychological measures, but only a few have focused on the relationship between PMH and aging. This study aimed: (i) to explore the association between PMH and biological aging; (ii) to determine if and to what extent the observed association could be explained by shared genetic and environmental effects. A total of 401 twins (age 19–81 years, 32% male) from the Italian Twin Registry were recruited, and the twin study design was applied. A self-report psychological test battery was used to evaluate several PMH components. Blood samples were collected from participants to determine telomere length (TL) and mitochondrial DNA copy number (mtDNAcn). TL was negatively associated with attachment anxiety (r = −0.11, p = 0.037). A bivariate twin model provided heritability estimates of 0.14 (95% CI 0.001–0.43) for TL and 0.32 (0.16–0.45) for attachment anxiety, and a substantial negative genetic correlation [r_g = −0.55 (−1.00–0.00)] between them. Under the limitations of a cross-sectional study with a self-report wellbeing assessment, these results suggest that anxiety in the relationship with a partner may contribute to accelerated TL shortening, and shared genetic factors may underlie this link. Full article